Understanding Asperger's Disorder in Children

Asperger's Disorder is one of the pervasive developmental disorders in children. Asperger's Syndrome was first described by a pediatrician (child health expert) from Vienna, Hans Asperger. In his 1944 thesis, Hans Asperger described four boys who lacked interactive, linguistic, and cognitive abilities, using the term “Autistic Psychopathy”. Leo Kanner and Hans Asperger described these children as individuals with very minimal social interaction, communication failures, and the development of special interests. b. Diagnostic criteria for Asperger's Disorder according to DSM-IV are as follows: 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, 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. 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). 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. G. There is no delay in language, cognitive, or adaptive behavior development. Note: Unlike infantile autism, Asperger's can only be detected at 6 – 11 years of age. c. Asperger's Scale (M.S. Garnett and A.J. Attwood, in Suhadianto 2009) The following questionnaire was developed to identify behaviors and abilities associated with Asperger's Syndrome in primary school-aged children, which is when their behavioral patterns and abilities can be clearly observed. Each of the following questions has a score rating starting from zero (0) or equivalent to the average level of a normal child: 0 = rarely, 6 = often. Questionnaire: SOCIAL AND EMOTIONAL ABILITIES 1. Does the child lack understanding of how to play with other children? For example, not being aware of unwritten game rules? |0|1|2|3|4|5|6| 2. If freely playing with other children, during school lunch, does the child refuse to make social contact with other children? For example, preferring a quiet place or going to the library? |0|1|2|3|4|5|6| 3. Does the child seem unaware of social customs or manners, then acts and makes inappropriate comments? For example, making a personal comment to someone, while seemingly unaware that their remark will anger others? |0|1|2|3|4|5|6| 4. Does the child usually expect others to understand their feelings, experiences, and opinions? For example, not realizing that we cannot know these things because we were not with them at the time? |0|1|2|3|4|5|6| 5. Does the child always need reassurance, especially when there are changes or if something goes wrong? |0|1|2|3|4|5|6| 6. Is the child unable to express their emotional experiences? For example, does the child show distressed or affectionate reactions that are inappropriate for a given situation/circumstance? |0|1|2|3|4|5|6| 7. Does the child lack the ability to express their emotions? |0|1|2|3|4|5|6| 8. Is the child uninterested in participating in sports, games, and other activities? A score of zero (0) means the child enjoys sports. |0|1|2|3|4|5|6| 9. Is the child indifferent to current trends or peer pressure? A score of zero (0) means the child is obsessed with trends. For example, does the child not follow the latest trends in choosing toys or clothes? |0|1|2|3|4|5|6| COMMUNICATION ABILITIES 1. Does the child tend to interpret explanations or criticisms literally? For example, do they get confused by idioms like ‘pull your socks up’, or ‘looks can kill’, or ‘hop on the scales’? |0|1|2|3|4|5|6| 2. Does the child have an unusual tone of voice? For example, does the child have a vocal emphasis that sounds unfamiliar, or a monotonous voice, or no emphasis on key/main words? |0|1|2|3|4|5|6| 3. When speaking, does the child tend to rarely look at their conversational partner as we would expect? |0|1|2|3|4|5|6| 4. Does the child speak too precisely or display their knowledge, for example, speaking in a very formal manner or like a walking dictionary? |0|1|2|3|4|5|6| 5. Does the child have difficulty repairing a conversation? For example, if confused, they (male or female) do not ask for clarification but simply switch to a topic they know or take a long time to find an answer. |0|1|2|3|4|5|6| RECOGNITION or COGNITIVE ABILITIES 1. Does the child read books specifically for information, and is not interested in fiction? For example, does the child enjoy reading encyclopedias or science books, but not storybooks about adventures? |0|1|2|3|4|5|6| 2. Does the child have a strong memory for events or facts? For example, being able to recall a neighbor's car license plate number seen several years ago, or easily remembering an event from several years ago. |0|1|2|3|4|5|6| 3. Does the child lack social imagination, for example, not including other children in their imaginative play or becoming confused when participating in pretend play with other children? |0|1|2|3|4|5|6| SPECIAL INTERESTS 1. Is the child fascinated by a specific topic and then enjoys collecting information or statistics about that topic? For example, does the child become a walking encyclopedia, possessing knowledge about vehicles, maps, or football league tables? |0|1|2|3|4|5|6| 2. Does the child become excessively angry or disappointed due to a change from the usual situation, or if a change occurs unexpectedly? For example: are they upset if they go to school via a different route than usual? |0|1|2|3|4|5|6| 3. Does the child perform (develop) a routine or ritual that must be completed? For instance, lining up their toys parallel before going to bed. |0|1|2|3|4|5|6| AGILITY IN MOVEMENT 1. Does the child have poor motor coordination? For example, being slow to catch a ball. |0|1|2|3|4|5|6| 2. Does the child run in an unusual way? |0|1|2|3|4|5|6| OTHER CHARACTERISTICS OR TRAITS For this section, check if the child shows signs that may indicate their traits as listed below: a. Unusual fear due to: Normal sounds, such as electronic devices. Gentle touch on the skin or head, Using certain accessories or items in clothing, Sudden loud noises, Seeing certain objects/items, Noise, being in a noisy place such as a supermarket b. Tends to flap or rock when experiencing excitement or frustration c. Less sensitive to mild pain. d. Slow in answering questions e. Shows strange/funny facial expressions d. Therapy 1. behavior modification, 2. parent counseling, 3. use of electric shock, 4. use of psychotropic medications. e. References: Kaplan, Harold I., Sadock, Benjamin J, Grebb, Jack A. (2002). Synopsis of psychiatry clinical psychiatric science. Jakarta : Binarupa Aksara. Nevid, Jeffrey S., Rathus, Spencer A., Greene, Beverly. (2002). Abnormal psychology volume two fifth edition. Jakarta : Erlangga Suhadianto. (2009). Diagnosis of pervasive developmental disorders. http://suhadianto.blogspot.com/2009/02/diagnosis-gangguan-perkembangan.html. source: http://tyaset4.blog.com/2010/04/asperger/