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).

What Does It Mean to be Autistic

Autism is a brain disorder that too often results in a lifetime of impaired thinking, feeling, and social functioning — our most uniquely human attributes. Autism typically affects a person’s ability to communicate, form relationships with others, and respond appropriately to the external world. The disorder becomes apparent in children generally by the age of 3.

Autism (sometimes referred to as “classical autism”) is the most common condition in a group of developmental disorders known as the autism spectrum disorders.

Other autism spectrum disorders include:

• Childhood disintegrative disorder
• Asperger syndrome
• Rett syndrome
• Pervasive developmental disorder not otherwise specified (usually called PDD-NOS).

Experts estimate that three to six children out of every 1,000 will become autistic. Males are four times more likely to be autistic than females. Autistic girls with tend to have more severe symptoms and greater cognitive impairment.

Common Autistic Behaviors

Autism is characterized by three distinctive behaviors. Autistic children:

• Display problems with verbal and nonverbal communication
• Have difficulties with social interaction
• Exhibit repetitive behaviors or narrow, obsessive interests.

Some autistic people can function at a relatively high level, with speech and intelligence intact. Others have serious cognitive impairments and language delays, and some never speak.

In addition, autistic individuals may seem closed off and shut down, or locked into repetitive behaviors and rigid patterns of thinking. An autistic infant may avoid eye contact, seem deaf, and abruptly stop developing language. The child may act as if unaware of the coming and going of others, or physically attack and injure others without provocation. Autistic infants often remain fixated on a single item or activity, rock or flap their hands, seem insensitive to burns and bruises, and may even mutilate themselves.

The Importance of Autism Aducation

Early and intensive autism education can help children grow and learn new skills. The goal of this education is to help with the difficult symptoms of autism in a child and to improve the child’s skills that help him or her talk, interact, play, learn, and care for his or her needs.

Where to Find Education for those with Autism

For every child eligible for special programs, each state guarantees special education and related services. The Individuals with Disabilities Education Act (IDEA) is a federally mandated program that assures a free and appropriate public education for children with diagnosed learning deficits. Usually, children are placed in public schools, and the school district pays for all necessary services. These will include, as needed, services provided by the following:

• Speech therapists
• Occupational therapists
• School psychologists
• Social workers
• School nurses
• Aides.

By law, the public schools must prepare and carry out a set of instruction goals or specific skills for every child in a special education program. The list of skills is known as the child’s Individualized Education Program (IEP). The IEP is an agreement between the school and the family on the child’s goals. When your child’s IEP is developed, you will be asked to attend the meeting. Several people will be at this meeting, including a special education teacher, a representative of the public schools who is knowledgeable about the program, other individuals invited by the school or by you (you may want to bring a relative, a child care provider, or a supportive close friend who knows your child well). Parents play an important part in creating the program, as they know their child best. Once your child’s IEP is developed, a meeting is scheduled once a year to review your child’s progress and to make any alterations to reflect his or her changing needs.

If your child is under three years of age, he or she should be eligible for an early intervention program; this program is available in every state. Each state decides which agency will be the lead in the early intervention program. These services are provided by workers qualified to care for toddlers with disabilities and are usually in the child’s home or a place familiar to the child. The services provided are written into an Individualized Family Service Plan (IFSP) that is reviewed at least once every six months. The plan will describe services that will be provided to the child, but will also describe services for parents to help them in daily activities with their child and for siblings to help them adjust to having a brother or sister with an autism spectrum disorder.

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.