This profile was developed as a concept and introduced to the world by British psychiatrist Lorna Wing in the 1980s. The term derives from a 1944 study by Austrian paediatrician Hans Asperger (new evidence about his problematic history has recently been revealed and provoked a big debate).
People with Asperger syndrome see, hear and feel the world differently to other people. If you have Asperger syndrome, you have it for life – it is not an illness or disease and cannot be ‘cured’. Often people feel that Asperger syndrome is a fundamental aspect of their identity.
Autism is a spectrum condition. All autistic people share certain difficulties, but being autistic will affect them in different ways. Some people with Asperger syndrome also have mental health issues or other conditions, meaning people need different levels and types of support.
People with Asperger syndrome are of average or above average intelligence. They don’t have the learning disabilities that many autistic people have, but they may have specific learning difficulties. They have fewer problems with speech but may still have difficulties with understanding and processing language.
With the right sort of support, all can be helped to live a more fulfilling life of their own choosing.
How common is Asperger syndrome?
Autism, including Asperger syndrome, is much more common than most people think. There are around 700,000 autistic people in the UK – that’s more than 1 in 100. People with Asperger syndrome come from all nationalities and cultural, religious and social backgrounds, although it appears to affect more men than women.
How do people with Asperger syndrome see the world?
Some people with Asperger syndrome say the world feels overwhelming and this can cause them considerable anxiety.
In particular, understanding and relating to other people, and taking part in everyday family, school, work and social life, can be harder. Other people appear to know, intuitively, how to communicate and interact with each other, yet can also struggle to build rapport with people with Asperger syndrome. People with Asperger syndrome may wonder why they are ‘different’ and feel their social differences mean people don’t understand them.
Autistic people, including those with Asperger syndrome, often do not ‘look’ disabled. Some parents of autistic children say that other people simply think their child is naughty, while adults find that they are misunderstood.
A diagnosis is the formal identification of the condition, usually by a multi-disciplinary diagnostic team, often including a speech and language therapist, paediatrician, psychiatrist and/or psychologist. Because Asperger syndrome varies widely from person to person, making a diagnosis can be difficult. It is often diagnosed later in children than autism and sometimes difficulties may not be recognised and diagnosed until adulthood.
Benefits of a diagnosis
Some people see a formal diagnosis as an unhelpful label, but for many, getting a timely and thorough assessment and diagnosis may be helpful because:
- it helps people with Asperger syndrome (and their families, partners, employers, colleagues, teachers and friends) to understand why they may experience certain difficulties and what they can do about them
How Asperger syndrome is diagnosed?
The characteristics of Asperger syndrome vary from one person to another, but in order for a diagnosis to be made, a person will usually be assessed as having had persistent difficulties with social communication and social interaction and restricted and repetitive patterns of behaviours, activities or interests since early childhood, to the extent that these “limit and impair everyday functioning”.
Read more about diagnostic criteria and the triad of impairments theory.
Persistent difficulties with social communication and social interaction:
Autistic people, including those with Asperger syndrome, have difficulties with interpreting both verbal and non-verbal language like gestures or tone of voice. Many have a very literal understanding of language, and think people always mean exactly what they say. They may find it difficult to use or understand:
- facial expressions
- tone of voice
- jokes and sarcasm
- abstract concepts.
People with Asperger syndrome usually have good language skills, but they may still find it hard to understand the expectations of others within conversations, perhaps repeating what the other person has just said (this is called echolalia) or talking at length about their own interests.
It often helps to speak in a clear, consistent way and to give people time to process what has been said to them.
People with Asperger syndrome often have difficulty ‘reading’ other people – recognising or understanding others’ feelings and intentions – and expressing their own emotions. This can make it very hard for them to navigate the social world. They may:
- appear to be insensitive
- seek out time alone when overloaded by other people
- not seek comfort from other people
- appear to behave ‘strangely’ or in a way thought to be socially inappropriate.
They may find it hard to form friendships. Some may want to interact with other people and make friends, but may be unsure how to go about it.
Restricted and repetitive patterns of behaviours, activities or interests :
REPETITIVE BEHAVIOUR AND ROUTINES
The world can seem a very unpredictable and confusing place to people with Asperger syndrome, who often prefer to have a daily routine so that they know what is going to happen every day. They may want to always travel the same way to and from school or work, or eat exactly the same food for breakfast.
The use of rules can also be important. It may be difficult for someone to take a different approach to something once they have been taught the ‘right’ way to do it. They may not be comfortable with the idea of change, but may be able to cope better if they can prepare for changes in advance.
Many people with Asperger syndrome have intense and highly-focused interests, often from a fairly young age. These can change over time or be lifelong, and can be anything from art or music, to trains or computers. An interest may sometimes be unusual. One person loved collecting rubbish, for example. With encouragement, the person developed an interest in recycling and the environment.
Many channel their interest into studying, paid work, volunteering, or other meaningful occupation. People with Asperger syndrome often report that the pursuit of such interests is fundamental to their wellbeing and happiness.
People with Asperger syndrome may also experience over- or under-sensitivity to sounds, touch, tastes, smells, light, colours, temperatures or pain. For example, they may find certain background sounds, which other people ignore or block out, unbearably loud or distracting. This can cause anxiety or even physical pain. Or they may be fascinated by lights or spinning objects.
Different names for autism
Over the years, different diagnostic labels have been used, such as autism, autism spectrum disorder (ASD), autism spectrum condition (ASC), classic autism, Kanner autism, pervasive developmental disorder (PDD), high-functioning autism (HFA), Asperger syndrome and Pathological Demand Avoidance (PDA). This reflects the different diagnostic manuals and tools used, and the different autism profiles presented by individuals.
Because of recent and upcoming changes to the main diagnostic manuals, ‘autism spectrum disorder’ (ASD) is now likely to become the most commonly given diagnostic term. Asperger syndrome remains a useful profile for many diagnosticians and professionals.
CAUSES AND CURE
Causes of Asperger syndrome
The exact cause of autism (including Asperger syndrome) is still being investigated. Research into causes suggests that a combination of factors – genetic and environmental – may account for differences in development. It is not caused by a person’s upbringing, their social circumstances and is not the fault of the individual with the condition.
Is there a cure?
There is no ‘cure’ for Asperger syndrome. However, there is a range of strategies and approaches which people may find to be helpful.
Problematic history of Hans Asperger
Asperger syndrome shares its name with Hans Asperger, a prominent figure in the early research into autism who worked as a paediatrician in Austria in the 20th century, including during the time of the Nazis. An eight-year study into his relationship with the Nazi regime was published in 2018, concluding that he assisted in their euthanasia programme.
This provoked a big debate among autistic people and their family members, particularly those who identify with the term ‘Asperger’. We are listening closely to the response to this news so we can continue to make sure the language we use to describe autism reflects the preferences of autistic people and their families.
Could Asperger’s Syndrome be inherited?
Some research shows that there are strikingly similar features in first or second degree relatives on either side of the family, or the family history includes “eccentric” individuals who have a mild expression of the syndrome. There are also some families with a history of children with AS and classic Autism. Should a relative have had similar characteristics when younger, they have a unique advantage in helping the child – they know what they are going through. There is no formal identification of the precise means of transmission if the cause is genetic, but we do have some suggestions as to which chromosomes may be involved. As our knowledge of genetics improves, we may soon be able to predict the recurrence rate for individual families.
Could a difficult pregnancy or birth have been a cause?
Some studies state that quite a high percentage of cases had a history of natal conditions that might have caused damage. But, in general, pregnancy may well have been unremarkable. However, the incidence of obstetric abnormalities is high. No one factor can be identified, but labour crises and neonatal problems are recorded with a significant number of children with AS. There is also a greater incidence of babies who are small for gestational age, and mothers in the older age range. It is recognised that there are three principal causes of Asperger’s Syndrome – genetic factors, unfavourable genetic events, and infections during pregnancy or early infancy that affect the brain.
Is there a specific area of the brain that is Dysfunctional?
There is increasing evidence to suggest that the frontal and temporal lobes of the brain are dysfunctional.
Could we have caused the condition?
Asperger’s Syndrome is not caused by emotional trauma, neglect or failing to love your child. The research studies have clearly shown that AS is a developmental disorder due to a dysfunction of specific structures and systems of the brain. These structures may not have fully developed due to chromosomal abnormalities or may have been damaged during pregnancy, birth or the first few months of life.
Can Asperger’s Syndrome occur with another disorder?
The simple answer to this question is YES. The symptoms of AS have been recognised in people with other conditions and disorders. Once a single diagnosis of AS is confirmed, it is wise to continue the diagnostic process to see if there is another specific medical condition associated with the AS.
What is the difference between the syndrome and the normal range of abilities and personality?
The normal range of abilities and behaviour in childhood is quite extensive. Many children have a shy personality, are not great conversationalists, have unusual hobbies and are a little clumsy. However, with AS the characteristics are qualitatively different. They are beyond the normal range and have a distinct pattern (see diagnostic scale in Information Sheets).
Could the pattern be secondary to a language disorder?
If a young child has difficulty understanding the language of other children and cannot speak as well as their peers, then it would be quite understandable for them to avoid interactions and social play, as speech is an integral part of such activities. However, the child with AS has more complex and severe social impairments, which identify the syndrome from other disorders.
Can Asperger’s Syndrome occur with Attention Deficit Disorder?
These are two distinct conditions, but it is possible for a child to have both. They have specific differences, but there are some similarities, and a child can have a dual diagnosis and require treatment for both conditions.
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