Asperger s Syndrome. severe difficulties interacting socially (Gillberg 2002). He named this difficulty

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1 Julie Burton ED 243 Paper Asperger s Syndrome History In 1944 an Austrian pediatrician named Hans Asperger wrote an article about a group of school- aged boys when he discovered that some of them had severe difficulties interacting socially (Gillberg 2002). He named this difficulty autistic psychopathy. At this same time in America, Leo Kanner was writing about autism. It was not until Asperger s article was translated into English in 1981 that it was realized that these two men were talking about two different types of the same disorder (McPartland 2006). Background Asperger s Syndrome, typically described as a high functioning or mild autism, is characterized by average or above average intelligence, but a decreased social aptitude (Kendall 2009). Near obsession with topics of interest, repetitive or ritualized behavior, and below average motor skills often accompany Asperger s Syndrome. Despite the similarities between Autism and Asperger s, there is still some debate as to whether or not Asperger s should be included as an Autism Spectrum Disorder. Many feel that according to the Diagnostic and Statistical Manual of Mental Disorders (DSM), Asperger s should be a distinct disorder (Khouzam 2004). While others say that Asperger s is simply at one end of a range of disorders under the broad category of Autism.

2 Although we are finding ways to diagnose Autism earlier and earlier, Asperger s is still difficult to diagnose before age four. This is in large part due to the fact that until age four children with Asperger s hit all of their developmental milestones on time or even early (Khouzam 2004). What makes age four significant is that this is normally when children enter some form of preschool or daycare where they must have social interactions with their peers. Children with Asperger s cease to continue socially as their peers do (McPartland 2006). This stunted delay in development often increases as the child ages and misses more and more opportunities to socialize with his or her peers. In addition to struggling more and more with connecting to their peers, children with Asperger s may develop other psychiatric disorders as they age. These include OCD, ADHD, depression, anxiety, and Tourette s Syndrome. Some of these disorders may be as a result of their social discomfort or may be a result of the nature of their personality. Comorbidity occurs most often with either depression or anxiety. Hyperactivity is also common and for this reason, people with Asperger s are often misdiagnosed with ADHD. Although some of the traits common in people with Asperger s, such as higher intelligence and limited empathy, are thought to make them predisposed to crime, there is no research to support this claim (McPartland 2006). Treatment/ Medication While there is no known cure or prevention for Asperger s Syndrome, nor is there a medication specifically for Asperger s, there are a variety of medications for the myriad of disorders that may come along with Asperger s. That being said, over

3 fifty percent of people with Asperger s take medication for it. The most common kinds are antipsychotics, antidepressants, anti- anxiety medications, stimulants and mood stabilizers when there is a history of bipolar disorder (Green 2006). Antipsychotics Antipsychotics such as Clozaril, Risperdal, and Thorazine, are often used in order to treat the stereotyped behaviors as well as the aggressive and violent behaviors (Kendall 2009). Oftentimes these drugs can be used by people with Asperger s for their intended purposes, but they can also be used for off- label uses to control obsessive compulsive tendencies and other non- psychotic disorders. Antipsychotics are split into two groups depending on when they were developed, however many of them work the same way. They act as sedatives or light tranquilizers in the brain. Common side effects include drowsiness, dry mouth, increased heart rate and blood pressure, change in weight, blood count and hormone level changes, and blurred vision. There is controversy surrounding these drugs in their addictive nature as well as the risk of death with long- term usage. Additionally there is controversy in describing these drugs as tranquilizers, (Mayo Clinic 2012). Antidepressants The most common anti depressants used by people with Asperger s are Zoloft, Prozac, and Paxil (Kendall 2009). There are several types of antidepressants. One of which that is common for people with Asperger s are the selective serotonin reuptake inhibitors (SSRIs). Zoloft, Prozac and Paxil are all three SSRI medications. This type of antidepressant works by blocking the transmission and uptake of

4 serotonin, a chemical in the brain. Although SSRIs are favored for their lower levels of side effects, there are still some such as anxiety, insomnia, decreased appetite, restlessness, agitation, and obsessive thoughts. There is controversy about giving these drugs to young people as the obsessive thoughts are often of suicide. Additionally there is controversy about the efficacy of these drugs (Mayo Clinic 2012). They are currently the most prescribed drugs in America, yet there is almost no significant difference in comparison to the use of a placebo. Anti- Anxiety Medication Xanax, Ativan, and Valium are the three most commonly prescribed anti- anxiety medications, or anxiolytics, for people with Asperger s Syndrome (Kendall 2009). As with antidepressants, there are many types of anxiolytics. Xanax, Ativan and Valium all are benzodiazepines, which work by affecting the neurotransmitter acids in the brain to treat severe short- term anxiety. They can also be used for less severe long- term anxiety, but when used at a high dosage for too long they can have hypnotic effects. The three most common side effects are drowsiness, deceased ability to focus, and muscle weakness. Although they are much less toxic than their predecessors, these drugs can be highly dangerous at high dosages and can cause long- term unconsciousness or death. They are also extremely dangerous to use during pregnancy. Finally they can be highly addictive and can cause withdrawal when ceasing to use the drug (Mayo Clinic 2012). Stimulants Stimulants are often prescribed for people with Asperger s and also display hyperactivity. The three most common stimulants prescribed for these people are

5 Ritalin, Adderall, and Dexedrine (Kendall 2009). These kinds of stimulants work by effecting the adrenaline and dopamine in the brain. Some common side effects of this kind of stimulant are restlessness, nausea, weight loss and weakness. Although there are many other types of stimulants such as caffeine, nicotine and cocaine, they all are highly addictive. There is a great deal of controversy regarding the over prescription of these drugs, especially Ritalin and Adderall, to children. This can be dangerous because of the drug s similarities to cocaine and meth (Mayo Clinic 2012). Conclusion As shown above, Asperger s is a milder disorder on the Autism Spectrum. This is not to say that people with Asperger s do not face their own unique set of challenges. These difficulties include social ostracization, depression, anxiety, and hyperactivity. People with Asperger s have a number of therapies available to them, however there is not a medication that is designed to treat the characterizing trait of Asperger s. This lack of social understanding is largely still not understood by scientists. As a result, they can only treat a variety of other disorders and symptoms that often accompany Asperger s Syndrome,

6 Works Cited Drugs and Supplements. (2012). Mayo Clinic. information/drugherbindex Gillberg, Christopher. (2002). A Guide to Asperger s Syndrome. Retrieved from Green, Vanessa A.. (2006). Internet survey of treatments used by parents of children with autism. Research in Developmental Disabilities (27) Retrieved from Jackson, Luke. (2003). Freaks, Geeks and Asperger s Syndrome- A User Guide to Adolescence. Retrieved from Kendall, Craig. (2009). The Asperger s Syndrome Survival Guide. Retrieved from Khouzam, Hani Raoul, Fayez El- Gabalawi, Nabeel Pirwani, and Fiona Priest (2004). Asperger s Disorder: A Review of Its Diagnosis and Treatment. Comprehensive Psychiatry, 3(45) Retrieved from McPartland, James and Ami Klin. (2006). Asperger s Syndrome. Adolescent Medicine Clinics. (17) Retrieved from firstconsult.com