Asperger's syndrome in children.

Asperger syndrome in children is a disorder whose nosological independence has not been determined; it is characterized by the same type of qualitative disturbances in social interaction as typical childhood autism, against the background of normal cognitive development and speech.

Asperger's syndrome in children is one of the forms of developmental deviation - a disorder of the nervous system similar to autism, which manifests itself in the psycho-emotional characteristics of the child's behavior when interacting and communicating with other people - parents, peers, teachers, caregivers, etc.

Synonyms: autistic psychopathy, childhood schizoid disorder.

ICD-10 code

F84.5 Asperger's syndrome.

Epidemiology

More common in boys (8:1).

[ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ]

Causes and pathogenesis of Asperger syndrome

To date, the causes of Asperger's syndrome in children are not fully known to science, and scientists continue to study possible factors that may be involved in the development of this syndrome. Such factors primarily include gene mutations and teratogenic effects of an exogenous (external) nature, as well as negative environmental impact on the process of embryo formation and embryo development during pregnancy.

According to the Diagnostic and Statistical Manual of mental disorders, adopted by the American Psychiatric Association (APA), Asperger syndrome in children is considered an autism spectrum disorder, and the name of the syndrome itself has ceased to be used in determining the diagnosis since mid-2013.

Neurophysiologists associate the occurrence of Asperger's syndrome in children, as well as Kanner's syndrome (autism), with anomalies of various structures of the brain and disturbances in their interaction at the level of synaptic connections during the period of early embryonic development of the future child. However, at present there is no convincing, scientifically substantiated evidence in favor of this version.

Most likely, Asperger syndrome in children occurs due to a combination of many factors, but there can be no doubt about its genetic etiology.

[ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ]

Symptoms of Asperger's Syndrome in Children

No physiological signs have been found for this type of mental disorder so far, so the symptoms of Asperger's syndrome in children can only be identified by a child psychiatrist observing the child's behavior and reactions.

Moreover, in the field of pediatric psychiatry, the diagnosis of Asperger syndrome is not always differentiated from autism due to the significant similarity of the manifestations of both disorders. Some specialists call Asperger syndrome in children high-functioning or non-syndromic autism, justifying their point of view by the higher level of cognitive abilities in children with Asperger syndrome.

Symptoms of Asperger syndrome in children may include:

• isolation and seclusion;
• increased awkwardness of movements that is inappropriate for age (clumsiness when moving, manipulating objects, maintaining a certain posture, etc.);
• fine motor skills disorders (difficulty fastening buttons, tying and untying, grasping small objects with fingers, etc.);
• reduced adaptability of behavior (frequent ignoring of standard norms and rules of behavior and inadequacy of behavior with any change in external circumstances);
• inability to perceive facial expressions, gestures and intonations of people's speech during communication, to feel and correctly understand their emotions (empathic underdevelopment);
• monotony of speech and difficulties in expressing one’s own feelings (the so-called verbal-nonverbal deficiency);
• unsociability and difficulties in establishing contact with other children and maintaining relationships with them;
• difficulties in engaging in imaginative play, such as imitating animal behavior or human actions;
• sensory disturbances (increased negative reaction to too bright light, increased sound volume, strong smell, etc.);
• literal perception of what was said (misunderstanding of comparisons, figurative meanings of words, etc.);
• an increased tendency to sequential and repetitive movements (of the limbs or the whole body) and actions (including a stereotypical order of their execution, for example, a constant route to school, etc.);
• the manifestation of an all-consuming interest in any one area (robots, dinosaurs, space, etc., and the child will talk about it a lot with enthusiasm).

Unlike autism, most children with Asperger's syndrome do not lag behind their peers in mental development and do not have speech disorders. And those that can be identified, according to most child psychiatrists, are not clinically significant and level out with age.

Diagnosis of Asperger's Syndrome in Children

Despite all efforts to develop clear criteria for classifying this pathology of the nervous system as one or another autism spectrum disorder, diagnosing Asperger's syndrome in children is associated with a number of problems.

According to foreign specialists in the field of psychoneurology, this diagnosis is made in children in most clinical cases in the age range from four to nine years, and in boys 3-4 times more often than in girls. Moreover, due to the wide variety of symptoms, no two children with Asperger's syndrome are alike. The presence of one or two symptoms (listed above) cannot be the basis for establishing the presence of the syndrome, therefore, when conducting diagnostics, the following should be used:

• collection and analysis of family history of both parents;
• survey of parents (for school-age children and teachers) regarding the child’s habits and typical behavioral reactions;
• genetic examination;
• neurological examination;
• direct communication between specialists and the child (in a relaxed atmosphere, in the form of a game) and their observation of his behavior with an assessment of the characteristics of psychomotor skills and the level of abilities for non-verbal communication;
• testing a child's intellectual development and learning ability.

Diagnosis of Asperger syndrome in children should be differentiated, since an incorrect diagnosis is fraught with negative consequences in both the short and long term.

According to American neuropsychiatrists, today in the United States there is a problem of “overdiagnosis of Asperger syndrome,” since due to the lack of qualifications of doctors, difficulties in family upbringing of children and their unsatisfactory academic performance and behavior at school can be attributed to this syndrome.

[ 11 ]

Treatment of Asperger's syndrome in children

The main treatment for Asperger's syndrome in children is psychological behavioral correction, since there are no special mixtures or pills to get rid of this pathology.

Psychotherapy for children with Asperger syndrome performs a compensatory function to develop skills in the child that he or she lacks: the ability to communicate with other children, relatives and other adults; the ability to correctly respond to the behavior of others and the ability to evaluate one's own and others' actions; development of coordination of movements and gestures, etc.

There is no single method for treating Asperger's syndrome in children even in the USA, but most often the following are conducted here: therapeutic physical training, classes to improve the level of fine motor skills, individual training (with the participation of parents) to develop communication skills and rules of behavior in public places. And, as the experience of parents shows, children gradually begin to pay more attention to the words of elders, become more obedient and less aggressive. But positive results need to be constantly reinforced, which is why the role of parents in the treatment of this syndrome is so great.

Among the medications prescribed to reduce anxiety, aggression and fear in Asperger's syndrome in adult patients, antipsychotic drugs-neuroleptics are in first place, but they are not used to treat children.

Prevention and prognosis of Asperger syndrome in children

No one has developed measures to be taken as a preventative measure against Asperger's syndrome in children, taking into account the still unclear etiology of the disease.

The prognosis for Asperger's syndrome in children - with understanding from loved ones and a desire to help them without traumatizing the child's psyche - is quite positive. It's okay that there are no pills, but there is the power of parental attention and support, which can develop the child's missing abilities. As the child grows, his mental state becomes more positive, but difficulties in the area of interpersonal communication most often remain.

And almost every fifth child with this developmental disorder does not stand out in any way as an adult – they get an education and start a family.

At the same time, one cannot ignore the problems that may arise (chronic frustration, depression, anxiety neurosis, aggressiveness, etc.) in adolescence – during puberty.

In principle, Asperger's syndrome in children forms a personality that is not inclined to broad communication and emotional openness, which in the psychological classification of K. Jung is called an introverted (inward-facing) personality type. In the end, signs of Asperger's syndrome, as it turned out, were manifested in Wolfgang Amadeus Mozart, Albert Einstein and Maria Sklodowska-Curie.