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Asperger Syndrome: What is it and how is it treated?

18 de February, 2024

On the occasion of International Asperger Syndrome Day, celebrated on February 18th, we share an opinion article by Dr. Joana Martins, Neuropediatrician at CNS Braga.

Asperger Syndrome is a neuropsychiatric disorder characterized by significant difficulties in social interaction, communication, and behavior. It is considered a milder form of Autism Spectrum Disorder (ASD). Children with this syndrome stand out for developing verbal language and having a normal or even above-average cognitive level in some areas.

Asperger Syndrome is much more common than classic autism, affecting 20 to 25 children per 10,000. In Portugal, it is estimated that there are about 40,000 people with this syndrome. It is more common in boys than girls (about 10 to one).

The clinical manifestations of the syndrome can be observed before the age of 2. Typical initial symptoms include difficulty maintaining comfortable eye contact and using it in conjunction with other forms of communication, and hypersensitivity to stimuli, particularly sounds, but also lights, flavors, or textures.

These symptoms are typically associated with:

-Difficulty in communication, especially in non-verbal communication. A child with Asperger’s syndrome struggles to decode messages beyond explicit verbal content, such as tone of voice, nuances, irony, humor, facial, and body expression. They tend to interpret things literally. There may be little communication initiative and/or communication very focused on topics of interest and from the individual’s perspective, with little opportunity for others to participate.

-Difficulty in relating to others, due to a lack of understanding of others and showing empathy.

-Difficulty in understanding social and conduct rules, such as raising a hand to speak in the classroom or waiting in line.

-Motor coordination and fine motor difficulties, affecting dexterity and making some sports challenging.

-Need to establish routines and resistance to changes in them, which usually cause anxiety and behavioral instability.

-Restricted interest in very specific topics dominating conversations and activities.

-Emotional dysregulation in overload situations, due to difficulty in understanding and managing one’s feelings and emotions.

However, the clinical presentation of Asperger’s syndrome is very varied and influenced by the age of onset and potential association with other comorbidities, such as attention deficit, tic disorders, anxiety, and depression, which must be recognized and addressed.

The causes of Asperger’s syndrome are not known, but it is known to have a strong genetic component. The identified genes are involved in brain development, influencing the transmission of signals between neurons and how information is processed. Additionally, the interaction between genetic and environmental factors seems to be equally relevant in the development of this disorder.

The diagnosis of Asperger’s syndrome is clinical, based on the medical history provided by parents and observing the child’s behavior during consultations, using formal development assessments.

There is no specific medication for Asperger’s syndrome, but there are therapeutic interventions that enable better coping with the condition. A child with Asperger’s syndrome, when supported from an early age, can follow the usual school path.

The intervention is multidisciplinary, involving neuropediatricians, pediatricians, child psychiatrists, psychologists, and therapists, and must be personalized to meet each patient’s needs. It may include psychological counseling, cognitive-behavioral therapy, and possibly speech and occupational therapy. Treating associated neuropsychiatric conditions is fundamental, and medication may be indicated to achieve better symptom control and greater success in other interventions.

In general, the support and understanding of family, friends, teachers, and classmates are fundamental. In fact, the family plays a central role in addressing the syndrome, by stimulating socialization and promoting the development of basic social skills, encouraging eye contact, anticipating and explaining routine changes, assisting in understanding one’s emotions and others, diversifying interests, and strengthening self-esteem by valuing successes.