Asperger's Syndrome

Symptoms

Although there are many possible symptoms of Asperger’s syndrome, the main symptom is severe trouble with social situations. Your child may have mild to severe symptoms or have a few or many of these symptoms. Because of the wide variety of symptoms, no two children with Asperger's are alike.

Symptoms during childhood

Parents often first notice the symptoms of Asperger's syndrome when their child starts preschool and begins to interact with other children. Children with Asperger's syndrome may:

• Not pick up on social cues and lack inborn social skills, such as being able to read others' body language, start or maintain a conversation, and take turns talking.
• Dislike any changes in routines.
• Appear to lack empathy.
• Be unable to recognize subtle differences in speech tone, pitch, and accent that alter the meaning of others’ speech. Thus, your child may not understand a joke or may take a sarcastic comment literally. Likewise, his or her speech may be flat and difficult to understand because it lacks tone, pitch, and accent.
• Have a formal style of speaking that is advanced for his or her age. For example, the child may use the term “beckon” instead of “call,” or “return” instead of “come back.”
• Avoid eye contact.
• Have unusual facial expressions or postures.
• Be preoccupied with only one or few interests, which he or she may be very knowledgeable about. Many children with Asperger's syndrome are overly interested in parts of a whole or in unusual activities, such as doing intricate jigsaw puzzles, designing houses, drawing highly detailed scenes, or astronomy.²
• Talk a lot, usually about a favourite subject. One-sided conversations are common. Internal thoughts are often verbalized.
• Have delayed motor development. Your child may be late in learning to use a fork or spoon, ride a bike, or catch a ball. He or she may have an awkward walk. Handwriting is often poor.
• Have heightened sensitivity and become overstimulated by loud noises, lights, or strong tastes or textures. For more information about these symptoms, see sensory integration dysfunction.

Although the condition is in some ways similar to autism, a child with Asperger's syndrome typically has normal to advanced language and intellectual development. Also, those with Asperger's syndrome typically make more of an effort than those with autism to make friends and engage in activities with others.

Symptoms during adolescent and teen years

Most symptoms persist through the teen years, and although teens with Asperger's can begin to learn those social skills they lack, communication often remains difficult. They will probably continue to have difficulty "reading" others' behaviour.

Your teen with Asperger's syndrome (like other teens) will want friends but may feel shy or intimidated when approaching other teens. He or she may feel "different" from others. Although most teens place emphasis on being and looking "cool," trying to fit in may be frustrating and emotionally draining for teens with Asperger's. They may be immature for their age and be naive and too trusting, which can lead to teasing and bullying.

All of these difficulties can cause teens with Asperger's to become withdrawn and socially isolated and to have depression or anxiety.³

However, some teens with Asperger's syndrome are able to make and keep a few close friends through the school years. Some of the classic Asperger's traits may also work to the benefit of your teen. Teens with Asperger's are typically uninterested in following social norms, fads, or conventional thinking, allowing creative thinking and the pursuit of original interests and goals. Their preference for rules and honesty may lead them to excel in the classroom and as citizens.

Symptoms in adulthood

Asperger's syndrome is a lifelong condition, although it tends to stabilize over time, and improvements are often seen. Adults usually obtain a better understanding of their own strengths and weaknesses. They are able to learn social skills and how to read others' social cues. Many people with Asperger's syndrome marry and have children.

Some traits that are typical of Asperger's syndrome, such as attention to detail and focused interests, can increase chances of university and career success. Many people with Asperger's seem to be fascinated with technology, and a common career choice is engineering. However, scientific careers are by no means the only areas where people with Asperger's excel. Indeed, many respected historical figures have had symptoms of Asperger's, including Wolfgang Amadeus Mozart, Albert Einstein, Marie Curie, and Thomas Jefferson.

Other conditions

Many children with Asperger's syndrome also have coexisting conditions and may have symptoms of these conditions as well. They include:

• Attention deficit hyperactivity disorder (ADHD).
• Anxiety disorder.
• Depression, especially in adolescents.
• Non-verbal learning disorder.
• Obsessive-compulsive disorder (OCD).
• Social anxiety disorder.

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Author:	Carrie Henley Sabra L. Katz-Wise	Last Updated: June 28, 2006
Medical Review:	Michael J. Sexton, MD - Pediatrics Tom Bailey, MD - Family Medicine Fred Volkmar, MD - Child Psychiatry
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