Academic journal article The Journal of Early and Intensive Behavioral Intervention

Asperger Syndrome: A Primer for Behavioral Interventionists

Academic journal article The Journal of Early and Intensive Behavioral Intervention

Asperger Syndrome: A Primer for Behavioral Interventionists

Article excerpt

Abstract

Children and adolescents with Asperger Syndrome are intellectually capable, rigid and often obsessive, adhere to stereotypic routines, demonstrate difficulties with pragmatic language and characteristically lack social skills. While the extent of these behaviors may wax and wane and vary by individual, they are in stark contrast with the high level of intellectual function seen in children and adolescents with this disorder. This primer will examine: the features of Asperger Syndrome, the theories which help explain the nature of the disorder, its comorbidity with other disorders, and the strategies that can impact positively on social skill development. The role that significant others in the environment (parents, teachers, clinicians and trained peers) can play in implementing these social skill strategies is also an area of focus.

Keywords: Asperger Syndrome, autism, autism spectrum disorders, social skills, theory of mind, executive function, comorbidity, attention deficit disorder, oppositional defiance disorder, generalization of training.

Introduction

Asperger Syndrome (AS) has received a lot of attention in the literature and in the media recently. Children who are diagnosed as having AS are often referred to as "nerdy" or "quirky." Labels aside however, the kinds of difficulties children with AS typically have can impact on every facet of life. Though intellectually capable, rigid and often times obsessive, adherence to stereotypic routines and accompanying problems with pragmatic language puts these children at risk educationally, socially and emotionally. These behaviors associated with AS (DSM-IV criteria for AS, 299.80) are in stark contrast with the high level of intellectual function seen in children with the disorder. Parents, teachers, clinicians and trained peers need to understand the features of this disorder, the strategies that can impact most positively on communication and social skill acquisition, and the role they can plan as significant others in the intervention process.

Asperger Syndrome versus High Functioning Autism

For a long time there has been a controversy as to whether AS really is a separate and distinct disorder from autism or a variant of High Functioning Autism (HFA). Since both AS and HFA can be categorized as autism spectrum disorders, this would explain why there is a great deal of similarity between them and in fact some overlap of symptoms. From a neurological standpoint there are marked differences however; Kanner's autism or HFA involves the left hemisphere of the brain, while AS, as well as nonverbal learning disabilities (NLD), involve the brain's right hemisphere (Volkmar et al., 2001; Ehlers et al., 1997).

What is known to date is that AS is characterized by the absence of clinically significant speech delay, generalized clumsiness, and later onset of symptoms that are characteristic of HFA. Moreover, children with AS are more likely to develop secondary psychiatric conditions than those with HFA. This may be due to the later onset of symptoms, the later diagnosis of the disorder, or both. The secondary psychiatric conditions that are often comorbid in adolescents with AS include depression as well as behaviors that is consistent with Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiance Disorder (ODD). Both ADHD and ODD are identified in the DSM-IV as part of the disruptive behavior cluster and have been reported in the literature as emerging developmentally, with ADHD occurring first (onset before 7 years of age), Oppositional Defiance Disorder emerging next (onset around puberty), and the most severe conduct disorders emerging in late adolescence. Polirstok (1999) suggested that this escalation of symptoms along the ADHD-ODD-CD continuum might be functionally related to the degree of failure, rejection and hostility encountered in the environment and may in fact be both incremental and developmental in nature (also see Patterson, 2002). …

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