Asperger’s Symptoms

Description:
Asperger’s syndrome is a pervasive developmental disorder that involves delays in the development of basic skills, especially the ability to socialize and communicate with others and use imagination. It often isn’t until a child or adult begins to have serious difficulties in school, the workplace or in his/her personal lives that the disorder can be diagnosed. Many adults receive their diagnosis after seeking help for related issues, such as depression or anxiety.

There are a number of therapy programs that are in place for individuals with Asperger’s symptoms, including cognitive behavioral therapy and group therapy sessions. People with Asperger’s can also focus on calming and confidence-boosting activities like yoga and music therapy. There is no cure for Asperger’s syndrome, but there are natural treatments and remedies that have proven to effective — similar to autism natural treatment.

Dr. Asperger’s findings went unnoticed until 1981, when English physician Lorna Wing published a series of case studies involving children with similar symptoms. Wing’s findings were widely published and popularized, and in 1994, Asperger’s syndrome was added to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders.

In 2015, Asperger’s was estimated to affect 37.2 million people globally. The syndrome is named after the Austrian pediatrician Hans Asperger, who in 1944 described children in his practice who lacked nonverbal communication, had limited understanding of others’ feelings, and were physically clumsy. The modern conception of Asperger syndrome came into existence in 1981 and went through a period of popularization. It became a standardized diagnosis in the early 1990s. Many questions and controversies remain about aspects of the disorder. There is doubt about whether it is distinct from high-functioning autism (HFA). Partly because of this, the percentage of people affected is not firmly established.

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Symptoms:

1. Failure to Develop Friendships:

Children and adults with Asperger’s syndrome may have difficulty connecting with their peers due to a lack of social skills. Social tasks like talking one on one, making eye contact or participating in group activities may be hard for people with Asperger’s, especially because they want to connect with their peers but aren’t comfortable with these types of engagements.

A lack of eye contact may also make people with Asperger’s seem unengaged in a conversation, or they don’t understand the use of gestures and sarcasm, so they appear to be socially awkward. Another Asperger’s symptom is selective mutism, which occurs when young children or adults only speak freely and comfortably with people they know well and not with strangers.

2. Inability to Empathize:

People with Asperger’s find it difficult to empathize or understand the feelings of others. For this reason, they may come off as insensitive, when really they don’t understand the appropriate behaviors in certain situations.

Over time, an individual with Asperger’s learns the accepted social behaviors and responses. Although he/she is reacting appropriately in the moment, he/she may not truly understand why the person is upset.

People with Asperger’s may also have trouble understanding the intent behind another person’s actions, so they may miss humor or unease in someone’s use of words and tone. This is why social interactions can sometimes be too overwhelming for people with Asperger’s — because they cannot see things from another person’s perspective, they aren’t able to predict or understand their actions.

3. Eccentric or Repetitive Behaviors:

According to Autism Speaks, individuals with Asperger’s syndrome can sometimes have a peculiar manner of speaking. Sometimes they speak overly loud or in a monotone voice.

However, people with Asperger’s have good language skills, but they use language in a different way. Their patterns may be unusual, with a rhythmic nature. They may come across as too formal, or their speech may even be high-pitched. Individuals with Asperger’s may also have trouble controlling their emotions, laughing or crying easily and at inappropriate times, and they have motor skill delays, coming across as awkward or clumsy.

4. Narrowed Interest:

A child with Asperger’s may develop a strong, sometimes obsessive interest in a few areas, such as music, weather, math, planes or maps. This serves as the most distinguishing Asperger’s symptom. Children with Asperger’s know everything about their topic of interest, and their conversations with others are about little else. They tend to become exceptionally talented and skilled in this particular area too.

5. Sticking to a Routine or Ritual:

People with Asperger’s sometimes develop a routine or ritual that they refuse to alter. They can become fixated on ensuring that their external environment and daily routines remain constant because sudden changes may exceed their coping mechanisms.

Some people with Asperger’s may experience motor or phonic tics in addition to other behavioral abnormalities. Some researchers believe that this is due to sensory deprivation, which contributes to the development of unusual and sometimes involuntary movements.

Causes:
Hans Asperger described common symptoms among his patients’ family members, especially fathers, and research supports this observation and suggests a genetic contribution to Asperger syndrome. Although no specific gene has yet been identified, multiple factors are believed to play a role in the expression of autism, given the phenotypic variability seen in children with AS. Evidence for a genetic link is the tendency for AS to run in families and an observed higher incidence of family members who have behavioral symptoms similar to AS but in a more limited form (for example, slight difficulties with social interaction, language, or reading). Most behavioral genetic research suggests that all autism spectrum disorders have shared genetic mechanisms, but AS may have a stronger genetic component than autism. There is probably a common group of genes where particular alleles render an individual vulnerable to developing AS; if this is the case, the particular combination of alleles would determine the severity and symptoms for each individual with AS.

A few ASD cases have been linked to exposure to teratogens (agents that cause birth defects) during the first eight weeks from conception. Although this does not exclude the possibility that ASD can be initiated or affected later, it is strong evidence that ASD arises very early in development. Many environmental factors have been hypothesized to act after birth, but none has been confirmed by scientific investigation.

Diagnosis:
Standard diagnostic criteria require impairment in social interaction and repetitive and stereotyped patterns of behavior, activities, and interests, without significant delay in language or cognitive development. Unlike the international standard,[28] the DSM-IV-TR criteria also required significant impairment in day-to-day functioning; DSM-5 eliminated AS as a separate diagnosis in 2013, and folded it into the umbrella of autism spectrum disorders. Other sets of diagnostic criteria have been proposed by Szatmari et al. and by Gillberg and Gillberg.

Diagnosis is most commonly made between the ages of four and eleven. A comprehensive assessment involves a multidisciplinary team that observes across multiple settings, and includes neurological and genetic assessment as well as tests for cognition, psychomotor function, verbal and nonverbal strengths and weaknesses, style of learning, and skills for independent living. The “gold standard” in diagnosing ASDs combines clinical judgment with the Autism Diagnostic Interview-Revised (ADI-R), a semistructured parent interview; and the Autism Diagnostic Observation Schedule (ADOS), a conversation and play-based interview with the child. Delayed or mistaken diagnosis can be traumatic for individuals and families; for example, misdiagnosis can lead to medications that worsen behavior.

Underdiagnosis and overdiagnosis may be problems. The cost and difficulty of screening and assessment can delay diagnosis. Conversely, the increasing popularity of drug treatment options and the expansion of benefits has motivated providers to overdiagnose ASD. There are indications AS has been diagnosed more frequently in recent years, partly as a residual diagnosis for children of normal intelligence who are not autistic but have social difficulties.

There are questions about the external validity of the AS diagnosis. That is, it is unclear whether there is a practical benefit in distinguishing AS from HFA and from PDD-NOS; the same child can receive different diagnoses depending on the screening tool. The debate about distinguishing AS from HFA is partly due to a tautological dilemma where disorders are defined based on severity of impairment, so that studies that appear to confirm differences based on severity are to be expected.

Differential diagnosis:
Many children with AS are initially misdiagnosed with attention deficit hyperactivity disorder (ADHD). Diagnosing adults is more challenging, as standard diagnostic criteria are designed for children and the expression of AS changes with age. Adult diagnosis requires painstaking clinical examination and thorough medical history gained from both the individual and other people who know the person, focusing on childhood behavior.

Conditions that must be considered in a differential diagnosis along with ADHD include other ASDs, the schizophrenia spectrum, personality disorders, obsessive–compulsive disorder, major depressive disorder, semantic pragmatic disorder, nonverbal learning disorder, social anxiety disorder, Tourette syndrome, stereotypic movement disorder, bipolar disorder, social-cognitive deficits due to brain damage from alcohol abuse, and obsessive–compulsive personality disorder (OCPD).

Treatment:
Asperger syndrome treatment attempts to manage distressing symptoms and to teach age-appropriate social, communication, and vocational skills that are not naturally acquired during development, with intervention tailored to the needs of the individual based on multidisciplinary assessment. Although progress has been made, data supporting the efficacy of particular interventions are limited.

Therapies:
The ideal treatment for AS coordinates therapies that address core symptoms of the disorder, including poor communication skills and obsessive or repetitive routines. While most professionals agree that the earlier the intervention, the better, there is no single best treatment package. AS treatment resembles that of other high-functioning ASDs, except that it takes into account the linguistic capabilities, verbal strengths, and nonverbal vulnerabilities of individuals with AS. A typical program generally includes:

A positive behavior support procedure includes training and support of parents and school faculty in behavior management strategies to use in the home and school;
An applied behavior analysis (ABA) technique called social skills training for more effective interpersonal interactions;

Cognitive behavioral therapy to improve stress management relating to anxiety or explosive emotions and to cut back on obsessive interests and repetitive routines;
Medication for coexisting conditions such as major depressive disorder and anxiety disorders;

Occupational or physical therapy to assist with poor sensory processing and motor coordination; and,
Social communication intervention, which is specialized speech therapy to help with the pragmatics and give-and-take of normal conversation.

Of the many studies on behavior-based early intervention programs, most are case reports of up to five participants and typically examine a few problem behaviors such as self-injury, aggression, noncompliance, stereotypies, or spontaneous language; unintended side effects are largely ignored. Despite the popularity of social skills training, its effectiveness is not firmly established. A randomized controlled study of a model for training parents in problem behaviors in their children with AS showed that parents attending a one-day workshop or six individual lessons reported fewer behavioral problems, while parents receiving the individual lessons reported less intense behavioral problems in their AS children. Vocational training is important to teach job interview etiquette and workplace behavior to older children and adults with AS, and organization software and personal data assistants can improve the work and life management of people with AS.

Other therapies:
1. Cognitive Behavioral Therapy:

Cognitive behavioral therapy is a type of therapeutic practice that helps a person to become more aware of inaccurate or negative thinking so he/she can view challenging situations more clearly, thereby responding to these triggers in a more effective way. This type of therapy helps people with Asperger’s shift the way they interpret situations, how they feel about challenging situations and how they respond to them.

2. Group Programs:

Group programs can be helpful for working on social skills. They also serve as a support system to individuals with Asperger’s and their families. The Asperger/Autism Network, for instance, offers a comprehensive array of programs and services for the Asperger’s community.

3. Speech and Language Therapy:

Speech therapy may be helpful for children with communication difficulties. These difficulties are not how the children speak or pronounce words, but how they perceive the meaning of other people’s words and respond to them.

4. Music Therapy:

Using music to reinforce communication can be helpful for individuals with autism and Asperger’s syndrome. Music is used to enhance social skills and communication development, and the positive effects on spoken and gestural communication have been noted in small trial studies.

5. Occupational and Physical Therapy:

Individuals with Asperger’s syndrome may use occupational therapy and physical therapy to maintain their highest level of function in activities of daily living, which includes dressing, bathing, grooming, eating and playing.

Supplements:

6. Vitamin B6/Magnesium

Vitamin B6 and magnesium have been used as a popular treatment for autism and mental health disorders for over 20 years. A 2006 study conducted in France involved 33 children with clinical symptoms of PDD or autism. The children were followed for at least six months. Another group of 36 children was used as the control group.

Researchers found that B6/magnesium supplementation improved PDD symptoms in 23 of 33 children with no adverse side effects — in addition, 23 of 33 experienced improved social reactions and 24 of 33 displayed improved communication.

7. Omega-3 Fatty Acids:

Polyunsaturated fatty acids, in particular omega-3 fatty acids, are crucial for brain development and cannot be manufactured in the body. Oral supplementation with essential fatty acids has become popular for children with developmental disorders, including those experiencing symptoms of ADHD and autism.

Lifestyle and Diet:

8. Yoga

Yoga increases the sense of well-being and control; it also has the potential to decrease anxiety, reduce aggression and help individuals regulate their emotions. It’s a calm and comfortable atmosphere and allows participants to explore different sensory experiences.

Yoga also facilitates deeper inhaling and exhaling, which calms the nervous system and works as a natural stress reliever. Experiencing a group yoga class can also help people with Asperger’s make new friends and work on their communication skills.

9. Lavender Essential Oil:

Lavender oil has a variety of therapeutic and curative properties. It helps induce relaxation, and studies have shown that it may be an effective treatment of several neurological disorders like Asperger’s Symptoms.

10. Magnesium Foods:

Magnesium-rich foods — such as spinach, chard, pumpkin seeds, yogurt, almonds, avocado, figs and bananas — can help fight anxiety and depression. They also increase the production of the antioxidant glutathione and improve nerve function. Making sure to eat at least three servings of vegetables a day can boost one’s daily nutrient intake and provides plenty of vitamins and minerals that may be able to relieve some Asperger’s symptoms.

Medications:
No medications directly treat the core symptoms of AS. Although research into the efficacy of pharmaceutical intervention for AS is limited, it is essential to diagnose and treat comorbid conditions. Deficits in self-identifying emotions or in observing effects of one’s behavior on others can make it difficult for individuals with AS to see why medication may be appropriate. Medication can be effective in combination with behavioral interventions and environmental accommodations in treating comorbid symptoms such as anxiety disorders, major depressive disorder, inattention, and aggression. The atypical antipsychotic medications risperidone and olanzapine have been shown to reduce the associated symptoms of AS; risperidone can reduce repetitive and self-injurious behaviors, aggressive outbursts, and impulsivity, and improve stereotypical patterns of behavior and social relatedness. The selective serotonin reuptake inhibitors (SSRIs) fluoxetine, fluvoxamine, and sertraline have been effective in treating restricted and repetitive interests and behaviors.

Care must be taken with medications, as side effects may be more common and harder to evaluate in individuals with AS, and tests of drugs’ effectiveness against comorbid conditions routinely exclude individuals from the autism spectrum. Abnormalities in metabolism, cardiac conduction times, and an increased risk of type 2 diabetes have been raised as concerns with these medications, along with serious long-term neurological side effects. SSRIs can lead to manifestations of behavioral activation such as increased impulsivity, aggression, and sleep disturbance. Weight gain and fatigue are commonly reported side effects of risperidone, which may also lead to increased risk for extrapyramidal symptoms such as restlessness and dystonia and increased serum prolactin levels. Sedation and weight gain are more common with olanzapine, which has also been linked with diabetes. Sedative side-effects in school-age children have ramifications for classroom learning. Individuals with AS may be unable to identify and communicate their internal moods and emotions or to tolerate side effects that for most people would not be problematic.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://en.wikipedia.org/wiki/Asperger_syndrome
https://draxe.com/aspergers-symptoms/

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