Asperger syndrome history and symptoms: Difference between revisions

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{{ Asperger syndrome}}
{{ Asperger syndrome}}
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==Overview==
== Overview ==
A [[pervasive developmental disorder]], Asperger's 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.<ref name="BehaveNet">{{cite book |title= Diagnostic and Statistical Manual of Mental Disorders |edition= 4th ed., text revision ([[DSM-IV-TR]]) |author= [[American Psychiatric Association]] |date=2000 |isbn=0-89042-025-4 |chapter= Diagnostic criteria for 299.80 Asperger's Disorder (AD) |chapterurl=http://www.behavenet.com/capsules/disorders/asperger.htm |accessdate=2007-06-28}}</ref> Intense preoccupation with a narrow subject, one-sided verbosity, restricted [[Prosody (linguistics)|prosody]], and physical clumsiness are typical of the condition, but are not required for diagnosis.<ref name="Klin">{{cite journal |journal= Rev Bras Psiquiatr |year=2006 |volume=28 |issue= suppl 1 |pages=S3–S11 |title= Autism and Asperger syndrome: an overview |author= Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en}}</ref>
Several symptoms may be seen in Asperger Syndrome (AS) with impairments in social interaction, communication and restricted, repetitive behaviors and interests being the most important. There may be impairments in motor and sensory functions, speech, language and sleep.  


==History and Symptoms==
== History and Symptoms ==
 
===<s>Social interaction</s>===
{{further|[[Sociological and cultural aspects of autism#Asperger syndrome and interpersonal relationships|Asperger syndrome and interpersonal relationships]]}}
 
<s>The lack of demonstrated empathy is possibly the most dysfunctional aspect of Asperger syndrome. Individuals with Asperger's syndrome 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; and impaired [[Nonverbal communication|nonverbal behaviors]] in areas such as eye contact, facial expression, posture, and gesture.<ref name="McPartland">{{cite journal |author= McPartland J, Klin A |title= Asperger's syndrome |journal= Adolesc Med Clin |volume=17 |issue=3 |pages=771–88 |year=2006 |pmid=17030291 |doi=10.1016/j.admecli.2006.06.010 |doi_brokendate=2008-06-25}}</ref></s>
 
<s>Unlike those with autism, people with AS are not usually withdrawn around others; they approach others, even if awkwardly, for example by engaging in a one-sided, long-winded speech about a favorite topic while being oblivious to the listener's feelings or reactions, such as signs of boredom or haste to leave.<ref name="Klin" /> This social awkwardness has been called "active but odd".<ref name="Klin" /> This failure to react appropriately to social interaction may appear as disregard for other people's feelings, and may come across as insensitive.<ref name="Klin" /> The cognitive ability of children with AS often lets them articulate social norms in a laboratory context,<ref name="McPartland" /> where they may be able to show a theoretical understanding of other people’s emotions; they typically have difficulty acting on this knowledge in fluid, real-life situations, however.<ref name="Klin" /> People with AS may analyze and distill their observation of social interaction into rigid behavioral guidelines and apply these rules in awkward ways—such as forced eye contact—resulting in demeanor that appears rigid or socially naïve. Childhood desires for companionship can be numbed through a history of failed social encounters.<ref name="McPartland" /></s>
 
<s>The [[hypothesis]] that individuals with AS are predisposed to violent or criminal behavior has been investigated but is not supported by data.<ref name="McPartland" /><ref name=":0">{{cite journal |journal= J Autism Dev Disord |year=2008 |title= Offending behaviour in adults with Asperger syndrome |author= Allen D, Evans C, Hider A, Hawkins S, Peckett H, Morgan H |pmid=17805955 |doi=10.1007/s10803-007-0442-9 |volume=38 |issue=4 |pages=748–58}}</ref> More evidence suggests children with AS are victims rather than victimizers.<ref name="Tsatsanis">{{cite journal |journal= Child Adolesc Psychiatr Clin N Am |year=2003 |volume=12 |issue=1 |pages=47–63 |title= Outcome research in Asperger syndrome and autism |author= Tsatsanis KD |pmid=12512398 |url=http://www.childpsych.theclinics.com/article/PIIS1056499302000561/fulltext |doi=10.1016/S1056-4993(02)00056-1}}</ref></s>
 
===<s>Restricted and repetitive interests and behavior</s>===
[[Image:Riboflavin penicillinamide.jpg|left|thumb|Those with AS often display intense interests, such as this boy's fascination with molecular structure.]]
<s>People with Asperger syndrome display behavior, interests, and activities that are restricted and repetitive and are sometimes abnormally intense or focused. They may stick to inflexible routines or rituals, move in stereotyped and repetitive ways, or preoccupy themselves with parts of objects.<ref name="BehaveNet" /></s>
 
<s>Pursuit of specific and narrow areas of interest is one of the most striking features of AS.<ref name="McPartland" /> Individuals with AS may collect volumes of detailed information on a relatively narrow topic such as dinosaurs or deep fat fryers,<!--This is cited text, it is not a joke, please do not remove--> without necessarily having genuine understanding of the broader topic.<ref name="McPartland" /><ref name="Klin" /> For example, a child might memorize camera model numbers while caring little about photography.<ref name="McPartland" /> This behavior is usually apparent by grade school, typically age 5 or 6 in the United States.<ref name="McPartland" /> 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 topics such as dinosaurs often capture the interest of children, this symptom may go unrecognized.<ref name="Klin" /></s>
 
[[Stereotypy|Stereotyped]] and repetitive motor behaviors are a core part of the diagnosis of AS and other ASDs.<ref name=":1">{{cite journal |journal= J Autism Dev Disord |year=2005 |volume=35 |issue=2 |pages=145–58 |title= Repetitive behavior profiles in Asperger syndrome and high-functioning autism |author= South M, Ozonoff S, McMahon WM |doi=10.1007/s10803-004-1992-8 |pmid=15909401}}</ref> They include hand movements such as flapping or twisting, and complex whole-body movements.<ref name="BehaveNet" /> These are typically repeated in longer bursts and look more voluntary or ritualistic than [[tic]]s, which are usually faster, less rhythmical and less often symmetrical.<ref name="RapinTS">{{cite journal |author= Rapin I |title= Autism spectrum disorders: relevance to Tourette syndrome |journal= Adv Neurol |volume=85 |pages=89–101 |year=2001 |pmid=11530449}}</ref>
 
===<s>Speech and language</s>===
<s>Although individuals with Asperger syndrome acquire language skills without significant general delay and their speech typically lacks significant abnormalities, language acquisition and use is often atypical.<ref name="Klin" /> Abnormalities include verbosity; abrupt transitions; literal interpretations and miscomprehension of nuance; use of [[metaphor]] meaningful only to the speaker; [[Auditory processing disorder|auditory perception deficits]]; unusually [[pedant]]ic, [[Register (linguistics)|formal]] or [[Idiosyncrasy#Psychiatry|idiosyncratic]] speech; and oddities in [[loudness]], [[Tone (linguistics)|pitch]], [[Intonation (linguistics)|intonation]], [[Prosody (linguistics)|prosody]], and [[rhythm]].</s>


<s>Three aspects of communication patterns are of clinical interest: poor prosody, tangential and circumstantial speech, and marked verbosity. Although [[inflection]] and intonation may be less rigid or monotonic than in autism, people with AS often have a limited range of intonation; speech may be unusually fast, jerky or loud. Speech may convey a sense of incoherence; the conversational style often includes monologues about topics that bore the listener, fails to provide context for comments, or fails to suppress internal thoughts. Individuals with AS may fail to monitor whether the listener is interested or engaged in the conversation. The speaker's conclusion or point may never be made, and attempts by the listener to elaborate on the speech's content or logic, or to shift to related topics, are often unsuccessful.<ref name="Klin" /></s>
Some major neuropsychological abnormalities in patients with Asperger Syndrome (AS) are:<ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref>


<s>Children with AS may have an unusually sophisticated vocabulary at a young age and have been colloquially called "little professors", but have difficulty understanding [[figurative language]] and tend to use language literally. Children with AS appear to have particular weaknesses in areas of nonliteral language that include humor, irony, and teasing. Although individuals with AS usually understand the cognitive basis of [[humor]] they seem to lack understanding of the intent of humor to share enjoyment with others.Despite strong evidence of impaired humor appreciation, there are anecdotal reports of humor in individuals with AS, which challenge theories of humor in AS.<ref>{{cite journal |author= Lyons V, Fitzgerald M |title= Humor in autism and Asperger syndrome |journal= J Autism Dev Disord |volume=34 |issue=5 |pages=521–31 |year=2004 |pmid=15628606 |doi=10.1007/s10803-004-2547-8}}</ref></s>
* Difficulty in passing [[theory of mind]] tasks
 
* Executive dysfunction
===<s>Other</s>===
* Tendency to interpret visual stimuli in parts rather than wholes (poor central coherence)
Individuals with Asperger syndrome may have signs or symptoms that are independent of the diagnosis, but can affect the individual or the family. These include differences in perception and problems with motor skills, sleep, and emotions.
* There are studies that suggest in patients with AS there is a Verbal IQ (VIQ) > Poor Performance IQ (PIQ) profile which shows strength on verbal skills relative to visuospatial skills and non-verbal problem solving ([[Nonverbal learning disorder|nonverbal learning disability]])<ref name="LincolnCourchesne1998">{{cite journal|last1=Lincoln|first1=Alan|last2=Courchesne|first2=Eric|last3=Allen|first3=Mark|last4=Hanson|first4=Ellen|last5=Ene|first5=Michaela|title=Neurobiology of Asperger Syndrome|year=1998|pages=145–163|doi=10.1007/978-1-4615-5369-4_8}}</ref>
 
Individuals with AS often have excellent auditory and visual perception.<ref>{{cite journal |journal= J Child Psychol Psychiatry |date=2004 |volume=45 |issue=4 |pages=672–86 |title= Emanuel Miller lecture: confusions and controversies about Asperger syndrome |author= Frith U |doi=10.1111/j.1469-7610.2004.00262.x |pmid=15056300}}</ref> Children with ASD often demonstrate enhanced perception of small changes in patterns such as arrangements of objects or well-known images; typically this is domain-specific and involves processing of fine-grained features.<ref>{{cite book |chapter= Psychological factors in autism |author= Prior M, Ozonoff S |pages=69–128 |title= Autism and Pervasive Developmental Disorders |edition= 2nd ed |editor= Volkmar FR |publisher= Cambridge University Press |year=2007 |isbn=0-521-54957-4}}</ref> Conversely, compared to individuals with HFA, individuals with AS have deficits in some tasks involving visual-spatial perception, auditory perception, or visual memory.<ref name="McPartland" /> Many accounts of individuals with AS and ASD report other unusual sensory and perceptual skills and experiences. They may be unusually sensitive or insensitive to sound, light, touch, texture, taste, smell, pain, temperature, and other stimuli, and they may exhibit [[synesthesia]];<ref>{{cite book |author= Bogdashina O |title= Sensory Perceptional Issues in Autism and Asperger Syndrome: Different Sensory Experiences, Different Perceptual Worlds |publisher= Jessica Kingsley |year=2003 |isbn=1-843101-66-1}}</ref> these sensory responses are found in other developmental disorders and are not specific to AS or to ASD. There is little support for increased [[fight-or-flight response]] or failure of [[habituation]] in autism; there is more evidence of decreased responsiveness to sensory stimuli, although several studies show no differences.<ref>{{cite journal |author= Rogers SJ, Ozonoff S |title= Annotation: what do we know about sensory dysfunction in autism? A critical review of the empirical evidence |journal= J Child Psychol Psychiatry |volume=46 |issue=12 |pages=1255–68 |year=2005 |pmid=16313426 |doi=10.1111/j.1469-7610.2005.01431.x}}</ref>
 
Hans Asperger’s initial accounts<ref name="McPartland" /> and other diagnostic schemes<ref name="EhlGill">{{cite journal |author= Ehlers S, Gillberg C |title= The epidemiology of Asperger's syndrome. A total population study |journal= J Child Psychol Psychiat |year=1993 |volume=34 |issue=8 |pages=1327–50 |doi=10.1111/j.1469-7610.1993.tb02094.x |pmid=8294522}}</ref> include descriptions of physical clumsiness. Children with AS may be delayed in acquiring skills requiring motor dexterity, such as riding a bicycle or opening a jar, and may seem to move awkwardly or feel "uncomfortable in their own skin". They may be poorly coordinated, or have an odd or bouncy gait or posture, poor handwriting, or problems with visual-motor integration.<ref name="McPartland" /><ref name="Klin" /> They may show problems with [[proprioception]] (sensation of body position) on measures of [[apraxia]] (motor planning disorder), balance, [[tandem gait]], and finger-thumb apposition. There is no evidence that these motor skills problems differentiate AS from other high-functioning ASDs.<ref name="McPartland" />
 
Children with AS are more likely to have sleep problems, including difficulty in falling asleep, frequent nocturnal [[Wakefulness|awakenings]], and early morning awakenings.<ref>{{cite journal |journal= J Intellect Disabil Res |year=2005 |volume=49 |issue=4 |pages=260–8 |title= A survey of sleep problems in autism, Asperger's disorder and typically developing children |author= Polimeni MA, Richdale AL, Francis AJ |doi=10.1111/j.1365-2788.2005.00642.x |pmid=15816813}}</ref><ref name="Tani" /> AS is also associated with high levels of [[alexithymia]], which is difficulty in identifying and describing one's emotions.<ref>Alexithymia and AS:
 
*{{cite journal |author= Fitzgerald M, Bellgrove MA |title= The overlap between alexithymia and Asperger's syndrome |journal= J Autism Dev Disord |volume=36 |issue=4 |pages=573–6 |year=2006 |pmid=16755385 |doi=10.1007/s10803-006-0096-z}}
*{{cite journal |author= Hill E, Berthoz S |year=2006 |title= Response |journal= J Autism Dev Disord |volume=36 |issue=8 |pages=1143–5 |doi=10.1007/s10803-006-0287-7 |pmid=17080269}}
*{{cite journal |journal= PLoS ONE |year=2007 |volume=2 |issue=9 |pages=e883 |title= Self-referential cognition and empathy in autism |author= Lombardo MV, Barnes JL, Wheelwright SJ, Baron-Cohen S |doi=10.1371/journal.pone.0000883 |pmid=17849012 |url=http://www.plosone.org/article/fetchArticle.action?articleURI=info:doi/10.1371/journal.pone.0000883}}</ref> Although AS, lower sleep quality, and alexithymia are associated, their causative relationship is unclear.<ref name="Tani">{{cite journal |author= Tani P, Lindberg N, Joukamaa M ''et al.'' |title= Asperger syndrome, alexithymia and perception of sleep |journal= Neuropsychobiology |volume=49 |issue=2 |pages=64–70 |year=2004 |pmid=14981336 |doi=10.1159/000076412}}</ref>
 
== Overview ==
 
== History and Symptoms ==


=== Social interaction and communication ===
=== Social interaction and communication ===
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* They have interest in to play or interact with others and social communication but find themselves isolated.<ref name="pmid30736970">{{cite journal| author=Mirkovic B, Gérardin P| title=Asperger's syndrome: What to consider? | journal=Encephale | year= 2019 | volume= 45 | issue= 2 | pages= 169-174 | pmid=30736970 | doi=10.1016/j.encep.2018.11.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30736970  }} </ref><ref name="pmid15909408" />
* They have interest in to play or interact with others and social communication but find themselves isolated.<ref name="pmid30736970">{{cite journal| author=Mirkovic B, Gérardin P| title=Asperger's syndrome: What to consider? | journal=Encephale | year= 2019 | volume= 45 | issue= 2 | pages= 169-174 | pmid=30736970 | doi=10.1016/j.encep.2018.11.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30736970  }} </ref><ref name="pmid15909408" />
* They do not realize that relationships and friendships are based on common interests and flexibility.<ref name="pmid30736970">{{cite journal| author=Mirkovic B, Gérardin P| title=Asperger's syndrome: What to consider? | journal=Encephale | year= 2019 | volume= 45 | issue= 2 | pages= 169-174 | pmid=30736970 | doi=10.1016/j.encep.2018.11.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30736970  }} </ref>
* They do not realize that relationships and friendships are based on common interests and flexibility.<ref name="pmid30736970">{{cite journal| author=Mirkovic B, Gérardin P| title=Asperger's syndrome: What to consider? | journal=Encephale | year= 2019 | volume= 45 | issue= 2 | pages= 169-174 | pmid=30736970 | doi=10.1016/j.encep.2018.11.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30736970  }} </ref>
* They often make formal communications with others and make one-sided speech and monologues about a specific topic regardless of other people's interest.<ref name="Klin" /><ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref><ref name="pmid15909408" />
* They often make formal communications with others and make one-sided speech and monologues about a specific topic regardless of other people's interest.<ref name="Klin">{{cite journal |journal= Rev Bras Psiquiatr |year=2006 |volume=28 |issue= suppl 1 |pages=S3–S11 |title= Autism and Asperger syndrome: an overview |author= Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en}}</ref><ref name="pmid18563474">{{cite journal| author=Woodbury-Smith MR, Volkmar FR| title=Asperger syndrome. | journal=Eur Child Adolesc Psychiatry | year= 2009 | volume= 18 | issue= 1 | pages= 2-11 | pmid=18563474 | doi=10.1007/s00787-008-0701-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18563474  }} </ref><ref name="pmid15909408" />
*They are verbal about a certain topic, but can not express feelings or recognize the feelings of others.<ref name="pmid17967920">{{cite journal| author=Johnson CP, Myers SM, American Academy of Pediatrics  Council on Children With Disabilities| title=Identification and evaluation of children with autism spectrum disorders. | journal=Pediatrics | year= 2007 | volume= 120 | issue= 5 | pages= 1183-215 | pmid=17967920 | doi=10.1542/peds.2007-2361 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17967920  }} </ref>
*They do not understand social and conversational rules.<ref name="pmid15909408" />
*They do not understand social and conversational rules.<ref name="pmid15909408" />
*Children with AS are usually victims of bullying at school.<ref name="pmid23901152">{{cite journal| author=Zablotsky B, Bradshaw CP, Anderson CM, Law P| title=Risk factors for bullying among children with autism spectrum disorders. | journal=Autism | year= 2014 | volume= 18 | issue= 4 | pages= 419-27 | pmid=23901152 | doi=10.1177/1362361313477920 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23901152  }} </ref>
*Children with AS are usually victims of bullying at school.<ref name="pmid23901152">{{cite journal| author=Zablotsky B, Bradshaw CP, Anderson CM, Law P| title=Risk factors for bullying among children with autism spectrum disorders. | journal=Autism | year= 2014 | volume= 18 | issue= 4 | pages= 419-27 | pmid=23901152 | doi=10.1177/1362361313477920 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23901152  }} </ref>
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=== Restricted and repetitive behaviors and interests ===
=== Restricted and repetitive behaviors and interests ===


*They include hand movements such as flapping or twisting, and complex whole-body movements.<ref name="BehaveNet" />
* Repetitive, limited and circumscribed interests<ref name="pmid15909401">{{cite journal| author=South M, Ozonoff S, McMahon WM| title=Repetitive behavior profiles in Asperger syndrome and high-functioning autism. | journal=J Autism Dev Disord | year= 2005 | volume= 35 | issue= 2 | pages= 145-58 | pmid=15909401 | doi=10.1007/s10803-004-1992-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15909401  }} </ref><ref name="pmid30736970" />
*These are typically repeated in longer bursts and look more voluntary or ritualistic than [[tic]]s, which are usually faster, less rhythmical and less often symmetrical.<ref name="RapinTS" />
*Extensive factual information about circumscribed topics (e.g., snakes, names of stars, dinosaurs, computers, train engine numbers)<ref name="pmid15909401">{{cite journal| author=South M, Ozonoff S, McMahon WM| title=Repetitive behavior profiles in Asperger syndrome and high-functioning autism. | journal=J Autism Dev Disord | year= 2005 | volume= 35 | issue= 2 | pages= 145-58 | pmid=15909401 | doi=10.1007/s10803-004-1992-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15909401  }} </ref><ref name="pmid16791390">{{cite journal| author=Klin A| title=[Autism and Asperger syndrome: an overview]. | journal=Braz J Psychiatry | year= 2006 | volume= 28 Suppl 1 | issue=  | pages= S3-11 | pmid=16791390 | doi=10.1590/s1516-44462006000500002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16791390  }} </ref>
* Repetitive, limited and circumscribed interests<ref name=":1" /><ref name="pmid30736970" />
*These symptoms might not be recognized because some topics and interests like dinosaurs are common among children.<ref name="pmid16791390">{{cite journal| author=Klin A| title=[Autism and Asperger syndrome: an overview]. | journal=Braz J Psychiatry | year= 2006 | volume= 28 Suppl 1 | issue=  | pages= S3-11 | pmid=16791390 | doi=10.1590/s1516-44462006000500002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16791390  }} </ref>
*Extensive factual information about circumscribed topics (e.g., snakes, names of stars, dinosaurs, computers, train engine numbers)<ref name=":1" /><ref name="Klin" />
*These interests may immerse the family and disrupt family activities.<ref name="pmid16791390">{{cite journal| author=Klin A| title=[Autism and Asperger syndrome: an overview]. | journal=Braz J Psychiatry | year= 2006 | volume= 28 Suppl 1 | issue=  | pages= S3-11 | pmid=16791390 | doi=10.1590/s1516-44462006000500002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16791390  }} </ref><ref name="pmid15909401">{{cite journal| author=South M, Ozonoff S, McMahon WM| title=Repetitive behavior profiles in Asperger syndrome and high-functioning autism. | journal=J Autism Dev Disord | year= 2005 | volume= 35 | issue= 2 | pages= 145-58 | pmid=15909401 | doi=10.1007/s10803-004-1992-8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15909401  }} </ref>
*These symptoms might not be recognized because some topics and interests like dinosaurs are common among children.<ref name="Klin" />
*Patients with autism spectrum disorder (ASD) usually have stereotyped and repetitive motor behaviors and speech such as lining up toys, flipping objects or [[echolalia]].<ref name=":0">{{cite journal |journal= J Autism Dev Disord |year=2008 |title= Offending behaviour in adults with Asperger syndrome |author= Allen D, Evans C, Hider A, Hawkins S, Peckett H, Morgan H |pmid=17805955 |doi=10.1007/s10803-007-0442-9 |volume=38 |issue=4 |pages=748–58}}</ref>
*These interests may immerse the family and disrupt family activities.<ref name="Klin" /><ref name=":1" />  
*Atypical behaviors such as peculiar mannerisms, unusual attachments to objects, obsessions, compulsions, self-injurious behaviors, and stereotypes.<ref name="pmid17967920" />
*Patients with autism spectrum disorder (ASD) usually have stereotyped and repetitive motor behaviors and speech such as lining up toys, flipping objects or [[echolalia]].  
* Stereotypes are repetitive and atypical behaviors such as hand flapping, finger movements, rocking, or twirling, finger flicking, unusual eye gazing, habitual toe walking, and/or persistent sniffing and licking of nonfood items.<ref name="pmid17967920" />
* The have unusual attachments for hard items; for example, ballpoint pens, flashlight, keys, action figures.<ref name="pmid17967920" />  


=== Language and Speech ===
=== Language and Speech ===


* Language is usually adequate or even precocious.<ref name="pmid15909408">{{cite journal| author=Klin A, Pauls D, Schultz R, Volkmar F| title=Three diagnostic approaches to Asperger syndrome: implications for research. | journal=J Autism Dev Disord | year= 2005 | volume= 35 | issue= 2 | pages= 221-34 | pmid=15909408 | doi=10.1007/s10803-004-2001-y | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15909408  }} </ref> Although mild language delay has been reported in AS.<ref name="pmid30043350">{{cite journal| author=de Giambattista C, Ventura P, Trerotoli P, Margari M, Palumbi R, Margari L| title=Subtyping the Autism Spectrum Disorder: Comparison of Children with High Functioning Autism and Asperger Syndrome. | journal=J Autism Dev Disord | year= 2019 | volume= 49 | issue= 1 | pages= 138-150 | pmid=30043350 | doi=10.1007/s10803-018-3689-4 | pmc=6331497 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30043350  }} </ref>
* Language is usually adequate or even precocious.<ref name="pmid15909408">{{cite journal| author=Klin A, Pauls D, Schultz R, Volkmar F| title=Three diagnostic approaches to Asperger syndrome: implications for research. | journal=J Autism Dev Disord | year= 2005 | volume= 35 | issue= 2 | pages= 221-34 | pmid=15909408 | doi=10.1007/s10803-004-2001-y | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15909408  }} </ref> Although mild language delay has been reported in AS.<ref name="pmid30043350">{{cite journal| author=de Giambattista C, Ventura P, Trerotoli P, Margari M, Palumbi R, Margari L| title=Subtyping the Autism Spectrum Disorder: Comparison of Children with High Functioning Autism and Asperger Syndrome. | journal=J Autism Dev Disord | year= 2019 | volume= 49 | issue= 1 | pages= 138-150 | pmid=30043350 | doi=10.1007/s10803-018-3689-4 | pmc=6331497 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30043350  }} </ref>
*Atypical language development.<ref name="pmid17967920" />
* Usually there is difficulty in communicative use of language:  
* Usually there is difficulty in communicative use of language:  
** Verbosity (e.g.,  the child ‘‘talks too much’’)<ref name="pmid15909408" />
** Verbosity (e.g.,  the child ‘‘talks too much’’)<ref name="pmid15909408" />
** Pragmatic deficits (e.g., one-sided style, tangential content)<ref name="pmid15909408" />
** Pragmatic deficits (e.g., one-sided style, tangential content)<ref name="pmid15909408" />
** One-sided speech and monologues about a specific topic.<ref name="pmid23901152" /><ref name="pmid15909408" />
** One-sided speech and monologues about a specific topic.<ref name="pmid23901152" /><ref name="pmid15909408" />
**Poor prosody<ref name="Klin" />  
**Poor [[prosody]] in regard to intonation, volume, rhythm and pitch<ref name="Klin">{{cite journal |journal= Rev Bras Psiquiatr |year=2006 |volume=28 |issue= suppl 1 |pages=S3–S11 |title= Autism and Asperger syndrome: an overview |author= Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en}}</ref><ref name="pmid17967920" />
 
**Overly formal (pedantic)<ref name="pmid17967920" />
* Pauses may be due to difficulty in answering questions and structuring their discourse.<ref name="pmid18563474" />
* Pauses may be due to difficulty in answering questions and structuring their discourse.<ref name="pmid18563474" />


===<s>Motor Functions  </s>===
===Motor Functions and Sensory System  ===
 
 
*<s>Clumsiness  gazziuddin 1994, gambattisa</s>
 
===<s>Sensory System  </s>===


*<s>grapel2005</s>
* Delay in acquiring motor skills such as catching a ball and opening jars.<ref name="Klin">{{cite journal |journal= Rev Bras Psiquiatr |year=2006 |volume=28 |issue= suppl 1 |pages=S3–S11 |title= Autism and Asperger syndrome: an overview |author= Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en}}</ref>
* Difficulty in fine motor skills such as writing, drawing and tying laces. <ref name="pmid30736970" />
*[[Poor coordination]], bouncy gait patterns and odd posture and awkwardness.<ref name="Klin">{{cite journal |journal= Rev Bras Psiquiatr |year=2006 |volume=28 |issue= suppl 1 |pages=S3–S11 |title= Autism and Asperger syndrome: an overview |author= Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en}}</ref>
* Clumsiness<ref name="pmid30736970" />
* Problems with sensory impairments may affect movement performance by causing problems in motor planning.<ref name="pmid21643861">{{cite journal| author=Siaperas P, Ring HA, McAllister CJ, Henderson S, Barnett A, Watson P | display-authors=etal| title=Atypical movement performance and sensory integration in Asperger's syndrome. | journal=J Autism Dev Disord | year= 2012 | volume= 42 | issue= 5 | pages= 718-25 | pmid=21643861 | doi=10.1007/s10803-011-1301-2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21643861  }} </ref>
* Hyporsensitivity<ref name="pmid30736970" />
** Lower pain thresholds (injuries going unnoticed and becoming infected)
** Indifference to temperature (wearing a t-shirt in winter)
** Vestibular symptoms (rocking or circular movements).  
* Hpersensitivity<ref name="pmid30736970" />
** Hearing (e.g. noisy environments, vacuum-cleaning),
** Taste (food selectivity)
** Touch (strongly reacting to the contact of certain types of clothing)
** Smell (body odour)


===<s>Intellectual Functioning  </s>===
=== Play Skills ===


*<s>AS have a distinct cognitive profile, characterized by a higher verbal IQ and a lower performance IQ  gazziudin 1996, volkmar 2009</s>
* Problems in pretend play skills with persistent sensory-motor play stage.<ref name="pmid17967920" />
* Preference to play with common objects (string, rocks, or sticks).<ref name="pmid17967920" />
* The nature of play is usually constructive (puzzles, computer games, and blocks), ritualistic (lining objects up or sorting/matching shapes or colors) or sensory-motor (mouthing, banging, twirling).<ref name="pmid17967920" />


===<s>Academic Achievement</s>===
=== Other ===


*<s>Low performances in handwriting, (f forming letters or using the paper space)  (Asperger 1944) and  (Jansiewicz et al. 2006; Fuentes et al. 2009)</s>  <br />
* Usually have relative good auditory and verbal skills.<ref name="Klin">{{cite journal |journal= Rev Bras Psiquiatr |year=2006 |volume=28 |issue= suppl 1 |pages=S3–S11 |title= Autism and Asperger syndrome: an overview |author= Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en}}</ref>
* Deficits in visual-motor and visual-perceptual skills<ref name="Klin">{{cite journal |journal= Rev Bras Psiquiatr |year=2006 |volume=28 |issue= suppl 1 |pages=S3–S11 |title= Autism and Asperger syndrome: an overview |author= Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en}}</ref>
* Deficits in conceptual learning<ref name="Klin">{{cite journal |journal= Rev Bras Psiquiatr |year=2006 |volume=28 |issue= suppl 1 |pages=S3–S11 |title= Autism and Asperger syndrome: an overview |author= Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en}}</ref>
*[[Alexithymia]] (difficulty in identifying and describing one's emotions).<ref name="pmid14981336">{{cite journal| author=Tani P, Lindberg N, Joukamaa M, Nieminen-von Wendt T, von Wendt L, Appelberg B | display-authors=etal| title=Asperger syndrome, alexithymia and perception of sleep. | journal=Neuropsychobiology | year= 2004 | volume= 49 | issue= 2 | pages= 64-70 | pmid=14981336 | doi=10.1159/000076412 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14981336  }} </ref>
* Asperger Syndrome (AS) is associated with several conditions which include:
**[[Attention deficit hyperactivity disorder|Attention deficit hyperactivity disorder (ADHD)]] (most common in pediatric patients) <ref name="pmid9786442">{{cite journal| author=Ghaziuddin M, Weidmer-Mikhail E, Ghaziuddin N| title=Comorbidity of Asperger syndrome: a preliminary report. | journal=J Intellect Disabil Res | year= 1998 | volume= 42 ( Pt 4) | issue= | pages= 279-83 | pmid=9786442 | doi=10.1111/j.1365-2788.1998.tb01647.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9786442  }} </ref>
**[[Depression]] (most common in adolescent and adult patients)<ref name="pmid9786442" /><ref name="pmid21515028">{{cite journal| author=Lugnegård T, Hallerbäck MU, Gillberg C| title=Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome. | journal=Res Dev Disabil | year= 2011 | volume= 32 | issue= 5 | pages= 1910-7 | pmid=21515028 | doi=10.1016/j.ridd.2011.03.025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21515028  }} </ref>
**[[Bipolar disorder]]<ref name="pmid9786442" /><ref name="pmid21515028" />
**[[Tourette syndrome|Tourette Syndrome]]<ref name="pmid9786442" />
**[[Obsessive-compulsive disorder|Obsessive compulsive disorder (OCD)]]<ref name="pmid9786442" /><ref name="pmid21515028" />
**[[Tic disorder]]<ref name="pmid9786442" />
**[[Anxiety]] disorders<ref name="pmid21515028" />
**[[Schizophrenia]]<ref name="pmid26936160">{{cite journal| author=Marinopoulou M, Lugnegård T, Hallerbäck MU, Gillberg C, Billstedt E| title=Asperger Syndrome and Schizophrenia: A Comparative Neuropsychological Study. | journal=J Autism Dev Disord | year= 2016 | volume= 46 | issue= 7 | pages= 2292-304 | pmid=26936160 | doi=10.1007/s10803-016-2758-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26936160  }} </ref> 
**[[Nonverbal learning disorder|Nonverbal learning disability]]<ref name="pmid15473168">{{cite journal| author=Cederlund M, Gillberg C| title=One hundred males with Asperger syndrome: a clinical study of background and associated factors. | journal=Dev Med Child Neurol | year= 2004 | volume= 46 | issue= 10 | pages= 652-60 | pmid=15473168 | doi=10.1017/s0012162204001100 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15473168  }} </ref>
**Difficulty in falling asleep, sleepiness after awakening and during daytime and poor sleep quality<ref name="pmid14981336">{{cite journal| author=Tani P, Lindberg N, Joukamaa M, Nieminen-von Wendt T, von Wendt L, Appelberg B | display-authors=etal| title=Asperger syndrome, alexithymia and perception of sleep. | journal=Neuropsychobiology | year= 2004 | volume= 49 | issue= 2 | pages= 64-70 | pmid=14981336 | doi=10.1159/000076412 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14981336 }} </ref>
**There have been case-reports of Asperger Syndrome (AS) associated with [[Aminoaciduria|aminoaciduria,]]<ref name="pmid3664113">{{cite journal| author=Miles SW, Capelle P| title=Asperger's syndrome and aminoaciduria: a case example. | journal=Br J Psychiatry | year= 1987 | volume= 150 | issue=  | pages= 397-400 | pmid=3664113 | doi=10.1192/bjp.150.3.397 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3664113  }} </ref> [[ligamentous laxity]]<ref name="pmid2273016">{{cite journal| author=Tantam D, Evered C, Hersov L| title=Asperger's syndrome and ligamentous laxity. | journal=J Am Acad Child Adolesc Psychiatry | year= 1990 | volume= 29 | issue= 6 | pages= 892-6 | pmid=2273016 | doi=10.1097/00004583-199011000-00008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2273016  }} </ref> and recurrent [[hypersomnia]]<ref name="pmid1644738">{{cite journal| author=Berthier ML, Santamaria J, Encabo H, Tolosa ES| title=Recurrent hypersomnia in two adolescent males with Asperger's syndrome. | journal=J Am Acad Child Adolesc Psychiatry | year= 1992 | volume= 31 | issue= 4 | pages= 735-8 | pmid=1644738 | doi=10.1097/00004583-199207000-00023 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1644738 }} </ref>.


==References==
==References==

Latest revision as of 15:05, 22 June 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]

Overview

Several symptoms may be seen in Asperger Syndrome (AS) with impairments in social interaction, communication and restricted, repetitive behaviors and interests being the most important. There may be impairments in motor and sensory functions, speech, language and sleep.

History and Symptoms

Some major neuropsychological abnormalities in patients with Asperger Syndrome (AS) are:[1]

  • Difficulty in passing theory of mind tasks
  • Executive dysfunction
  • Tendency to interpret visual stimuli in parts rather than wholes (poor central coherence)
  • There are studies that suggest in patients with AS there is a Verbal IQ (VIQ) > Poor Performance IQ (PIQ) profile which shows strength on verbal skills relative to visuospatial skills and non-verbal problem solving (nonverbal learning disability)[2]

Social interaction and communication

  • They usually fail to build friendships due to their odd or lack of social communication skills.[3]
  • They have interest in to play or interact with others and social communication but find themselves isolated.[3][4]
  • They do not realize that relationships and friendships are based on common interests and flexibility.[3]
  • They often make formal communications with others and make one-sided speech and monologues about a specific topic regardless of other people's interest.[5][1][4]
  • They are verbal about a certain topic, but can not express feelings or recognize the feelings of others.[6]
  • They do not understand social and conversational rules.[4]
  • Children with AS are usually victims of bullying at school.[7]

Restricted and repetitive behaviors and interests

  • Repetitive, limited and circumscribed interests[8][3]
  • Extensive factual information about circumscribed topics (e.g., snakes, names of stars, dinosaurs, computers, train engine numbers)[8][9]
  • These symptoms might not be recognized because some topics and interests like dinosaurs are common among children.[9]
  • These interests may immerse the family and disrupt family activities.[9][8]
  • Patients with autism spectrum disorder (ASD) usually have stereotyped and repetitive motor behaviors and speech such as lining up toys, flipping objects or echolalia.[10]
  • Atypical behaviors such as peculiar mannerisms, unusual attachments to objects, obsessions, compulsions, self-injurious behaviors, and stereotypes.[6]
  • Stereotypes are repetitive and atypical behaviors such as hand flapping, finger movements, rocking, or twirling, finger flicking, unusual eye gazing, habitual toe walking, and/or persistent sniffing and licking of nonfood items.[6]
  • The have unusual attachments for hard items; for example, ballpoint pens, flashlight, keys, action figures.[6]  

Language and Speech

  • Language is usually adequate or even precocious.[4] Although mild language delay has been reported in AS.[11]
  • Atypical language development.[6]
  • Usually there is difficulty in communicative use of language:
    • Verbosity (e.g., the child ‘‘talks too much’’)[4]
    • Pragmatic deficits (e.g., one-sided style, tangential content)[4]
    • One-sided speech and monologues about a specific topic.[7][4]
    • Poor prosody in regard to intonation, volume, rhythm and pitch[5][6]
    • Overly formal (pedantic)[6]
  • Pauses may be due to difficulty in answering questions and structuring their discourse.[1]

Motor Functions and Sensory System  

  • Delay in acquiring motor skills such as catching a ball and opening jars.[5]
  • Difficulty in fine motor skills such as writing, drawing and tying laces. [3]
  • Poor coordination, bouncy gait patterns and odd posture and awkwardness.[5]
  • Clumsiness[3]
  • Problems with sensory impairments may affect movement performance by causing problems in motor planning.[12]
  • Hyporsensitivity[3]
    • Lower pain thresholds (injuries going unnoticed and becoming infected)
    • Indifference to temperature (wearing a t-shirt in winter)
    • Vestibular symptoms (rocking or circular movements).  
  • Hpersensitivity[3]
    • Hearing (e.g. noisy environments, vacuum-cleaning),
    • Taste (food selectivity)
    • Touch (strongly reacting to the contact of certain types of clothing)
    • Smell (body odour)

Play Skills

  • Problems in pretend play skills with persistent sensory-motor play stage.[6]
  • Preference to play with common objects (string, rocks, or sticks).[6]
  • The nature of play is usually constructive (puzzles, computer games, and blocks), ritualistic (lining objects up or sorting/matching shapes or colors) or sensory-motor (mouthing, banging, twirling).[6]

Other

References

  1. ↑ 1.0 1.1 1.2 Woodbury-Smith MR, Volkmar FR (2009). "Asperger syndrome". Eur Child Adolesc Psychiatry. 18 (1): 2–11. doi:10.1007/s00787-008-0701-0. PMID 18563474.
  2. ↑ Lincoln, Alan; Courchesne, Eric; Allen, Mark; Hanson, Ellen; Ene, Michaela (1998). "Neurobiology of Asperger Syndrome": 145–163. doi:10.1007/978-1-4615-5369-4_8.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Mirkovic B, Gérardin P (2019). "Asperger's syndrome: What to consider?". Encephale. 45 (2): 169–174. doi:10.1016/j.encep.2018.11.005. PMID 30736970.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 Klin A, Pauls D, Schultz R, Volkmar F (2005). "Three diagnostic approaches to Asperger syndrome: implications for research". J Autism Dev Disord. 35 (2): 221–34. doi:10.1007/s10803-004-2001-y. PMID 15909408.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Klin A (2006). "Autism and Asperger syndrome: an overview". Rev Bras Psiquiatr. 28 (suppl 1): S3–S11. doi:10.1590/S1516-44462006000500002. PMID 16791390.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 Johnson CP, Myers SM, American Academy of Pediatrics Council on Children With Disabilities (2007). "Identification and evaluation of children with autism spectrum disorders". Pediatrics. 120 (5): 1183–215. doi:10.1542/peds.2007-2361. PMID 17967920.
  7. ↑ 7.0 7.1 Zablotsky B, Bradshaw CP, Anderson CM, Law P (2014). "Risk factors for bullying among children with autism spectrum disorders". Autism. 18 (4): 419–27. doi:10.1177/1362361313477920. PMID 23901152.
  8. ↑ 8.0 8.1 8.2 South M, Ozonoff S, McMahon WM (2005). "Repetitive behavior profiles in Asperger syndrome and high-functioning autism". J Autism Dev Disord. 35 (2): 145–58. doi:10.1007/s10803-004-1992-8. PMID 15909401.
  9. ↑ 9.0 9.1 9.2 Klin A (2006). "[Autism and Asperger syndrome: an overview]". Braz J Psychiatry. 28 Suppl 1: S3–11. doi:10.1590/s1516-44462006000500002. PMID 16791390.
  10. ↑ Allen D, Evans C, Hider A, Hawkins S, Peckett H, Morgan H (2008). "Offending behaviour in adults with Asperger syndrome". J Autism Dev Disord. 38 (4): 748–58. doi:10.1007/s10803-007-0442-9. PMID 17805955.
  11. ↑ de Giambattista C, Ventura P, Trerotoli P, Margari M, Palumbi R, Margari L (2019). "Subtyping the Autism Spectrum Disorder: Comparison of Children with High Functioning Autism and Asperger Syndrome". J Autism Dev Disord. 49 (1): 138–150. doi:10.1007/s10803-018-3689-4. PMC 6331497. PMID 30043350.
  12. ↑ Siaperas P, Ring HA, McAllister CJ, Henderson S, Barnett A, Watson P; et al. (2012). "Atypical movement performance and sensory integration in Asperger's syndrome". J Autism Dev Disord. 42 (5): 718–25. doi:10.1007/s10803-011-1301-2. PMID 21643861.
  13. ↑ 13.0 13.1 Tani P, Lindberg N, Joukamaa M, Nieminen-von Wendt T, von Wendt L, Appelberg B; et al. (2004). "Asperger syndrome, alexithymia and perception of sleep". Neuropsychobiology. 49 (2): 64–70. doi:10.1159/000076412. PMID 14981336.
  14. ↑ 14.0 14.1 14.2 14.3 14.4 14.5 Ghaziuddin M, Weidmer-Mikhail E, Ghaziuddin N (1998). "Comorbidity of Asperger syndrome: a preliminary report". J Intellect Disabil Res. 42 ( Pt 4): 279–83. doi:10.1111/j.1365-2788.1998.tb01647.x. PMID 9786442.
  15. ↑ 15.0 15.1 15.2 15.3 Lugnegård T, Hallerbäck MU, Gillberg C (2011). "Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome". Res Dev Disabil. 32 (5): 1910–7. doi:10.1016/j.ridd.2011.03.025. PMID 21515028.
  16. ↑ Marinopoulou M, Lugnegård T, Hallerbäck MU, Gillberg C, Billstedt E (2016). "Asperger Syndrome and Schizophrenia: A Comparative Neuropsychological Study". J Autism Dev Disord. 46 (7): 2292–304. doi:10.1007/s10803-016-2758-9. PMID 26936160.
  17. ↑ Cederlund M, Gillberg C (2004). "One hundred males with Asperger syndrome: a clinical study of background and associated factors". Dev Med Child Neurol. 46 (10): 652–60. doi:10.1017/s0012162204001100. PMID 15473168.
  18. ↑ Miles SW, Capelle P (1987). "Asperger's syndrome and aminoaciduria: a case example". Br J Psychiatry. 150: 397–400. doi:10.1192/bjp.150.3.397. PMID 3664113.
  19. ↑ Tantam D, Evered C, Hersov L (1990). "Asperger's syndrome and ligamentous laxity". J Am Acad Child Adolesc Psychiatry. 29 (6): 892–6. doi:10.1097/00004583-199011000-00008. PMID 2273016.
  20. ↑ Berthier ML, Santamaria J, Encabo H, Tolosa ES (1992). "Recurrent hypersomnia in two adolescent males with Asperger's syndrome". J Am Acad Child Adolesc Psychiatry. 31 (4): 735–8. doi:10.1097/00004583-199207000-00023. PMID 1644738.


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