Asperger's syndrome: knowing how to recognize the signs

Asperger's syndrome is a complex disorder often confused with autism due to some similar behaviors. The main characteristics of Asperger's syndrome are difficulties in acquiring social skills and behaviors, which contrast with demonstrably good language development and intellectual functioning.

Causes

It is generally agreed that Asperger's syndrome has a primarily genetic origin, but so far no cause has been identified.

Diagnostic criteria

Asperger's syndrome is often diagnosed later in development than autism because language and cognitive functions fall within the normal range, causing early signs of difficulties with social skills to go unnoticed. A formal diagnosis may not be made until primary school, secondary school, or even adulthood, once differences in an individual's ability to socialize become more apparent.

The diagnosis is based on a comprehensive and multidisciplinary approach involving the collection of information from various sources:

• Parents – family genes and the child's developmental history;
• Professionals (e.g., teams of child psychiatrists and child psychologists) – using standardized assessment instruments such as the Autism Diagnostic Observation Schedule (ADOS-G) and the Autism Diagnostic Interview – Revised (ADI-R). Parents and teachers will also complete a behavior checklist to document various behaviors (social interaction, communication, behavior, and coping skills);
• Auxiliary professionals – a thorough assessment of cognitive and language functions using appropriate standardized tests;
• Diagnostic teams – on   will often ask the family to undergo genetic testing to rule out related disorders, such as fragile X syndrome.

Areas of difficulty  

Asperger's syndrome can affect a child in various ways. The main difficulties experienced include the following:

• Difficulty in reciprocal social interactions and in understanding the rules that govern these interactions (e.g., interpreting facial expressions and body language, respecting turn-taking in conversations);
• Social withdrawal;
• Rare eye contact;
• Underdeveloped sense of social responsibility;
• Few facial expressions (absence of certain common facial expressions or extreme expressions);
• Speech abnormalities (e.g., little modulation in voice accent, monotonous or exaggerated tone, speaking too loudly or too softly);
• The content of speech or preferences in activities may be limited to one or two particular areas of interest, impairing the ability to communicate with others and to be interested in other subjects;
• High degree of anxiety, especially in social situations;
• Perfectionism;
• Preference for structured contexts and resistance to changes in habits or environment;
• Unusual sensory interests (e.g., aversion to certain sounds or textures, or seeking out particular sounds or textures);
• Mannerism of the hands and fingers or other complex gestures (e.g., small hand movements, head, neck or finger movements);
• Difficulty paying attention.

Key strengths of children with Asperger's syndrome

• Good early childhood language development, or even rapid acquisition (e.g., use of formal language and complex vocabulary at a young age);
• Excellent verbal memory for facts, especially in certain areas of interest;
• Good factual memory can help with success in subjects like mathematics and science;
• Expertise in certain fields of interest;
• Ability to acquire certain skills (e.g., social skills) that are difficult for the individual with specialized instruction and the use of concrete and visual methods.