What is asperger syndrome?

- So Asperger Syndrome or Asperger's is one of the Autism Spectrum Disorders. And while everyone with Asperger's is affected a little differently most people with this syndrome have some difficulties relating to other people. And this stems from having trouble with social communication and interactions. So let's draw a few pictures here to better understand what we mean by trouble with communication and interactions. So, I'm just going to draw this face here and let's make this face happy. And now imagine if you were having a conversation with this person here and all of a sudden their smile here it turned upside down into a frown. Well, that might indicate to you that something about this conversation, maybe something you said, or something you did, or maybe something that the person was thinking about, something upset or bothered this person here, right, to make them frown. Well, if a person with Asperger's was having a conversation with someone and their facial expression changed, like it did here, the person with Asperger's actually might not really notice this. And that's because people with Asperger's have trouble using and understanding these sorts of non verbal behaviours like facial expressions or gestures. And they might continue on with the conversation as though nothing had changed because this doesn't really indicate to them that the person is unhappy. And if we draw a person here and maybe let's say that this person is walking by and they say, "Good morning" and they wave, and smile. Well, for someone with Asperger's they might not really realize that they're supposed to return or reciprocate this gesture by also saying, "Good morning," and waving back. It might not really occur to them that this is something that they're supposed to do. For someone with Asperger's it doesn't really seem like a required response. And we actually describe this as trouble with social and emotional reciprocity. And Reciprocity here just means kind of returning or exchanging something. So in this case, it means returning the friendly greeting. So this social and emotional reciprocity is kind of like the give and take of a conversation. It's what allows us to converse and interact with other people. And this is something that people with Asperger's have a lot of trouble with. And let's draw one final picture here, so let's say that it just rained and now there's this really pretty rainbow in the sky. Well, if you saw that you might have a desire to point it out and share this pretty rainbow with someone around you. But for someone with Asperger's they don't really have this spontaneous desire to share something of interest or enjoyment with someone else. So they don't really point things out that interest them, or excite them, or share their achievements with other people. So this trouble with communication and interaction is one of the main features of Asperger's. And these different examples here are some ways that this trouble with communication and interaction can manifest in someone with Asperger's. And there's one other main feature of Asperger's and that's Restricted Interests and Repetitive Behaviours. So in order for us to see what we mean by Restricted Interests let's actually draw a graph here. A graph that shows the level of interest in a few different activities. And you'll see what I mean in a sec. So on our y-axis here, let's make this the Level of Interest so the higher up we are here, the more interest there is. And on our x-axis here we'll put down some different activities. And we'll use this pink color here to show what we might Expect from the average child. And we'll use this green color here to show what we might see from a child with Asperger's. Okay, so let's put down a few activities here. So let's put down Reading and we'll put down Drawing. And let's do one more, we'll put down Playing with Blocks. So these are a few of the activities that we're going to look at. So maybe we would expect that quite a few kids like to Read so let's maybe draw our Reading bar to about here. So this about the Level of Interest that we might expect from the average kid. And maybe we would expect even more kids like to Draw than they do Read so maybe we'll make this bar a little higher here. And let's say that we expect kids to like Playing with Blocks about the same as we would expect them to like Drawing. So maybe we'll make that one about the same height here. Now for kids with Asperger's they usually have an activity or two that they're really, really keen on, they're super into it. But then they don't really show interest in other activities. So for example, maybe for someone with Asperger's they really aren't really interested or keen on Reading. So their little bar would be way down here, a lot lower than what we might expect from the average child. And they don't really want to Draw at all so their bar is also really low. But let's say they absolutely love Playing with Blocks. They would spend all their time Playing with Blocks if they could, they're really keen on blocks. And they're way more keen then we would expect from an average kid so their interest level is way up here. So while every kid with Asperger's is different and has different levels of interest in different activities generally what we see is something like this. This restricted interest in one or two activities and then not much interest at all in anything else. So this kind of shows us what we mean by Restricted activities. And when we say Repetitive Behaviours here what we mean are things like lining up toys or moving certain body parts in repetitive ways. So this is something that we also often see in someone with Asperger's. So it turns out that these main signs of Asperger's are actually what we use to diagnose the syndrome. There really isn't a blood test or a brain scan that we can use to confirm Asperger's so we really rely on looking for these behavioral signs. And how we usually go about doing that is by asking the parent questions and watching the kid who we think has Asperger's interact with other people. So maybe we watch to see if they're making eye contact or using non verbal cues. We'd look to see if they're picking up on the body language changes or changes in tone of voice from other people when they're talking to them. We might play with them and see if they want to show us their toys that they like or share something with us. We might ask them or their parents about their interests to see if they seem kind of restrictive like this graph here. These sorts of questions and observations would help us look for these signs of Asperger's. Now at this point you might be wondering what's the difference between Asperger's and Autistic Disorder? Because if you've read or heard anything about Autistic Disorder it sounds pretty similar to what we're describing here. So while the two are very similar there's one kind of main thing that sets Asperger's apart from Autistic Disorder. So kids with Asperger's they don't really appear to have any delays in language or intellectual development. They don't really miss any of those key language milestones like their first word. Whereas for kids with Autistic Disorder this is something that is often noticed by the parents pretty early on. The parents notice that their kid is kind of missing language milestones or just doesn't quite seem to be developing the way they should be. So that's one of the big differences between Asperger's and Autistic Disorder. And you can imagine that if there aren't really any apparent delays in language with kids with Asperger's it could mean that it would take quite a while to figure out that a kid has Asperger's and to make the diagnosis. And this is, indeed, the case. So for a lot of kids with Asperger's it isn't really picked up on until later on when they're put into a demanding social situation like a new school environment. Now while we're on the topic of diagnosing Asperger's I should actually point out that a few years ago one of the main manuals, the main guides that we use to make diagnoses which is called the "Diagnostic & Statistical Manual of Mental Disorders" or the "DSM", well, the "DSM" actually changed a bit. And it removed Asperger's as its own diagnosis. So in the previous version of the "DSM" the "DSM 4" and just so you know we're currently on the "DSM 5" so in the older version the "DSM 4" someone could be diagnosed with one of a few different Autism Spectrum Disorders. So there was Asperger's, Autistic Disorder, Childhood disintegrative disorder, and Pervasive developmental disorder. So these were all individual disorders that someone can be diagnosed with. But when the new "DSM 5" came out it was decided that it would be better to kind of merge these all together, these different disorders into one disorder, Autism Spectrum Disorder. The idea was that this one Spectrum here would better account for all the different variations that we see in people with Autistic Disorders by putting everyone on one Spectrum rather than having several distinct disorders with different criteria. So that's what the "DSM 5" looks like. So now in the "DSM 5" instead of having Asperger's as a diagnosis that can be made there's just one Autism Spectrum Disorder. But not every country uses the "DSM" so depending on what guidelines are used in your country to make a diagnosis, you might still see a diagnoses of Asperger Syndrome made. So whether someone is diagnosed with Asperger's or Autism Spectrum Disorder instead the Management is very similar. There isn't any medication or specific plan to manage Asperger's. And because everyone is very different Management plans can vary a lot between different people with the syndrome. So the main sort of goal of Management is to get the parents, and other family members, and teachers to create an environment that allows the kid with Asperger's to work on improving their communication and interaction skills. So to help the kid work on their social skills parents might encourage making eye contact and understanding and using body language during conversations. They might help the kid understand social conventions like sharing, and smiling, and greeting people, and really emphasizing these on a daily basis. And in order to encourage new interests because remember, kids with Asperger's can be really Restrictive with their interests. Parents and teachers might try to find activities that are similar to but still different from the one that the kid with Asperger's enjoys. So maybe if the kid really enjoys drawing, for example, parents and teachers might try to encourage other similar artistic activities like painting or sculpting.