Asperger’s Disorder Ashleigh Pogue and Kayla Roth

What is Asperger’s Syndrome? Considered to be a subtype of Pervasive Development Disorders Characterized by limited interests or a preoccupation with a certain subject that leads to exclusion of other activities Also involves language and communication skills impairment Is part of the Autism Spectrum Disorder - Autism, Rett syndrome, childhood disintegrative disorder and PDD- NOS

Overview of Asperger’s First observed in children by Hans Asperger in 1944 Young AS children generally have normal development in language skills Motor development delays are usually the first to indicate the disorder Boys are three to four times more likely to have AS

Symptoms AS children are usually of normal to above- average intelligence In addition to a specific interest, the disorder is characterized by differences in speech patterns, poor expression recognition and underdeveloped motor skills Are more social than children with classic autism but are frequently rejected because if their eccentric behavior and narrow interests Asperber’s if frequently comorbid with anxiety, depression, ADHD, tic disorders and OCD

Causes A genetic component exists but a specific gene has not yet been identified Recent research suggests that there are specific interactions between multiple mutated genes The varied genes produce brain abnormalities which have been found to cause AS Brain defects are due to abnormal migration of embryonic cells These cells later form the neural connections for thought and behavior

Diagnosis and Treatment Diagnosis criteria is included in the DSM-IV Some doctors consider AS to be a form of high- functioning autism (HFA) and not a separate disorder Treatment focuses on 3 core symptoms: communication skills, repetitive routines and clumsiness The most effective treatments includes numerous therapies, medication and parental training and support

DSM-IV Criteria Diagnostic criteria for Asperger's Disorder Diagnostic criteria for Asperger's Disorder A. Qualitative impairment in social interaction, as manifested by at least two of the following: (1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction (2) failure to develop peer relationships appropriate to developmental level (3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) (4) lack of social or emotional reciprocity A. Qualitative impairment in social interaction, as manifested by at least two of the following: (1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction (2) failure to develop peer relationships appropriate to developmental level (3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people) (4) lack of social or emotional reciprocity B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: (1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus (2) apparently inflexible adherence to specific, nonfunctional routines or rituals (3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) (4) persistent preoccupation with parts of objects B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following: (1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus (2) apparently inflexible adherence to specific, nonfunctional routines or rituals (3) stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements) (4) persistent preoccupation with parts of objects C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning. C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning. D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years). D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years). E. There is no clinically significant delay in cognitive development or in the development of age- appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood. E. There is no clinically significant delay in cognitive development or in the development of age- appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood. F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia. Pervasive Developmental DisorderSchizophreniaPervasive Developmental DisorderSchizophrenia

Medication Treatment Often problematic to treat because of the difficulty in distinguishing AS symptoms from comorbid problems Research suggests that medication is effective in treating comorbid symptoms A complete medical assessment must be performed and the patient must be closely monitored for side effects Stimulants, antidepressants, anti-anxiety medications and treatments for Tourettes’ and sleep disorders have been found to be effective

Medication Treatment

Additional Treatments

Social-Behavioral Learning Strategy SODA Strategy: Stop, Observe, Deliberate, Act Developed to help children with AS learn social cues, process cues, and utilize social skills in activities A baseline was used to compare behavior without SODA to behavior with SODA Three dependent measures of replacement behavior: participate in cooperative learning, play a board game with peers and visit one or more peers while eating lunch

SODA Results A significant result was found more all dependent measure Social interaction with peers increased in all areas Long-term memory of the program was found to exist and participant continued to use SODA even after the study ended May help adolescents to use metacognitive processes to understand the mental state of others

Cognitive-Behavioral Therapy Summer program that compared two treatment types: social skills instruction (SS) only versus social skills instruction with behavioral treatment (SS+BT) Dependent measures included social skills, adaptability and atypicality The Skillstreaming curriculum was used to address the specific problems associated with AS

Results Significant main effects were found for each of the dependent measures or the parent’s ratings Staff ratings found significant main effects for social skills and atypicality Provides evidence a cognitive-behavioral approach is a promising approach for developing social skills The significant increase in social skills ratings was found to exist even after the program ended Parent’s reported social skills improvement, better adaptability and a decrease in odd or unusual behavior

Teaching Emotion Recognition Involved an emotion recognition pretest, 10 week intervention and posttest Mind Reading software was used to present material in the form of photographs, movie and audio clips Significant results were found All children demonstrated increased skill in recognizing emotion in facial expressions and voice They were also found to be able to better recognize emotion in voices not used in the program suggesting that their learned skills can be generalized

References sperger.htm sperger.htm ersyndrome.htm ersyndrome.htm Lopata, Christopher, Marcus L. Thomeer, Martin A. Volker, and Robert E. Nida. Effectiveness of a cognitive-behavioral treatment on the social behaviors of children with Asperger disorder. [Electronic version]. Focus on Autism and Other Developmental Disabilities 21.4 (Winter 2006): 237(8). Lopata, Christopher, Marcus L. Thomeer, Martin A. Volker, and Robert E. Nida. Effectiveness of a cognitive-behavioral treatment on the social behaviors of children with Asperger disorder. [Electronic version]. Focus on Autism and Other Developmental Disabilities 21.4 (Winter 2006): 237(8).

References Tsai, Luke Y. Asperger syndrome and medication treatment. [Electronic version] Focus on Autism and Other Developmental Disabilities 22.3 (Fall 2007): 138(11). Tsai, Luke Y. Asperger syndrome and medication treatment. [Electronic version] Focus on Autism and Other Developmental Disabilities 22.3 (Fall 2007): 138(11). Bock, Marjorie A. A social-behavioral learning strategy intervention for a child with Asperger syndrome: brief report. [Electronic version]. Remedial and Special Education 28.5 (Sept-Oct 2007): 258(8). Bock, Marjorie A. A social-behavioral learning strategy intervention for a child with Asperger syndrome: brief report. [Electronic version]. Remedial and Special Education 28.5 (Sept-Oct 2007): 258(8).