Asperger's Syndrome is a lifelong disorder that is characterized by severe difficulties in social communication, perception of the surrounding world, and a stereotypical, repetitive set of interests and activities.

Asperger's syndrome is one of the common developmental disorders. Thanks to statistical data, it has been established that boys are much more likely to suffer from Asperger's syndrome (about 80% of all registered cases).

Some scientists argue that this syndrome proves the existence of a significant difference in the functioning of the brain of men and women, and therefore men are more likely to be brilliant and talented.

It has been established that this mental disorder was noted in Einstein, Newton and the modern director Steven Spielberg.

Kinds

The term "Asperger's Syndrome" was proposed by psychiatrist Lorna Wing, who named social communication and adjustment disorders in honor of the pediatrician and psychiatrist Hans Asperger, who dealt with children with the listed mental dysfunctions.

Asperger himself called this syndrome autistic psychopathy.

.Until now, there is no consensus on how to call this symptom complex: a disorder or a syndrome. It was proposed to rename Asperger's syndrome into autism spectrum disease with its subdivision into degrees of severity. Asperger's Syndrome has much in common with autism, but is also fundamentally different from it.

Causes of the syndrome

The exact causes of Asperger's syndrome have not been established, but it is assumed that it has the same origins as autism.

The main role in the development of this disorder is assigned to heredity (genetic factor). Many cases are known when members of the same family have Asperger's syndrome in varying degrees of severity.

It is also believed that the occurrence of Asperger's syndrome is influenced by biological and teratogenic (harmful) factors that acted on the woman's body at the very beginning of pregnancy (there is a violation of the formation of neurofunctional connections in the brain).

In addition, exposure to environmental factors after birth is assumed, but this theory has no scientific support.

Manifestations of Asperger's symptom

Asperger's Syndrome is a "hidden disorder", which indicates that it is impossible to suspect that someone has this disease by appearance. Asperger's syndrome is characterized by the well-known "triad of disorders":

• social communication
• social interaction
• social imagination.

It is clear that children with Asperger's syndrome are significantly different from other children. Moreover, the child himself with this syndrome sooner or later notices that he is not like the others.

Social interaction or communication

First of all, this is expressed in the difficulty of understanding gestures, intonations and facial expressions (that is, difficulties in verbal communication).

A child with Asperger's Syndrome does not put into his speech different shades of tone in conversation, and does not understand the same in other children.

In appearance, a sick child seems indifferent and incapable of emotions. This leads to communication difficulties and an inability to make friends.

Such children cannot figure out how to choose a topic for conversation, and if it does take place, they cannot understand that it is time to end it or that it is not interesting for the interlocutor.

A child with Asperger's syndrome may use complex words and sentences without fully understanding their meaning, but, nevertheless, confuse the interlocutor with their knowledge.

Also, such children are characterized by a literal understanding of a particular phrase, so they do not have a sense of humor, do not understand veiled turns of speech (metaphors, idioms), irony and sarcasm.

People with Asperger's syndrome do not understand unwritten social laws (for example, you can not violate the living space, that is, stand too close to the interlocutor) or may start a dialogue on an unpleasant topic for a friend. They perceive the people around them as unpredictable and capable of confusing them.

Social interaction or cooperation

People with Asperger's Syndrome find it very difficult to form and maintain friendships. They do not understand that friendship requires such concepts as the ability to wait, empathize and sympathize, support each other, discuss not only topics that interest them, but also those that are interesting to a prospective friend.

Incorrectness, and often tactlessness in communication with others repels people from them. Over time, patients with Asperger's syndrome can learn the norms of behavior and the concepts of friendship, which is rather based not on understanding all of the above, but on intuitive copying (such patients have a very fine mental organization) of other people.

Often, patients with Asperger's syndrome offend others with their statements, without wanting or understanding it themselves.

social imagination

People with Asperger's Syndrome often have a rich fantasy and imagination. Such patients often become famous scientists, writers, musicians.

Their only difference from healthy people is that it is difficult for them to imagine and predict other options for the final.

It is difficult for them to understand the points of view of other people, as they differ from their own.

Make up a certain difficulty and the ability to interpret the feelings, intonations and thoughts of other people, as they do not perceive body language (gestures and facial expressions).

People with Asperger's Syndrome are not able to play creative or role-playing games, it is difficult for them to pretend and pretend to be someone. They prefer those games and activities that require logic and a sequence of actions (solving puzzles, mathematical problems, crossword puzzles).

Other signs of Asperger's Syndrome

• Love for order

Considering the world to be chaotic and disorderly, people with Asperger's syndrome try to establish a strict and definite order in their little world. They create certain strict rituals and rules, strictly comply with them and force others to obey this.

For example, the route to school or work should be the same, without any deviations and delays. Any shift in the rules they created can lead to severe anxiety, and even depression (rearrangement in the lesson schedule, change in the movement of the bus of a certain route).

• Narrow and obsessive interests

Individuals with Asperger's Syndrome tend to be over-focused and obsessed with collecting, hobbies, and other pursuits. Moreover, these interests are so narrow that they are incomprehensible to others.

For example, they can collect a collection of African tribal hymns, get carried away and analyze train schedules, and so on. Most often, interests are reduced to vehicles, computers, mathematics, astronomy and dinosaurs. Knowledge in the topic of interest to them is so deep that they work without difficulty and with brilliance in a particular area.

• Sensory disturbances (vision, hearing, smell, taste, touch)

Individuals with Asperger's are very sensitive and sometimes can't stand noise, bright lights, strong smells, and certain types of food. For example, the ticking of a clock, which a normal person does not perceive after a few minutes, becomes torture for them.

• Physical clumsiness

Children with Asperger's syndrome lag behind in the development of skills that require dexterity, such as swimming, cycling, and have difficulty developing fine motor skills (writing, cutting with scissors, and more).

Their coordination of movements suffers, the gait can be staggering and unsteady. Such individuals are not able to perform a certain sequence of small movements (for example, knitting or crocheting).

• Sleep problems

It is not uncommon for people with Asperger's Syndrome to have difficulty sleeping (trouble falling asleep, nocturnal awakenings, and getting up early in the morning).

Diagnostics

Asperger's syndrome is diagnosed between 4 and 11 years of age. The earlier the diagnosis is established, the less traumatic it is for both the family and the child himself.

To make a diagnosis, a group of specialists from various fields is involved (neurological, genetic examinations, intellectual tests, psychomotor skills, determination of the ability to live independently).

In addition, a mandatory conversation is held with parents and with the child himself (in the form of games and communication).

Treatment of Asperger's Syndrome

A psychiatrist is engaged in the correction and observation of people with Asperger's syndrome. It defines the tactics of management and non-drug therapy in each individual case of Asperger's syndrome. In the treatment, special trainings and tests are used to adapt a person to social life, which teach how to make friends, maintain and develop relationships with other people.

Psychotherapy is educational and psychological in nature, which allows people with Asperger's syndrome to learn to live with their diagnosis, deal with anxiety and fear, and even start a family.

Drug treatment is practically not used due to pronounced side effects, and is prescribed only in case of concomitant diseases (depression and anxiety neurosis).

Forecast

The prognosis for Asperger's syndrome is relatively favorable, and in some cases favorable.

The prognosis depends on the timely diagnosis and psychotherapeutic measures. About 20% of people, becoming adults, lose the "status" of a person with Asperger's syndrome. Moreover, science knows cases when some individuals with Asperger's syndrome became famous scientists, brilliant mathematicians, and some even received the Nobel Prize.

Asperger's disease is a distinct form of autism that is not characterized by mental retardation. Pathology is expressed by disturbances in the perception of the surrounding world, a clear limitation in interaction with society. The first begin to appear in children from the age of six. A timely diagnosis is the key to adequate psychological assistance, which helps to improve the quality of human life in the future.

The essence of the disease

In 1944, an English scientist, by whose name the disease was later named, began to observe children of different ages. During the study, Hans Asperger described the signs of behavior that distinguished children from their peers. The scientist was able to identify a number of specific patterns. For example, children with autistic psychopathy have a complete lack of interest in the surrounding reality. They try to live in their own world. Sparing speech and facial expressions do not allow understanding what such children think and feel. All these symptoms became the basis for the perception of the disease or Asperger's syndrome as a separate form of autism.

Scientists have not been able to accurately determine whether the pathology is a separate neurological disorder or a specific behavior. Why? The thing is that Asperger's is not accompanied by mental disorders. Later, psychologists developed a unique test to determine the level of intelligence. Its first results added to the controversy among scientists. In 90 children out of 100, high mental abilities were observed. They could build undeniable logical chains, solve serious mathematical problems in their minds. On the other hand, little patients were deprived of creativity, sense of humor, and imagination. As a result, there were difficulties in interacting with society.

Causes

Asperger's disease attracts the attention of scientists from all over the world. However, they still cannot name the exact reasons that trigger the mechanism of its development. Most experts adhere to the version of an etiology similar to autism. Therefore, among the main causes of Asperger's disease, it is customary to single out the following:

• hereditary and genetic predisposition;
• injuries received during childbirth;
• intoxication of the fetus during fetal development.

Modern methods of computer diagnostics and special testing make it possible to more accurately determine the causes of neurological dysfunction.

The classic triad of symptoms

In Asperger's psychiatry, it is customary to view illness through the prism of a triad of symptoms:

• communication problems;
• lack of creative component, emotions and experiences;
• difficulties in spatial perception of the world.

What other symptoms does Asperger's Syndrome have? Photos of small patients with such a diagnosis give a complete picture of the pathology. Its first symptoms begin to appear at an early age. For example, small children are annoyed by any harsh sound or strong smell. Many parents do not understand this reaction of the child, so it is rarely correlated specifically with Asperger's disease. With age, it is replaced by a non-standard understanding of the world around. Smooth and pleasant to the touch objects seem prickly, and a tasty dish is disgusting. The clinical picture is complemented by a clumsy gait, some physical awkwardness. Experts explain this phenomenon by excessive self-absorption.

Signs of the syndrome in children

In young patients up to six years of age, the pathology practically does not manifest itself. On the contrary, such children develop fully. They start talking and walking early, easily memorize new words. Sometimes they show amazing abilities for counting or foreign languages.

The main problem of children with Asperger's disease is communication disorders. Manifestations of social disability begin after six years. Usually this period coincides with the time when the child is sent to school. Among the main symptoms of pathology in young patients, the following can be distinguished:

• unwillingness to participate in active games with other children;
• a strong passion for a calm hobby that requires perseverance;
• dislike for funny cartoons due to loud sounds and music;
• lack of contact with new people and children.

A child with Asperger's disease is very attached to home and parents. A change in familiar surroundings can scare him. Such children feel comfortable only if household items always lie in their places. With minor changes in the daily routine, they literally fall into hysterics. For example, if the mother always picks up the child from school, but then the father arrives, an attack of uncontrollable hysteria may occur.

Asperger's syndrome in adults

Treatment of this disease begins with the appearance of the first symptoms. If, from an early age, parents, together with specialists, did not adjust communication skills, the pathology can progress. In adulthood, patients experience acute social isolation. They find it difficult to find a common language in a team, they cannot maintain friendly relations, they experience problems in their personal lives.

People with Asperger's Syndrome are never managers or senior executives. They may know the enterprise thoroughly, have a high level of intelligence, but prefer the usual routine work. Career success does not bother them at all. Moreover, often such people become real social outcasts due to seeming impoliteness. They refuse to follow the rules of etiquette when they do not see the point in them. Often make tactless remarks and interrupt the conversation, immersed in their own thoughts.

Why is Asperger's disease dangerous?

Dysfunctions detected at an early stage allow timely psychological correction. The disease practically does not pose a threat to human life. Children gradually adapt to the surrounding reality, many of them make progress in science. However, positive dynamics is not observed in all patients. Some find it difficult to find their purpose in adulthood, while others develop phobias. Therefore, parents should instill communication skills in the child from an early age so that in the future he can fully exist in harmony with the outside world.

Diagnostic methods

An experienced psychologist can confirm Asperger's disease based on behavioral observation and the patient's history. However, it is not always possible to determine the cause of the pathology solely by external characteristics. Often the clinical picture of the disease is similar to the character traits of an ordinary introvert. Therefore, in modern psychiatry, various tests are used to diagnose the syndrome. They allow to identify neurological disorders. Tests for adults and children with Asperger's disease vary in the complexity of the questions. In addition, they are conventionally divided into groups according to their purpose:

• assessment of the level of intelligence;
• characteristic of creative imagination;
• determination of sensory sensitivity.

Modern testing techniques through questions and image interpretation help to detect Asperger's disease at an early stage. Based on the results obtained, the doctor prescribes the appropriate treatment.

Therapeutic methods

First of all, patients suffering from manifestations of Asperger's syndrome require the advice of a qualified psychiatrist. The basis of treatment is the competent adaptation of children and adults to constantly changing living conditions. To combat nervous disorders, sedatives are additionally prescribed. In especially serious cases, treatment is not complete without the use of antidepressants. It is impossible to completely change the attitude of patients to society, but their behavior can be corrected and adapted. People diagnosed with Asperger's disease have extraordinary thinking, so they need to be explained in detail. Only in this case they will strive to overcome difficulties on their own.

And in this article, you can get acquainted with one of its specific forms - Asperger's syndrome. Patients with true autism differ from other people in disharmonious mental and intellectual development. They seem to live in their own world, and this peculiarity of them can be found out only when communicating with them. With Asperger's syndrome, the patient has no signs of mental disability. In patients with this diagnosis, there is a distortion of perception, which is not expressed in the form of hallucinations or illusions, a tendency to limit communication with society, and a lack of communication.

The facts in this article will help you get an idea of ​​this developmental disorder, you will learn about the dangers of Asperger's syndrome, how it manifests itself in children and adults, and ways to identify and treat this disorder.

In contrast to true autism, the syndrome can be detected only after 3-4 years (usually between 4-5 and 11 years). Such a late diagnosis is associated with the fact that before this age the child does not need to expand the circle of his contacts with society.

A bit of history

Children with Asperger's do not need to communicate with others, they live in their own world.

In 1944, the Austrian psychiatrist and pediatrician Hans Asperger described a group of children aged 8-18 who were distinguished by their limited empathy for peers, clumsiness, and lack of non-verbal communication abilities. The disorder he considered was called autistic psychopathy, and later a different term appeared in the ICD-10 - "schizoid disorder of childhood." Subsequently, in 1981, this developmental deviation was named after the doctor who described it - "Asperger's syndrome".

In the course of many years of research, the Austrian psychiatrist was able to identify the following features of the unusual development of the observed children:

• they completely lack the desire to communicate with society;
• children do not experience hallucinations or illusions, but live in their own world;
• facial expressions and speech of patients is poor, limited and does not make it possible to determine their emotional state.

Hans Asperger studied only the behavioral components and did not delve into the biological, genetic and neuropsychological aspects of this syndrome. The disorders identified by the doctor were not suitable for determining the disease in the “rank” of autism known at that time. Then such children became "outcasts" and such a restriction had a negative impact on their development and emotional state.

It was these factors that led Asperger to call this disorder "autistic psychopathy" and single it out as a special form of autism. Even now, psychologists and psychiatrists continue to argue about what is Asperger's syndrome - a specific neurological disorder or a form of autism? There is only one reason for such a debate - children with this disorder do not have a lag in intellectual development.

When conducting a test to assess the mental abilities of children with this syndrome, it was recorded that more than 80% of those tested have impressive intellectual abilities:

• some of them showed incredible aptitude for mathematics;
• others showed perfect hearing, phenomenal memory, etc.

Scientists have come to the conclusion that most children with Asperger's syndrome have extraordinary abilities. According to the observations of experts, this disorder is 4 times more common in boys.

Some people with this syndrome refer to themselves as "aspies".

A number of experts suggest that this disorder was present in such famous people:

• Socrates;
• Isaac Newton;
• Charles Darwin;
• Andy Warhole;
• Albert Einstein;
• Lewis Carroll;
• Marie Curie;
• Jane Austen.

Some sources report that it is possible that the syndrome in question is observed in the following of our contemporaries:

• Steven Spielberg;
• Dan Ackroyd.

What is the danger of the syndrome

All Asperger's autists, in whom the syndrome was detected in time and corrected in a timely manner, adapt well in society and their physical and mental state does not suffer in any way. Some "aspies" show their talents and become unsurpassed masters in one area or another. As a rule, they achieve high success in some kind of monotonous or delicate work, in the exact sciences.

In the absence of timely and correct correction in adulthood, Asperger's autists may face the following difficulties:

• various changes in the usual rhythm of life can lead to depression (including severe);
• development of phobic or obsessive states;
• exposure to exploitation by outsiders;
• inability to understand the possible consequences of some of their actions;
• impossibility of adaptation in society and falling into the marginal layers: social, economic, political, biological, age, ethnic, criminal, religious.

When correcting the disorders observed in the “aspie”, the child’s parents must understand that they are obliged not only to constantly visit a psychologist and do “homework” given by a specialist, but also learn to interact correctly and constantly with a small “patient”. The activity of adults surrounding the child with Asperger's syndrome acquires a significant part in psychotherapy and significantly improves the prognosis for a successful correction of this disorder.

• Many children with Asperger's Syndrome can attend regular classes, but in some cases, due to behavioral or social problems, parents of aspies may be advised to organize special education for the child.
• In adolescence, patients may encounter certain difficulties that are associated with difficulties in self-care, organization, romantic or social relationships.
• Subsequently, many "aspies" may experience difficulties in marriage or employment.

These and other problems in social adaptation in some cases lead individuals with Asperger's syndrome to the development of severe depressive states, which in some cases end in suicidal attempts or suicide. According to the observations of a number of experts, the frequency of such sad and tragic outcomes among aspies is increased, but large-scale studies in this area have not yet been conducted.

Prevalence

The mental development of children with Asperger's syndrome is not impaired.

So far, there are no reliable and unified data on the prevalence of the syndrome. According to the results of studies in 2003, the proportion of childhood autism was 0.03-4.84 per 1000 patients, and the ratio of this indicator to the prevalence of the disorder in question varied from 1.5 to 1 to 16 to 1.

British researchers from the National Autistic Society found that asperger autistics with an IQ of 70 or more is 3.6 per 1000 patients. An analysis carried out in 2007 by Finnish researchers according to various criteria shows the following prevalence of "aspie":

• according to DSM-IV - 2.5 per 1000 children;
• according to ICD-10 - 2.9 per 1000;
• according to Shatmari and co-authors - 1.6 per 1000;
• according to Gillberg and Peter Satmari - 2.7 per 1000;
• for any of the 4 criteria - 4.3 per 1000.

The geographic distribution of Asperger's syndrome is also not yet fully understood. According to observations in 2006, an increase in patients with such a diagnosis was noted among the child population of Silicon Valley, but in 2010 these data were different and the accumulation of "aspies" in regions with large industrial bases working in the field of IT technologies was not found. Along with this, the Californian researchers noted an increase in the number of aspergeria autistics in areas and families in which the parents of the children were more highly educated than in neighboring geographical divisions.

Positive aspects

Parents of a child who has been diagnosed with Asperger's Syndrome should not panic. This disorder can really complicate life, but among the little "aspies" there are many talented and capable children.

This is confirmed by the following facts:

• focus on details and a systematic type of thinking can help achieve success in some professions (for example, IT technologies, accounting, etc.);
• many autistic aspergers have excellent memories;
• isolation on their own internal interests can lead children to gain extensive knowledge or skills in a particular area, and in the future the child can become a leading expert and specialist;
• Autistic Aspergers can view the world from a special angle, and sometimes this gift helps them make discoveries and take creative approaches in different areas of activity.

Possible causes

So far, scientists and experts have not come to a common point of view regarding the causes that provoke the occurrence of this disorder. Most of them are inclined to believe that the "start" of the syndrome is caused by the same factors as childhood autism.

The main causes of Asperger's syndrome can be:

• fetal intoxication during fetal development;
• birth trauma;
• in an older child;
• genetic mutations;
• hereditary burden.

Today, computer programs help specialists to understand the possible root causes of the development of the syndrome and the essence of the disorder. Subsequently, thanks to these modern methods, they can plan further and more effective tactics for its correction (i.e., treatment).

The classic Asperger's triad of symptoms

Children with Asperger's syndrome find it difficult to interact with society, they have limited speech and there is a lack of emotions, an inability to express them.

Pathologists, psychotherapists and psychiatrists identify the following classic symptom complex in Asperger's syndrome:

• lack of emotions, inability to express them in verbal form and lack of creative thinking;
• the complexity of interacting with society and the impaired ability to communicate with people through speech;
• difficulties in the spatial and sensory perception of the environment.

The debut of the appearance of the above triad of symptoms can be observed even at an early age. A child may react by crying to sudden lights in a dark room or unpleasant odors, loud music or strong winds.

At an early age, it is difficult to differentiate the norm and pathology, which is expressed in the baby’s violent reaction to one or another irritant, and therefore belonging to the “aspie” is usually detected after the age of 5.

The above hypersensitivity reactions change with age, and it transforms. Sometimes they acquire a grotesque character and can interfere even with the patient himself. For example, in older adults, slightly uncomfortable or even comfortable clothing can cause discomfort and pain. In some patients, synesthesias are detected - conditions when the patient claims that sensations have sound, color, etc.

Aspies are extremely clumsy. This problem is caused by the fact that the external world of the patient is limited to his own body and all his experiences are directed inwards. As a result, patients are often distracted and do not notice people and objects around them on their way. However, when concentration is needed, people with Asperger's syndrome are able to intelligently control motor skills.

Manifestations in children

Starting from the age of 4-5 years, the following disorders can be detected in “aspie” children:

• refusal of group or active games;
• clumsiness;
• one-sided hobbies (usually calm and monotonous);
• dislike for typical cartoons due to a lack of understanding of the emotions broadcast in them, relationships or dislike for a loud sound range that irritates the child;
• a reaction of protest in contact with strangers (attempts to enter into a conversation with such a child may cause a reaction of protest or avoidance);
• the desire to play apart from peers with their toys.

Children with "aspie" syndrome are often called "home" and any change of scenery causes them pronounced discomfort, anxiety and anxiety. Even a change in the usual way of life within the family can provoke violent reactions in Asperger's autistic people, which at their peak can reach hysteria.

Manifestations in adults

In the absence of timely correction of the disorder in childhood, adolescents and adults with Asperger's syndrome show signs of maladaptation to society and prefer self-isolation. These problems show up in the following ways:

• the impossibility of establishing friendly or friendly contacts;
• inertia towards the opposite sex;
• inability to find points of contact with other people.

Aspie teenagers prefer to engage in monotonous and monotonous hobbies and are not interested in moving up the career ladder (for example, at school, university, etc.). They may score high on IQ tests, show deep knowledge in professiograms of various professions, but show no interest in the possibility of developing their abilities to reach higher levels.

Some male adolescents show signs of schizoidness:

• complete lack of sense of humor;
• one-sidedness of thinking when perceiving aphorisms and proverbs (that is, they understand them literally);
• inability to understand metaphors;
• lack of inclination to analyze events (cannot distinguish truth from lies).

These signs are not symptoms of schizophrenia. Their presence is explained by the lack of imagination, which is characteristic of the syndrome we are considering.

Difficulties in communicating with others that arise in the "aspie" can be perceived by people as rudeness or bad manners. Such an attitude is formed by such features of asperger's autistics:

• they say what they think and at the same time do not think about the appropriateness of the statement;
• can comment aloud on issues that public opinion has “decided” not to notice;
• ignore public etiquette, preferring personal comfort;
• cannot perceive the emotions that their interlocutor is trying to convey;
• do not know empathy;
• are able to get up and leave during a conversation without explaining the reason due to their own experiences;
• never interested in making a good impression (for example, on a girl, teacher, employer, etc.).

With age, Asperger's syndrome can acquire a malignant course and lead patients to absurd actions. Adult aspies tend to be hypochondriacal and suspicious. For example, during a visit to a surgeon, they may ask many questions about the sterility of gloves, the cleanliness of the walls of the office, the disposability of instruments, etc. Because of this behavior, others often perceive such people as boring or petty, and attempts at open criticism plunge Asperger autists into even great closure.

Possible additional disorders

Sometimes, along with Asperger's syndrome in children and adults, the following abnormalities are detected:

• hyperactivity disorder or attention deficit disorder;
• major depressive disorder or adjustment disorder with depressed mood;
• generalized anxiety disorder;
• defiant oppositional disorder;
• obsessive-compulsive disorder.

Diagnostics

Sometimes Asperger's syndrome can be very similar to severe introversion, but a highly trained psychologist is able to detect the need to differentiate these conditions. For a more detailed diagnosis, psychometric tests are used, which allow not only to identify the disorder considered in this article, but also to determine its severity. There are many such methods, and each of them has its own focus (target group). Conventionally, such tests can be divided into:

• a test to assess sensory sensitivity and motor skills;
• test for intellectual development;
• projective and clinical methods;
• test to determine creativity.

The following test methods can be used to detect the syndrome:

• ASQQ;
• RAADS-R;
• Aspie Quiz;
• Toronto Asperger Scale.

All of the above tests can be performed by specialists - psychologists or psychiatrists - and are not suitable for self-diagnosis. In addition to them, the doctor can use additional methods for examining patients with Asperger's syndrome.

Treatment

The purpose of the correction of this syndrome is aimed at mitigating its manifestations and better adaptation of the patient in society. It can be carried out by a psychotherapist or psychiatrist. The tactics of treatment is always chosen strictly individually and takes into account the personal characteristics of the patient.

Non-drug therapy

Teaching the patient empathy, skills, and social engagement is the main goal of therapy. To achieve these goals, the doctor may prescribe the following treatment methods:

• social skills training - to get more progressive interactions with others;
• occupational therapy and exercise therapy - to improve sensory abilities and coordination of movements;
• cognitive behavioral therapy - to eliminate fears, repetitive routines ("rewind") and explosive emotions;
• speech therapy consultations - to gain the skills to conduct a normal dialogue;
• trainings for parents and members of the aspi family;
• treatment and depression.

Medical treatment

Medicines for this syndrome are prescribed only if it is necessary to relieve depressions or neurotic conditions arising against the background of the disorder. They should be used with caution, as their side effects can be difficult to assess in such a disorder.

To eliminate neurotic and depressive conditions, the following can be prescribed:

• specific antidepressants.

Which doctor to contact

If hypersensitivity to external stimuli and isolation are detected, the child's parents should contact a pediatrician, psychotherapist or psychiatrist. To make a diagnosis and exclude possible neurological pathologies, the doctor may prescribe a number of additional studies.

Asperger's syndrome is one of the five main forms of childhood autism. This disorder has not yet been sufficiently studied by specialists, but with timely correction, children can socialize well enough and achieve some success in various fields of activity. For the treatment of such a deviation, various psychotherapeutic methods and, in especially difficult cases, drugs can be prescribed to eliminate the complications that arise against the background of the disease and concomitant disorders and diseases.

An autism spectrum disorder characterized by specific difficulties in social interaction. Children with Asperger's syndrome experience problems with non-verbal communication, making and maintaining friendships; prone to the same type of behavior and actions; have inhibited motor skills, stereotyped speech, narrowly focused and, at the same time, deep interests. The diagnosis of Asperger's syndrome is established on the basis of psychiatric, clinical, neurological examination data. Children with Asperger's syndrome need to develop social interaction skills, psychological and pedagogical support, medical correction of the main symptoms.

ICD-10

F84.5

General information

Asperger's Syndrome is a common developmental disorder related to high-functioning autism, in which the ability to socialize remains relatively intact. According to the classification accepted in modern psychiatry, Asperger's syndrome is one of the five autism spectrum disorders, along with early childhood autism (Kanner's syndrome), childhood disintegrative disorder, Rett's syndrome, nonspecific pervasive developmental disorder (atypical autism). According to foreign authors, signs that meet the criteria for Asperger's syndrome are found in 0.36-0.71% of schoolchildren, while this syndrome remains undiagnosed in 30-50% of children. Asperger's syndrome is 2-3 times more common among the male population.

The syndrome was named after the Austrian pediatrician Hans Asperger, who observed a group of children with similar symptoms, which he himself described as "autistic psychopathy." Since 1981, the name "Asperger's syndrome" has been assigned to this disorder in psychiatry. Children with Asperger's syndrome have poorly developed abilities for social interaction, behavioral problems, learning difficulties, and therefore require increased attention from educators, child psychologists and psychiatrists.

Causes of Asperger's Syndrome

The study of the causes of Asperger's syndrome continues to the present day and is far from complete. So far, the primary morphological substrate and pathogenesis of the disease have not been identified.

As a working hypothesis, it is suggested that an autoimmune reaction of the maternal organism, causing damage to the fetal brain, is put forward. There is a lot of talk about the negative effects of preventive vaccinations, the negative impact of mercury-containing preservatives in vaccines, as well as complex vaccination, which allegedly overloads the child's immune system. The theory of hormonal failure in a child (low or high levels of cortisol, elevated testosterone levels) has not yet found reliable scientific confirmation; the relationship between autistic disorders, including Asperger's syndrome, and prematurity, attention deficit hyperactivity disorder, is being studied.

Likely risk factors for the development of Asperger's syndrome are called genetic predisposition, male sex, exposure to toxic substances on the developing fetus in the first months of pregnancy, intrauterine and postnatal viral infections (rubella, toxoplasmosis, cytomegaly, herpes, etc.).

Characteristics of Asperger's Syndrome

Social difficulties in children with Asperger's syndrome

Asperger's syndrome is a complex general (pervasive) disorder that affects all aspects of a child's personality. The structure of the disorder includes difficulties in socialization, narrowly focused but intense interests; features of speech profile and behavior. Unlike classical autism, children with Asperger's syndrome have an average (sometimes above average) intelligence and a certain lexicographic base.

Typically, the characteristic signs of Asperger's syndrome become noticeable by 2-3 years of age and can range from moderate to severe. In infancy, Asperger's syndrome can be manifested by increased calmness of the child or, on the contrary, irritability, mobility, sleep disturbance (difficulty falling asleep, frequent awakenings, sensitive sleep, etc.), selectivity in nutrition. Communication disorders specific to Asperger's syndrome appear early. Children attending a kindergarten hardly part with their parents, do not adapt well to new conditions, do not play with other children, do not enter into friendly relations, preferring to stay apart.

Difficulties in adaptation make the child vulnerable to infections, so children with Asperger's syndrome are often ill. In turn, this further limits the social interaction of children with peers, and by school age, the signs of Asperger's syndrome become pronounced.

Disorder of social behavior in children with Asperger's syndrome is manifested in insensitivity to the emotions and feelings of other people, expressed by facial expressions, gestures, shades of speech; inability to express one's own emotional state. Therefore, children with Asperger's syndrome often appear self-centered, callous, emotionally cold, tactless, unpredictable in their behavior. Many of them do not tolerate the touch of other people, practically do not look into the eyes of the interlocutor, or look with an unusual fixed gaze (as if at an inanimate object).

The greatest difficulty a child with Asperger's syndrome experiences when communicating with their peers, preferring the company of adults or young children. During interaction with other children (joint games, problem solving), a child with Asperger's syndrome tries to impose his own rules on others, does not compromise, cannot cooperate, does not accept other people's ideas. In turn, the children's collective also begins to reject such a child, which leads to even greater social isolation of children with Asperger's syndrome. Teenagers have a hard time enduring their loneliness, they may experience depression, suicidal tendencies, drug and alcohol addiction.

Features of intelligence and verbal communication in children with Asperger's syndrome

The intelligence quotient in children with Asperger's syndrome may be within the age range or even exceed it. However, when teaching children, an insufficient level of development of abstract thinking and the ability to comprehend is revealed, as well as the lack of the skill of independent problem solving. With a phenomenal memory and encyclopedic knowledge, children sometimes cannot adequately apply their knowledge in the right situations. However, Aspergers often excel in areas they are passionate about: usually history, philosophy, geography, mathematics, and programming.

The range of interests of a child with Asperger's syndrome is limited, but they give themselves passionately and fanatically to their hobbies. At the same time, they overly focus on details, concentrate on trifles, “fixate” on their hobby, constantly stay in the world of their thoughts and fantasies.

In children with Asperger's syndrome, there is no tempo delay in the development of speech, and by the age of 5-6, their speech development is significantly ahead of their peers. The speech of a child with Asperger's Syndrome is grammatically correct, but is characterized by a slow or accelerated pace, monotony and unnatural timbre of the voice. Excessive academic and bookish style of speech, the presence of speech patterns contribute to the fact that the child is often called the "little professor".

Children with Asperger's Syndrome can talk for a very long time and in detail about a subject of interest to them, without monitoring the reaction of the interlocutor. Often they are not able to be the first to start a conversation and maintain a conversation that goes beyond their area of ​​​​interest. That is, despite potentially high speech skills, children are not able to use language as a means of communication. Semantic dyslexia, rote reading without reading comprehension, is common in children with Asperger's Syndrome. At the same time, children may have an increased ability to express their thoughts in writing.

Features of the sensory and motor sphere of children with Asperger's syndrome

Children with Asperger's syndrome are characterized by a disorder of sensory sensitivity, which manifests itself in increased susceptibility to various visual, sound, tactile stimuli (bright light, the sound of dripping water, street noise, touching the body, head, etc.). From childhood, Aspergers are distinguished by excessive pedantry and stereotyped behavior. Children follow routine rituals from day to day, and any change in conditions or procedures leads them to confusion, causes anxiety and anxiety. Very often, children with Asperger's syndrome have well-defined gastronomic preferences and categorically reject any new dishes.

A child with Asperger's syndrome may have unusual obsessive fears (fear of rain, wind, etc.) that are different from the fears of children their age. At the same time, in dangerous situations, they may lack the instinct of self-preservation and the necessary caution.

As a rule, a child with Asperger's syndrome has impaired motor skills and coordination of movements. They take longer than their peers to learn how to fasten buttons and tie shoelaces; at school they have uneven, sloppy handwriting, which is why they receive constant comments. Asperger children may have stereotypical compulsive movements, clumsiness, a "special" child at various stages of his life. Despite the fact that children with Asperger's syndrome can attend a general education school, they need individualized learning conditions (organization of a stable environment, creating motivation conducive to academic success, accompanying a tutor, etc.).

The developmental disability is not completely overcome, so a child with Asperger's syndrome grows into an adult with the same problems. In adulthood, a third of patients with Asperger's syndrome are able to live independently, create a family, and work at a regular job. In 5% of individuals, the problems of social adaptation are fully compensated and can only be detected with the help of neuropsychological testing. Particularly successful are people who have found themselves in areas of interest, where they show a high level of competence.

Asperger's Syndrome is one of five common (pervasive) developmental disorders, sometimes referred to as a form of high-functioning autism (that is, autism in which the ability to function is relatively preserved). Simply put, individuals with Asperger's Syndrome are rare and do not appear to be mentally retarded. They have at least normal or high intelligence, but non-standard or underdeveloped social abilities; often because of this, their emotional and social development, as well as integration, occur later than usual.

The term "Asperger Syndrome" was proposed by the English psychiatrist Lorna Wing in a 1981 publication. The syndrome was named after the Austrian psychiatrist and pediatrician Hans Asperger, who himself used the term "autistic psychopathy".

In most people with autism, and especially children, developmental delay can be easily detected. They give the impression of being "retarded", even though their IQ levels are often well above average. But there are people who can be called autistic by similarity, but do not come across as mentally retarded, people whose high development of certain skills is more striking than the deficit in communication, social behavior and imagination. Their verbal communication, in particular, is quite well developed - it is this type of developmental disorder that was described by Hans Asperger and named, in his honor, Asperger's syndrome.

The most common and important characteristics of Asperger's syndrome can be divided into several broad categories: social difficulties; narrow but intense interests; strangeness of speech and language. There are other features of this syndrome, which, however, are not always considered mandatory for its diagnosis. It should be noted that this chapter reflects mainly the position of Attwood, Gillberg, and Wing regarding the most important characteristics of the syndrome; The DSM-IV criteria (Diagnostic and Statistical Manual of Mental Illness published by the American Psychiatric Association) present a somewhat different view of things.

The social impairments encountered in Asperger's Syndrome often do not have the same severity as in low-intelligence autism. Egocentrism with little or no desire or ability to interact with peers is a hallmark of the disorder. Characteristics are social naivete, excessive truthfulness, and embarrassment after remarks made by unfamiliar adults or children.

While there is no single trait that all people with Asperger's share, difficulties in social behavior are almost universal, and are probably the most important criterion that defines the condition. People with Asperger's do not have the natural ability to see and feel the subtext of social interaction. As a result, a person with Asperger's syndrome can, for example, offend others with his own words, although he did not intend to offend anyone at all: he simply does not feel the boundaries of what is permitted in this situation. Often people with Asperger's are also unable to communicate their own emotional state.

Non-autistic people are able to get a lot of information about the cognitive (mental) and emotional state of others based on the context of communication, facial expressions and body language, but this ability is not developed in people with Asperger's syndrome. This is sometimes called "social blindness" - the inability to create a model of the thoughts of another mind in your own. It is difficult or impossible for them to understand what exactly the other person means, unless he speaks directly (i.e. "read between the lines"). It's not because they can't come up with an answer, but because they can't choose between possible answers - an individual with "social blindness" can't gather enough information to do so, or doesn't know how to interpret the information gathered.

People with Asperger's syndrome are "blind" to other people's gestures and nuances of speech, so they only notice what was said, and in a literal sense. For example, a person may not feel other people's bodily boundaries and stand too close, literally "hanging" over the interlocutor and causing irritation in him.

Along with this difficulty in "reading" other people's non-verbal (non-verbal) messages, most people with Asperger's syndrome have difficulty expressing their own emotional state with "body language", facial expressions and intonation to the extent that most people are capable of. They have the same or even stronger emotional reactions than most people (although they do not always emotionally react to the same things), the difficulty is in expressing emotions, although to an external observer it may seem that they are devoid of emotions.

Many people with Asperger's syndrome may have difficulty making eye contact. Many make very little eye contact, as it overwhelms them emotionally; others make eye contact with an unemotional, "staring" look that may seem uncomfortable to other people. Gazing is mostly unusual, and Asperger himself emphasized its fixed nature, due to the fact that in people with Asperger's syndrome, when they look at another person, the part of the brain that normally perceives visual signals when looking at an inanimate object fires. Gesticulation can also be almost absent or, conversely, look exaggerated and out of place.

It is also worth noting that because the syndrome is classified as a spectrum disorder, some people with Asperger's may have a near-normal ability to interpret facial expressions and other subtle forms of communication. However, most people with Asperger's Syndrome are not naturally gifted with this ability. They have to learn social skills with the help of the intellect, as a result of which social development is delayed.

According to some scholars, many of the social difficulties of autistic people are more correctly characterized as mutual misunderstandings between autistic and non-autistic people. Just as it is difficult for an autistic person to understand the body language of a non-autistic person, it is also difficult for a non-autistic person to understand the body language of an autistic person. Some autistics claim that the body language of other autistics is much easier for them to understand than the body language of non-autistics. In this case, the misunderstanding between autistics and non-autists can be compared to the misunderstanding between people of different cultures.

In at least some cases, "lack of social skills" may simply be an unwillingness to interact with other people. Even if the person is unable to interpret facial expressions, etc., reluctance to communicate may be an additional factor. If a non-autistic person may consciously avoid contact with a certain person because of the evil that he has done to him, or for moral reasons, then a person with Asperger's syndrome may not want to communicate with anyone, except perhaps for some one person about whom he very high opinion.

Asperger's Syndrome can include intense and obsessive (obsessive) levels of focusing on objects of interest. Also typical are examples of interests, when a person intensively studies or is overly interested in subjects that may seem strange for his age or cultural development. For example, a child in early school age has a special interest in "dead composers". It was this hobby that interested psychotherapists so much that for 2 years they tried to analyze the content and meaning of it, without coming to a meaningful conclusion. This boy's real interest was in CDs. He liked to watch them spin on the turntable. Like many others with Asperger's, he dreamed of a "complete collection" of CDs. One way to achieve this was to focus on dead composers: if they died, then at least he could be sure that they would no longer write a single piece of music.

Particularly popular interests: vehicles and transport (for example, trains), computers, mathematics, astronomy, dinosaurs. These are all normal interests of ordinary children; the unusualness lies in the intensity of interest. Sometimes these interests persist throughout life, other times they change at unpredictable points in time. In any case, there is usually one or two interests present at any given time. In their area of ​​interest, people with Asperger's syndrome are often very subtle, capable of almost obsessive concentration, and exhibit phenomenal, sometimes even eidetic, memory. Hans Asperger called his young patients "little professors" because, in his opinion, his thirteen-year-old patients had the same comprehensive and subtle understanding in their areas of interest as university professors. But, unfortunately, due to the unwillingness of people with Asperger's syndrome to establish contacts with other people, especially those close in age, and also because of the inability (or unwillingness) to communicate their thoughts to others, extensive knowledge of various sciences is destined to remain in the depths. their mind.

Not all physicians fully agree with this characterization; for example, both Wing and Gillberg argue that there is often mere rote learning rather than real understanding of areas of interest, although sometimes the opposite is true. It is worth noting that this detail does not play a role in the diagnosis, even according to Gillberg's own criteria.

When a person with Asperger's is doing what interests him, he does not see or hear anything, in the truest sense of the word, demonstrating a rare competence in the chosen area. Outside of their areas of interest, people with Asperger's are often quite lazy. In their school years, many of them are perceived as smart but underachieving, clearly capable of surpassing their peers in their area of ​​interest, but constantly lazy to do homework (sometimes even in their area of ​​interest). Others, on the contrary, are able to excel in all subjects and are highly motivated to excel their peers. This makes it difficult to diagnose the syndrome. In serious cases, the combination of social problems and narrow interests can lead to peculiar behavior, for example, when meeting a stranger, a person with Asperger's syndrome, instead of introducing himself, as is customary, starts a long monologue about his special interest. However, as adults, they sometimes overcome their laziness and lack of motivation and develop a tolerance for new activities and new people. Even those who manage to integrate into society continue to experience the discomfort of the alienity of their social role that they repress in themselves. Many latent Asperger's autistics fight a secret battle with themselves throughout their lives, disguising themselves and adapting to the environment and adapting it to themselves.

People with Asperger's Syndrome are often distinguished by a very pedantic manner of speaking, using more formal and structured language than the situation deserves. A five-year-old child with this syndrome may regularly speak a language that would fit a university textbook, especially in their area of ​​interest. Asperger's language, despite the old-fashioned words and expressions, is grammatically correct.

The development of speech in a child is exceptionally early, developing slowly due to the typical Asperger's attachment to structure and unchanged life norms, or vice versa, somewhat late in comparison with brothers and sisters, after which it develops very quickly, so that at the age of 5-6 years, speech in any case, she looks correct, pedantic, precocious and overly adult-like. Often a child who remembers speech patterns may appear to understand the conversation. However, it is difficult or completely impossible for him to be a real conversationalist. Speech professionals commonly refer to this type of problem as semantic pragmatic impairment, meaning that despite normal or well-defined speech skills, there is an inability to use language to communicate in real life settings. The tone of the voice may be disturbed (too strong, hoarse, excessively low), the rate of speech is increased or decreased. Words are often spoken in an unnecessarily flat and monotonous way.

Another common (though not universal) symptom is literal understanding. Attwood gives the example of a girl with Asperger's Syndrome who one day received a phone call asking "Is Paul here?" Although the required Pavel was present in the house, he was not in the room, and after looking around to make sure of this, she answered "no" and hung up. The caller had to call back and explain to her that he wanted her to find Pavel and ask him to pick up the phone.

People with Asperger's Syndrome do not perceive those unwritten social laws that we learn from experience. These are just the people who, as in the well-known joke, to the question "How are you?" They really start talking about how they're doing. Or, on the contrary, knowing that the answer to the question for the interlocutor may seem too long - they are silent. And if you tell them "Call at any time", they can call at three in the morning with a clear conscience. The complete inability to understand hints and "read between the lines" complicates relations with others, but it must be remembered that the reverse side of this is honesty and straightforwardness. Many people with Asperger's do not know how to lie at all, and there is no need to fear intrigues on their part either.

Many people with Asperger's also use words specifically, including words that are newly invented or combined from the knowledge of the spoken language with the roots of the ancients from which it originated, as well as unusual combinations of words. They may develop a rare gift for humor (especially puns; puns; stanzas that sacrifice meaning to rhyme; satire) or writing books. (Another potential source of humor comes when they realize that their literal interpretations amuse others.) Some are so good at writing that they meet the criteria for hyperlexia (the ability to understand written language is above normal, but the ability to understand spoken language is below normal).

People affected by Asperger's Syndrome may also exhibit a range of other sensory, physiological, and developmental anomalies. Children with Asperger's Syndrome often show evidence of delayed development of fine motor skills. They may have a peculiar "waddling" or "chopping" posture when walking, and when walking they may hold their hands in an unusual manner, may be clumsy in their movements. Coordination of movements is impaired to a greater extent than fine motor skills. There may be difficulties in learning to ride a bike, swim, ski and skate. Aspergers give the impression of being extremely clumsy. This is especially noticeable in social settings, surrounded by many people.

Generally speaking, individuals with Asperger's Syndrome love order. Some researchers mention being forced into rigid daily rituals (of oneself or others) as one of the criteria for diagnosing this condition. Rituals may be "higher level" (and even more elaborate) than those found in autism. For example, one 10-year-old boy demanded that his parents drive him, his brother and sister in a car every Saturday morning so that he could, sitting in the back seat of the car, make entries in his diary, which determined whether they drove near each fountain in the center of their hometown. Apparently, the changes in their daily rituals are terrifying for at least some people with the condition.

Some people with Asperger's suffer from varying degrees of sensory overload, and may be pathologically sensitive to loud noises or strong smells, or dislike being touched - for example, some children with Asperger's have strong resistance to being touched on the head or having their hair disturbed. This sensory overload can exacerbate the problems children with Asperger's face at school, where the noise level in the classroom can become unbearable for them. Some also fail to block certain repetitive stimuli, such as the constant ticking of a clock. While most children will stop registering this sound within a short time, and can only hear it through willpower, children with Asperger's may become distracted, agitated, or even (in rare cases) aggressive if the sound is not stopped.

There seems to be a strong correlation between those with Asperger's or high-functioning autism and those with the INTP personality type (introversion, intuition, thinking/logical, perceiving/irrational) according to the Myers-Briggs Personality Type Indicator ( MBTI): Description 1, Description 2. Another theory states that Asperger's Syndrome is correlated with the INTJ (Introversion, Intuition, Thinking/Logic, Judgment/Rationality) personality type, while High Functioning Autism is correlated with the INFJ (Introversion, Intuition, Feeling) personality type. /ethics, judgment/rationality).

Almost 1/3 of people with Asperger's syndrome are able to do "normal" work and live independently, although they usually cannot do both. The most capable - 5% of the total number of patients - in many cases cannot be distinguished from normal people, but adaptation problems can be detected during neuropsychological testing.

Asperger's Syndrome usually results in problems in normal social interactions with peers. These problems can be very serious, especially in childhood and adolescence; children with Asperger's Syndrome are often victims of bullies, bullies and bullies at school because of their specific behaviors, speech and interests and because of their weak or immature ability to perceive and adequately and socially accept non-speech cues, especially in situations of interpersonal conflict . A child or teenager with Asperger's syndrome is often puzzled by the source of such mistreatment, not understanding what was done "wrong" ("out of line", "out of line"). Even later in life, many people with Asperger's complain of feeling that they are unwittingly becoming disconnected from the world around them.

Children with Asperger's Syndrome often show advanced abilities for their age in language, reading, math, spatial reasoning, music, sometimes reaching the level of "gifted"; however, as noted above, this may be counterbalanced by marked delays in development in other areas. These traits, taken together, can create problems for teachers and others in positions of authority or power. It may be relevant here that one of the social conventions that most people with Asperger's Syndrome ignore is respect for authority. Attwood notes their tendency to feel that all people should be treated equally, regardless of their position in society; A student with Asperger's may not show respect until he believes it has been earned. Many teachers will either not understand this attitude or will make a strong exception for it. Like most gifted children, a child with Asperger's may be considered "problematic" or "underachieving" by teachers. A child's extremely low tolerance and motivation for what they perceive as repetitive and unremarkable tasks (like typical homework) can easily be frustrating; the teacher may even consider the child to be arrogant, vindictive, and disobedient. Meanwhile, the child silently sits at a desk, feeling upset and unfairly offended, and often does not know how to express these feelings.

Asperger's syndrome does not doom a person to an unhappy life. The intense concentration and tendency to problem solve logically that are characteristic of Asperger's syndrome often give people with the syndrome a high level of ability in their area of ​​interest. When these special interests coincide with a materially or socially beneficial task, individuals with Asperger's Syndrome can often live in abundance. A child who is passionate about shipbuilding can grow up to become a successful ship carpenter.

On the other hand, many people with Asperger's Syndrome may become overly sensitive about the disruption of their daily rituals or the inability to express their special interests. For example, a child with Asperger's may be a gifted writer for his age and enjoy working on his stories during class. And the teacher may insist that the student, instead, be attentive in class or work on assigned homework. A non-autistic child in such conditions may be a little upset, but is likely to obey the teacher. For a child with Asperger's Syndrome, on the other hand, the ordeal can be extremely traumatic, and the reaction is to amaze the teacher and other children in the class: the normally withdrawn child suddenly becomes angry or upset out of proportion to the situation. Criticizing the child's actions at this point (for example, as immature or disrespectful) can greatly damage the child's self-esteem, which is already quite fragile.

Although many people with Asperger's syndrome do not achieve in their lives what is usually considered "success in society", and many of them remain lonely all their lives, they may well find understanding in other people and develop close relationships with them. Many autistic people have children, and these children may not have autism spectrum syndrome. Also, many people with Asperger's recognize their difficulties and try to adjust to life among people without Asperger's, even if they have never heard the term "Asperger's" or think it does not apply to them. A child with Asperger's Syndrome can, through training and self-discipline, become an adult who, although suffering from Asperger's Syndrome, is able to socially interact well with others. However, due to slow social development, people with Asperger's may sometimes feel most comfortable with people who are slightly younger than they are.

Partners and family members of people with Asperger's are often more depressed than the average population because people with Asperger's cannot spontaneously express sympathy and can be very literal; it can be difficult to connect with them emotionally. However, just because they don't show sympathy (or at least they don't do it in the usual way) doesn't mean that he or she doesn't feel it. Understanding this can allow the partner not to feel rejected. There are ways around these problems, such as not hiding your needs. For example, when describing emotions, one should speak directly and avoid fuzzy expressions such as "upset", when the emotion is more accurately described as "angry". It is often most effective to simply state in plain language what the problem is and ask the partner with Asperger's about their emotions and the reasons for the particular emotion. It is very helpful if a family member or partner reads as much as possible about Asperger's Syndrome and other comorbid disorders (such as those mentioned in this article).

One of the main problems of people with Asperger's syndrome is that others do not understand their characteristics and explain them as "abnormal", "eccentric" or "lazy". The problem is that they are expected to have the same standards and behavior as most people, and people on the autism spectrum themselves often make inadequate demands of themselves. It is important to understand that a person can be talented and successful at one thing and incompetent at another, even if it is something as simple as talking on the phone or just making small talk. However, it is important to understand this in relation to all people - we exaggerate our similarities and often overlook or discriminate against people with differences, and this applies not only to Asperger's syndrome.

Asperger's Syndrome is defined in Chapter 299.80 of the Diagnostic and Statistical Manual of Mental Illness (DSM-IV) as:

1. Qualitative difficulty in social interactions, as demonstrated by at least two of the following:
Marked impairments in the use of many nonverbal nuances of behavior, such as eye contact, facial expressions, body (posture), and gestures, to regulate social interaction.
Failure to develop relationships with peers to a developmental level.
Lack of spontaneous urge to share joy, interest, or achievement with other people (for example, not showing, bringing, or pointing out interesting items to other people).
Lack of social or emotional reciprocity.

2. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, exhibiting at least one of the following:
All-consuming preoccupation with one or more stereotyped and limited sets of interests, abnormal either in intensity or concentration.
Obviously inflexible adherence to specific, non-functional daily routines and rituals.
Stereotypical and repetitive motor movements (mannerisms) (for example, clapping or twirling with a finger or palm, or complex movements of the whole body).
Persistent preoccupation with details or objects.

3. This violation leads to clinically significant shortcomings in social, official and other important areas of activity.

4. There is no clinically significant general delay in speech development (i.e. single words are used by the age of two, connected phrases by the age of three).

5. There is no clinically significant delay in cognitive development, or in the development of age-appropriate self-care skills or adaptive behavior (excluding social interactions) and curiosity about the social environment in childhood.

6. Criteria for other specific Pervasive Developmental Disorder or schizophrenia are not met.

Please see the DSM cautionary statement. This handbook's diagnostic criteria have been criticized for being vague and subjective; a condition that one psychologist might define as "major" may be defined by another psychologist as very minor.

Christopher Gillberg, in Christopher Gillberg: A Guide to Asperger Syndrome (Cambridge: Cambridge University Press, 2002), also criticizes "no significant delay" turns in the DSM, and to a lesser extent some others; and argues that these phrases indicate a misunderstanding or oversimplification of the syndrome. He argues that although there may be significant delay in some areas of language development, it is often combined with exceptionally high functioning in other language-related areas, and argues that this combination only superficially resembles, but is in fact very different from, normal development. in language and adaptive behavior.

Partly due to its relatively recent appearance in the DSM, and partly due to differences of opinion such as Gillberg's, there are at least three other somewhat distinct sets of criteria used in practice besides the DSM-IV definition above. One of them is the work of Gillberg himself and his wife, and is also recommended by Attwood; among other differences, this definition emphasizes linguistic details not mentioned in the criteria in DSM-IV. Another definition is the work of a group of Canadian researchers, often referred to as the "Szatmari definition", after the first signing author of the publication in which these criteria first saw the light. Both of these definitions were published in 1989. The third definition, ICD-10, is very similar to the DSM-IV definition, and Gillberg criticizes it in the same way as the DSM-IV version.

Experts today generally agree that there is no single psychiatric condition called autism. Instead, there is a spectrum of autistic disorders, and different forms of autism occupy different positions on that spectrum. But in some circles of the autism community, this concept of "spectrum" is seriously questioned. If differences in development are solely the result of differential skill acquisition, then trying to distinguish between different "severities" can be dangerously misleading. An individual may be subjected to unrealistic expectations, or even be denied vital services based solely on very superficial observations made by others in that community.

In the 1940s, Leo Kanner and Hans Asperger, working independently in the United States and Austria, identified essentially the same population, although Asperger's group was perhaps more "socially functional" than Kanner's. Some of the children Kanner identified as autistic might be diagnosed with Asperger's today, and vice versa. To say that "Kanner's autistic child" is a child who sits and sways is a mistake. Kanner's subjects were from all parts of the spectrum.

Traditionally, Kanner's autism is characterized by significant deficits in cognitive and communication development, including delays or lack of speech. It is often quite clear that these people are not functioning normally. Individuals with Asperger's syndrome, on the other hand, do not show speech delays. This is a more subtle disorder, and affected individuals often just look eccentric.

Researchers are trying to tackle the problem of how to divide this spectrum. There are many different dividing lines, such as autistic people who can talk versus those who can't; autistics with and without seizures; autistics with more "stereotypical behaviors" versus those with less, and so on.

The spectrum of autistic disorders is also difficult to classify by the presence of certain genetic traits. A specific gene that causes autism has not been found. The question of the correlation of individual symptoms with certain mutations is now being studied more. Many genes have already been found, mutations in which can lead to autism. Macroscopic mutations occur in 1-2% of cases of autism, in another 10% minor mutations are recorded - gene duplications or deletions. For example, a mutation in the NOXA1 gene (NADPH oxidase) was localized; duplication in chromosome 15pter-q13.2; other. It is possible that autism develops in a complex, in the presence of many hereditary changes.

Some clinicians believe that communication and/or cognitive deficiencies are so central to the concept of autism that they prefer to consider Asperger's syndrome as a separate, distinct condition from autism. This is a minority opinion. Uta Frith, one of Kanner's early autism researchers, wrote that there seems to be more than a grain of autism in people with Asperger's syndrome. Others, like Lorna Wing and Tony Attwood, share Frith's conclusions. Dr. Sally Ozonoff of the Davis's MIND Institute at the University of California argues that there should be no dividing line between "high-functioning" autism and Asperger's, and that the fact that some individuals do not start talking until they are older is not the reason to separate the two groups, since both require exactly the same approach.

The possible causes and origins of Asperger's Syndrome are a hotly debated and controversial topic. The majority opinion, today, is that the causes of Asperger's syndrome are the same as those of autism. Some, however, do not agree with this, and argue that different things lead to Asperger's syndrome and autism. All of this is happening against the backdrop of an ongoing wider debate over whether Asperger's syndrome and other conditions (such as attention deficit hyperactivity disorder (ADHD)) are part of the so-called autism spectrum.

Among the many competing theories about the cause of autism (and therefore, as many believe, Asperger's syndrome) are the unconnectedness theory developed by cognition researchers at Carnegie Mellon University and the University of Pittsburgh, Simon Baron-Cohen's marginal male brain theory, -working autism, social construction theory and genetics.

Some theorists make more arguments in favor of Asperger's syndrome than autism. It is sometimes argued that certain particular theories play a more significant role in Asperger's syndrome, such as social construction theory and genetics. However, this is an area of ​​considerable controversy.

With the increase in the number of Asperger's syndrome diagnoses, its image continues to shift from a simple image of the disease to a more complex perception of the syndrome, with its own advantages and disadvantages; since there are adults diagnosed with Asperger's or autism who have been able to become very successful in their areas of expertise, perhaps as a direct result of the gifts of intelligence, above-average focus and motivation associated with the syndrome. For example, some prominent individuals diagnosed with Asperger's Syndrome are Nobel Prize-winning economist Vernon Smith, Dr. Temple Grandin, director Steven Spielberg, comedian Dan Aykroyd, and the Australian rock musician Craig Nichols (leader of The Vines).

Recently, some researchers, notably Simon Baron-Cohen and Ioann James, have suggested that famous people from the past such as Albert Einstein and Isaac Newton had Asperger's syndrome because they exhibited some of the behavioral tendencies characteristic of the syndrome, such as intense interest in one topic or social problem. One of the chapters of Gillberg's book mentioned deals with this topic, including a detailed analysis of the case of the philosopher Ludwig Wittgenstein, and concludes that his behavior meets the criteria for Asperger's syndrome. Naturally, the absence of a diagnosis during a person's lifetime does not imply that there was nothing to diagnose, especially if one bears in mind that at that time there was no widespread knowledge of the syndrome (as is often the case with Asperger's syndrome, which more recently was widely recognized in psychiatric circles). However, such post-mortem diagnoses remain controversial.

Arguments for alleged autism spectrum disorders in famous personalities vary from person to person. Some argue that in the case of Albert Einstein (one of the most frequently cited alleged autistics), he was a late talker, a lonely child, threw violent tantrums, silently repeated previously spoken sentences, and needed his wives to play the role of parents when he was an adult - stereotypical factors for an autistic individual. Isaac Newton stuttered and suffered from epilepsy. Many of these purported historical cases of Asperger's syndrome may have been fairly mild (nonexpressive), but some skeptics argue that these cases only show some of the features of autism and are not enough to diagnose the autism spectrum. After all, many critics of historical diagnostics argue that it is simply impossible to diagnose the non-living; and therefore nothing can be said with certainty about whether historical figures had Asperger's syndrome.

All of these assumptions may just be an attempt to create a role model for people with autism and demonstrate that they can do constructive things and contribute to society. Such presumptive diagnoses are often used by autism rights activists to show that a cure for autism would be a loss to society. However, other people in the autism rights movement don't like these arguments because they feel that people with autism should appreciate their uniqueness even if they don't want to be healed, whether or not people like Einstein were autistic.

Some features of appearance and facts of activity indicate that John Carmack is also a person with S.A., or has another non-standard personality type of a similar nature.

The alleged contributions to society by autistic individuals have contributed to the perception of autism spectrum disorders as complex syndromes rather than diseases that must be cured. Supporters of this view reject the concept that there is an ideal configuration of the brain, and that any deviation from the "norm" should be considered pathological. They demand tolerance for what they call their "neurodiversity" in the same way that gays and lesbians demanded tolerance for themselves. Such views are the basis of the "autistic rights and autistic pride" movements.

There is a controversial theory among fantasy fans that most of the hallmarks of their subculture can be explained by the fact that most of them have Asperger's syndrome. In addition, a Wired magazine article titled "The Geek Syndrome" suggests that Asperger's syndrome is more prevalent in Silicon Valley, considered heaven on earth for computer scientists and mathematicians. Which allowed it to evolve into a long-lived idea, popularized in periodicals and self-help books, that "Geek Syndrome" equals Asperger's Syndrome, and condensed a rain of hasty self-diagnosis; in particular because the magazine article was printed along with the 50 questions of the Simon Baron-Kohan Autism Spectrum Index Test. Like some people with Asperger's, geeks may show extreme professional or casual interest in computers, science, engineering, and related fields, and may be introverted, or prioritize work on other aspects of life. However, no one has yet tried to determine whether the Freak Syndrome personality type is directly related to autism, or if it is just a variant of the usual personality type that is not part of the autism spectrum.

Some people, including some diagnosed with Asperger's Syndrome, argue that the syndrome is a social construct. Professor Simon Baron-Kohan of the Center for Autism Research has written a book in which he argues that Asperger's syndrome is the extreme way in which men's brains differ from women's brains. He says that, generally speaking, men are more systematizing than women, and that women are more empathetic than men (Baron-Cohen, 2003). Hans Asperger himself is quoted as saying of his patients that they have "an extreme version of the masculine form of intelligence". The concept of masculine versus feminine intelligence, however, is controversial, and while the theory of biodeterminism is popular among psychology and sociology researchers in 2005, it remains theory, not proven fact.

As a category that claims to have a well-defined neurobiological foundation, Asperger's syndrome probably holds as much validity as a whole host of other psychiatric terms, such as Attention Deficit Hyperactivity Disorder, widely criticized by leading psychiatrists as eg Peter Breggin and Sami Timimi Sami Timimi; obsessive-compulsive disorder (OCD) (see OCD) and clinical depression, which are being heavily promoted by the growing psychiatric medical and pharmaceutical industries. All the behavioral traits associated with this condition are also manifested to varying degrees in the general population. People diagnosed with Asperger's Syndrome vary widely in terms of intellectual, occupational and social performance, range of interests, talkativeness, conformity, hypersensitivity, and more. While a small minority may be truly high-functioning autistics (with a lack of communication and attachment evident from early childhood), and there is considerable confusion about diagnosis among autism experts, there is no scientific evidence for an association between Kanner-type severe autism and eccentric or somewhat unfamiliar traits of many people in our society. Subtle differences in environment, somatic and neurological differences can influence our personality development and our socialization strategies. Among those diagnosed with Asperger's Syndrome, very many have a form of dyspraxia (difficulty in planning body movements), which leads in childhood to a preference for studying alone rather than with others. Much attention has been given to the central role played by the "theory of mind" model in categorizing the autism spectrum, but it is clear that there is enormous variation among the general population in the relative levels of social naivete and egocentricity. Many of our social skills are acquired in early childhood through attachment to our symbol of motherhood, and further through play with peers. Environmental factors that interfere with these formative processes can leave a lifelong imprint, causing some to move away from the social mainstream and become withdrawn, non-social individuals.

Another objection to this view is that while Asperger's is more common among men than among women, the personalities of women with Asperger's do not necessarily appear masculine, and some may show an exclusive interest in supposedly "feminine" or "right-brain" activities like the arts or dancing. However, going back, what is perceived as a "masculine personality" may not be what Baron-Cohen had in mind when talking about male intelligence, advancement in the arts and artistry can only be considered feminine due to certain social conventions. That the arts, or dancing, are perceived by some as feminine pursuits, clearly does not mean that the patient's interest in them is motivated or directed by an unsystematic (presumably "feminine" in Baron-Cohan's work) brain structure.

Many people with Asperger's Syndrome generally refer to themselves in everyday conversations with the milder "aspie", or "aspy". Others prefer "Aspergian", "Asperger's autistic" or no special names at all. Many who believe that there is no significant difference between Asperger's and autism due to their similar spectrum variations may prefer the term "autie" or simply "autistic" as a more general term.

To refer to themselves as a group, many people with Asperger's use the term "neurodivergent", which has its origins in the fact that Asperger's is considered a neurological disorder by medical professionals. To refer to people who are not autistic, many will use the term "neurotypical" or NT for short. In addition, people in search of a cure for autism are sometimes derisively referred to as "curebies".

In 2007, the feature film Ben X was shot by the Dutch director Nick Balthazar. The film fully reveals the problem of people with Asperger's syndrome. The hero suffering from this disease has become so immersed in the world of online games that the line between the real and the virtual world begins to blur. The whole picture is built on a mixture of frames from the game and real life. The film is based on real events.

In the sitcom The Big Bang Theory, protagonist Sheldon Cooper, a genius in physics and allied sciences, exhibits many of the characteristics of people with Asperger's syndrome, such as having difficulties in social life.

In 2009, a full-length cartoon Mary and Max was released about an 8-year-old girl from Australia and a 44-year-old man from New York, who has Asperger's syndrome. They corresponded for 18 years.

Excerpt from the case history of patient D.: “At the age of 19, D., working in a hotel, constantly looked in the mirror and smeared feces on the walls. At the same time, D. moved to live with a 71-year-old acquaintance whom he called “his girl”. They lived together for several years, and during this time D. repeatedly attacked his partner, injuring her."