Asperger's syndrome

introduction

a developmental disorder which in DSM V will be included with autism spectrum disorder (ASD) as it is difficult to distinguish from high-functioning autism (HFA)
the Austrian pediatrician Hans Asperger in 1944 studied and described children in his practice who:
- lacked nonverbal communication skills
- demonstrated limited empathy with their peers
- and were physically clumsy
the term came into existence in 1981 and became a standardized diagnosis in the early 1990's which is distinguished by a pattern of symptoms rather than a single symptom.
prevalence of AS appears to be ~0.26 per 1,000 (~ 1/5th the prevalence of ASD)
behavior is usually apparent by age 5 or 6
it is characterized by:
- qualitative impairment in social interaction
  - lack of demonstrated empathy is possibly the most dysfunctional aspect
  - lack of social or emotional reciprocity
  - impaired nonverbal behaviors in areas such as eye contact, facial expression, posture, and gesture
  - social awkwardness
- stereotyped and restricted patterns of behavior, activities and interests
  - pursuit of specific and narrow areas of interest is one of the most striking features of AS
  - individuals with AS may collect volumes of detailed information on a relatively narrow topic such as weather data or star names, without necessarily having a genuine understanding of the broader topic
  - a lack of interest in fiction and a positive preference towards non-fiction is common among adults with AS
- no clinically significant delay in cognitive development or general delay in language, however they often have specific language abnormailities such as:
  - verbosity
  - abrupt transitions
  - literal interpretations and miscomprehension of nuance
  - use of metaphor meaningful only to the speaker
  - auditory perception deficits
  - unusually pedantic, formal or idiosyncratic speech
  - oddities in loudness, pitch, intonation, prosody, and rhythm
individuals with AS often have excellent auditory and visual perception, and enhanced perception of small changes in patterns
may be delayed in acquiring skills requiring motor dexterity and may be poorly coordinated, or have an odd or bouncy gait or posture, poor handwriting, or problems with visual-motor integration
more likely to have sleep problems, including difficulty in falling asleep, frequent nocturnal awakenings, and early morning awakenings
they often have difficulty in identifying and describing one's emotion
most children improve as they mature to adulthood, but social and communication difficulties may persist

aetiology

there appears to be genetic factors on the paternal side