Asperger's Syndrome: Is it Different from Autism?
The American Psychiatric Association announced in February that the organization is revision the current edition of the Diagnostic and Statistical Manual IV which helps health professionals identify mental health disorders. The fifth edition of the DSM will be officially released in 2013, but some of the new guidelines, especially for those that fall under the Autism Spectrum Disorders, propose that Asperger’s syndrome should not be a separate diagnosis from other autistic disorders generating a furry of comments and concerns.
Asperger’s Syndrome is a developmental disorder that affects two-way social interaction, both verbal and nonverbal communication, and a reluctance to accept change. Patients also have an inflexibility of thought and an obsessively narrow area of interest. They require a structured environment and rely on routines. Asperger patients are often highly intelligent, excelling especially in math and science. They have excellent rote memory skills for remembering things such as facts, figures, and dates.
In addition to a deficit in social skills, Asperger patients may also show delayed motor skills and a presence of “motor clumsiness”. They may take longer pedaling a bike, catching a ball, or have trouble with other manipulative tasks such as opening a jar.
The National Institutes of Health estimates that Asperger’s syndrome affects about two out of every 10,000 children. It appears to affect boys more than girls. Unlike autism, language acquisition and cognitive development are not delayed and Asperger’s is usually diagnosed later in childhood.
Because the severity of the symptoms range within the syndrome and some experts do not recognize mild cases, often calling a patient “odd” or “eccentric”, the American Psychiatric Association Committee feels that reclassifying Asperger’s patients as “highly functioning autism” patients may help children get the services and support they need. Dr. Charles Raison, psychiatrist at Emory University, says that “it is more accurate to call it a form of autism. From a scientific point of view, I think the use of these spectrum ideas is much closer to the underlying biology.”
Rosalyn Lord, Coordinator of CASSEL – a support group for Asperger’s patients in the UK – maintains the conditions should remain separate diagnoses. At the Online Asperger Syndrome Information and Support (OASIS) Center, she writes that while both syndromes are characterized by a difficulty with social skills, autism is often interpreted as a withdrawal from normal life and the impairments are much greater than those of Asperger’s. Children with autism often have little or no language and have a greater difficulty in learning. Those with Asperger are more verbal and have a cognitive ability that is usually above average.
Both autistic and Asperger patients find the world confusing and frustrating, leading to behavioral problems that need special attention. Language and communication therapies can be helpful for both, but with different focuses. While autistic patients need encouragement to acquire more verbal skills, Asperger patients need help with understanding the subtleties of language – that everything said is not black and white.
Parents of children with both conditions need to understand routines and structure that can be helpful for children diagnosed with an autistic spectrum disorder. OASIS gives this list of helpful strategies to help, especially with Asperger’s Syndrome children:
• Keep all your speech and instructions simple - to a level they understand. The use of lists or pictures may help.
• Try to get confirmation that they understand what you are talking about/or asking - don't rely on a stock yes or no - that they like to answer with.
• Explain why they should look at you when you speak to them. Encourage them, give praise for any achievement - especially when they use a social skill without prompting.
• In some young children who appear not to listen - the act of 'singing' your words can have a beneficial effect.
• Limit any choices to two or three items.
• Limit their 'special interest' time to set amounts of time each day if you can.
• Use turn taking activities as much as possible, not only in games but at home too.
• Pre-warn them of any changes, and give warning prompts if you want them to finish a task.
• Try to build in some flexibility in their routine, if they learn early that things do change and often without warning - it can help.
• Don't always expect them to 'act their age' they are usually immature and you should make some allowances for this.
• Try to identify stress triggers and avoid them if possible.
• Promises and threats you make will have to be kept - so try not to make them too lightly.
• Let them know that you love them and that you are proud of them. It can be very easy with a child who rarely speaks not to tell them all the things you feel inside.