Asperger disorder is a form of pervasive developmental disorder characterized by persistent impairment in social interactions, repetitive behavior patterns, and restricted interests. Unlike autistic disorder, no significant aberrations or delays occur in language development or cognitive development. Asperger disorder is generally evident in children older than 3 years and occurs more often in boys.

Children with this disorder often exhibit a limited capacity for spontaneous social interactions, a failure to develop friendships, and a limited number of intense and highly focused interests. Although some people with Asperger disorder may have certain communication problems, including poor nonverbal communication and pedantic speech, many individuals have good cognitive and verbal skills. Bowler and colleagues have reported that, although people with Asperger disorder have fewer memories, the experiences of remembering are qualitatively similar in people with Asperger disorder compared with healthy control subjects.¹ Physical symptoms may include early childhood motor delays, clumsiness, fine motor difficulty, gait anomalies, and odd movements.

Individuals with Asperger disorder have normal or even superior intelligence and may make great intellectual contributions while demonstrating social insensitivity or even apparent indifference toward loved ones. Published case reports of individuals with Asperger disorder suggest an association with the capacity to accomplish cutting-edge research in computer science, mathematics, and physics. Although the deficits manifested by those with Asperger disorder are often debilitating, many individuals experience positive outcomes, especially those who excel in areas not dependent on social interaction.

Persons with Asperger disorder have exhibited outstanding skills in mathematics, music, and computer sciences. Many are highly creative, and many prominent individuals demonstrate traits suggesting Asperger syndrome. For example, biographers describe Albert Einstein as a person with highly developed mathematical skills who was unaware of social norms and insensitive to the emotional needs of family and friends.

Although normal language and cognitive development differentiate Asperger disorder from other developmental disorders, the severe social impairment associated with this condition overlaps with disorders such as high-functioning autism (HFA).

De Spiegeleer and Appelboom (2007) have pointed out that Asperger syndrome is an autism spectrum disorder. For clinical management purposes, Asperger disorder and HFA may be considered together. Impaired social skills are associated with several other conditions (eg, developmental learning disability of the right hemisphere, nonverbal learning disability, schizoid personality disorder, semantic-pragmatic processing disorder, social-emotional learning disabilities).

Misinformation about autism is very common. Claims of a cure for autism are constantly presented to families of autistic individuals. There are various treatment models found within both the educational and clinical settings. Yet, there is only one treatment approach that has prevailed over time and is effective for all persons, autistic or not. That treatment model is an educational program that is suitable to a student’s developmental level of performance. For adults, that treatment model refers to a vocational program that is suitable to the individual’s developmental level of functioning.

Under the Individuals with Disabilities Educational Act (IDEA) Act of 1990, students with a handicap are guaranteed an “appropriate education” in the Least Restrictive Environment (LRE), which is generally considered to be as normal an educational setting as possible. As a result of this legislation, autistic children have generally been placed in a mainstreamed classroom and pulled out for whatever supplementary services were needed. Depending on the child’s needs, he or she could be placed up to 100% of the school day in a mainstreamed or a special education setting or any combination of the two.

There is an increasing trend, however, among the advocates for autistic children, to segregate these children into small, highly structured and controlled academic settings that are almost free from auditory and visual stimulation. All instruction is broken down into manageable segments. Information is presented in tiny units and the child’s response is immediately sought. A classic stimulus-response approach is used to maximize learning. Each unit of information is mastered before another is presented. A fundamental behavior such as putting hands on the tabletop, for example, must be mastered before the child is required to perform any other tasks, or before more information is presented. The long-term effects of this type of treatment as well as the ability of the child to transfer this to a broader context continue to be evaluated.

Autistic individuals must be taught how to communicate and interact with others. This is not a simple task, and it involves the entire family as well as other professionals. Parents of an autistic child or adult must continually educate themselves about new treatments and keep an open mind. Some treatments may be appropriate for some individuals but not for others. Many treatments have yet to be scientifically proven. Treatment decisions should always be made individually after a thorough assessment and based on what is suitable for that child and his or her family.

It is important to remember, despite some recent denials, that autism is virtually a lifelong condition. Treatment will change as the individual develops. Families must beware of treatment programs that give false hope of a cure. Acceptance of the condition in a family member is a very critical, foundational component of any treatment program and is understandably quite difficult.

Several medications have been tried or are under current scrutiny for the treatment of autism. No medication has consistently proven to be of benefit in closely controlled clinical trials. In the past, a piece on a television news show prompted a great deal of interest in the hormone secretin as a treatment for autism. An autistic child with chronic gastrointestinal complaints showed dramatic improvement following some routine testing performed by a gastroenterologist during which a small dose of secretin was administered. The family and their physicians felt that the secretin may have resulted in the improvement in the symptoms of autism. Many physicians began prescribing secretin, which can be costly for their autistic patients. However, studies published appear to completely refute the claim that secretin treatment benefits autistic patients. This example underscores the importance of good clinical trials in determining whether a drug will help patients with autism.

Autism At A Glance

• Autism is characterized by impaired development in social interaction, communication, and behavior.
• The degree of autism varies from mild to severe.
• Severely afflicted patients can appear to have a profound intellectual disability.
• The cause of autism is unknown.
• The optimal treatment of autism involves an educational or vocational program that is suited to the developmental level of the child or adult, respectively.