Asperger’s Syndrome: What Is, Symptoms, Diagnosis & Treatment

Pediatrician and Pediatric Pulmonologist
March 2022

Asperger’s syndrome is a condition that is part of the autism spectrum, but it has some characteristics that differentiate it from autism. A person with Asperger’s syndrome may find it hard to relate and communicate with others and may not understand their emotions nor what happens around them and their emotions. However, they do not present with any learning disabilities, and may even have above-average cognitive skills.

The severity of symptoms can vary greatly from one child to another, and less obvious cases may be more difficult to identify. This is why many people only discover that they have Asperger’s when they are adults. A diagnosis is often confirmed during a depressive episode or when a person experiences intense and recurrent episodes of anxiety.

Unlike autism, Asperger’s syndrome does not cause widespread learning difficulties. It is common for people diagnosed with autism to have a need to create fixed routines. 

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Common symptoms

To confirm a diagnosis of Asperger’s in a child or adult, an assessment by a pediatrician, a psychologist, or a psychiatrist is necessary. They will look for symptoms like:

1. Difficulty relating to other people

Children and adults with Asperger’s often demonstrate difficulty relating to other people, as they have rigid thinking and difficulty understanding their own emotions and the emotions of others. It may seem like they do not care about other people's feelings and needs.

2. Difficulty communicating

People with Asperger's syndrome have difficulty understanding the meaning behind non-verbal language (e.g. tone of voice, facial expressions, body gestures) and indirect messages (e.g. sarcasm). They often only understand the literal sense of things.

They also have difficulties expressing what they think or feel, and will not voluntarily share what interests them or what they think of other people. They often avoid eye contact with other people.

3. Not understanding rules

It is common for the child to not be able to accept common sense or respect simple rules such as waiting your turn in line or waiting for your turn to speak. This makes social interaction for these children more and more difficult as they grow up.

4. No delay in language, development, or cognitive skills

Children with this syndrome have normal cognitive development and do not require extra time or interventions to learn to speak or write. Their intelligence level is often normal or above average.

5. Need to create fixed routines

To make the world a little less confusing, people with Asperger's syndrome tend to create fairly fixed routines. Changes in habits, scheduled activities or appointments are not well-accepted.

Examples of this characteristic in children can include the need to take the same route to get to school every day, getting upset when they don't leave the house on time, or not understand why someone else is sitting in the chair they usually use. 

6. Very specific and intense interests

It is common for people with Asperger's to focus on specific activities for long periods of time, and to be entertained or engaged with the same thing, such as a conversation topic or an object, for a long time.

7. Impatience

People with Asperger's syndrome are typically impatient. They may have difficulty understanding the needs of others and can come off as rude. In addition, it is common for them to not enjoy talking to people their own age, as they prefer a more formal speech with a lot of depth on a specific topic.

8. Motor incoordination

There may be a lack of coordination of movements, which are often awkward and clumsy. It is common for children with this syndrome to have an unusual or strange body posture.

9. Lack of emotional control

With Asperger's syndrome, it is difficult to understand feelings and emotions. Therefore, when people with Asperger's are emotionally overloaded, they may find it difficult to regulate their reactions.

10. Hypersensitivity to stimuli

People with Asperger's usually have heightened senses and, therefore, it is common for them to overreact to stimuli such as lights, sounds, or textures.

However, there are also some cases of Asperger's where the senses seem to be under-developed, which ends up pronouncing their inability to relate to the world around them.

How it is diagnosed

To diagnose Asperger's syndrome, parents should take their child to a pediatrician or child psychologist should signs indicative of Asperger's syndrome appear. 

During the appointment, the doctor will complete a physical and psychological assessment of the child to better understand the origin of their behavior. The goal will be to confirm or rule out a diagnosis of Asperger's syndrome diagnosis.

The earlier the diagnosis is made and the treatment is started, the better the child's adaptation to the environment and quality of life will be.

Treatment for children

The treatment goals of Asperger's Syndrome are usually aimed at improving the quality of life and overall wellness of the child. Sessions with a psychologist and speech therapist can help the child to socialize and relate to other people. Treatment should be started as soon as a diagnosis is confirmed, as it is possible to achieve better results with the right treatment.  

People with Asperger's Syndrome are usually highly intelligent, and have a very logical, but apathetic way of thinking. It is difficult for them to relate to other people for this reason. With the intervention of a psychologist, a child can better understand the atypical social behaviors they may have and learn how to cope with them.

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1. Psychological therapy

Psychological therapy is fundamental in Asperger's syndrome. During sessions, the therapist is able to observe the child's behaviors and identify the situations where these behaviors arise most frequently. Therapy also encourages the child to communicate with people who are not part of their day-to-day.

It is important for the child's parents, caregivers and/or teachers to collaborate with the therapist in order to support the child. Some ways that parents, caregivers and/or teachers can help a child with Asperger's Syndrome include:

  • Give simple and clear orders (e.g. Say "put away your puzzle when you're done playing" instead of "put away your toys when you're done playing")
  • Ask a child why they are behaving a certain way in the moment
  • Explain in a clear and calm way why a certain behavior is not appropriate (e.g. explaining that curse words or throwing objects at others is not nice and can hurt someone's feelings)
  • Avoid criticizing the child for their behaviors

Additionally, the therapist can help a child cope with their inappropriate behaviors by playing games that encourage socialization or helping them understand their behaviors and how they can impact others. Many times, children with Asperger's syndrome are unable to differentiate right from wrong.

2. Speech therapy

Many children with Asperger's syndrome have difficulty communicating with other people, and sessions with the speech therapist can help to develop speech skills. These sessions can involve teaching the child how to form sentences and how to control the volume of their voice (as some children are unsure about when loud voices are appropriate).

In addition to helping the child to socialize, the speech therapist can also help the child express their feelings. It is important for speech therapy to occur alongside psychological therapy so that the child can identify feelings that emerge in specific situations.

3. Treatment with medication

There is no standard medication used for Asperger's syndrome. However, if the child presents with symptoms of anxiety, depression, hyperactivity or attention deficit, the psychologist can refer the child to a psychiatrist, who can prescribe medication to help with these conditions. The treatment goal with medication is typically to improve the child's quality of life.

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Edited by Tua Saude editing team in March 2022. Medical review completed by Dr.ª Sani Santos Ribeiro - Pediatrician and Pediatric Pulmonologist in November 2021.

References

  • AUTISMO E REALIDADE. Síndrome de Asperger e Autismo de Alta Funcionalidade Kit de Ferramentas. 2010. Available on: <http://autismo.institutopensi.org.br/wp-content/uploads/manuais/Manual_para_Sindrome_de_Asperger.pdf>. Access in 22 Jun 2020
  • NATIONAL AUTISTIC SOCIETY. Asperger syndrome. Available on: <https://www.autism.org.uk/about/what-is/asperger.aspx>. Access in 03 Jun 2020
Show more references
  • THE NATIONAL AUTISTIC SPCIETY. What is Asperger syndrome?. Available on: <https://www.sabp.nhs.uk/application/files/4215/1964/9052/What_is_Asperger_Syndrome.pdf>. Access in 03 Jun 2020
Pediatrician and Pediatric Pulmonologist
Obtained medical degree at Rio Grande Federal University. CRM license #28364. Member of the Brazilian Pediatric Association.