Asperger's syndrome

Article Abstract:

Frequently, a major difficulty in psychiatry is arriving at a correct diagnosis, particularly in children. Increased clinical experience and new research often suggest that certain previously unlinked disorders actually form a spectrum of a single disease entity, while a previously single diagnosis is better broken down into subclasses. Asperger's syndrome was described in 1944 as a disorder predominantly affecting boys, in which social interactions and dialogue, but not language, were effected. While intelligent, creative, and having specific restricted interests, affected individuals were not able to conform to ordinary situations, as found in school life. In spite of this rather specific description, Asperger's syndrome has not been listed as a subcategory in recent classifications of disease. Rather, it has been classified as a part of infantile autism, which itself has been listed as a subcategory of pervasive developmental disorders. An autism spectrum disorder has now been proposed, in which Asperger's syndrome would represent high-functioning autistic individuals. In this issue, Professor Cox disputes this new classification and suggests that, for a variety of reasons, Asperger's syndrome should stand apart from the classification of autism. Cox's opinion is supported by this commentary by Wolff, who reviews studies of children affected by Asperger's syndrome. Wolff suggests that these children's difficulties are constitutional, not caused willfully or by the parents, and the children frequently have some characteristics reminiscent of the schizophrenia spectrum. With special school and other arrangements, many may develop into adults capable of work and marriage, although overall adjustment may be poorer than in others. The author suggests that correct diagnosis is important, to allow better understanding of these disorders and to provide affected children with understanding, appropriate treatment, and access to resources so that they may develop to their maximum potential. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Identification and classification, Childhood mental disorders, Child psychopathology, Child psychiatry

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Childhood autism: its diagnosis, nature, and treatment

Article Abstract:

An American psychiatrist named Leo Kanner described the first cases of childhood autism in 1943. Children with autism do not interact well with other children and they have difficulty establishing relationships. They do not show emotion and do not understand the concept of friendship. Autism is diagnosed based on three main classes of symptoms: lack of social interaction; slow speech development; and repetitive behavior, such as rocking back and forth. These symptoms usually appear within the first two and a half years of life. The exact cause of autism is unknown, but it is though to involve some form of brain damage and it may be genetic. It is a rare condition that affects approximately 4 out of every 10,000 children and it is more common in boys than in girls. Approximately half of the children with an intelligence quotient (IQ) less than 50 show signs of autism. The best predictor of a good outcome is an IQ of 50 at the preschool age and the ability to communicate through speech by the age of six. The early symptoms of autism tend to disappear with age and the children with IQs within the normal range for their age can recover, although the number of children who do recover is small. A recent study of 16 autistic children with an average IQ of 92 reported that four had recovered by the age of 26 and were living independently, four others were independent, six needed minimal supervision, and seven had graduated from college. However, six had symptoms of hallucinations, paranoid thinking or schizophrenia. Treatment of autism requires getting the child to develop language and social interaction skills, and eliminating the child's repetitive behaviors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment

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Is Asperger's syndrome a useful diagnosis?

Article Abstract:

A common difficulty in psychiatry is arriving at the correct diagnosis, particularly in children. There is ongoing debate about whether autism and Asperger's syndrome, which are similar, should be viewed as separate disorders. Asperger's syndrome was first described in 1944 as a disorder predominantly affecting boys, in which social interactions and dialogue, but not language, were impeded. While patients are intelligent, creative, and have specific interests, they are not able to conform to ordinary situations, as occur in school life. In spite of this rather specific description, Asperger's syndrome has not recently been listed as a subcategory in classifications of disease. Rather, it has been considered part of infantile autism, which itself has been listed as a subcategory of pervasive developmental disorders. An autism spectrum disorder has now been proposed, in which Asperger's syndrome would represent high-functioning autistic individuals. In this article, this new classification is disputed, and the author suggests that, for a variety of reasons, Asperger's syndrome should stand apart from the classification of autism. The controversies surrounding the diagnosis of Asperger's syndrome and autism, and the possible deficits associated with each (particularly social and language abnormalities) are reviewed. Retention of these individual diagnoses is important because it allows for better treatment and parental understanding of the problem. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical examination, Physiological aspects, Developmental disabilities

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