March 27, 2003

Asbergers Syndrome Believed to Be a Form of Autism

A natural reaction of new parents is to count all their baby’s fingers and toes and make sure they appear to be physically intact. On occasion, even though a baby appears to be normal, parents discover their child has a physical or neurological condition that affects his or her ability to develop and thrive. One such condition that often reveals itself months after birth is autism.

Autism has been described as a “severe, lifelong, pervasive developmental disorder” that occurs in 14 to 16 of every 10,000 live births. It affects people of all racial, ethnic, social, and economic backgrounds. Boys are three to four times as likely as girls to have autism, and the symptoms may be evident at birth, or not appear until the child is 2 or 3 years old. Autistic children live a normal life expectancy, and their autism lasts the entire lifetime. The cause of autism remains unknown.

Autism is classified as a syndrome, meaning there are clusters of characteristics typical of this disorder. All people with autism have varying degrees of difficulty in all of the following areas: language and communication, social interaction, and behavior.

Language and communication problems include absence of or late onset speech, absent or distorted gestures and facial expressions, repetitive use of certain words, phrases, or sentences, unusual speech production, inappropriate use of words, limited or impaired symbolic activity, and difficulty initiating or engaging in sustained conversations.

Typical difficulties in social interaction include indifference or even dislike of being held or cuddled, little or no apparent awareness of other people or their feelings, preference for solitary play, and difficulty establishing relationships.

The behavior of autistic children characteristically includes ritualistic activities, such as rocking, spinning, or finger flicking. They may be preoccupied by specific parts of objects or form unusual attachments to objects. Autistic children may experience prolonged periods of hyperactivity, throw tantrums for no apparent reason, and display limited interests and activities. They often strongly resist any changes in routine or environment

In addition, children with autism frequently experience associated problems: they may be prone to inappropriate laughing or crying, trouble sleeping, eating, or toileting, and have unusual responses to sensory stimulation (touch, smell, light, sound, or taste). They may engage in self-injurious behavior, and may seem unaware of physical discomfort from pain, heat, or cold.

Autism, or Autistic Spectrum Disorders, is a classification that includes a number of related conditions. One of the most recently recognized conditions is Asbergers syndrome. This is a condition characterized by a collection of neurological defects, and is often considered to be a less severe form of autism.

Asbergers syndrome is a severe disorder typified by difficulties in social interaction, restricted interests, and unusual patterns of behavior. Like autism, boys are more likely to suffer from Asbergers syndrome than girls. Although the children often have well-developed verbal skills, they are severely lacking in social skills. Their ability to interpret social cues is impaired, as is their ability to empathize with others. Even though they can describe the emotions of others and the gists of conversations, they are unable to act upon this knowledge in an intuitive, spontaneous fashion. They often have clumsy, stiff body language, use inappropriate facial expressions, and may speak in a monotone. Some talk incessantly, but usually about a topic of interest only to themselves, so they bore the listener.

Although they may appear to be rude, this is a neurological disorder and not insensitivity. In fact, children with Asbergers are keenly aware of others around them, and become anxious in social settings. Because they tend to be “nerdy,” these children often are subject to social rejection by their peers. This, in turn, frequently leads to anger, depression, and withdrawal, compounding the problem even more. Like their peers, children with Asbergers syndrome want to be accepted, but their disability makes this difficult. These children do well with logical, sequential thinking, so they tend to be successful academically and even have superior skills in an area of interest to them. However, holistic thinking is different; they often cannot deal with metaphors, puns, and creativity. Holistic thinking is required to be successful at reading social situations and responding appropriately.

Since the child with Asbergers syndrome primarily has problems with social skills, especially relating to peers as opposed to adults, the diagnosis, treatment, and prognosis are very different than for classical autism. Psychotherapy and treatment in a program for the emotionally disturbed tend not to be helpful. (In fact, one school of thought regards Asbergers syndrome as a nonverbal learning disability as opposed to a mild form of autism.) One therapy that has been effective is Computer Aided Emotional Restructuring (CAER), which greatly reduces the anger, anxiety, and depression brought on by the social rejection these children usually experience. As they become more relaxed in social settings, these children become free to learn to effectively read and respond to social cues, and social skills training becomes more successful.

A number of resources are available to learn more about autism and Asbergers syndrome. For those with internet access, go to the Asbergers Syndrome Coalition of the US at www.FAAAS.org, Noah’s Ark Children’s Association (NACA) at www.yautism.org, or Maap Services, Inc. at www.maapservices.org. Maap may also be reached at (219)662-1311.