Asperger syndrome in children

Asperger syndrome in children is a disorder whose nosological independence is not defined; is characterized by the same type of qualitative disorders of social interaction as typical children's autism, against the background of normal cognitive development and speech.

Asperger syndrome in children is one of the forms of deviation in development - a disorder of the nervous system by type of autism, which manifests itself in the psychoemotional features of the child's behavior when interacting and communicating with other people - parents, peers, teachers, educators,

Synonyms: autistic psychopathy, schizoid disorder of childhood.

ICD-10 code

F84.5 Asperger Syndrome.

Epidemiology

It is 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 known to science, and scientists continue to research possible factors that may be involved in the development of this syndrome. Such factors include, in the first place, gene mutations and teratogenic effects of 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's syndrome in children is considered a disorder of the autistic spectrum, and the name of the syndrome has ceased to be used since the middle of 2013 in determining the diagnosis.

The emergence of Asperger syndrome in children, as well as Kanner's syndrome (autism), neurophysiologists associate with the anomalies of various brain structures and the disruption of their interaction at the level of synaptic connections during the early embryonic development of the unborn child. However, at present no convincing, scientifically substantiated evidence is in favor of this version yet.

Most likely, Asperger syndrome in children arises from a combination of many factors, but in its genetic etiology there can be no doubt.

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

Symptoms of Asperger's Syndrome in Children

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

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

Symptoms of Asperger syndrome in children can be manifested as:

• isolation and isolation;
• heightened awkwardness of movements, inappropriate age (awkwardness when moving, manipulating objects, maintaining a certain position, etc.);
• violations of fine motor skills (difficulties with fastening buttons, tying and untying, finger grasping of small items, etc.);
• reduced adaptive behavior (often ignoring standard norms and rules of conduct and inadequate behavior in any change in external circumstances);
• inability to perceive facial expressions, gestures and intonations of people's speech when communicating, 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 insufficiency);
• the lack of sensitivity and difficulty in establishing contact with other children and maintaining relations with them;
• difficulties in participating in games of imagination, for example, depicting the habits of animals or human actions;
• sensory disturbances (increased negative reaction to too bright light, increased sound volume, strong smell, etc.);
• a literal perception of what has been said (misunderstanding of comparisons, figurative meanings of words, etc.);
• increased inclination to consecutive and repetitive movements (limbs or whole body) and actions (including the stereotyped order of their implementation, for example, a permanent route to school, etc.);
• manifestation of all-consuming interest in any one sphere (robots, dinosaurs, space, etc., and the child will talk about it 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, in the opinion of most children's psychiatrists, are not of clinical significance and are leveled with age.

Diagnosis of Asperger's Syndrome in Children

With all diligence to develop clear criteria for attributing this pathology of the nervous system to a particular disorder of the autistic spectrum, the diagnosis of Asperger syndrome in children involves a number of problems.

According to foreign experts in the field of psychoneurology, this diagnosis is made for children in most clinical cases in the age range of four to nine years, with boys 3-4 times more likely than girls. And, due to a wide variety of symptoms, there are no two children with Asperger's syndrome, similar to each other. The presence of one or two symptoms (given above) can not be a basis for ascertaining the presence of the syndrome, therefore, when conducting the diagnosis, the following should be used:

• collection and analysis of family history of both parents;
• a survey of parents (for schoolchildren and teachers) on the habits and typical behavioral reactions of the child;
• genetic examination;
• neurological examination;
• direct communication of specialists with 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 the psychomotor and the level of abilities for non-verbal communication;
• testing of the 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 both in the immediate and in the distant future.

According to American psychoneurologists, today in the United States there is a problem of "excessive diagnosis of Asperger's syndrome", since with a lack of qualification of doctors for this syndrome, difficulties in family upbringing of children and their unsatisfactory performance and behavior at school can be written off.

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Treatment of Asperger syndrome in children

The main treatment for Asperger syndrome in children is the psychological correction of behavior, since neither special potions nor tablets for getting rid of this pathology exist.

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

There is no uniform methodology for treating Asperger's syndrome in children, even in the US, but most often there are: physical therapy classes, small motility classes, individual trainings (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 show more attention to the words of elders, become more obedient and less aggressive. But positive results must be permanently fixed, therefore parents' role in the treatment of this syndrome is so great.

Among medications prescribed to reduce anxiety, aggressiveness and a sense of fear in Asperger syndrome in adult patients, antipsychotics-antipsychotics are on the first place, but they are not used to treat children.

Prophylaxis and prognosis of Asperger syndrome in children

Measures that should be taken as a prophylaxis for Asperger syndrome in children have not been developed with due regard for the unexplained etiology of the disease.

The prognosis for Asperger's syndrome in children - with the understanding of close people and their desire to help, without hurting the child's psyche - is quite positive. It's nothing that there are no pills, but there is the power of parental attention and support that can develop the child's lacking abilities. As the child grows, his mental state becomes more positive, but difficulties in interpersonal communication often remain.

And practically every fifth child with this deviation in development in the adult state does not stand out for anything "special" - gets education, acquires a family.

At the same time, one can not ignore the problems that can arise (chronic frustration, depression, anxious neurosis, aggressiveness, etc.) in adolescence - in the pubertal period.

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