Thursday, March 17, 2005

About Asperger's syndrome

Asperger’s Syndrome is a neurobiological disorder in the autism spectrum. The name Asperger’s syndrome comes from the psychiatrist Hans Asperger’s paper written in 1944. The term is used to describe certain patients who have never been easy to classify but who seem to constitute a recognizable type of autistic individual. The discovery of autism was credited to Leo Kanner in 1943. Kanner was an Austrian who immigrated to the United States in 1924. Asperger, also an Austrian, remained in Vienna. They both worked independently and by coincidence described the same type of disturbed child and used the term autism.

There is a great deal of overlap between Asperger’s and Kanner’s views of autism, they are mostly in agreement on all the major features. The features described first by Asperger were oddities of non-verbal communication; eye gaze, gestures, posture, voice quality, prosody and word choice. He also highlighted lack of humor and pedantry.

There is much to be learnt about Asperger’s Syndrome, our knowledge is still patchy. However, a consistent picture is beginning to emerge. Following are the six diagnostic criteria based on Asperger’s paper in 1944.

1) Speech- no delay, odd content, pedantic, stereotyped.

2) Non-verbal communication- little facial expression, monotone voice, inappropriate gestures.

3) Social Interactions-not reciprocal, lacking in empathy

4) Resistance to change-enjoys repetitive activities

5) Motor co-ordination- gait and posture odd, gross movements, clumsy, sometimes stereotypes

6) Skills and interests- good rote memory, circumscribed special interests.

Children with Asperger’s Syndrome show impairments in cognition. This has an affect on the child’s play, language, sociability and academic achievement. The have difficulties in extracting a meaningful whole from what they see and hear.

Cognitive Difficulties.

The more complex the environment the more difficulty they have in extracting vital information.

Sociability.

They usually want to be sociable but often go about this the wrong way. They often appear rude, shy or overfriendly. They can be distressed when hurt or ignored but have little idea about how they are sending out the wrong signals for friendships to develop. Also, they can behave appropriate when left on their own but become overwhelmed by large groups.

Language.

Children with Asperger’s make literal interpretations of other peoples’ conversations and can over react to comments. Other people’s teasing and sarcasm can distress them, although they may learn to use it themselves. They rarely make the connection between the harm they inflict on others and that directed towards them. They are often impulsive saying things that others only dare think. This can make them sound arrogant, rude or hurtful. They acquire language through memory rather than meaning and tend to convey messages obliquely.

Play.

Asperger’s children understand that toys represent real objects but often have problems with more abstract substitutions or omissions. They often have a poor imagination and find it difficult to role-play.

Identifying problematic conditions helps to ensure that specialist provision can be made for all those involved. There is a case to be made against the use of labels. The term ‘diagnosogenesis’ has been used to describe a process of labeling where a person given the label creates or exacerbates the disorder. However, an equally powerful plea for the diagnosis of autistic spectrum disorders is that knowing someone has the disorder will tell you how to treat and teach that person. Needs that are not recognized or met can lead to a lifetime of misery.

Not so long ago, autistic spectrum disorders were blamed on the mother. It was claimed that children became withdrawn and autistic because of a lack of maternal attention when very young. The term ‘refrigerator mother’ was coined. Fortunately, it is now known that this accusation was false. The actual cause of autism is still uncertain but it is believed to be of genetic source. Often members of the same family will have the syndrome. It is also found to be more common in males than females and is rarely recognized before the child is three years old. More recent therapies have included a gluten-free diet, although it has not been proved to be affective.

It takes time and understanding to improve the quality of life for an autistic spectrum disorder child. There are many useful resources for information both in books and on the internet. It is often helpful to join groups and associations who can offer support and advice. Many children with Asperger’s Syndrome find school difficult, although it is often possible for them to attend mainstream school. They concentrate better in smaller groups and may need extra explanation of what work is expected of them. Routine and structure is important to them and anxiety can occur if this is disrupted. Unstructured moments of the day, such as playtime, can cause the most problems. They will need extra supervision as they are often teased or bullied by other children. The best strategy to avoid problems seems to be protection rather than exposure.

Unwanted behaviors at home may be diminished by the use of a behavior chart. Recording behaviors, when they occur, what triggered them and what happened afterwards, can give cares a greater understanding of why the behaviors occurred. A strategy can then be worked out on how to prevent the unwanted behaviors re-occurring. A clearly presented behavior chart is also a useful tool to explain to the child which behaviors are acceptable and which are not.
About Asperger's syndrome : Health Section ExpressNewsline.com- ExpressNewsline.com

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