Asperger syndrome

[14] The syndrome was named in 1976 by English psychiatrist Lorna Wing after the Austrian pediatrician Hans Asperger, who, in 1944, described children in his care who struggled to form friendships, did not understand others' gestures or feelings, engaged in one-sided conversations about their favorite interests, and were clumsy.

[31][32][33] The ASD classification is to some extent an artifact of how autism was discovered,[34] and it may not reflect the true nature of the spectrum;[35] methodological problems have beset Asperger syndrome as a valid diagnosis from the outset.

Like other neurodevelopmental conditions, ASD begins in infancy or childhood, has a steady course without remission or relapse, and has impairments that result from maturation-related changes in various systems of the brain.

[41] Intense preoccupation with a narrow subject, one-sided verbosity, restricted prosody, and physical clumsiness are typical of the condition, but are not required for diagnosis.

[44] Individuals with Asperger syndrome experience difficulties in basic elements of social interaction, which may include a failure to develop friendships or to seek shared enjoyments or achievements with others (e.g., showing others objects of interest); a lack of social or emotional reciprocity; and impaired nonverbal behaviors in areas such as eye contact, facial expression, posture, and gesture.

[45] The cognitive ability of children with Asperger syndrome often allows them to articulate social norms in a laboratory context,[19] where they may be able to show a theoretical understanding of other people's emotions; however, they typically have difficulty acting on this knowledge in fluid, real-life situations.

[31] Abnormalities include verbosity; abrupt transitions; literal interpretations and miscomprehension of nuance; use of metaphor meaningful only to the speaker; auditory perception deficits; unusually pedantic, formal, or idiosyncratic speech; and oddities in loudness, pitch, intonation, prosody, and rhythm.

The speaker's conclusion or point may never be made, and attempts by the listener to elaborate on the speech's content or logic, or to shift to related topics, are often unsuccessful.

[67] Children with ASD often demonstrate enhanced perception of small changes in patterns such as arrangements of objects or well-known images; typically this is domain-specific and involves processing of fine-grained features.

They may be unusually sensitive or insensitive to sound, light, and other stimuli;[69] these sensory responses are found in other developmental disorders and are not specific to AS or to ASD.

Children with AS may be delayed in acquiring skills requiring dexterity, such as riding a bicycle or opening a jar, and may seem to move awkwardly or feel "uncomfortable in their own skin".

[19] There may be shared genes in which particular alleles make an individual vulnerable, and varying combinations result in differing severity and symptoms in each person with AS.

[76] Asperger syndrome appears to result from developmental factors that affect many or all functional brain systems, as opposed to localized effects.

[77] Abnormal fetal development may affect the final structure and connectivity of the brain, resulting in altered neural circuits controlling thought and behavior.

[89] Standard diagnostic criteria require impairment in social interaction and repetitive and stereotyped patterns of behavior, activities, and interests, without significant delay in language or cognitive development.

Unlike the international standard,[40] the DSM-IV-TR criteria also required significant impairment in day-to-day functioning;[41] As noted above, in the 2010s, Asperger syndrome, as a separate diagnosis, was eliminated and folded into autism spectrum disorder in the DSM-5 and the ICD-11.

[94] There are indications AS has been diagnosed more frequently in recent years, partly as a residual diagnosis for children of normal intelligence who are not autistic but have social difficulties.

[96][97] Adult diagnosis requires painstaking clinical examination and thorough medical history gained from both the individual and other people who know the person, focusing on childhood behavior.

[8][19] The United States Preventive Services Task Force in 2016 found it was unclear if screening was beneficial or harmful among children in whom there are no concerns.

[19] Treatment attempts to manage distressing symptoms and to teach age-appropriate social, communication, and vocational skills that are not naturally acquired during development.

[128] Vocational training may be important to teach job interview etiquette and workplace behavior to older children and adults with AS, and organization software and personal data assistants can improve the work and life management of people with AS.

[76] It is vital to remember that research of AS specifically operates upon the out-dated classification of this syndrome as external to ASD (Autism Spectrum Disorder).

The selective serotonin reuptake inhibitors (SSRIs) fluoxetine, fluvoxamine, and sertraline have been effective in treating restricted and repetitive interests and behaviors,[19][44][75] while stimulant medication, such as methylphenidate, can reduce inattention.

[131] In addition, scientists have made a noteworthy finding that oxytocin, a hormone, plays a significant role in shaping human social behavior and the formation of interpersonal connections.

[124] Abnormalities in metabolism, cardiac conduction times, and an increased risk of type 2 diabetes have been raised as concerns with antipsychotic medications,[132][133] along with serious long-term neurological side effects.

[140] Anxiety may stem from preoccupation over possible violations of routines and rituals, from being placed in a situation without a clear schedule or expectations, or from concern with failing in social encounters;[19] the resulting stress may manifest as inattention, withdrawal, reliance on obsessions, hyperactivity, or aggressive or oppositional behavior.

[154][155] In 1944, Asperger gave detailed descriptions of four representative children in his practice[44] who had difficulty in integrating themselves socially and showing empathy towards peers.

[8] Hundreds of books, articles, and websites later described AS and prevalence estimates increased dramatically for ASD, with AS recognized as an important subgroup.

[163][164] Some autistic people have advocated a shift in perception of autism spectrum disorders as complex syndromes, neurodivergences, and/or neurominority cognitive styles rather than diseases that must be cured.

[173] By contrast, Pier Jaarsma and Welin wrote in 2011 that the "broad version of the neurodiversity claim, covering low-functioning as well as high-functioning autism, is problematic.

A young boy is seen stacking several colorful cans on top of each other.
People with Asperger syndrome often display restricted or specialized interests, such as this boy's interest in stacking cans.
Monochrome fMRI image of a horizontal cross-section of a human brain. A few regions, mostly to the rear, are highlighted in orange and yellow.
Functional magnetic resonance imaging provides some evidence for mirror neuron theory. [ 79 ]
Three children are seen holding a banner which says "Different NOT Less! We ARE UNIFIED" in brightly colored text.
Students and families walk to support Autism Awareness Month.