Asperger Syndrome

Mety Tri Nurnuzulawati, S.Psi., M.Psi, Psikolog

Definition Asperger Syndrome

Asperger syndrome, also known as Asperger's syndrome or Asperger's disorder, is a neurodevelopmental disorder characterized by impairments in social interaction and communication, as well as restricted and repetitive patterns of behavior and interests. It was first described by Hans Asperger, an Austrian pediatrician, in 1944.

Asperger syndrome is considered to be a variant or milder form of autism spectrum disorder (ASD). It is clinically differentiated from autism and high-functioning autism by the absence of clinically delayed speech .

Some common comorbidities associated with Asperger syndrome include:

1.  Attention deficit hyperactivity disorder (ADHD)
2. Anxiety disorders
3. Depression
4. Obsessive-compulsive disorder (OCD) 
5. Bipolar disorder
6. Specific learning disabilities
7. Tourette syndrome
8. Epilepsy 
9. Sleep disorders 
10. Gastrointestinal issues (such as irritable bowel syndrome) 

These comorbidities often coexist with Asperger syndrome and can have a significant impact on an individual's overall functioning and quality of life.

Symptoms Asperger Syndrome

Asperger syndrome (AS) is characterized by several key characteristics and symptoms. These include:

1. Impairments in social interaction: Individuals with AS often have difficulty understanding and engaging in social interactions. They may struggle with nonverbal communication cues, have difficulty maintaining eye contact, and struggle with understanding social norms and expectations.  
2. Narrow and restrictive interests: People with AS often have intense and specific interests in certain topics or activities. They may spend a significant amount of time and energy focused on these interests, often to the exclusion of other activities.
3. Repetitive routines: Individuals with AS may have a strong need for routine and predictability. They may become upset or anxious if their routines are disrupted or changed. 
4. Motor clumsiness: Many individuals with AS may have difficulties with coordination and motor skills. They may appear clumsy or awkward in their movements. 
5. Speech and language peculiarities: While individuals with AS typically have normal intelligence, they may exhibit peculiarities in their speech and language. This can include a formal or pedantic style of speaking, a lack of understanding of sarcasm or humor, and difficulties with pragmatics and social communication. 

It is important to note that these characteristics and symptoms can vary widely among individuals with AS, and not all individuals will exhibit every symptom. Additionally, it is crucial to consult with a healthcare professional for a comprehensive evaluation and diagnosis. 

Asperger syndrome is diagnosed through a comprehensive evaluation that includes a thorough medical and developmental history, observation of behavior, and standardized assessments. The criteria used for diagnosis may vary slightly depending on the diagnostic manual being used, such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD).

The DSM-5, which is the current edition, provides the following criteria for diagnosing Asperger syndrome:

1. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following:

• Deficits in social-emotional reciprocity, such as abnormal social approach, failure of normal back-and-forth conversation, and reduced sharing of interests, emotions, or affect.
• Deficits in nonverbal communicative behaviors used for social interaction, such as poorly integrated verbal and nonverbal communication, abnormalities in eye contact and body language, and deficits in understanding and using gestures.
• Deficits in developing, maintaining, and understanding relationships, such as difficulties adjusting behavior to suit various social contexts, difficulties in sharing imaginative play or making friends, and absence of interest in peers.

2. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following:

• Stereotyped or repetitive motor movements, use of objects, or speech.
• Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior.
• Highly restricted, fixated interests that are abnormal in intensity or focus.
• Hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment.

3. Symptoms must be present in the early developmental period.

4. Symptoms cause clinically significant impairment in social, occupational, or other important areas of functioning.

5. These disturbances are not better explained by intellectual disability or global developmental delay.

It is important to note that the diagnosis of Asperger syndrome requires the presence of symptoms in the absence of clinically delayed speech. Additionally, the evaluation may also include assessments of cognitive abilities, language skills, and adaptive functioning to provide a comprehensive understanding of an individual's strengths and challenges.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Anurogo, D., & Ikrar, T. (2015). Asperger Syndrome. CDK-225, 42(2), 106.

Mazzone, L., Ruta, L., & Reale, L. (2012). Psychiatric comorbidities in Asperger syndrome and high functioning autism: Diagnostic challenges. Annals of General Psychiatry, 11(1), 16.