   #copyright

Asperger syndrome

2007 Schools Wikipedia Selection. Related subjects: Health and medicine

   CAPTION: Asperger syndrome
   Classifications and external resources

     ICD- 10   F84.5
     ICD- 9    299.8
      OMIM     608638
   DiseasesDB  31268
   MedlinePlus 001549
    eMedicine  ped/147

   Asperger syndrome — also referred to as Asperger's syndrome,
   Asperger's, or just AS — is one of five neurobiological pervasive
   developmental disorders (PDD) that is characterized by deficiencies in
   social and communication skills. It is considered to be part of the
   autistic spectrum and is differentiated from other PDDs and from high
   functioning autism (HFA) in that early development is normal and there
   is no language delay. It is possible for people with AS to have
   learning disabilities concurrently with Asperger syndrome. In these
   cases, differential diagnosis is essential to identify subsequent
   support requirements. Conversely, IQ tests may show normal or superior
   intelligence, and standard language development compared with classical
   autism. The diagnosis of AS is complicated by the lack of adoption of a
   standardized diagnostic screen, and, instead, the use of several
   different screening instruments and sets of diagnostic criteria. The
   exact cause of AS is unknown and the prevalence is not firmly
   established, due partly to the use of differing sets of diagnostic
   criteria.

   Asperger syndrome was named in honour of Hans Asperger (1906-1980), an
   Austrian psychiatrist and pediatrician, by researcher Lorna Wing, who
   first used the eponym in a 1981 paper. In 1994, AS was recognized in
   the 4th edition of the Diagnostic and Statistical Manual of Mental
   Disorders (DSM-IV) as Asperger's Disorder.

   AS is often not identified in early childhood, and many individuals do
   not receive diagnosis until after puberty or when they are adults.
   Assistance for core symptoms of AS consists of therapies that apply
   behaviour management strategies and address poor communication skills,
   obsessive or repetitive routines, and physical clumsiness. Many
   individuals with AS can adopt strategies for coping and do lead
   fulfilling lives - being gainfully employed, getting married or having
   successful relationships, and having families. In most cases, they are
   aware of their differences and recognize when they need support to
   maintain an independent life. There are instances where adults do not
   realize that they have AS personalities until they are having
   difficulties with relationships and/or attending relationship
   counseling. Recognition of the very literal and logical thought
   processes that are symptomatic of AS can be a tremendous help to both
   partners in a close/family relationship.

Classification and diagnosis

   AS correlates with Asperger's Disorder defined in section 299.80 of the
   Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) by six
   main criteria. These criteria define AS as a condition in which there
   is:
    1. Qualitative impairment in social interaction;
    2. The presence of restricted, repetitive and stereotyped behaviors
       and interests;
    3. Significant impairment in important areas of functioning;
    4. No significant delay in language;
    5. No significant delay in cognitive development, self-help skills, or
       adaptive behaviors (other than social interaction); and,
    6. The symptoms must not be better accounted for by another specific
       pervasive developmental disorder or schizophrenia.

   AS is an autism spectrum disorder (ASD), one of five neurological
   conditions characterized by difference in language and communication
   skills, as well as repetitive or restrictive patterns of thought and
   behaviour. The four related disorders or conditions are Autism, Rett
   syndrome, childhood disintegrative disorder, and PDD-NOS (pervasive
   developmental disorder not otherwise specified).

   The diagnosis of AS is complicated by the use of several different
   screening instruments. The diagnostic criteria of the Diagnostic and
   Statistical Manual are criticized for being vague and subjective. Other
   sets of diagnostic criteria for AS are the ICD 10 World Health
   Organization Diagnostic Criteria, Szatmari Diagnostic Criteria,
   Gillberg Diagnostic Criteria, and Attwood & Gray Discovery Criteria.
   The ICD-10 definition has similar criteria to the DSM-IV version.
   Asperger's syndrome had at different times been called Autistic
   psychopathy and Schizoid disorder of childhood., although those terms
   are now understood as archaic and inaccurate, and therefore no longer
   accepted in common use.

   Some doctors believe that AS is not a separate and distinct disorder,
   referring to it as high functioning autism (HFA). The diagnoses of AS
   or HFA are used interchangeably, complicating prevalence estimates: the
   same child can receive different diagnoses, depending on the screening
   tool the doctor uses, and some children will be diagnosed with HFA
   instead of AS, and vice versa. Many experienced clinicians apply the
   early onset on High Functioning Autism or the regressive pattern of
   development as the distinguishing factor in differentiating between AS
   and HFA. The current classification of the pervasive developmental
   disorders (PDDs) is unsatisfying to many parents, clinicians, and
   researchers, and may not reflect the true nature of the conditions.
   Peter Szatmari, a Canadian researcher of PDD, feels that greater
   precision is needed to better differentiate between the various PDD
   diagnoses. The DSM-IV and ICD-10 focus on the idea that discrete
   biological entities exist within PDD, which leads to a preoccupation
   with searching for cross-sectional differences between PDD subtypes, a
   strategy which has not been very useful in classification or in
   clinical practice.

Characteristics

   AS is characterized by:
     * Limited interests or preoccupation with a subject to the exclusion
       of other activities;
     * Repetitive behaviors or rituals;
     * Peculiarities in speech and language;
     * Socially and emotionally inappropriate behaviour and interpersonal
       interaction;
     * Problems with nonverbal communication; and,
     * Clumsy and uncoordinated motor movements.

   The most common and important characteristics of AS can be divided into
   several broad categories: social impairments, narrow but intense
   interests, and peculiarities of speech and language. Other features are
   commonly associated with this syndrome, but are not always regarded as
   necessary for diagnosis. This section mainly reflects the views of
   Attwood, Gillberg, and Wing on the most important characteristics of
   AS; the DSM-IV criteria represent a slightly different view. Unlike
   most forms of PDDs, AS is often camouflaged, and many people with the
   disorder blend in with those that do not have it. The effects of AS
   depend on how an affected individual responds to the syndrome itself.

Social differences

   Although there is no single feature that all people with AS share,
   difficulties with social behaviour are nearly universal and are one of
   the most important defining criteria. People with AS lack the natural
   ability to see the subtexts of social interaction, and may lack the
   ability to communicate their own emotional state, resulting in
   well-meaning remarks that may offend, or finding it hard to know what
   is "acceptable". The unwritten rules of social behaviour that mystify
   so many with AS have been termed the " hidden curriculum". People with
   AS must learn these social skills intellectually rather than
   intuitively.

   Non- autistics are able to gather information about other people's
   cognitive and emotional states based on clues gleaned from the
   environment and other people's facial expression and body language,
   but, in this respect, people with AS are impaired; this is sometimes
   called mind-blindness.

   A person with AS may have trouble understanding the emotions of other
   people: the messages that are conveyed by facial expression, eye
   contact and body language are often missed. They also might have
   trouble showing empathy with other people. Thus, people with AS might
   be seen as egotistical, selfish or uncaring. In most cases, these are
   unfair labels because affected people are neurologically unable to
   understand other people's emotional states. They are usually shocked,
   upset and remorseful when told that their actions are hurtful or
   inappropriate. It is clear that people with AS do not lack emotions.
   The concrete nature of emotional attachments they might have (i.e., to
   objects rather than to people), however, often seems curious or can
   even be a cause of concern to people who do not share their
   perspective.

   Failing to show affection—or not doing so in conventional ways—does not
   necessarily mean that people with AS do not feel it. Understanding this
   can lead partners or care-givers to feel less rejected and to be more
   understanding. Increased understanding can also come from learning
   about AS and any comorbid disorders. Sometimes, the opposite problem
   occurs; the person with AS is unusually affectionate to significant
   others and misses or misinterprets signals from the other partner,
   causing the partner stress.

Speech and language differences

   People with AS typically have a highly pedantic way of speaking, using
   a far more formal register of language than appropriate for a context.
   A five-year-old child with this condition may regularly speak in
   language that could easily have come from a university textbook,
   especially concerning his or her special area of interest.

   Literal interpretation is another common, but not universal hallmark of
   this condition. Attwood gives the example of a girl with AS who
   answered the telephone one day and was asked, "Is Paul there?" Although
   the Paul in question was in the house, he was not in the room with her,
   so after looking around to ascertain this, she simply said "no" and
   hung up. The person on the other end had to call back and explain to
   her that he meant for her to find him and get him to pick up the
   telephone.

   Individuals with AS may use words idiosyncratically, including new
   coinages and unusual juxtapositions. This can develop into a rare gift
   for humor (especially puns, wordplay, doggerel and satire). A potential
   source of humor is the eventual realization that their literal
   interpretations can be used to amuse others. Some are so proficient at
   written language as to qualify as hyperlexic. Tony Attwood refers to a
   particular child's skill at inventing expressions, e.g., "tidying down"
   (the opposite of tidying up) or "broken" (when referring to a baby
   brother who cannot walk or talk).

   Children with AS may show advanced abilities for their age in language,
   reading, mathematics, spatial skills, or music, sometimes into the
   'gifted' range, but these talents may be counterbalanced by appreciable
   delays in the development of other cognitive functions. Some other
   typical behaviors are echolalia, the repetition or echoing of verbal
   utterances made by another person, and palilalia, the repetition of
   one's own words.

   A 2003 study investigated the written language of children and youth
   with AS. They were compared to neurotypical peers in a standardized
   test of written language skills and legibility of handwriting. In
   written language skills, no significant differences were found between
   standardized scores of both groups; however, in hand-writing skills,
   the AS participants produced significantly fewer legible letters and
   words than the neurotypical group. Another analysis of written samples
   found that people with AS appear to be able to write quantitatively
   similarly to their neurotypical peers using grammatical rules, but have
   difficulty in producing qualitative writing.

   Tony Attwood states that a teacher may spend considerable time
   interpreting and correcting an AS child's indecipherable scrawl. The
   child is also aware of the poor quality of his or her handwriting and
   may be reluctant to engage in activities that involve extensive
   writing. Unfortunately for some children and adults, high school
   teachers and prospective employers may consider the neatness of
   handwriting as a measure of intelligence and personality. The child may
   require assessment by an occupational therapist and remedial exercises,
   but modern technology can help minimize this problem. A parent or
   teacher aide could also act as the child's scribe or proofreader to
   ensure the legibility of the child's written answers or homework.

Narrow, intense interests

   AS can involve an intense and obsessive level of focus on things of
   interest. Particularly common interests are: means of transport (e.g.,
   trains), computers, foreign languages, mathematics, science fiction,
   fantasy, astronomy, geography, history, and dinosaurs. Note that many
   of these are normal interests in ordinary children; the difference in
   children with AS is the unusual intensity of their interest. Some have
   suggested that these "obsessions" are essentially arbitrary and lacking
   in any real meaning or context, but recent research has suggested that
   this isn't usually the case.

   Sometimes these interests are lifelong; in other cases, they change at
   unpredictable intervals. In either case, there are normally one or two
   interests at any given time. In pursuit of these interests, people with
   AS often manifest extremely sophisticated reasoning, an almost
   obsessive focus, and a remarkably good memory for trivial facts
   (occasionally even eidetic memory). Hans Asperger called his young
   patients "little professors" because he thought his patients had as
   comprehensive and nuanced an understanding of their field of interest
   as university professors.

   Some clinicians do not entirely agree with this description. For
   example, Wing and Gillberg both argue that, in children with AS, these
   areas of intense interest typically involve more rote memorization than
   real understanding, despite occasional appearances to the contrary.
   Such a limitation is an artifact of the diagnostic criteria, even under
   Gillberg's criteria, however.

   People with AS may have little patience for things outside these narrow
   interests. In school, they may be perceived as highly intelligent
   underachievers or overachievers, clearly capable of outperforming their
   peers in their field of interest, yet persistently unmotivated to do
   regular homework assignments (sometimes even in their areas of
   interest). Others may be hypermotivated to outperform peers in school.
   The combination of social problems and intense interests can lead to
   unusual behaviour, such as greeting a stranger by launching into a
   lengthy monologue about a special interest rather than introducing
   oneself in the socially-accepted way. However, in many cases adults can
   outgrow this impatience and lack of motivation and develop more
   tolerance to new activities and meeting new people.

Other differences

   Those affected by AS may show a range of other sensory, developmental,
   and physiological anomalies. Children with AS may evidence a slight
   delay in the development of fine motor skills. In some cases, people
   with AS may have an odd way of walking, and may display compulsive
   finger, hand, arm or leg movements, including tics and stims.

   In general, orderly things appeal to people with AS. Some researchers
   mention the imposition of rigid routines (on self or others) as a
   criterion for diagnosing this condition. It appears that changes to
   their routines cause inordinate levels of anxiety for some people with
   this condition.

   Some people with AS experience varying degrees of sensory overload and
   are extremely sensitive to touch, smells, sounds, tastes, and sights.
   They may prefer soft clothing, familiar scents, or certain foods. Some
   may even be pathologically sensitive to loud noises (as some people
   with AS have hyperacusis), strong smells, or dislike being touched; for
   example, certain children with AS exhibit a strong dislike of having
   their head touched or their hair disturbed while others like to be
   touched but dislike loud noises. Sensory overload may exacerbate
   problems faced by such children at school, where levels of noise in the
   classroom can become intolerable for them. Some are unable to block out
   certain repetitive stimuli, such as the constant ticking of a clock.
   Whereas most children stop registering this sound after a short time
   and can hear it only if they consciously attend to it, a child with AS
   can become distracted, agitated, or even (in cases where the child has
   problems with regulating emotions such as anger) aggressive if the
   sound persists. A study of parent measures of child temperament found
   that children with autism were rated as presenting with more extreme
   scores than typically-developing children.

History

   In 1944, an Austrian pediatrician named Hans Asperger observed four
   children in his practice who had difficulty integrating socially.
   Although their intelligence appeared normal, the children lacked
   nonverbal communication skills, failed to demonstrate empathy with
   their peers, and were physically clumsy. Their way of speaking was
   either disjointed or overly formal, and their all-absorbing interest in
   a single topic dominated their conversations. Dr. Asperger called the
   condition “autistic psychopathy” and described it as a condition
   primarily marked by social isolation. He also stated that "exceptional
   human beings must be given exceptional educational treatment, treatment
   which takes into account their special difficulties. Further, we can
   show that despite abnormality, human beings can fulfill their social
   role within the community, especially if they find understanding, love
   and guidance".

   Hans Asperger and Leo Kanner identified essentially the same
   population, although the group identified by Asperger was perhaps more
   "socially functional" than Kanner's. Traditionally, Kannerian autism is
   characterized by significant cognitive and communicative deficiencies,
   including delays in or lack of language. A person with AS will not show
   delays in language, however.

   Asperger’s observations, published in German, were not widely known
   until 1981, when an English doctor named Lorna Wing published a series
   of case studies of children showing similar symptoms, which she called
   “Asperger’s” syndrome. Wing’s writings were widely published and
   popularized. In 1992, the tenth published edition of the World Health
   Organization’s diagnostic manual and the International Classification
   of Diseases (ICD-10) included AS, making it a distinct diagnosis.
   Later, in 1994, the Diagnostic and Statistical Manual of Mental
   Disorders (DSM-IV) and the American Psychiatric Association’s
   diagnostic reference book also added AS.

   Uta Frith (an early researcher of Kannerian autism) wrote that people
   with AS seem to have more than a touch of autism to them. Others, such
   as Lorna Wing and Tony Attwood, share Frith's assessment. Dr. Sally
   Ozonoff, of the University of California at Davis's MIND Institute,
   argues that there should be no dividing line between "high-functioning"
   autism and AS, and that the fact that some people do not start to
   produce speech until a later age is no reason to divide the two groups
   because they are identical in the way they need to be treated.

Clinical perspective

Research

   Some research is to seek information about symptoms to aid in the
   diagnostic process. Other research is to identify a cause, although
   much of this research is still done on isolated symptoms. Many studies
   have exposed base differences in areas such as brain structure. To what
   end is currently unknown; research is ongoing, however.

   Peter Szatmari suggests that AS was promoted as a diagnosis to spark
   more research into the syndrome: "It was introduced into the official
   classification systems in 1994 and has grown in popularity as a
   diagnosis, even though its validity has not been clearly established.
   It is interesting to note that it was introduced not so much as an
   indication of its status as a 'true' disorder, but more to stimulate
   research ... its validity is very much in question."

Research into causes

   The direct cause(s) of AS is unknown. Even though no consensus exists
   for the cause(s) of AS, it is widely accepted that AS has a hereditary
   factor. It is suspected that multiple genes play a part in causing AS,
   since the number and severity of symptoms vary widely among
   individuals. Studies regarding the mirror neurons in the inferior
   parietal cortex have revealed differences which may underlie certain
   cognitive anomalies such as some of those which AS exhibits (e.g.,
   understanding actions, learning through imitation, and the simulation
   of other people's behaviour). Non-neurological factors such as poverty,
   lack of sleep, substance abuse by the mother during pregnancy,
   discrimination, trauma during early childhood, and abuse may also
   contribute.

   Other possible causative mechanisms include a serotonin dysfunction and
   cerebellar dysfunction. Simon Baron-Cohen proposes a model for autism
   based on his empathising-systemising (E-S) theory. The E-S theory holds
   that the female brain is predominantly hard-wired for empathy, while
   the male brain is predominantly hard-wired for understanding and
   building systems, and that AS is an extreme of the male brain.

Other research

   There are several studies linking autism with differences in
   brain-volumes such as enlarged amygdala and hippocampus. Current
   research points to structural abnormalities in the brain as a cause of
   AS. These abnormalities impact neural circuits that control thought and
   behaviour. Researchers suggest that gene/environment interactions cause
   some genes to turn on or turn off, or turn on too much or too little in
   the wrong places, and this interferes with the normal migration and
   wiring of embryonic brain cells during early development.

   Other finds include brain region differences, such as decreased gray
   matter density in portions of the temporal cortex which are thought to
   play into the pathophysiology of ASDs (particularly in the integration
   of visual stimuli and affective information), and differing neural
   connectivity. Research on infants points to early differences in
   reflexes, which may be able to serve as an "early detector" of AS and
   autism.

   Some professionals believe AS is not necessarily a disorder and thus
   should not be described in medical terms.

Treatment

   Treatment coordinates therapies that address the core symptoms of AS:
   poor communication skills, obsessive or repetitive routines, and
   physical clumsiness. AS and high-functioning autism may be considered
   together for the purpose of clinical management.

   A typical treatment program generally includes:
     * social skills training, to teach the skills to more successfully
       interact with others;
     * cognitive behavioural therapy, to help in better managing emotions
       that may be explosive or anxious, and to cut back on obsessive
       interests and repetitive routines;
     * medication, for co-existing conditions such as depression and
       anxiety;
     * occupational or physical therapy, to assist with sensory
       integration problems or poor motor coordination;
     * specialized speech therapy, to help with the trouble of the "give
       and take" in normal conversation; and,
     * parent training and support, to teach parents behavioural
       techniques to use at home.

   Many studies have been done on early behavioural interventions. Most of
   these are single case with one to five participants. The single case
   studies are usually about controlling non-core autistic
   problem-behaviors like self-injury, aggression, noncompliance,
   stereotypies, or spontaneous language. Packaged interventions such as
   those run by UCLA or TEACCH are designed to treat the entire syndrome
   and have been found to be somewhat effective.

   Unintended side effects of medication and intervention have largely
   been ignored in the literature about treatment programs for children or
   adults, and there are claims that some treatments are not ethical and
   do more harm than good.

Prognosis

   Persons with AS appear to have normal lifespans, but have an increased
   prevalence of comorbid psychiatric conditions such as depression, mood
   disorders, and obsessive-compulsive disorder.

   Children with AS can learn to manage their differences, but they may
   continue to find social situations and personal relationships
   challenging. Many adults with AS are able to work successfully in
   mainstream jobs, although they may continue to need encouragement and
   moral support to maintain an independent life.

   Individuals with AS may make great intellectual contributions:
   published case reports suggest an association with accomplishments in
   computer science, mathematics, and physics. The deficits associated
   with AS may be debilitating, but many individuals experience positive
   outcomes, particularly those who are able to excel in areas less
   dependent on social interaction, such as mathematics, music, and the
   sciences.

Epidemiology

   The prevalence of AS is not well established, but conservative
   estimates using the DSM-IV criteria indicate that two to three of every
   10,000 children have the condition, making it rarer than autistic
   disorder itself. Three to four times as many boys have AS compared with
   girls. The universality of AS across races, and validity of
   epidemiologic studies to date, is questioned.

   A 1993 broad-based population study in Sweden found that 36 per 10,000
   school-aged children met Gillberg's criteria for AS, rising to 71 per
   10,000 if suspected cases are included. The estimate is convincing for
   Sweden, but the findings may not apply elsewhere because they are based
   on a homogeneous population. The Sweden study demonstrated that AS may
   be more common than once thought and may be currently underdiagnosed.
   Gillberg estimates 30-50% of all persons with AS are undiagnosed. A
   survey found that 36 per 10,000 adults with an IQ of 100 or above may
   meet criteria for AS.

   Leekam et al. documented significant differences between Gillberg's
   criteria and the ICD-10 criteria. Considering its requirement for
   "normal" development of cognitive skills, language, curiosity and
   self-help skills, the ICD-10 definition is considerably more narrow
   than Gillberg's criteria, which more closely matches Hans Asperger's
   own descriptions.

   Like other autism spectrum disorders, AS prevalence estimates for males
   are higher than for females, but some clinicians believe that this may
   not reflect the actual incidence rates. Tony Attwood suggests that
   females learn to better compensate for their impairments due to gender
   differences in the handling of socialization. The Ehlers & Gillberg
   study found a 4:1 male to female ratio in subjects meeting Gillberg's
   criteria for AS, but a lower 2.3:1 ratio when suspected or borderline
   cases were included.

   The prevalence of AS in adults is not well understood, but Baron-Cohen
   et al. documented that 2% of adults score higher than 32 in his Autism
   Spectrum Quotient (AQ) questionnaire, developed in 2001 to measure the
   extent to which an adult of normal intelligence has the traits
   associated with autism spectrum conditions. All interviewed
   high-scorers met at least 3 DSM-IV criteria, and 63% met threshold
   criteria for an ASD diagnosis; a Japanese study found similar AQ Test
   results.

Comorbidities

   Most patients presenting in clinical settings with AS have other
   comorbid psychiatric disorders. Children are likely to present with
   attention-deficit hyperactivity disorder (ADHD), while depression is a
   common diagnosis in adolescents and adults. A study of referred adult
   patients found that 30% presenting with ADHD had ASD as well.

   Research indicates people with AS may be far more likely to have the
   associated conditions. People with AS symptoms may frequently be
   diagnosed with clinical depression, oppositional defiant disorder,
   antisocial personality disorder, Tourette syndrome, ADHD, general
   anxiety disorder, bipolar disorder, obsessive compulsive disorder or
   obsessive-compulsive personality disorder. Dysgraphia, dyspraxia,
   dyslexia or dyscalculia may also be diagnosed.

   The particularly high comorbidity with anxiety often requires special
   attention. One study reported that about 84 percent of individuals with
   a Pervasive Developmental Disorder (PDD) also met the criteria to be
   diagnosed with an anxiety disorder. Because of the social differences
   experienced by those with AS, such as trouble initiating or maintaining
   a conversation or adherence to strict rituals or schedules, additional
   stress to any of these activities may result in feelings of anxiety,
   which can negatively affect multiple areas of one's life, including
   school, family, and work. Treatment of anxiety disorders that accompany
   a PDD can be handled in a number of ways, such as through medication or
   individual and group cognitive behavioural therapy, where relaxation or
   distraction-type activities may be used along with other techniques in
   order to diffuse the feelings of anxiety.

Non-clinical perspective

   Some professionals contend that, far from being a disease, AS is simply
   the pathologizing of neurodiversity that should be celebrated,
   understood and accommodated instead of "treated" or "cured".

Shift in view

   Autistic people have contributed to a shift in perception of autism
   spectrum disorders as complex syndromes rather than diseases that must
   be cured. Proponents of this view reject the notion that there is an
   'ideal' brain configuration and that any deviation from the norm is
   pathological. They demand tolerance for what they call their
   neurodiversity in much the same way physically handicapped people have
   demanded tolerance. These views are the basis for the autistic rights
   and autistic pride movements. Researcher Simon Baron-Cohen has argued
   that high-functioning autism is a "difference" and is not necessarily a
   "disability." He contends that the term "difference" is more neutral,
   and that this small shift in a term could mean the difference between a
   diagnosis of AS being received as a family tragedy, or as interesting
   information, such as learning that a child is left-handed.

Autistic culture

   People with AS may refer to themselves in casual conversation as
   "aspies", coined by Liane Holliday Willey in 1999, or as an
   "Aspergian". The term neurotypical (NT) describes a person whose
   neurological development and state are typical, and is often used to
   refer to people who are non-autistic.

   A Wired magazine article, The Geek Syndrome, suggested that AS is more
   common in the Silicon Valley, a haven for computer scientists and
   mathematicians. It posited that AS may be the result of assortative
   mating by geeks in mathematical and technological areas. AS can be
   found in all occupations, however, and is not limited to those in the
   math and science fields.

   The popularization of the Internet has allowed individuals with AS to
   communicate with each other in a way that was not possible to do
   offline due to the rarity and the geographic dispersal of individuals
   with AS. As a result of increasing ability to connect with one another,
   a subculture of "Aspies" has formed. Internet sites have made it easier
   for individuals to connect with each other.

Social impact

   AS may lead to problems in social interaction with peers. These
   problems can be severe or mild depending on the individual. Children
   with AS are often the target of bullying at school due to their
   idiosyncratic behaviour, language, interests, and impaired ability to
   perceive and respond in socially expected ways to nonverbal cues,
   particularly in interpersonal conflict. Children with AS may be
   extremely literal and may have difficulty interpreting and responding
   to sarcasm or banter.

   The above problems can even arise in the family; given an unfavourable
   family environment, the child may be subject to emotional abuse. A
   child or teen with AS is often puzzled by this mistreatment, unaware of
   what has been done incorrectly. Unlike other pervasive development
   disorders, most children with AS want to be social, but fail to
   socialize successfully, which can lead to later withdrawal and asocial
   behaviour, especially in adolescence. At this stage of life especially,
   they risk being drawn into unsuitable and inappropriate friendships and
   social groups. People with AS often get along a lot better with those
   considerably older or younger than them, rather than those their own
   age.

   Children with AS often display advanced abilities for their age in
   language, reading, mathematics, spatial skills, and/or music—sometimes
   into the "gifted" range—but this may be counterbalanced by considerable
   delays in other developmental areas. This combination of traits can
   lead to problems with teachers and other authority figures. A child
   with AS might be regarded by teachers as a "problem child" or a "poor
   performer." The child’s extremely low tolerance for what they perceive
   to be ordinary and mediocre tasks, such as typical homework
   assignments, can easily become frustrating; a teacher may well consider
   the child arrogant, spiteful, and insubordinate. Lack of support and
   understanding, in combination with the child's anxieties, can result in
   problematic behaviour (such as severe tantrums, violent and angry
   outbursts, and withdrawal).

   Although adults with AS may have similar problems, they are not as
   likely to be given treatment as a child would. They may find it
   difficult finding employment or entering undergraduate or graduate
   schools because of poor interview skills or a low score on standardized
   or personality tests. They also may be more vulnerable to poverty and
   homelessness than the general population, because of their difficulty
   finding (and keeping) employment, lack of proper education, premature
   social skills, and other factors. If they do become employed, they may
   be misunderstood, taken advantage of, paid less than those without AS,
   and be subject to bullying and discrimination. Communication deficits
   may mean people at work have difficulty understanding the person with
   AS, and problems with authority figures continue as difficult, tense
   relations with bosses and supervisors become prevalent.

   People with AS report a feeling of being unwillingly detached from the
   world around them. They may have difficulty finding a life partner or
   getting married due to poor social skills and poverty. In a similar
   fashion to school bullying, the person with AS is vulnerable to
   problems in their neighbourhood, such as anti-social behaviour and
   harassment. Due to social isolation, they can be seen as the ' black
   sheep' in the community and thus may be at risk of wrongful suspicions
   and allegations from others.

   On the other hand, some adults with AS do get married, get graduate
   degrees, become wealthy, and hold jobs. The intense focus and tendency
   to work things out logically often grants those people with AS a high
   level of ability in their field of interest. When these special
   interests coincide with a materially or socially useful task, the
   person with AS often can lead a profitable life. The child obsessed
   with naval architecture may grow up to be an accomplished shipwright.
   More research is needed on adults with AS.

Adults with AS as parents

   One area of study in which more of such research is sorely needed
   concerns adults with AS who do marry and subsequently become parents.
   AS adults who marry often find it difficult to stay married; some
   initial research puts the divorce rate at approximately eighty percent.
   The resulting split can be fraught with intense or "high" conflict or
   domestic violence. Custody cases, already often difficult affairs, are
   complicated when one or both parties has AS. The parenting skills of a
   person with AS may be inadequate to the task to the point of inflicting
   long-term psychological damage on children, neurotypical or otherwise,
   raised in such an environment. Such damage may be even more pronounced
   when the AS parent goes undiagnosed and fails to receive the intensive
   help s/he may need in developing and maintaining adequate parenting
   skills.

   Even with support, AS parents simply may not be up to the enormous
   task. Raising a psychologically healthy child involves complex
   emotional interaction between parent and child, as well as the ability
   to avoid parental behaviors damaging to a child's well-being. Typical
   adult symptoms of AS include the inability to empathize with others,
   lack of comprehension of the emotions and motives of others, difficulty
   in holding conversations and actively listening to others, and poor
   ability to control feelings of anxiety and, importantly, anger and
   rage, especially in stressful situations. Sheila Jennings Linehan notes
   that these problems can at times be simply incompatible with successful
   parenting.

   AS parents should not, however, be stereotyped or categorized as evil,
   uncaring, or intentionally abusive. As Australia's Better Health
   Channel puts it, "Because the affected person is neurologically unable
   to understand other people's emotional states, they are usually
   shocked, upset and remorseful when told their actions were hurtful or
   inappropriate." Jennings Linehan notes that "problems in parenting are
   linked directly to the core neuro-cognitive clinical features of
   Asperger's Syndrome itself", rather than to "character flaws" or "ill
   will" on the part of parents. Thus it seems clear that more research
   and better coping strategies are needed on the part of everyone
   involved in the welfare of a child who has a parent or parents with AS.

Notable cases

   Albert Einstein may have had AS.
   Enlarge
   Albert Einstein may have had AS.

   AS is sometimes viewed as a syndrome with both advantages and
   disadvantages, and notable adults with AS or autism have achieved
   success in their fields. Prominent AS-diagnosed individuals include
   Nobel Prize-winning economist Vernon Smith, electropop rocker Gary
   Numan, Vines frontman Craig Nicholls, and Satoshi Tajiri, the creator
   of Pokémon. Colorado State University professor and author Temple
   Grandin was diagnosed with autism at a young age, and has used her
   autism to her advantage in her profession as an animal behaviorist
   specializing in livestock handling.

   Some AS researchers speculate that well-known figures, including Albert
   Einstein, Isaac Newton, Glenn Gould, Ludwig Wittgenstein, and Stanley
   Kubrick, had AS because they showed some AS-related tendencies or
   behaviors, such as intense interest in one subject, or social problems.
   Autistic rights activists use such speculative diagnoses to argue that
   it would be a loss to society if autism were cured. Speculative
   diagnoses, especially posthumous ones, remain controversial, however.

   Retrieved from " http://en.wikipedia.org/wiki/Asperger_syndrome"
   This reference article is mainly selected from the English Wikipedia
   with only minor checks and changes (see www.wikipedia.org for details
   of authors and sources) and is available under the GNU Free
   Documentation License. See also our Disclaimer.
