KEY FEATURES OF ASPERGER'S DISORDER

(Note:  This paper was from a lecture By Dr. Clark given to Mental Health Professionals at Dixie Hospital in St. George Utah.)

Kids interpret many/most communications literally - and therefore fail to comprehend humor, sarcasm, idioms*, and generalities.

    *Adults use a lot of idioms in routine conversation.  A.D. kids often misunderstand due to         
      only literal interpretations, e.g.:
   *  Mom:  "That is as clear as mud1"
   *  Child:  "Mud isn't clear."

*  Personal hygiene is typically ignored or only partially performed by A.D> kids.  They often don't "get the point of it."

*  Attachment to parents and sibs usually is highly selective, e.g. to one parent, but not both.  "Split attachment" is common.

*  Attraction to other people ranges from little interest in anyone to XS XS fixation on one individual - to the point of imagined love and many or most cases of stalking.  This fixation can be very intense and may require legal measures - which often fail due to A.D. individuals having no sense of duty to follow legal restrictions!

*  Temper when fixations are blocked can be fierce, and resulting behavior can be violent.  This often requires Rx with neuroleptic meds e.g. Risperdal, Abilify, etc.

*  Odd sensitivities can be intense and socially disabling.  These odd reactions include (to mention a few) perceptions of light, taste, odors, touch, fabrics, noises, pitch and/or volume of music or speech, tone, and machine made sounds e.g. washing machines, vacuum cleaners, air blowers, and many other common life/household items.  Misinterpretation of parents' or teachers' "tone of voice" can trigger emotional outbursts, e.g. when an A.D> child perceives a parents "tone of voice" as being angry.

*  Many, perhaps most, A.D. children and adults are ultra time conscious and become upset when something in class or at home is not done at precisely the expected time, or for the wrong duration.  Most A.D. individuals are also pathologically "rule conscious," to the point of becoming upset when other people seemingly break something they interpret as a hard fast rule, like using 6 squares of toilet paper in one classic case.

***  Bear in mind seemingly "obsessional" ideas like these are not obsession of the kind we see in people with OCD.  When people who have OCD cannot relieve an obsession they become anxious.  When people who have A.D. are thwarted and cannot follow through on a fixation they become angry.

***  Some A.D. patients also have OCD

***  Almost all A.D. patients have ADHD

Incidence

*  CDC currently estimate +/- 1.2 - 1.5% of all boys and men have A.D., and an estimated 0.3 - 0.5% of all girls and women have A.D.

Origin

*  Most authorities currently conclude 80% of A.D. cases have a genetic origin, and all matter of autoimmune and related problems in fetal or early infantile development account for or contribute to the other 20%.

*  Please note:  Studies conducted worldwide have decisively disproven and relationship between A.D. and autism and Autism-Spectrum Disorders and immunization!

***  The "learning - related" appelationj "Non Verbal Learning Disorder" (NVLD) and the old term "High Functioning Autism" are Synonymous with A.D.

Treatment


*  Parent education
*  School / Teacher / Administrator education
*  Patient education regarding features of his/her condition to start as soon as possible
*  CBT - related therapy for parents and child
*  Medication:  To treat comorbid ADHD; to treat fixations by making them less intense; to treat significantly impairing anger / temper problems

Prognosis

*  Adequately treated children and adolescents can usually succeed in achieving good success in school (as many as 50% home-schooled or educated in private, specialized school).  Many A.D. adolescents and young adults are much more successful in college than elementary or secondary schools.

*  Most A.D. individuals are delayed in developing outside of home coping skills such as driving, using all forms of public transportation, being able to shop for themselves and of course in developing satisfying social relationships, and recreational interests.

Most A.D. individuals find some "niche" in which they can support themselves in the workplace.  This is usually a long struggle and vocational achievement is often substantially below family expectations.

*  Some A.D. individuals are truly disabled and require SSI assistance for many years, sometimes life long.