Asperger s Syndrome Symptoms Causes and Effective Treatments

Life is full of differences and diversities, and everyone has their unique way of understanding and interacting with the world. Among these diversities are Asperger's Syndrome and Autism, which are part of the autism spectrum. Although they share many similarities, there are clear differences that affect how people communicate, think, and interact with others. In this Daily Medical guide, we will talk about Asperger's Syndrome and Autism, their impact on daily life, and how we can better understand and support them.

Average Age of Onset for Asperger’s Syndrome
Asperger’s Syndrome typically appears in early childhood, but diagnosis may be delayed until a later age, especially if symptoms are subtle or if the child has good language skills.

Average Age of Onset or Diagnosis:

Symptom Onset: Symptoms often begin to appear between the ages of 2 - 5 years, but they may be difficult to notice compared to other types of autism since language skills are often normal or even advanced.
Actual Diagnosis: Diagnosis often occurs between the ages of 6 - 11 years, or even during adolescence or adulthood.
Adult Diagnosis: Many individuals discover they have Asperger’s Syndrome during adulthood when they notice persistent social difficulties or undergo specialized assessments.

Why Might Diagnosis Be Delayed?

Good Language Skills: People with Asperger’s Syndrome often have excellent language skills and a rich vocabulary, which may lead parents and teachers to believe there is no problem.
High Intelligence: They may have normal or high intelligence levels, making social difficulties less obvious.
Lack of Awareness: Many people may not have adequate knowledge about the syndrome, especially in communities where psychological assessment culture is not widespread.

What is the Difference Between Asperger’s Syndrome and Autism?
Asperger’s Syndrome and autism are no longer considered separate conditions; they are now classified under the Autism Spectrum Disorder (ASD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

However, some families still prefer to use the term “Asperger’s Syndrome” because the term “autism” is often associated with social stigma that still surrounds people with the condition.

The only noticeable difference is that individuals with Asperger’s Syndrome are often more flexible and less anxious compared to those with autism who have more complex needs.

How to Recognize Someone with Asperger’s Syndrome?
People with Asperger’s Syndrome often have difficulty understanding verbal and non-verbal communication, social interaction, and conducting conversations. They may interpret words literally, making it hard for them to understand metaphors or jokes. Additionally, they may experience learning difficulties, lack flexibility in thinking and behavior, and avoid direct eye contact when speaking. Other challenges include difficulty expressing emotions and integrating into society.

How to Help Someone with Asperger’s Syndrome?
✔ Put yourself in their shoes and understand the difficulties they face in communication and interaction.
✔ Show empathy for their experiences and do not dismiss their feelings or experiences.
✔ Accept their differences and do not try to change them to be like others.
✔ Help them discover and enhance their strengths.
✔ Explain their condition to those interacting with them to prevent misunderstandings or ridicule.
✔ Use direct and simple language when communicating with them to avoid any misunderstandings.
✔ Understand that their different behavior reflects their unique way of understanding the world, not necessarily inappropriate behavior.

What is Asperger’s Syndrome?
Asperger’s Syndrome is a neurodevelopmental disorder classified under the autism spectrum. Individuals with this syndrome struggle with social interaction and understanding non-verbal cues, yet they typically have average or above-average cognitive abilities. They also tend to develop an intense interest in specific subjects, dedicating a significant amount of time and energy to them.

What are the most common disorders associated with Asperger’s Syndrome?
Some of the most common co-occurring disorders with Asperger’s Syndrome include:

Depression
Anxiety
Attention Deficit Hyperactivity Disorder (ADHD)
Obsessive-Compulsive Disorder (OCD)

Is there a connection between Asperger’s Syndrome and intelligence?
Yes, individuals with Asperger’s Syndrome often have high intelligence levels. Many of them possess strong analytical skills, logical thinking, and excellent memory, especially in areas they are deeply interested in.

Can older adults develop Asperger’s Syndrome?
No, Asperger’s Syndrome does not develop later in life. It begins in early childhood. However, some individuals may not realize they have it until adulthood, when they face social or professional challenges that lead them to seek a diagnosis.

Speech and Language Issues in Individuals with Asperger’s Syndrome and Autism (ASD)

Although both conditions fall under the autism spectrum, there are clear differences in their impact on speech and language.

Speech and Language Issues in Individuals with Asperger’s Syndrome:

Speech is usually normal or advanced compared to their peers.
They often have an extensive and detailed vocabulary, particularly in topics of interest.
Their speech may sound formal or mechanical, as if they are reading from a book.
Their tone of voice may be flat or inconsistent with emotions, meaning they might speak in the same tone whether they are happy or sad.
They struggle to understand jokes or figurative language, often interpreting words literally.
They may have difficulty managing conversations, sometimes interrupting others unintentionally or talking excessively about a specific topic without realizing if others are interested.

Speech and Language Issues in Individuals with Autism (ASD):

They may experience delayed language development, and in some cases, they might not speak at all.
They have difficulty forming coherent sentences and may use a limited or disconnected set of words.
They struggle to understand complex instructions or open-ended questions.
They often exhibit echolalia, repeating words or phrases they hear without fully understanding their meaning.
They may confuse pronouns, saying “He wants” instead of “I want.”
Their voice may sound unusual—either too high-pitched or abnormally low.

Do Speech and Language Issues Improve Over Time?

For individuals with Asperger’s Syndrome:

They usually do not experience speech delays, but they may need training in social skills to better understand non-verbal cues and improve their interactions with others.

For individuals with Autism:

Improvement is possible, especially with early intervention and appropriate therapies such as speech and communication therapy.
Some individuals may use alternative communication methods, such as picture-based systems or electronic apps, to aid their communication.

Do Speech and Language Skills Develop in Individuals with Asperger’s Syndrome and Autism?

For Individuals with Asperger’s Syndrome:

Speech typically develops normally, but they can improve in conversational skills and social interaction through social skills training and Cognitive Behavioral Therapy (CBT).
They may gain a better understanding of humor or figurative language over time with experience and guidance.

For Individuals with Autism:

Significant progress is often made with early intervention (such as speech therapy and behavioral therapy).
Improvement may be slower if there is severe speech delay or if the autism is more profound.
Using alternative communication methods (such as pictures or technological applications) can greatly enhance their ability to express themselves.

Symptoms of Asperger’s Syndrome:

Asperger’s Syndrome symptoms manifest across six main areas of a child’s or adolescent’s life: social interaction, communication, interests, repetitive routines, learning difficulties, and lack of interest in sexual relationships.

1. Impaired Social Interaction:

Children with Asperger’s Syndrome often have poor social skills, struggling to respond appropriately and emotionally to various social situations.
They show a lack of desire to share information and experiences with others, which may not be immediately noticeable to parents and teachers.
The problem becomes evident when the child has difficulty making friends with peers, leading to frustration and behavioral issues.
Children with Asperger’s Syndrome often perceive the world as a confusing place and prefer isolation, especially if they have experienced bullying or mistreatment unless they have supportive friends who understand and protect them.

2. Impaired Communication:

Verbal and non-verbal communication can be challenging for individuals with Asperger’s Syndrome.

Spoken Language: Speech may sometimes be unclear or difficult to understand, so using simple and direct language is preferred when communicating with them.
Literal Interpretation: They often interpret spoken words literally, making it challenging for them to grasp metaphors or jokes.
Non-verbal Communication: They may exhibit a blank facial expression or maintain prolonged staring instead of normal eye contact.

3. Limited Interests:

One of the most prominent symptoms of Asperger’s Syndrome is an intense preoccupation or obsession with specific topics such as:

Phones,
Computers,
Trains,
Dinosaurs,
Maps.

These interests may change over time but remain narrow and intensely focused compared to other children.

4. Lack of Flexibility:

Children with Asperger’s Syndrome often impose strict rules and routines on themselves and others.
This may manifest in how they prefer tasks to be done or their specific food preferences.
While this behavior can be frustrating for parents, improvement is possible over time.
Lack of flexibility appears in various ways, making them struggle academically or have difficulty adapting to changes such as switching teachers or altering daily schedules.

5. Learning Difficulties:
If a child with Asperger’s Syndrome is attending a mainstream school, it is crucial for them to receive additional support.

These children may experience learning difficulties, confusion, and exhaustion due to the educational process.
Schools must be prepared to understand the challenges faced by the child and establish continuous communication between school and home to exchange information about the child’s achievements and difficulties.

6. Apathy Toward Sexual Relationships:
Asperger’s Syndrome presents challenges in marital and romantic relationships.

Individuals with Asperger’s may struggle to initiate romantic relationships or may delay engaging in intimate encounters.
This is not due to a lack of desire or need but rather due to difficulties in expressing emotions and understanding how others perceive them.
They may struggle with empathy, communication, and interaction with a romantic or sexual partner.

7. Sadness and Depression:
Some individuals with Asperger’s Syndrome experience depression or anxiety due to their difficulties in adapting to society.

Isolation, rigid routines, and obsessive behaviors can increase the likelihood of criticism and isolation, leading to higher rates of depression and loneliness.

Causes of Asperger’s Syndrome

There are several factors believed to contribute to Asperger’s Syndrome, including:

Genetic Factors:

Genetic factors may play a significant role in the development of Asperger’s Syndrome, with approximately half of the cases thought to have a genetic component.

Fragile X Syndrome (FXS):

Fragile X Syndrome is a genetic disorder caused by changes in a gene called the “Fragile X gene,” which produces a protein known as Fragile X Mental Retardation Protein (FMRP).
This syndrome is considered a potential contributing factor to the development of Asperger’s Syndrome.

Rett Syndrome:

Rett Syndrome is a rare genetic disorder that affects brain development, resulting in severe cognitive and physical impairments.
It is believed to potentially play a role in the development of Asperger’s Syndrome.

Premature Birth:

Children born before the 26th week of pregnancy may be at higher risk of developing Asperger’s Syndrome later in life.

Diagnosing Asperger’s Syndrome

Diagnosing Asperger’s Syndrome involves identifying abnormal behavioral patterns, as there is no specific test or medical examination that can accurately detect the condition. The diagnosis is typically made by a specialized team that may include:

Neurologist
Pediatrician
Psychologist

Diagnostic Signs and Symptoms of Asperger’s Syndrome

1. Difficulty Understanding Body Language:

Children generally develop the ability to understand body language and interpret facial expressions and interactions gradually without verbal communication.
However, children with Asperger’s Syndrome have difficulty understanding body language, making them unable to correctly interpret facial expressions or eye movements.

2. Repetitive Behaviors and Speech:

Individuals with Asperger’s Syndrome may display repetitive speech patterns and behaviors, repeating what they hear without effectively engaging in reciprocal conversation or meaningful dialogue.

3. Limited Emotional Expression:

Individuals with Asperger’s Syndrome find it difficult to engage in social interactions.
They can, however, show a limited range of emotions, distinguishing them from those with severe autism spectrum disorder who may exhibit even less emotional response.
Their interaction with peers and surroundings is greater than that of traditional autism patients but still below the typical level.

4. Fear of Change:

Those with Asperger’s Syndrome often exhibit a clear fear of change in routines or their environment.
They may require a long time to adapt to new places or people, making it challenging to cope with changes such as switching classrooms or altering daily schedules.
Any disruption to their usual routine can lead to episodes of stress and anxiety.

5. Assessing Educational Skills:

Individuals with Asperger’s Syndrome generally do not experience significant language delays as seen in classic autism.
They often have average or above-average intelligence and may excel in specific subjects such as mathematics or science.
However, learning certain subjects may be more challenging due to difficulties related to social communication or lack of concentration.

6. Motor Skills Difficulties:

Individuals with Asperger’s Syndrome often struggle with motor skills compared to typically developing children.
These difficulties may include trouble performing activities like riding bicycles or engaging in group play, making them less adaptable to physical activities.

7. Hyperfocus:

Individuals with Asperger’s Syndrome are often characterized by their ability to focus intensely on specific details, particularly if they are interested in a particular topic.
They may remember precise details, such as the color of a pen used in writing or specific words someone said.
However, they may find it challenging to engage in ordinary conversations or participate in social activities.

Asperger’s Syndrome Test

Asperger’s Syndrome tests are usually a set of questions and questionnaires assessing various aspects such as:

1. Social Skills:

Do you have difficulty understanding body language or facial expressions?
Do you find it challenging to start or maintain a conversation?
Do you feel uncomfortable in social gatherings?

2. Interests and Activities:

Do you have very specific and focused interests (such as a particular topic you want to learn everything about)?
Do you tend to repeat the same activities or routines daily and dislike changing them?

3. Communication Skills:

Do you find it difficult to understand jokes or metaphors (like the phrase “It’s raining cats and dogs”)?
Do you feel that your voice might sound overly formal or monotonous?

4. Sensory Sensitivity:

Do you have heightened or reduced sensitivity to sounds, lights, textures, or smells?

5. Rigid Thinking:

Do you struggle to accept changes or break away from established routines?
Do you find yourself focusing excessively on details?

Popular Tests Used to Assess Asperger’s Syndrome:

AQ Test (Autism Spectrum Quotient):

Consists of 50 questions evaluating symptoms related to autism and Asperger’s Syndrome.
If the score is above a certain threshold (usually 32 or higher), this may indicate symptoms that warrant evaluation by a specialist.

RAADS-R (Ritvo Autism Asperger Diagnostic Scale-Revised):

A longer and more accurate questionnaire consisting of about 80 questions, typically used for adults.

EQ (Empathy Quotient) and SQ (Systemizing Quotient):

Assess the ability to empathize and understand emotions versus the ability to analyze and organize logically.

CAST (Childhood Autism Spectrum Test):

Used with children, based on observations from parents or teachers.

Symptoms and Challenges of Asperger’s Syndrome in Adults

Symptoms of Asperger’s Syndrome in adults are similar to those in children, but the approaches to treatment and response may differ. With early intervention and appropriate support, symptoms can be better managed over time. The most common challenges faced by adults with Asperger’s Syndrome include:

1. Emotional Difficulties:

Emotional difficulties are among the most prominent challenges faced by adults with Asperger’s Syndrome.
They may find it difficult to manage their emotional responses to everyday situations, leading to inappropriate reactions or excessive emotional outbursts.
They also face significant challenges in building emotional relationships due to difficulty understanding or adapting to others’ emotions.

2. Communication Difficulties:

People with Asperger’s Syndrome may struggle to show empathy, whether through facial expressions, body language, or even conversations with new people.

3. Behavioral Differences:

Individuals with Asperger’s Syndrome may experience bouts of fear, anxiety, and distress when faced with unexpected stimuli (such as loud noises, bright lights, or sudden touch).
These triggers may not bother others, but they can be a significant source of discomfort for those with Asperger’s, making them feel different from others.

4. Lack of Close Friendships:

Adults with Asperger’s Syndrome may find it difficult to form close friendships or receive mutual emotional responses from others, due to challenges in communication and self-expression.

5. Difficulty Finding Suitable Employment:

Through behavioral and psychological therapy, individuals may work towards social integration to some extent.
However, many struggle to find or maintain suitable employment due to behaviors they find difficult to modify.

6. Social Isolation:

Adults with Asperger’s Syndrome experience greater social isolation compared to children.
During childhood, parents and teachers can provide appropriate support and assistance. However, as they age, social integration becomes more challenging, which can lead to feelings of depression in some cases.

Treatment of Asperger’s Syndrome:

Asperger’s Syndrome is a neurodevelopmental disorder that affects how the nervous system develops and functions. While there is no cure or way to prevent the syndrome, there are guidelines and psychological support systems aimed at improving the quality of life for affected individuals and their families. Below are the commonly available treatment options:

1. Psychotherapy:

Psychotherapy, particularly Cognitive Behavioral Therapy (CBT), focuses on enhancing the strengths of children or adults with Asperger’s Syndrome, promoting their social integration, and encouraging participation by developing learning and social interaction skills. It also provides tools for self-regulation and helps them build a positive self-image.

Behavioral therapy is the cornerstone of treating Asperger’s Syndrome, as it helps the affected person understand the world around them, which may seem confusing or unsafe. It also helps reduce difficulties related to understanding social communication and nonverbal cues, which may lead to isolation or seemingly inappropriate reactions.

2. Physical Therapy:

Depending on the challenges faced by the individual with Asperger’s Syndrome, therapy may involve working with physical therapists or massage specialists to improve motor or sensory aspects.

3. Speech Therapy:

Speech therapy may be necessary to help the affected child develop clear speech, enhance their ability to understand and interpret others’ speech, and improve their overall communication skills.

How Families Can Deal With a Child With Asperger’s Syndrome:

Families play a crucial role in supporting children with Asperger’s Syndrome, providing the psychological and social support they need. Below are some strategies families can follow:

1. Early Detection:

Early detection of the first symptoms of Asperger’s Syndrome is essential. This involves understanding and addressing the child’s social and emotional difficulties.

2. Using Simple Language:

Children with Asperger’s Syndrome often struggle to understand others' language. Families should simplify their speech to match the child's level of understanding.

3. Simplifying Instructions:

When giving instructions to the child, keep them simple and use lists or visual aids if the task is complex to ensure full comprehension.

4. Ensuring Understanding:

Families should make sure that the child understands what is being said, rather than just relying on a “yes” response, as the child may sometimes say yes without truly understanding.

5. Encouraging Eye Contact:

Explain the importance of making eye contact with the person speaking, and encourage the child to do so, praising them when they demonstrate good social skills.

6. Reducing Available Choices:

To avoid confusion, limit the choices offered to the child to just two or three options.

7. Participating in Their Activities:

Parents should engage with their child in daily activities such as games, studies, or other activities at home or outside.

8. Preparing Them for Changes:

If there is a future change in routine, prepare the child for it indirectly, such as informing them that they will go shopping after finishing their coloring activity.

9. Identifying Stress Triggers:

It is essential to recognize the things that cause the child stress and try to avoid them whenever possible, while also finding alternative ways to distract them.

10. Embracing Them When They Make Mistakes:

If the child behaves inappropriately, hugging them or responding calmly can be more effective than scolding, especially if the behavior is not dangerous.

11. Keeping Promises:

Parents should honor all promises made to the child, even the simple ones, as breaking promises may confuse the child and diminish their trust.

12. Developing Strategies for Difficult Situations:

Train the child on techniques to handle challenging situations, such as deep breathing or counting to twenty when feeling like crying or getting upset in public.

13. Teaching the Difference Between Public and Private Spaces:

It is advisable to teach the child early on about the difference between public and private spaces, so they can develop appropriate social strategies in the future.

14. Showing Pride in Them:

The child should feel that their parents love and are proud of them. Not expressing emotions toward them may make them feel unloved or unwelcome.

15. Remembering They Are Children:

Parents must always remember that their child with Asperger’s Syndrome is like other children, with strengths and weaknesses, likes and dislikes. They need patience and greater understanding from those around them.

Differences Between Asperger’s Syndrome and Autism

Aspect	Asperger’s Syndrome	Autism (Autism Spectrum Disorder - ASD)
Language Skills	Usually normal or excellent; may have a rich vocabulary and complex language use.	May have delayed language development or clear communication difficulties.
Social Interaction	Difficulty understanding social cues; may feel uncomfortable in social situations but have a desire to communicate.	More significant issues with social interaction; may show a lack of interest in others or difficulty understanding emotions.
Focused Interests	Intense interest in specific topics with deep knowledge, such as numbers or scientific subjects.	Repeated or limited interests, often more apparent and not necessarily involving deep understanding.
Learning Ability	Generally normal or above average.	Can range from delayed development to high intellectual abilities.
Repetitive Behaviors	Present but less severe than in autism, such as repetitive movements or strict adherence to routines.	More noticeable, with continuous repetitive movements and difficulty handling change.
Social Relationships	May be able to form friendships, but with difficulty, especially understanding social rules.	Often faces significant challenges in forming or understanding relationships.
Diagnosis	Previously diagnosed separately, now part of the autism spectrum in DSM-5.	Diagnosed as a broad spectrum including various levels of autism.
Speech & Expression	Typically fluent speech but may have unusual tone or formal style; difficulty understanding jokes or hints.	May have issues with language development or using language appropriately.
Treatment & Support	Requires social skills training and Cognitive Behavioral Therapy for psychological challenges.	Requires early intervention, behavioral therapy, specialized education, and sometimes medical interventions if there are additional symptoms.

The specialist who treats Asperger's Syndrome is usually one of the following:

Psychiatrist:
- Specializes in diagnosing and treating mental and neurological disorders, and can prescribe medications if necessary.
Psychologist:
- Provides behavioral therapy, such as Cognitive Behavioral Therapy (CBT), to help patients cope with social and emotional challenges.
Neurologist:
- May be involved in evaluating brain functions and ruling out other neurological conditions.
Speech Therapist:
- Helps improve communication and speech skills, especially if there are difficulties in understanding language or using the appropriate tone.
Occupational Therapist:
- Assists in improving motor and sensory skills, especially if the individual has hypersensitivity to sounds or touch.