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Asperger syndrome - causes, therapy and symptoms
contents
- So how do parents know if their child suffers from Asperger syndrome??
- History of Asperger's Syndrome
- characteristics
- Symptoms of Asperger's Syndrome
- Causes of Asperger's Syndrome
- Depression, anxiety and Asperger
- collapse
- Sensual and motor problems
- treatment
- Asperger and medication
- The "theory of mind" and its effect on social interaction
- Develop social competence
- references
The reason is that it is difficult for people without training to recognize children with the syndrome because such children are often intelligent, have normal language skills and no physical defects - unlike classical autistic people.
Asperger syndrome. For example, those affected can not recognize sarcasm. Image: Maik Dörfert - fotolia As adults, they can usually cope on their own and even occupy specialist positions in special areas, such as computers and science.
So how do parents know if their child suffers from Asperger syndrome??
Children with this disorder are often obsessed with certain objects or actions. The objects of this obsession may vary from case to case - whatever object of obsession, sufferers talk about it continuously: These may be bicycles, housing architecture, weapons systems, but rarely interpersonal. The so possessed do not realize whether someone else is interested in the topic.
The (often involuntary) listeners put the verbiage easily as impolite, they are annoyed and consider those affected outrageous people who like to hear talk, so to consciously empathy.
In fact, here the relationship between Asperger and autism shows, because this inability to recognize the interest of others, coincides with other types of autistic form.
While some affected children show social skills that appear normal, others lack social behavior. They then show, for example, an undifferentiated body language, speak monotonously, they can not recognize humor, in particular no irony and have problems with non-verbal communication. Because of these features, they are sometimes shunned or marginalized by other children and are considered a "skurill".
Some children with the syndrome have motor problems with activities such as riding a bike, climbing or playing games that require physical effort. Such children seem awkward even at normal altivities like walking or running. Some children also stereotypically repeat behavior like clapping their notes or spinning in circles.
History of Asperger's Syndrome
The syndrome is probably known since the 16th century, when John Mathesisus, a companion of Luther, published a story about a 12-year-old boy who showed a behavior of the autistic form circle. Luther considered the boy to be a soulless mass of flesh that the devil had occupied.
In the 1940s, the Viennese child psychologist Hans Asperger described the syndrome for the first time. He examined children who showed autism-like behavior but who were normally intelligent and had no speech problems.
Many experts said that the behavior was simply a mild form of autism and called the disorder "high-functioning autism". Uta Fried, a neuroscientist from London, described patients as "a bit autistic".
In 1994, the American Psychiatric Association listed Asperger as a separate disorder besides autism. However, to this day many professionals still regard Asperger as autism but as a weak type. Finally, in 2013, autism was fanned out into a range of forms that included Asperger.
characteristics
The syndrome is different from classic autism due to less severe symptoms and the lack of speech disorders. Affected children often have good language and cognitive skills. For the layman, such a patient often appears like a "normal" child, behaving strangely.
Unlike classic autistic people, who are not interested in their environment, many people with Asperger try to get involved in social relationships. However, their "autism" is that they do not know how. So they often do not understand social rules or show a lack of empathy. They often shy away from eye contact, appear disinterested in the conversation and do not understand gestures.
Her interest in her particular topos becomes an obsession. Affected children often collect things of a particular category, such as stones or bottles. They are terrific in storing specific information like baseball statistics or latin plant names. You have a good memory but problems with abstract concepts.
One of the main differences between Asperger and classic autism is the lack of speech disorder: although these children generally have good language skills, they use language differently than non-affected people. For example, their speech patterns are unusual or rhythmic in nature, then again formally correct, but too loud or too shrill. Children with Asperger often do not understand the subtext of a message, and they often do not understand the give and take - the social meaning of communication.
Those affected often have problems imagining something and excel in learning facts. This brings problems at school, especially in subjects such as literature and philosophy.
While people with classic autism are often intellectually disabled, most Asperger's patients have average to high intelligence.
They leverage their power by learning tons of facts about specific topics. Others are extremely precise at organizing objects. These interests can be developed so that patients study and work in their specialty.
They tell classic autistic people that any unexpected change in their routine will upset them. For example, if an affected child always walks the same route to school, but the road is closed due to an accident, his orientation system collapses. Asperger's patients become frightened when someone comes too late or spontaneous class excursions break through the usual structure.
Symptoms of Asperger's Syndrome
Affected children often find it difficult to build friendships. They then find no connection with peers because of their lack of social skills. You have problems talking to other children or participating in group activity.
This can shake these children, because they want to connect intensively with their peers. However, some sufferers have no desire to make friends and prefer to be alone.
Young children with the disorder sometimes show selective mutism. That is, they only speak freely, for example, if they are familiar with those present and are silent about strangers. Immediate family members are usually unaffected because the child feels comfortable talking to them.
Clearly, this avoidance behavior manifests itself in the school and the public, and some children refuse to talk to strangers from a very early age. This behavior sometimes disappears on its own, with other children a therapy helps.
Affected individuals often find it difficult to empathize with others. As they get older, however, they learn how others respond to them. They learn it, but they do not feel it. For example, while they respond appropriately and give the "right" answers, they do not understand why they are snubbing others.
This is when Asperger children play too harshly with other children or use harsh words without knowing that they are offending the other person. When addressed, these children then respond that what they have said is true, and they do not understand the problem.
People who suffer from the disorder often find it difficult to make eye contact with their interlocutors. Some believe this behavior results from a lack of trust. Others assume that eye contact makes those affected feel uncomfortable.
There is even the theory that patients do not understand how important eye contact is and why, because they do not understand social communication. This can even lead to the opposite problem, if those affected force eye contact and unsettle other people.
The idea that sufferers have no feelings is wrong. Experts describe these patients as "active but unformed". For example, they become socially active and form close friendships. Others surround themselves with many acquaintances, but enter no firm bonds.
Affected are often bad at school, but have specific interests. However, these interests are very focused, and they develop a wealth of specialized knowledge, whether it's about model airplanes, video games or drawing.
The focus on these interests gives them security. If they are forced to leave their projects, they will be in great stress - as will their projects. One expert said of one concerned: "He has an almost erotic interest in his bikes."
To follow a routine is very important for Aspergerpatienten. They become stressed and are afraid when their structure changes. New situations make you shudder. A routine helps them control their anxiety. Luckily, much of our life is routine, and if a child suffers from the disorder, it can be made.
A symptom of the disorder appears in the immediate interpretation of what has been said. For example, those affected do not understand sarcasm, but take what someone says at face value.
At the same time, they sometimes understand humor. If, after an explanation, they comprehend the meaning of what they have literally understood, they find it as funny as "normal".
Another symptom is the surprising ability to recognize patterns. Often these people try to capture the road network of their environment as young children. While they have problems in many subjects, patterns in math and art are easy for them. If this natural talent is required, Asperger's patients can become masters of their craft.
Some sufferers find it difficult to control their fine motor skills. This shows in bad handwriting, because the coordination of eye and hand causes them problems.
Causes of Asperger's Syndrome
Changes in the brain are responsible for many symptoms of this disorder. However, doctors still can not say exactly where these changes originated. Genetic factors may play a role as well as toxins, chemicals or viruses. Boys are more often affected than girls.
Asperger is more common than classic autism: while only 4 out of 10 000 people suffer from classic autism, it is 25. Here, a cautious empirical study by the Gilbergś group in Sweden found that about 0.7% of children examined had a clinical picture of Asberger. If such studies included children with many signs of the disorder, but more "normal", the number of those affected increases.
All the studies showed that Asperger occurs far more in boys than girls. The reasons are unknown. Asperger is often associated with other diagnoses, such as depression and anxiety disorders. In some cases, there is a clear genetic component when a parent has either the full spectrum of the syndrome or some symptoms.
Some features, such as intense and narrowly defined interests, a rigid body language, and social deficits such as fears, appear to be common among relatives of Aspergers.
Sometimes there is a family history of autism, suggesting that Asperger and classic autism are related. Other studies show a high rate of depression, both bipolar and unipolar, in relatives of patients.
As with classic autism, there is obviously a genetic basis, but various other factors come to mind.
Depression, anxiety and Asperger
Depression, anxiety and other mood disorders are typical for comorbidity, especially in young Asperger patients. Puberty is a change for all young people, and for adolescent teenagers, adolescent problems are associated with the feeling of being different from other children.
Affected children are often marginalized and teased. Image: Tomsickova - fotolia The typical characteristics may then be hidden under a mask of anxiety and depression, making diagnosis difficult. Left untreated, the combination of the disorders leads these young people into an unhappy life.
The good news, however, is that there are effective treatments for children and adolescents with these comorbidities that help relieve depression or anxiety. It is important to evaluate accurately the signs of depression and anxiety. Changes in behavior, sleep, energy levels, food and interactions with others are part of the analysis.
collapse
In the event of a collapse, those affected lose control of their emotions in the short term through triggers in the environment. These triggers are usually not a specific item.
Instead, stimuli accumulate until they overpower people so much that they no longer convey information. Those affected described the feeling as if a bottle of coke was shaken and then opened - so the emotions hiss in all directions.
It is best if those present bring the affected person out of the situation, or if he leaves the situation, if he is able to do so. There is no patent solution, but there is a consensus that it is most important for someone who suffers an emotional breakdown to be left alone in a place where he feels safe, can listen to music, take a bath or sleep.
After a collapse, those affected are often ashamed, depressed or stressed.
Sensual and motor problems
Those affected often have problems in organizing and implementing information they receive through the senses.
For example, when ordinary people sit down to focus on a topic, they filter the background noise. The many smells and visual charms of a shopping mall will not disturb you, but you will find and find exactly the object you are looking for.
People with Asperger's Syndrome who have a disability to process such sensory impressions have extremely low frustration tolerance.
When they are in inner cities, they are easily totally emotionally disconnected because the impressions overwhelm them. Or they fail at school because they throw off the smallest events, for example, when a classmate sharpens the pencil.
In addition, there is a hypersensitivity to noise, touch, light and odors, which often means those affected can not process new material fast enough to do a normal job.
This over-stimulation of the senses can not be cured, but there are many therapies to relieve them. Some are as simple as playing music in the background or giving the child more time to solve tasks. Aromatherapy, art therapy and massage help some children. Others recover in the 1 to 1 work with a coach.
Some suffering children have difficulty balancing on a board and standing on tiptoe. This is due to the mediation of motor skills through the brain, more precisely, to the movement planning. The brain formulates the movement before a human transmutes it, but the regions in which it occurs are likely to be damaged in Asperger's patients.
Affected people have a whole series of problems coordinating their movements, as shown by three-dimensional games on the playground, such as pulling up nets, rocking or climbing ladders.
These disorders do not disappear with age, and they often take the form of mild disabilities. In particular, there are three motor disorders in which the sufferer suffers: fine motor skills of the hand like playing the piano or writing; when catching and throwing, they lack eye-to-hand communication, and third, keep their balance.
treatment
The average age for treatment is 11 years, compared to 5.5 years for classic autism. This is in many cases too late, because Asperger's patients learn best in early programs social competence.
Common methods of treating the disorder include behavioral therapies, child-centered programs, painting therapy, developmental therapies and education in socially pragmatic principles.
Therapy offers for children and adolescents. Picture: alexsokolov - fotolia The main priority is the communication of core elements of social communication, in addition to positive changes of problematic behavior, individualized modules and complementary support of families.
Asperger and medication
There is an identified biochemical problem in Asperger, and that is why many researchers think the syndrome is the result of fundamental changes in brain structure. According to them, medications can not cure Asperger.
On the other hand, many medications help alleviate the symptoms of Asperger, and this is especially true for comorbidities.
Atomoxetine, for example, alleviates the symptoms of Aspergers that are similar to those of ADHD, especially the repetition of speech.
Antidepressants help those patients who suffer from secondary depression, which is not part of Asperger's but is a result of the unfortunate circumstances that this syndrome can bring.
In addition, Asperger's patients often suffer from insomnia. While it is best to try drug-free ways to remedy sleep problems, in severe cases there is good experience with sleeping pills.
Medications that relieve anxiety may be needed if Asperger sufferers are plagued by nervousness or lose their orientation.
But there is no drug to treat the core symptoms of Asperger.
The "theory of mind" and its effect on social interaction
In 1996, Baron-Cohen concluded that disturbances in the "theory of mind" are the main cause of the social difficulties of Autism and Asperger. He described this phenomenon as "mind blindness".
To form a "theory of the mind" is to understand that a person thinks of something other than oneself. Without such a "theory of the mind" it is impossible to recognize the thought patterns of other people, and who can not, behavior can only derived from behavior. In short, such a person recognizes by the expression that someone is mad at him, but he does not understand what angered him with what he said earlier.
Such a "theory of the mind" results from the human ability to interpret social roles, to communicate, and to be aware of other people's feelings. Those who fully develop this ability have an instinctive intuition to interpret the thoughts and behavior of others. People with Asperger, however, often get into trouble in social interactions because they do not understand others' thoughts.
The first phase of this understanding process begins ten months after birth, when the child imagines situations, for example, by using a banana as a phone. The second phase usually begins at the age of two, when children perceive their own visual perspective and their individual knowledge.
This is reflected, for example, in the search and hide-and-seek game with an object; at the age of three, children finally understand that other people can not know what they are thinking. But kids at this age still think what they believe is real.
At the age of four or five, children develop the third level of the "theory of mind". This means being able to understand the thoughts, desires and emotions of another person, which helps to explain his behavior and his intentions.
Children with the syndrome reach the first level of the "Theory of Mind" around the age of six. At the age of ten, children with Asperger are able to scale the second level. Most fail, however, at the third stage in their development.
Develop social competence
An essential focus for most programs to help Asperger patients is the promotion of their social skills. Social skills are communicated to aspergers in a variety of situations - such as school cliques, class community, private social skills training, supervision, and individualized therapies.
The methods to teach social skills include role-playing, modeling, social stories, in-vivo practice with peers, and constructive feedback. The social narrative method uses stories that can be written and illustrated to prepare for any situation, with the aim of providing information about what people think, do and feel in this situation. Social narratives identify important social encounters and their meaning and show the child what to say.
They are particularly meaningful for new situations for Asperger affected. They often cause anxiety, but they are useful in all situations to show the child what others expect of them.
Other teaching techniques include showing social skills by breaking them down into small sub-skills, and then demonstrating each of these sub-skills through models and role-playing games.
Regarding conversation, for example, such parts would be to find a topic, to present the topic, to use non-verbal communication such as eye contact, facial expressions and gestures, to check whether the listener is interested in ending the conversation (goodbye, until the next one) times, etc.).
If the social skills are already developed, it is about resolving conflicts, dealing with criticism and showing empathy. Capturing the child's cognitive development is critical to creating a social learning program tailored to their individual needs. (Somayeh Khaleseh Ranjbar, translated by Dr. Utz Anhalt)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)
references
- http://www.autism-society.org/what-is/aspergers-syndrome/
- http://www.activebeat.com/your-health/10-symptoms-of-aspergers-syndrome
- http://www.medicinenet.com/asperger_syndrome/page2.htm
- http://www.mayinstitute.org/pdfs/0908_may_institute_exceptional_parent.pdf
- http://www.bbc.com/news/blogs-ouch-28746359
- http://neuronetlearning.com/blog/movement-performance-and-sensory-integration-in-aspergers-syndrome/
- http://www.yourlittleprofessor.com/working-with-sensory-integration-disorders/
- http://www.myaspergerschild.com/2007/08/aspergers-and-medication.html
- http://www.macswd.sa.gov.au/files/links/Asperger_report_771KB_PDF.pdf