Asperger’s Syndrome

What Causes Asperger’s Syndrome?

The causes of Asperger’s and autism spectrum disorders have not yet been discovered. Some studies have identified risk factors that seem to be associated with ASD, but much of the research into causes has been inconclusive.

It is important to note that no reliable scientific study has found a connection between childhood vaccines and autism spectrum disorders.

The following factors may increase the risk of autism, but none of them is a reliable predictor of the disorder:

• Sex. Boys are much more likely than girls to be diagnosed with Asperger’s.
• A mother or father who is 35 or older at the time of conception.
• Family history. A family with one child with Asperger’s or ASD is more likely to have other children with the disorders.
• Pregnancy and birth complications, including extreme prematurity (earlier than 26 weeks), low birth weight, and multiple births (twins, triplets, etc.).
• Pregnancies spaced less than one year apart.
• Chronic stress during pregnancy.
• Vitamin D deficiency during pregnancy.
• Too much or too little folic acid (also called folate or vitamin B). Pregnant women should talk to their doctor before taking vitamin supplements.
• Viral infections during pregnancy. Exposure of the mother to rubella (German measles) or a cytomegalovirus (CMV) infection during pregnancy may increase the risk.
• Use of certain drugs, such as valproic acid, thalidomide, and misoprostol, during pregnancy.
• Environmental triggers and exposure to toxic chemicals such as bisphenol-A (BPA).

Is Asperger’s Syndrome Hereditary?

Asperger’s arises from a complex interplay of genes and the environment. Genetics plays a role in ASD, but scientists still don’t know precisely how risk for the disorder is inherited. While some genes and gene variations are known to increase the condition’s risk, these genes don’t necessarily mean that an individual will develop ASD.

Even if the genetic connection is not understood, it is clear that there is a strong genetic component in Asperger’s and other autism spectrum disorders. Among identical twins, if one twin has a disorder on the ASD spectrum, the other twin also has an autism spectrum disorder as much as 90% of the time. In people with Asperger’s, at least one of the person’s parents also exhibits some symptoms of ASD about a third of the time.

How Is Asperger’s Syndrome Detected?

Asperger’s often goes undiagnosed until late in childhood or even adulthood because its symptoms don’t always impair daily functioning to a great degree. The symptoms may impede social interaction and communication, but people with Asperger’s often have extraordinary intelligence or skills. This may allow them to function well or even excel, especially within their areas of particular interest.

To identify Asperger’s as early as possible, look for these signs:

• Difficulty making eye contact
• Difficulty understanding gestures and body language
• Difficulty understanding metaphors, hints, humor, irony, and sarcasm
• Difficulty carrying on a back-and-forth conversation
• Difficulty understanding emotional situations and concepts
• Difficulty understanding the idea of personal space
• Preference for routines and well-defined rules
• Intense interest in a specific topic (and tendency to talk about the subject even when others aren’t interested)
• Unusual speaking pattern (monotone, lack of emotional inflection, stilted language)
• Physical clumsiness or awkwardness
• Repetitive, habitual movements
• Sensitivity to sensory stimulation from sounds, touch, etc.

How Is Asperger’s Syndrome Diagnosed?

No lab test, blood work, or imaging exams are used to diagnose Asperger’s. Pediatricians usually assess a child’s 18- and 24-month checkups to look for the disorder’s developmental signs.

Doctors observe the child’s behavior and talk to parents. If concerns arise, an autism specialist may be recommended to evaluate a child’s behavior and development to make a diagnosis.

If Asperger’s is suspected, healthcare professionals will work through a series of diagnostic steps to pursue a diagnosis. Some of these steps might include:

• Observation of the person’s social interactions and communication skills
• Administrations of tests to measure sensory function, language skills, cognitive skills, social skills, and behavior
• Comparison of the person’s symptoms to the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
• Possible genetic testing to look for disorders that are risk factors for ASD, such as fragile X syndrome and Rett syndrome

PLEASE CONSULT A PHYSICIAN FOR MORE INFORMATION.

How Is Asperger’s Syndrome Treated?

Current approaches to the treatment of Asperger’s focus on managing behavioral symptoms and helping with social skills.

The FDA has approved no drugs to treat the core symptoms of Asperger’s. Some other conditions such as obsessive-compulsive disorder (OCD), anxiety, and depression often co-exist with Asperger’s. Some medications, such as selective serotonin re-uptake inhibitors (SSRIs), are sometimes used to treat symptoms of these co-existent disorders.

A wide range of behavioral therapies and psychotherapy approaches have proven to be effective at treating Asperger’s. Commonly used treatments include:

• Behavioral management therapy
• Cognitive behavior therapy (CBT)
• Educational and school-based therapies
• Joint attention therapy
• Nutritional therapy
• Occupational therapy
• Parent-mediated therapy
• Physical therapy
• Social skills training
• Speech-language therapy
• Applied Behavior Analysis Therapy 

How Does Asperger’s Syndrome Progress?

People with Asperger’s syndrome are very often able to function well on a day-to-day basis. In many cases, their unique skills and abilities lead them to very productive, successful lives. With treatment, many people with Asperger’s can compensate for their social difficulties. They can live independently and have fulfilling friendships and relationships.

However, without proper treatment and support, people with Asperger’s are at risk of falling into behavior patterns that endanger their social and professional lives. Co-existent disorders such as depression and anxiety can have long-term negative impacts, as well.

Long-term complications can include:

• Social isolation
• School or work difficulties
• Financial problems
• Depression or anxiety
• Obsessive-compulsive disorder

How Is Asperger’s Syndrome Prevented?

There is no known way to prevent or cure Asperger’s syndrome. The causes of the disorder are unknown, making it difficult to develop treatments. Although some risk factors for the condition have been identified, no substantial data suggests that avoiding the risk factors effectively prevents Asperger’s.

Early detection and prompt treatment of Asperger’s is the best course of action. The earlier a child is diagnosed with the disorder, the better the chance that therapeutic intervention will help manage their symptoms.

Asperger’s Syndrome Caregiver Tips

Some of the ways you can help your loved one cope with Asperger’s include:

• Learn about Asperger’s, ASD, and your loved one’s unique challenges. Everyone experiences Asperger’s differently, and you must know how the disorder affects your loved one. People with Asperger’s have unique limitations and strengths. If you understand how your loved one is special, you can help them capitalize on what they do best and more easily overcome their challenges.
• Learn how to spot pseudo-science. The causes of Asperger’s and ASD are unknown, so you should be skeptical of anyone who claims to know why your loved one has Asperger’s or how they can be “cured.”
• Be an advocate for your loved one. Teachers and other authority figures often have trouble understanding children with Asperger’s, especially when they are skilled in certain areas. Make sure educators know about your child’s sensitivities, behavioral issues, and learning style. You and your child have a right to a supportive educational environment, and it’s up to you to advocate for it.

Many people with Asperger’s also suffer from other brain and mental health-related issues, a condition called co-morbidity. Here are a few of the disorders commonly associated with Asperger’s syndrome:

• Many people with Asperger’s suffer from depression or anxiety.
• Bipolar disorder and obsessive-compulsive disorder are also commonly co-morbid with Asperger’s.
• Asperger’s is often associated with attention-deficit/hyperactivity disorder (ADHD).
• As many as one in five people with Asperger’s also have a tic disorder such as Tourette syndrome.

Asperger’s Syndrome Brain Science

Many scientists believe that people with Asperger’s and ASD think and behave differently because their brains work differently than typical brains in some fundamental ways. For example, brain scans have shown that people with Asperger’s react to facial expressions using their brain’s planning and judgment center. Typical brains respond to facial expressions with the brain’s emotion center. This suggests that the person with Asperger’s sees a facial expression as a puzzle to be solved rather than as evidence of another person’s emotion.

One study has found that people with Asperger’s brains may function differently from the brains of people with other autism spectrum disorders. The study found that connections in the brain’s language center were weak in children with Asperger’s and ASD. But connections in the part of the brain responsible for logic and reasoning were stronger in Asperger’s brains than in the brains of both children with ASD and typical children. This finding seems to support the argument of some scientists who continue to think that Asperger’s is distinct from ASD in important ways.

Asperger’s Syndrome Research

Title: Transcranial Magnetic Stimulation for Restricted and Repetitive Behavior in ASD (TMS for ASD)

Stage: Recruiting

Contact: Eleanor J.  Cole, PhD 

Stanford University

Palo Alto, CA

Investigating the efficacy of a form of TMS called theta-burst stimulation for restricted and repetitive behavior in ASD.

Inclusion Criteria:

Diagnosis of Autism Spectrum Disorder (ASD), Asperger’s or Autism.

Meet criteria for ASD on clinical assessments (ADOS-2 or CARS/BOSA if conducted remotely & ADI-R)

Aged between 12-45 years old

Have a reliable informant who can complete relevant questionnaires

Must have previously not responded or not tolerated 2 treatments.

Title: Understanding the Effects of Intervention on the Brain in Autism

Stage: Recruiting

Principal investigator: Amy Van Hecke, PhD 

Marquette University

Milwaukee, WI

This study examines how the PEERS (Laugeson & Frankel, 2010; Laugeson, 2016) social-behavioral intervention affects social relationships and brain development and function in autistic preschoolers, adolescents, and young adults.

Title: Services to Enhance Social Functioning in Adults With Autism Spectrum Disorders

Stage: Recruiting

Principal investigator: Edward Brodkin, MD 

University of Pennsylvania

Philadelphia, PA

The purpose of this study is to test a novel, three-part cognitive-behavioral treatment strategy to improve social functioning in adults with an autism spectrum disorder.

The treatment, named TUNE In (Training to Understand and Navigate Emotions and Interactions), includes components to address the many behavioral domains involved in social functioning, including social motivation, social anxiety, social cognition, social skills, and generalization of the skills to community settings.

We will test the efficacy of TUNE In to improve social functioning in adults with autism spectrum disorder (ASD), using a randomized controlled trial using the SRS-2 as the primary outcome measure.