Asperger syndrome: diagnosis and treatment
Asperger’s syndrome is included in the International Classification of Diseases ICD-10 among “severe developmental disorders”. By taking an anamnesis , it is possible to obtain important information for determining the diagnosis . At the same time, the doctor ( pediatrician ; child psychiatrist ) asks, for example, about the unusual course of pregnancy or childbirth and is interested in the child’s development to date.
At the same time, the doctor notices noticeable developmental signs (e.g. in movement, expression or interpersonal communication) and examines the child physically and neurologically . Diagnostics is extended by an EEG examination . Magnetic resonance imaging may also be necessary in case of neurological abnormalities . Vision and hearing should also be examined . Clinical psychologists (e.g. for clinical-psychological diagnosis) or speech therapists (for speech assessment) or doctors of other specialties can also take part in establishing the diagnosis .
During the diagnosis, emphasis should also be placed on the strengths of the affected person (e.g. what he is particularly good at, how he has been able to adapt to the syndrome so far ).
Questionnaires for testing
There are several screening questionnaires that can facilitate the diagnosis of Asperger syndrome in children. Special questionnaires are used for adults, such as the ASQ (the abbreviation comes from the English term Autism Spectrum Quotient ). However, screening questionnaires by themselves are not enough to establish a diagnosis, time and experience are necessary for diagnosis.
The Autism Diagnostic Interview (ADI-R) in combination with the Autism Diagnostic Observation Scale (ADOS, ADOS2) is considered key in the diagnosis of autism for the standardized recording of Asperger syndrome symptoms. ADOS is a structured procedure for recording communication, interaction and play behavior. Depending on the age and level of speech abilities of the patient in question, one of five modules is selected, which can examine symptoms relevant to the diagnosis of autism using purposefully staged game elements, activities and interviews. In addition, it absolutely belongs to the diagnostic standard of checking cognitive abilities (IQ test or developmental test).
Some studies point to the fact that the disability of the autism spectrum disorder remains more often unrecognized in female patients, or the diagnosis is established later – especially in the case of Asperger’s syndrome. It appears that girls with autism spectrum disorders must also exhibit more accompanying behavioral abnormalities and cognitive difficulties for the same severity of symptoms to be clinically diagnosed . This results in a diagnostic bias in favor of boys based on known behavioral criteria, or better adaptive abilities and compensatory mechanisms in affected girls.
Criteria for diagnosis
The criteria for a diagnosis of Asperger syndrome include the following:
- social behavior disability:
- lack of social understanding and the ability to empathize,
- difficulty making friends at school, work etc. and related problems such as bullying etc.
- inability to make and maintain adequate eye contact,
- deficiencies in facial expressions and body posture,
- deficiencies in the area of gestures regulating social interaction,
- problems with conducting a conversation and hypercorrect use of language , inappropriate emphasis on certain words,
- reduced ability to express feelings,
- limited but extremely powerful interests,
- stereotyped patterns of behavior that are repeated over and over or are always the same,
- possible delay in motor development.
Furthermore, other psychological or developmental disorders must be ruled out. In particular, the definition of autism is important .
Treatment of Asperger syndrome
Asperger syndrome cannot be cured. However, with the help of treatment measures, disabled people can learn to cope better with everyday life, while the individual’s development and strengths are enhanced. It is also possible to reduce psychological distress. Early treatment and development support have positive effects. The therapy is individually tailored to the given child/adult. Available course data suggest that symptoms may generally decrease with age.
Behavioral therapeutic measures
There are a number of therapy programs designed specifically for Autism Spectrum Disorders. Existing evidence indicates the highest effectiveness of behavioral therapy programs in the field of psychotherapy .
In many therapeutic programs focused on autism, methods from the field of learning theory are important pillars. Important behavioral therapy programs in the field of autism are the techniques of so-called discrete learning and modern applied behavioral analysis ABA (English Applied Behavior Analysis ), in preschool age EIBI (the abbreviation comes from the English name Early Intensive Behavioral Intervention ). The aim is to improve understanding of speech and expression, strengthen attention to social perceptions, build the ability to imitate, acquire (pre)school skills and achieve independence in carrying out everyday activities. In addition, structuring a daily routine , which is an important tool for planning daily activities, helps the disabled a lot .
Other treatment options
Other forms of treatment include special communication exercises, group games, early care , speech therapy , physiotherapy and occupational therapy . It is also possible to use music therapy . Medicines are used in case of accompanying psychological problems or physical diseases .
Who can I contact?
In case of suspicion of Asperger’s syndrome in children, seek a child psychiatrist , for very young children first a pediatrician .
In adulthood, you can turn to a neurologist or psychiatris
