What Is Asperger’s Syndrome?

What Is Asperger’s Syndrome?

From 1994 to 2013, Asperger's syndrome existed as a distinct category in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and was considered one of five pervasive developmental disorders. In 2013, due to inconsistencies in the diagnostic criteria, Asperger's was folded into one general category for Autism Spectrum Disorder (ASD).

Since U.S. practitioners can no longer officially diagnose someone with Asperger's syndrome, anyone who was given that diagnosis prior to that year is now considered to have autism spectrum disorder.

Roseann Capanna-Hodge, LPC, a psychologist and pediatric mental health expert told Verywell, “Asperger’s is referred to as a ‘high functioning’ autism because individuals [typically] have less severe symptoms and don’t have speech delays. Generally speaking, individuals with Asperger’s have at least average intelligence, with many being well above average in specific areas. They do, however, display the same core issues as those with autism."

Autism results from a complex combination of genetic and environmental factors. According to the Centers for Disease Control and Prevention (CDC), about 1 in 54 children are diagnosed with autism.Asperger’s, specifically, is estimated to affect 37.2 million people across the world.

History

Asperger’s is named after the Viennese pediatrician, Hans Asperger. Back in the mid-1940s, he noted a recurring theme of social struggle in some of his patients.

These patients often found it difficult to make new friends, struggled to comprehend typical social cues and emotions, and often had fixations on certain topics that would lead to one-sided conversations.

For many years, Asperger’s syndrome was considered its own isolated disorder. Capanna-Hodge says, “In 2013, it was folded into the broader category of Autism Spectrum Disorder (ASD) when the Diagnostic and Statistical Manual (DSM-5) was updated and it is no longer considered a separate disorder.”

Symptoms

Those with Asperger’s syndrome display a wide range of functioning across cognitive, social, and communication domains. These signs also vary according to age and gender.

Symptoms in Young Children

Though it’s less common, largely because it’s difficult to detect, some children can be diagnosed with Asperger’s even before they turn three years old. Some common signs include:

• Loss of previously acquired speech
• Delays in speech, babbling, or social functioning
• Delayed processing or learning
• Limited eye contact
• No response to their name being called
• Little or no desire to interact
• Low activity levels
• No back and forth smiling or engagement
• Lack of facial expressions
• Extreme irritability
• Fixation on certain objects

Symptoms in All Ages

In addition to the aforementioned symptoms, Cappana-Hodge says that older children and adults might also experience the following signs:

• Delayed language development
• Lack of reciprocal communication skills 
• Sensory processing difficulties, including under or overstimulated reactions to sensory stimuli (sounds, smells, tastes, textures, lights and/or colors)
• Avoidance of eye contact
• Difficulty with back and forth body language, facial expressions, and gestures
• Avoidant behaviors and general lack of engagement with others
• Difficulty comprehending other people’s feelings
• Struggles with time management
• Persistent repetition of words or phrases (echolalia)
• Resistance and reaction to minor changes in routine or surroundings
• Restricted interests
• Fixated interests
• Repetitive behaviors, such as flapping, rocking, and spinning

Diagnosis

Diagnosing someone on under the spectrum of autistic disorders is done by identifying observed (and reported) carefully defined clinical symptoms.

Autism Diagnostic Observation Schedule (ADOS-2)

“The process largely consists of clinical interviews and observations and behavioral rating scales. Sometimes one-to-one assessments are conducted that look at social, cognitive, behavioral, and emotional functioning, as well as learning,” notes Cappana-Hodge. “While there is technically no [universal] assessment measure, The Autism Diagnostic Observation Schedule (ADOS-2) is often considered the gold standard.”

Under-Diagnoses of Females with Asperger’s Syndrome

Originally, Hans Asperger made these cognitive observations about boys, so it was believed that primarily boys were affected.

According to the Asperger/Autism Network (AANE), because of that original and perpetuated belief, girls and women are often diagnosed less often. When they are diagnosed with Asperger’s, it is often much later in their life compared to boys—this is still true even today. This is largely because they were either misdiagnosed with other disorders, or the Asperger's is missed entirely by professionals since it doesn’t present itself in a typical fashion.

The AANE also notes that girls with Asperger's may prefer solitary versus social situations, demonstrate an aversion to what's considered typically feminine, and work hard to camouflage social anxiety via imitation of others or fantasy escapism. Like boys and men, she might also have an intense fixation on certain topics, including literature, animals, and the arts.

There are also racial-ethnic disparities associated with the diagnosis. Specifically, Black children are less likely to be identified and when they are, it is more likely to be identified later in life.

Treatment

There is technically no medication that specifically treats Asperger’s syndrome. However, many people with Asperger’s are prescribed medications in an effort to remedy some of the most common symptoms, which include difficulties with focus, anxiety, mood, and obsessive-compulsive behaviors. 

While medications can help, it’s exceedingly helpful for those diagnosed with Asperger’s syndrome to engage in various therapies.

Capanna-Hodge adds that the single most important thing that a parent can do if they think their child is on the autism spectrum is to get their child early intervention.

Additionally, “Formal and ongoing social support is pivotal for both the immediate social development of children and their longterm integration into the world,” she says. “People with autism have a better quality of life when they are able to incorporate the things that they are highly interested in into their jobs and lives, as this helps them integrate into the world in a much more positive and natural way.”

A Word from Verywell

Anyone diagnosed with Asperger’s syndrome can enjoy a high-quality, thriving, joy-filled life. It’s important to identify and diagnose the disorder as early as possible and to participate in necessary therapies that will help provide the ultimate tool set for navigating the world.