January 10th, 2018
Autism an Asperger’s Syndrome
Autism and Asperger’s syndrome are part of the disorders classified under pervasive developmental disorders (PDD). PDD was a term whose use started in the 1980s in reference to a set of five disorders with various manifestations in common (Glicken 229). The common manifestations include severe and extensive impairment of social skills, verbal and nonverbal communication skills, and imaginative capabilities (Glicken 229). Individuals suffering from such disorders also engage in a restricted number of activities that they perform repetitively (Glicken 229). The five disorders are autistic disorder, Asperger’s syndrome, Rett’s disorder, Childhood disintegrative disorder, and PDD not otherwise specified (PDD-NOS). PDD-NOS comprise PDDs whose manifestation does not meet the threshold for classification under any of the other categories. A discussion of Autism and Asperger’s syndrome is presented subsequently.
Autism is marked by greatly impaired communication, social and imaginative skills, which greatly hinder the ability of the affected children to understand their surroundings (Glicken 231). The disorder is estimated to affect one out of every 150 children in the U. S. (Glicken 229). Apart from the impairments noted, children with autism are likely to have mental retardation and likely to fail to form emotional bonds with parents and other members of their families. Typically, the manifestation of the disorder will be evident in children below 3 years old, but likely to last for the entire lifespan (Glicken 231). Features that necessitate evaluation of whether a child is suffering from autism include failure to babble or cool even after attaining an age of one year, failure to gesture (e.g. point or wave) by the age of one year, and failure to alter even a single word by the age of one and half years (Glicken 232). Other indicators that a child is possibly suffering from autism are failure to independently (without assistance or without repeating what someone else just alters) alter two-word phrases, and loss of language and social skills that were initially present (Glicken 231).
Although the cause of autism has not been specifically identified, heredity (e.g. having schizophrenic parents, and mothers with a history of personality disorders), infections, and birth complications have been associated with increased odds of a child developing autism (Glicken 231-233). Despite the concerns raised by parents that the vaccine for measles, mumps and rubella (MMR vaccine) may cause autism, subsequent studies, as reported by Glicken, have not shown any such link, with cases of autism rising even after the 2001 removal of mercury in MMR vaccinations (233). An explanation has thus been that such parents’ concerns are more likely to be coincidental since symptoms of autism typically appear at an age when the child is likely to be receiving MMR vaccine (Glicken 233). There being no cure for autism, treatment approaches focus on management. In this respect, management involves modification of education approaches to meet the child’s special needs, behavioral modification aimed to encourage positive behavior and discourage problem behaviors, and speech and occupational therapy to improve the child’s functional skills (Glicken 233). Use of medications (e.g. Risperidone) is designed only for symptomatic reprieve such as reducing the child’s anxiety.
The differential diagnosis between Asperger’s syndrome (AS) and autism remains a point of debate in literature. However, the use of the term Asperger’s syndrome started in 1981, when Lorna Wing used it in reference to observations that some individuals exhibiting autistic symptoms had less impaired language and social skills (as cited in Tryon et al. 2). Subsequent inclusion of the disorder as a separate category in the fourth edition of the Diagnostic and statistical manual of mental disorders (DSM-IV) in 1994, appeared to indicate a building consensus, at the time, that AS was a distinct disorder from autism. Such consensus led to suggestions that the distinctive characteristics of AS are deficits in two primary aspects: social interaction and repetitive, stereotypical patterns of behavior restricted to a limited set of activities and interests (Glicken 234). Following such suggestions, Lopata et al. (37; as cited in Glicken 236), demonstrated that a streaming process comprised of nine steps involving aspects such as defining the skill, modeling the skill, establishing skill needed for a trainee and selecting a role player could enhance the abilities of children diagnosed with Asperger’s syndrome. The other steps in the streaming process are setting up the role play, performing the role play, providing feedback on performance, assigning homework to improve skills, and selecting next role player. Subsequently, however, an increasing consideration of autistic disorder to be a spectrum disorder characterized by stages that differ in terms of severity in two core domains has led to the deletion of the Asperger’s category in the fifth edition of DSM (DSM-5; American Psychiatric Association [APA] 1-2). Currently, the DSM-5 classifies four of the disorders categorized as PDD (in exception of Rett’s disorder) as autism spectrum disorder (APA 1-2).
Autism and Asperger’s syndrome consist of disorders characterized by impaired social, communication and imaginative skills. The disorders are also characterized by repetitive performance of a limited set of activities by the affected children. With the perspective of the autistic disorder changing to its consideration as a spectrum disorder, both autism and Asperger’s syndrome have been considered a single condition but at different magnitudes of severity. The disorders have been associated with a genetic onset and treatment is mainly aimed at management rather than cure.
American Psychiatric Association. Highlights of Changes from DSM-IV-TR to DSM-5. Arlington, VA: American Psychiatric Publishing. Web. 27 September 2013. <http://www.psychiatry.org/File%20Library/Practice/DSM/DSM-5/Changes-from-DSM-IV-TR–to-DSM-5.pdf>.
Glicken, Morley D. Evidence-Based Practice with Emotionally Troubled Children and Adolescents. Oxford: Academic Press, 2009. Web. 27 September 2013. <http://dx.doi.org/10.1016/B978-0-12-374523-1.00014-8>
Tryon, Patti Ann, et al. “Can Asperger’s Disorder be Differentiated from Autism Using DSM-IV Criteria” Focus on Autism and Other Developmental Disabilities 21.1 (2006): 2-6. Sage Journals Online. Web. 27 September 2013. <doi:10.1177/10883576060210010101>.