Asperger's Disorder

1
Asperger's Disorder
Elizabeth Ashmann Theresa LaLoggia Sophia McLin
2

• Pervasive developmental disorder on the autism
  spectrum
• Can be high-functioning autism because of normal
  early development and lack of language delay
  compared with autism patients
• (Frith, 2004)

3

• History
• Named in honor of Hans Asperger
• He performed a study where he observed four
  children who had difficulty in social situations
• All of the children had normal intelligence but
  there nonverbal communication skills were poor
• Children were unable to show empathy with each
  other and were clumsy
• He diagnosed them with autistic psychopathy
• (Frith, 2004)

4

• History Continued
• In 1981, when Hans had died the year before, a
  psychiatrist, Lorna Wing gave the diagnosis
  Aspergers Syndrome to children she had studied
• In 1994 the DSM-IV and the American Psychiatric
  Associations reference book recognized
  Aspergers syndrome as a disorder

5

• DSM-IV
• Symptoms must be severe enough and there must be
  sustained impairment in social interactions
• A development of restrictive, repeated patterns
  of behaviors, interests, and activities
• The disorder must cause significant impairment in
  social, occupational, and or other areas of
  functioning in ones life
• There are no clinically significant delays in
  language acquisition unlike autism
• In the first three years of life, there are no
  significant delays in cognitive development in
  discovering the environment or a delay in
  age-appropriate learning skills and adaptive
  behaviors
• Criterion not met for any other specific
  pervasive developmental disorder or schizophrenia
• (DSM-IV, 2000)

6

• Symptoms
• Lack of social interaction
• Children unable to develop peer relationships
• Cannot exhibit nonverbal behaviors
• Unable to maintain eye-to-eye gaze, lack facial
  expressions, impairment in body posture and
  gestures when in contact with other children and
  adults
• Do not have the need to make friends
• Difficult time showing emotions and seeking a
  reaction from other children
• Solitary in behaviors and activities they
  participate in
• Some will show an extreme form of egocentrism
• Child is self-absorbed and a disregard for others

7

• Conversations with others
• Preoccupations common
• Can talk about cars, trains, meteorology,
  astronomy or history for hours and hours
• The children do not direct their discussion to
  anyone specifically but will just speak their
  mind to anyone who is listening
• Child fails to use conventional rules of
  conversation
• Articulation is clumsy
• Switch topics often and do not speak
  grammatically correct
• Their speech can have abnormalities of inflection
  and a repetitive pattern can appear
• (Frith, 2004)

8

• Strengths
• Large vocabulary
• Rote-auditory memory is excellent
• Far superior written language than spoken
  language

9

• Age of symptoms
• Before the age of three symptoms are not heavily
  displayed
• At a younger age, more symptoms of inattention
  and over activity than social dysfunction
• Many children will be diagnosed with ADHD as a
  child
• Hyperlexia can be a precursor
• A diagnosis is difficult because of the strengths
  that exist
• Average age doctor confirms the diagnosis for
  Aspergers is 11 years
• Parents recognize symptoms at 30 months old.
• Prevalence not known

10

• Course of Aspergers
• A life-long disorder
• A younger child may have good verbal abilities
  but will lack social skills
• Older children will have interest in making new
  friendships but will lack the understanding of
  the convention of social interaction
• May become employed and be capable of
  self-sufficiency
• (DSM-IV, 2000)

11

• Comoribity
• ADHD
• Depression
• Oppositional-defiant disorder
• Antisocial personality disorder
• Tourette syndrome
• General anxiety disorder
• Bipolar disorder
• Obsessive-compulsive disorder
• (DSM-IV, 2000)

12

• Genetics
• Twin Studies
• MZ 60-90
• DZ 0
• Chromosome
• 15

13

• Maternal Illness
• Rubella
• Herpes
• Strepococcal Infection-b
• Tuberous Sclerosis
• Thalidomide

14

• Neurotransmitters
• Seratonin
• Increased levels
• SSRIs effective in alleviating symptoms in some
  patients
• Dopamine
• Controversial
• Increased levels stereotypic motor movements
  hyperarousal
• DA antagonists effective in alleviating symptoms

15

• Structural Anomalies
• Enlarged Brain Size
• Cerebellum
• Increased white matter
• Decreased size of vermis
• Decreased number of Purkinje cells

16

• Structural Anomalies
• Decreased size of amygdala
• Underactivation of the prefrontal cortex

17

• Structural Anomalies
• Increased activation of the HPA axis

18

• Structural Anomalies
• Fusiform Face Area

19

• What Aspergers looks like within the school
  setting
• Elementary School vs. Middle/High School
• Interventions and Accommodations

20

• ASPERGERS IN THE ACADEMIC SETTING
• IDEA doesnt identify AD as eligibility category
• 75 of AD individuals have behavior problems when
  sensory issues are ignored
• Social problems/taboos that frustrate both peers
  and teachers
• Teachers emphasizing social interaction through
  group work can cause problems
• Crowded school events cause social
  anxiety/sensory overload
• Do not usually display difficulty in cognitive
  development
• Often educated in general education classroom

21

• ELEMENTARY VS. MIDDLE/HIGH SCHOOL
• Elementary
• Subtle nature of signs/symptoms often make early
  referral difficult
• May have difficulty with comprehension, problem
  solving, abstract thinking, receptive/expressive
  language, and organizational skills
• Motoric and sensory indicators easier to ID in
  young AD children
• Middle/High School
• Problems with increased grading rigor, more
  homework, larger population, increased academic
  competition
• Significant mismatch between the skills required
  and the abilities of the student with AD (Adreon
  and Stella, 2001)
• Need for flexibility and organization that is
  often beyond AD childs scope
• Proper level of support in transition is crucial
  to success

22

• INTERVENTION AND ACCOMODATIONS
• Six Common Interventions/Accommodations
• One-to-one aids
• Structured seating arrangements/group work
• Provide a safe haven
• Prepare child for changes in routine
• Use available resources technology
• Promote positive peer interactions

23
Video
http//www.youtube.com/watch?vloxYmUr70eI
24
Questions?