- Asperger’s Disease Definition
- Causes of Asperger’s Disease
- Symptoms of Asperger’s Disease
- 1. Communication Impairments
- 2. Problems with Social Interaction
- 3. Behavioral Problems
- 4. Motor and Coordination Problems
- Autism in Asperger’s Disease
- Asperger’s Disease in Children and Adults
- Asperger’s Disease in Children
- Asperger’s Disease in Adults
- Diagnosis (Tests) of Asperger’s Syndrome
- 1. Patient’s History
- 2. Psychological Assessment
- 3. Communication Assessment
- 4. Psychiatric Exam
- Treatment of Asperger’s Disease
- Psychosocial Management
- Psychiatric Medications
Asperger’s Disease Definition
Asperger’s Disease or Syndrome is a developmental disorder which falls in the category of autism spectrum disorders . It is also referred to as a High Functional form of autism.
This means that people with Asperger’s possess higher quality of intellectual capacity while manifesting social and behavioral problems. It is named after Dr. Hans Asperger, an Austrian physician who first discovered and described the condition in 1944 .
Autism spectrum disorders are a group of disorders which involves developmental disabilities such as in the case of autism and other disorders with the same characteristics. These disorders are given such term since most of the manifestations vary in severity among the affected people .
Picture 1: 39% of Children with ASD have the initial diagnosis of Asperger’s Syndrome
Causes of Asperger’s Disease
The exact cause of Asperger’s Disease remains unknown. Most of the mental health researchers believe that it may be due to many causes. Some believe that it may have a hereditary origin. There are some researches that found out that this condition occurs in first or second degree relatives in one or both sides of the family. Also, in some studies, the condition is associated with pregnancy problems.
Experts have found out that Asperger’s is common in children who have experienced oxygen deficiency at birth. Furthermore, a study also discovered that most individuals with this condition have cell adhesion in the protein molecules. These protein molecules play a vital role with message transmission in the nervous system. 
Symptoms of Asperger’s Disease
The manifestations of Asperger’s Disease have late onset. It is commonly observed at the age of three. The occurrence of the symptom may vary with individuals affected by the disease. Usually, the symptoms of the disease may be similar with the other kinds of autism. 
1. Communication Impairments
- Children with Asperger’s tend to speak in monotone
- Incoherent speech
- Failure in understand language nuances like jokes, metaphor, or sarcastic remarks
- Talking loudly or in other cases talking too formally
- Not able to keep up with changes in topic
- Tendency to express so much of their inner thoughts
- Problems with high-level language skills like problem solving, verbal reasoning
- Non-stop talking about their favorite topics and ignoring if the person they’re talking to is interested or trying to reply. [1, 4, 5]
2. Problems with Social Interaction
- Most people with Asperger’s Disease describe themselves as loners even though they want to make friends.
- Difficulty in interacting with other people
- Being unable to understand other person’s feelings
- Making unusual facial expressions as well as body language (inappropriate staring, acting disinterested, avoiding making eye contact) [4, 5]
3. Behavioral Problems
- Interest with unusual topics (stars, snakes)
- Any change occurring would cause them to feel stressed or anxious
- Preference of routines
- Difficulties in controlling their feelings such as anxiety, depression, anger [1, 4, 5]
Picture 2: Occurrence of anxiety and depression in individuals with Asperger’s Syndrome
4. Motor and Coordination Problems
- People with Asperger’s have a history of delays in motor skills such as catching ball or riding bike.
- Doing awkward movements such as unusual posture and rigid walks
- Poor handwriting
- Clumsiness 
According to the experts, Asperger’s disease continues over the lifespan of a person. However, there are instances wherein the symptoms diminish, and that intervention given at an early stage will be extremely beneficial. 
Autism in Asperger’s Disease
Asperger’s Disease is known to belong in the autism spectrum disorders (ASD). This group of developmental disorders is generally characterized by problems in areas such as communication, behavior, and social interactions. Most of the ASDs occur in infancy or childhood and the medical experts’ goal is to diagnose it at age 2. This usually goes undetected in these stages since social interaction cannot be observed yet.
There are various severities of ASD occurrence in individuals. The symptoms of ASDs may greatly affect an individual with disability. Even though this is the case, many individuals can be aided with trainings and therapies to help them develop their ability to perform activities of daily living.
The hallmarks of autism are the problems with social interaction and communication as well as interests and behaviors which are peculiar, repetitive, and fixated. In individuals with Asperger’s Syndrome, they are considered as highly-functioning. 
Also, in contrast to autism, people with asperger’s have no proven significant delays in their speech development, cognitive development, as well as the age-appropriate skills development. 
Asperger’s Disease in Children and Adults
Asperger’s Disease in Children
A child with Asperger’s Syndrome having problems in making friends
Younger children with Asperger’s Syndrome may experience problems in school with matters concerning social interaction and behavior. Though this is the case, these children do not present any issues in their studies. They can even perform well academically since studying will involve memorization of facts.
As for the older children and teens, their lack of social interaction and presence of peculiar interest may result to their condition of being bullied or teased. As a consequence of this situation, it may be hard for them to establish friendships. 
If these children are given prompt treatment, they can be taught to manage their disabilities effectively. Though establishing personal and social relationships may be challenging, they can manage this with the support coming from their family members. 
Asperger’s Disease in Adults
In some individuals diagnosed with Asperger’s Syndrome, problems with living independently as an adult may be present. Also, together with this fact, is their difficulty to maintain work and personal relationships. 
On the other hand, there are still those who have achieved normal functioning and employment . Many of them have become successful with their careers. This has been possible with the aid of their loved ones .
Aside from that, some individuals with Asperger’s are able to maintain successful relationships and have their own children. Like most of the married couples, they also undergo misunderstandings and problems. However, the most common marital problem they have is the unjust parting of responsibilities. These people feel that they need to take all of the responsibilities in their relationship. This results to tension in the relationship.
In order to get this solved, understanding is a key point. The partner of a person with Asperger’s disease must be able to accept the diagnosis and learn to cope with it. In this case, counseling or a support group is suggested to help them talk matters about their relationship and how they are going to make it work. 
Diagnosis (Tests) of Asperger’s Syndrome
Asperger’s Syndrome is a condition which is hard to diagnose. This is due to the fact that the symptoms are not observable until they grow up. The disorder usually presents its symptoms when the child is sent to school .
Consequently, the diagnosis of this condition is required to be extensively assessed by a well-experienced interdisciplinary team. Prior to starting the process to rule out the individual’s condition, there are some points to remember. These are:
- First, in order to make the appropriate diagnosis, the family, especially the parents need to participate. They should be encouraged to do the observations on how their child is doing. With this, the information that they will have can become a great help in the assessment of the child.
- Second, the findings must be well-understood. The members of the interdisciplinary team must know the implications of the findings that they have gathered.
- Third, lack of awareness can lead to wrong diagnosis. There are few professionals who use Asperger’s Syndrome as a common diagnosis for those who are having troubles in social interaction and establishing relationships. Some healthcare professionals who may have insufficient information need constant and direct contact with the evaluators of care. Also, they must be working together to implement their desired interventions. This to ensure that proper diagnosis and treatment are made.
In most cases, the comprehensive assessment done to properly rule out the presence of Asperger’s Syndrome in an individual are:
1. Patient’s History
- Pregnancy and neonatal period information
- Characteristics and development of the child
- Family history
- Medical history
- Information about the onset of problems: This includes language patterns, motor skills development, special interests of the patient, social interaction, relationship with family members and friends, emotional development, mood, and self-concept.
2. Psychological Assessment
- The goal of this section is to evaluate the patient’s overall performance in intellectual functioning, his/her styles of learning, and list of strengths and weaknesses. This assessment involves:
- Adaptive Functioning: This refers to the individuals’ independence in real-life situations.
- Personality Assessment: Involves assessment of the person’s common interests, coping strategies, mood presentation.
- Neuropsychological Functioning: Concept formation, motor and coordination, memory, problem solving, visual perceptual skills, and other executive functions.
3. Communication Assessment
- This area aims to gather qualitative and quantitative information regarding the child’s skills in communication. It includes:
- Speech and language: This involves vocabulary, comprehension, articulation, and sentence construction.
- Usually, this is the area where most people with Asperger’s excel in.
- Nonverbal communication: gaze, gestures, facial expressions,
- Pragmatics: sensitivity to cues, being able to meet typical rules of conversation with other people
- Nonliteral language: This is to test if they understand the meaning, when irony, sarcasm, humor, or metaphor is used.
- Speech prosody: volume, pitch, tone when talking
- Content and coherence when a person with Asperger’s is conversing.
- Being able to adhere with social reciprocity and changing topics is also observed.
4. Psychiatric Exam
- This is performed in both less and more structured periods. An example of this is during a typical interaction with the family members while being observed by one of the evaluators. The evaluator would observe for the following:
- Degree of attachment to family
- Areas of interest and leisure activities
- Affective and social presentation
- Establishment of friendships
- Certain reactions in some situations
- Sensitivity to other people’s feelings
- Ability to understand sarcastic or teasing remarks 
Treatment of Asperger’s Disease
It has been known that there is no cure for Asperger’s Syndrome. Even if this is the case, most professionals suggest that prompt intervention should be made. Based on the National Institute of Neurological Disorders and Stroke, the ideal management involves addressing the three main symptoms of the disorder which are impaired communication skills, physical clumsiness, and repetitive habits or routines. 
- Applied Behavior Analysis (ABA): This technique is based on the theory of positive reinforcement wherein the desired behavior, when continuously performed, is given a reward. This goes the same in ABA. The appropriate skills and social behavior of a person with Asperger’s are rewarded.
- Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH): This is performed as a structured form of teaching about interaction as well as helping the child to perform skills. This method helps the child’s memorization and visual skills to be enhanced.
- Social skills training: This is a group therapy wherein children with Asperger’s are taught how to socialize with other children.
- Cognitive behavioral therapy: This is a kind of therapy that allows the children to express their feelings and emotions. This is very beneficial to children who are anxious or angry. Also, this can be used to cut off their repetitive routines and peculiar interests.
- Occupational/Physical Therapy: This aids children with physical clumsiness.
- Parent education and training: To assist parents in using behavioral techniques at home.
- Individual Psychotherapy: This aims to teach the child about detecting social cues and dealing with the emotions related to the syndrome.
- Language therapy: This therapy trains children to converse properly and normally.
- Job training for adults with Asperger’s [4, 5, 6]
Certain medications are prescribed by the doctors to control the other signs and symptoms experienced by people with Asperger’s disease. These include medications for:
- Aggression and irritability
- Compulsions, preoccupations, and rituals
- Impulsive, inattention, and hyperactivity