david24,
Thanks for your patience!
You didn’t specify whether you were interested in treatment
information for adults, children, or both, so I am going to include
some of each. I am also going to include links to websites which I
felt would provide helpful information.
Unfortunately, at this stage the causation of Asperger’s is still so
poorly understood, that current treatment options typically consist of
cognitive therapy for children, and coping strategies for adults. In
addition to the compulsion to adhere to a rigid set of internally
generated rules for the way things must be done, the hallmark of
Asperger’s is the person’s tendency to fixate / perseverate on one or
two specific areas of interest to the exclusion of all others, to the
detriment of the person’s social and professional lives. This can
manifest in behaviors such as arranging things in a specific order,
collecting lists of things by category, pursuing to an extreme degree
a hobby of collecting related objects or amassing information on a
certain subject, and participating in all "social" interactions
exclusively in relation to the subject of their fixation.
DSM-IV Diagnostic Criteria for Asperger’s Syndrome
While many sources refer to Asperger’s as a type of Autism, current
thinking is that Asperger’s is its own distinct Pervasive
Developmental Disorder, in the same "Autistic Spectrum Disorders"
class as Autism, Rett's Syndrome, Childhood Disintegrative Disorders,
and Pervasive Developmental Disorders Not Otherwise Defined.
The DSM-IV Criteria, from the Indiana Resource Center for Autism’s
(Indiana University, Bloomington) website:
"A. Qualitative impairment in social interaction, as manifested by at
least two of the following:
1) marked impairment in the use of multiple nonverbal behaviors…
2) failure to develop peer relationships…
3) a lack of spontaneous seeking to share enjoyment, interests, or
achievements with other people…
4) lack of social or emotional reciprocity
B. Restricted repetitive and stereotyped patterns of behavior,
interests, and activities, as manifested by at least one of the
following:
1) encompassing preoccupation with one or more stereotyped and
restricted patterns of interest that is abnormal either in intensity
of focus
2) apparently inflexible adherence to specific, nonfunctional
routines or rituals
3) stereotyped and repetitive motor mannerisms…
4) persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairment in social,
occupational, or other important areas of functioning.
D. There is no clinically significant general delay in language (e.g.,
single words used by age 2 years, communicative phrases used by age 3
years).
E. Criteria are not met for another specific Pervasive Developmental
Disorder or Schizophrenia."
http://www.iidc.indiana.edu/irca/generalinfo/aspergercha.html
From the ERIC Clearinghouse on Disabilities and Gifted Education:
"Individuals with AS show marked deficiencies in social skills, have
difficulties with transitions or changes and prefer sameness. They
often have obsessive routines and may be preoccupied with a particular
subject of interest. They have a great deal of difficulty reading
nonverbal cues (body language) and very often the individual with AS
has difficulty determining proper body space. Often overly sensitive
to sounds, tastes, smells, and sights, the person with AS may prefer
soft clothing, certain foods, and be bothered by sounds or lights no
one else seems to hear or see. It's important to remember that the
person with AS perceives the world very differently. Therefore, many
behaviors that seem odd or unusual are due to those neurological
differences and not the result of intentional rudeness or bad
behavior, and most certainly not the result of "improper parenting."
http://ericec.org/faq/asperger.html
From the archived version of Kaan R. Ozbayrak, MD’s Aspergers Syndrome
website:
“What are the differences between Asperger's Disorder and 'High
Functioning' (i.e. IQ > 70) Autism?
It is believed that in Asperger's Disorder
- onset is usually later
- outcome is usually more positive
- social and communication deficits are less severe
- circumscribed interests are more prominent
- verbal IQ is usually higher than performance IQ (in autism, the case
is usually the reverse)
- clumsiness is more frequently seen
- family history is more frequently positive
- neurological disorders are less common
http://web.archive.org/web/20010607161441/http://www.ummed.edu/pub/o/ozbayrak/aspdiff.html
So what all this means, in terms of treatment options, is that the
Asperger’s patient is typically more socially functional, and has more
motivation for social interaction than the typical Autism patient.
Subsequently, cognitive and behavioral therapies seem to have some
success, in both children and adults, in assisting the Asperger’s
patient in improving their social skills, and in helping them to
control their obsessive tendencies. In addition, anti-depressants and
certain other medications seem to provide some assistance in achieving
behavioral modification and control of the obsessive tendencies.
From PsychNet UK’s page on Asperger’s:
Treatment:
"There is no specific treatment or "cure" for Asperger's Disorder. All
the interventions outlined below are mainly symptomatic and/or
rehabilitational.
Counseling and Psychotherapy…
- Individual psychotherapy to help the individual to process the
feelings aroused by being socially handicapped.
- Parent education and training.
- Behavioral modification.
- Social skills training.
- Educational interventions
Pharmacotherapy…
- For hyperactivity, inattention and impulsivity: Psychostimulants
(methyphenidate, dextroamphetamine, metamphetamine, pemoline),
Clonidine, Tricyclic Antidepressants (desipramine, nortriptyline).
- For irritability and aggression: Mood Stabilizers (valproate,
carbamazepine, lithium), Beta Blockers (nadolol, propranolol),
Clonidine, Naltrexone, Neuroleptics (risperidone, haloperidol).
- For preoccupations, rituals and compulsions: SSRIs (fluvoxamine,
fluoxetine), Tricyclic Antidepressants (clomipramine).
- For anxiety: SSRIs (sertraline, fluoxetine), Tricyclic
Antidepressants (imipramine, clomipramine, nortriptyline)."
http://www.psychnet-uk.com/dsm_iv/aspergers_syndrome.htm
From "Asperger's Syndrome, High Functioning Autism and Disorders of
the Autistic Continuum", by Sally Bloch-Rosen, Ph.D. (April 8 1999)
"Volkmar and Klin (1997) suggest that skills and concepts be taught in
an explicit and rote fashion where possible, employing a parts to
whole verbal instructional approach. Learning strategies will be most
effective when based on the specific pattern of strengths and deficits
demonstrated in neuropsychological assessment. If motor and
visual-motor deficits are identified, physical and occupational
therapies are indicated.
Interventions designed to improve communication and social skills may
have any or all of the following as its goals, depending on the
specific needs of the individual: enhanced awareness of one's own
nonverbal behaviours (e.g., the use of verbal inflection, eye contact,
and gaze in social interaction); verbal decoding strategies for more
accurately interpreting the nonverbal behaviour of others; more
integrated processing of visual and auditory stimuli; improved social
awareness and perspective taking. Techniques for teaching nonverbal
communication skills have been described in the literature on learning
disabilities (e.g., Minskoff, 1980). "
http://www.aspie.com/articlea4.html
"Asperger Syndrome", by Stephen Bauer, MD, MPH, provides a great
section on treatment approaches for children (please see the article
for the full text):
"- The classroom routines should be kept as consistent, structured,
and predictable as possible…
- Rules should be applied carefully. Many of these children can be
fairly rigid about following "rules" quite literally…
- Staff should take full advantage of a child's areas of special
interest when teaching. The child will learn best and show greatest
motivation and attention when an area of high personal interest is on
the agenda…
- Most students with AS respond well to the use of visuals: schedules,
charts, lists, pictures, etc…
- Avoid language that may be misunderstood by the child with AS, such
as sarcasm, confusing figurative speech, idioms, etc…
- Explicit, didactic teaching of strategies can be very helpful, to
assist the child gain proficiency in "executive function" areas such
as organization and study skills…
- Insure that school staff outside the classroom, such as physical
education teachers, bus drivers, cafeteria monitors, librarians, etc.,
are familiar with the child's style and needs and have been given
adequate training in management approaches…
- Try to avoid escalating power struggles. These children often do not
understand rigid displays of authority or anger and will themselves
become more rigid and stubborn if forcefully confronted…
- Approaches that have been most successful utilize direct modeling
and role playing at a concrete level (such as in the Skillstreaming
curriculum). By rehearsing and practicing how to handle various social
situations, the child can hopefully learn to generalize the skills to
naturalistic settings."
http://www.asperger.org/asperger/asperger_bauer.htm
Helpful links for adults with Asperger’s Syndrome:
FAAAS - Families of Adults Afflicted with Asperger's Syndrome
http://www.faaas.org
About.com’s page on "Adults With Asperger's":
http://autism.about.com/library/weekly/aa062701a.htm
The Asperger Marriage Web Site
http://www.asperger-marriage.info/links.html
Helpful links for parents of children with Asperger’s Syndrome:
OASIS - Online Asperger Syndrome Information & Support
http://www.aspergersyndrome.org or
http://www.udel.edu/bkirby/asperger
Asperger Syndrome Australian Information Centre
http://members.ozemail.com.au/%7Erbmitch/Asperger.htm
AACAP’s page of links to adolescent psychiatrists.
http://www.aacap.org/ReferralDirectory/index.htm
Other helpful resources:
PubMed’s list of Extracts from medical literature regarding Asperger’s
(currently 455 documents)
http://www4.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=4&term=asperger*&dispmax=*
WebRing List of nearly 100 sites devoted to Asperger’s:
http://f.webring.com/hub?sid=&ring=bb1&id=&list
"The Geek Syndrome", excellent, lengthy article, By Steve Silberman,
Wired Magazine (December 2001)
This article includes interesting information about the high
preponderance of Asperger’s diagnoses in Silicon Valley, perhaps due
to the fact that Asperger’s seems to have a strong genetic component,
and that computer programming is a profession friendly and well-suited
to people with the characteristics of Asperger’s!
http://www.wired.com/wired/archive/9.12/aspergers.html
Wired Magazine’s Asperger’s Quotient Test
http://www.wired.com/wired/archive/9.12/aqtest.html
From the archived version of Kaan R. Ozbayrak, MD’s Aspergers Syndrome
website:
Asperger's Disorder Clinicians (U.S.) (Last update on April 12, 2000)
This is a list of clinicians who stated that they are familiar with
Asperger's Disorder and willing to evaluate children and/or adults who
have this problem. I choose to list their names and contact phones
and/or addresses as a service to the community, without taking any
responsibility regarding their qualification and/or competence since I
do not know them personally. Please do not contact me, contact them to
obtain any further information, before you make your final decision
about requesting an appointment.
http://web.archive.org/web/20010407085920/http://www.ummed.edu/pub/o/ozbayrak/asplist.html
Links to Asperger’s related websites:
http://web.archive.org/web/20010602060036/http://www.ummed.edu/pub/o/ozbayrak/asplinks.html
Clinicians from other countries
http://web.archive.org/web/20010407090926/http://www.ummed.edu/pub/o/ozbayrak/aspother.html
Asperger Syndrome Coalition of the U.S.
http://www.asperger.org/index_asc.html
Maryland Asperger Advocacy & Support Group
http://www.aspergers.org
About.com
http://autism.about.com/cs/aspergersyndrome/index.htm?terms=aspergers
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov/search.htm?Text2=asperger%27s&Text1=asperger%27s&Go+Search%21=Go
Aspie.org Parental support group
http://www.aspie.org/group.html
Ohio State’s Nisonger Center.
http://nisonger.osu.edu/Clinics.htm |
