Asperger syndrome

Asperger syndrome (AS), also known as Asperger disorder (AD) or simply Asperger's, is an autism spectrum disorder (ASD) that is characterized by significant difficulties in social interaction andnonverbal communication, alongside restricted and repetitive patterns of behavior and interests. It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. Although not required for diagnosis, physical clumsiness and atypical (peculiar, odd) use of language are frequently reported.[1][2]

The syndrome is named after the Austrian pediatrician Hans Asperger who, in 1944, studied and described children in his practice who lacked nonverbal communication skills, demonstrated limited empathywith their peers, and were physically clumsy.[3] The modern conception of Asperger syndrome came into existence in 1981[4] and went through a period of popularization,[5][6] becoming standardized as adiagnosis in the early 1990s. Many questions remain about aspects of the disorder.[7] There is doubt about whether it is distinct from high-functioning autism (HFA);[8] partly because of this, its prevalence is not firmly established.[1] The diagnosis of Asperger's was eliminated in the 2013 fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and replaced by a diagnosis of autism spectrum disorder on a severity scale.[9]

The exact cause is unknown. Although research suggests the likelihood of a genetic basis,[1] there is no known genetic cause[10][11] and brain imaging techniques have not identified a clear common pathology.[1] There is no single treatment, and the effectiveness of particular interventions is supported by only limited data.[1] Intervention is aimed at improving symptoms and function. The mainstay of management is behavioral therapy, focusing on specific deficits to address poor communication skills, obsessive or repetitive routines, and physical clumsiness.[12] Most children improve as they mature to adulthood, but social and communication difficulties may persist.[7] Some researchers and people with Asperger's have advocated a shift in attitudes toward the view that it is a difference, rather than a disability that must be treated or cured.[13][14]


As a pervasive developmental disorder, Asperger syndrome is distinguished by a pattern of symptoms rather than a single symptom. It is characterized by qualitative impairment in social interaction, by stereotyped and restricted patterns of behavior, activities and interests, and by no clinically significant delay in cognitive development or general delay in language.[28] Intense preoccupation with a narrow subject, one-sided verbosity, restricted prosody, and physical clumsiness are typical of the condition, but are not required for diagnosis.[8]

Social interaction

A lack of demonstrated empathy has a significant impact on aspects of communal living for persons with Asperger syndrome.[2] Individuals with AS experience difficulties in basic elements of social interaction, which may include a failure to develop friendships or to seek shared enjoyments or achievements with others (for example, showing others objects of interest), a lack of social or emotional reciprocity (social "games" give-and-take mechanic), and impaired nonverbal behaviors in areas such aseye contactfacial expression, posture, and gesture.[1]

People with AS may not be as withdrawn around others compared to those with other, more debilitating, forms of autism; they approach others, even if awkwardly. For example, a person with AS may engage in a one-sided, long-winded speech about a favorite topic, while misunderstanding or not recognizing the listener's feelings or reactions, such as a wish to change the topic of talk or end the interaction.[8] This social awkwardness has been called "active but odd".[1] This failure to react appropriately to social interaction may appear as disregard for other people's feelings, and may come across as insensitive.[8] However, not all individuals with AS will approach others. Some of them may even display selective mutism, speaking not at all to most people and excessively to specific people. Some may choose to talk to only people they like.[29]

The cognitive ability of children with AS often allows them to articulate social norms in a laboratory context,[1] where they may be able to show a theoretical understanding of other people's emotions; however, they typically have difficulty acting on this knowledge in fluid, real-life situations.[8] People with AS may analyze and distill their observations of social interaction into rigid behavioral guidelines, and apply these rules in awkward ways, such as forced eye contact, resulting in a demeanor that appears rigid or socially naive. Childhood desire for companionship can become numbed through a history of failed social encounters.[1]

The hypothesis that individuals with AS are predisposed to violent or criminal behavior has been investigated, but is not supported by data.[1][30] More evidence suggests children with AS are victims rather than victimizers.[31] A 2008 review found that an overwhelming number of reported violent criminals with AS had coexisting psychiatric disorders such as schizoaffective disorder.[32]

Restricted and repetitive interests and behavior

People with Asperger syndrome often display behavior, interests, and activities that are restricted and repetitive and are sometimes abnormally intense or focused. They may stick to inflexible routines, move in stereotyped and repetitive ways, or preoccupy themselves with parts of objects.[28]

Pursuit of specific and narrow areas of interest is one of the most striking features of AS.[1] Individuals with AS may collect volumes of detailed information on a relatively narrow topic such as weather data or star names, without necessarily having a genuine understanding of the broader topic.[1][8] For example, a child might memorize camera model numbers while caring little about photography.[1] This behavior is usually apparent by age 5 or 6.[1] Although these special interests may change from time to time, they typically become more unusual and narrowly focused, and often dominate social interaction so much that the entire family may become immersed. Because narrow topics often capture the interest of children, this symptom may go unrecognized.[8]

Stereotyped and repetitive motor behaviors are a core part of the diagnosis of AS and other ASDs.[33] They include hand movements such as flapping or twisting, and complex whole-body movements.[28] These are typically repeated in longer bursts and look more voluntary or ritualistic than tics, which are usually faster, less rhythmical and less often symmetrical.[34]

According to the Adult Asperger Assessment (AAA) diagnostic test, a lack of interest in fiction and a positive preference towards non-fiction is common among adults with AS.[35]