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Asperger Syndrome Texto de apoio ao curso de especialização Atividade física adaptada e saúde Prof. Dr. Luzimar Teixeira Asperger syndrome (sometimes called Asperger's syndrome, AS, or the more common shorthand Asperger's), is characterized as one of the five pervasive developmental disorders, and is commonly referred to as a form of high-functioning autism. In very broad terms, individuals with Asperger's have normal or above average intellectual capacity, and atypical or poorly developed social skills, often with emotional/social development or integration happening later than usual as a result. Asperger described his patients as "little professors". The term "Asperger's syndrome" was coined by Lorna Wing in a 1981 medical paper. She named the syndrome after Hans Asperger, an Austrian psychiatrist and pediatrician who himself had used the term autistic psychopathy. Contents [hide] • 1 Prevalence • 2 Characteristics o 2.1 Social impairments o 2.2 Narrow, intense interests o 2.3 Speech and language peculiarities o 2.4 Other characteristics • 3 Living with Asperger syndrome • 4 Definitions and diagnostic criteria • 5 Relationship to autism • 6 A gift and a curse o 6.1 Speculation about recognized people who may have Asperger syndrome o 6.2 Shift away from view as a disease • 7 Causes and etiology • 8 Controversies • 9 Culture • 10 See also • 11 Further reading • 12 References • 13 External links [edit] Prevalence A 1993 total population study carried out in Sweden found that, at a minimum, 3.6 per 1000 school-aged children definitely meet the criteria for Asperger syndrome. If merely suspected cases are included, the prevalence becomes approximately 7.1 per 1000 (Ehlers & Gillberg). Data for the adult population is not available. Like other conditions classified as autism spectrum disorders, Asperger syndrome appears to be more prevalent among males than females, with males making up approximately 75–80 percent of diagnoses. Many clinicians believe that this may not reflect the actual incidence among females; well-known Asperger syndrome expert Tony Attwood suggests that females learn to better compensate for their impairments because of differences in socialization (Attwood, pp 151–2). Some preliminary evidence for this is found in the Ehlers & Gillberg study, which found a 4:1 male to female ratio in the people they thought definitely had Asperger's but a much less lopsided 2.3 to 1 ratio when merely suspected or otherwise borderline cases were included. The overwhelming majority of available information on Asperger syndrome relates to children; there is currently more conjecture than hard evidence on how it affects adults. It is thought that most people with Asperger syndrome learn to cope with their social impairments later in life. However, there is no "cure" as such, and some people, including prominent clinicians such as Attwood and some of those diagnosed with Asperger's, would strenuously argue that a cure is neither possible nor desirable (see "A gift and a curse" and "Culture" below), mainly pointing out that the syndrome is a hereditary trait and attempts to "cure" or eliminate it would be an example of eugenics. Organizations such as Cure Autism Now disagree; this remains a highly controversial area. [edit] Characteristics The most common and important characteristics of Asperger syndrome can be divided into several broad categories: social impairments, narrow but intense interests, and speech and language peculiarities. Other features are commonly associated with this syndrome but not always held to be necessary for diagnosis. This section reflects mainly Attwood, Gillberg, and Wing's thinking on the most important characteristics of Asperger; the DSM-IV criteria (see below) represent a slightly different view. [edit] Social impairments Although there is no single feature that all people with Asperger syndrome share, difficulties with social behavior are nearly universal and are perhaps the most important criteria that define the condition. People with Asperger syndrome lack the natural ability to see the subtexts of social interaction (sometimes resulting in well- meaning remarks that may offend and so on, finding it hard to know what is "acceptable") and also tend to lack the ability to broadcast their own emotional state. Non-autistics, often colloquially called neurotypicals, are able to gather a host of information about other people's cognitive and emotional states based on clues gleaned from the environment and the other person's facial expression and body language, but people with Asperger syndrome have an impairment in this ability, sometimes called mind-blindness. To be mind-blind is to find it difficult or even impossible to figure out things a person implies but does not say directly (more colloquially, to "read between the lines"). This is not because they cannot imagine the answer but because they cannot choose between the possibilities; the mind- blind person cannot reliably gather enough information to do so or does not know how to interpret the information that they do gather. Along with this difficulty in reading the nonverbal communication of others, most people with Asperger's have difficulty expressing their own emotional state via body language, facial expression, and nuances as most people do. Some such people have emotional responses as strong as, or perhaps stronger than, those of most people, although what generates an emotional response might not always be the same; the difficulty is in expressing these feelings, although it sometimes comes across as lacking them. And some such people do truly lack, or have reduced levels of emotions. For example, many people with Asperger syndrome have difficulty with eye contact. Some make very little eye contact because they find it overwhelming, whereas others have unmodulated, staring eye contact that can cause discomfort to other people. Similarly, the use of gestures may be almost nonexistent or may seem exaggerated and differ from what would normally be considered appropriate for a situation. It is worth noting that because it is classified as a spectrum disorder, some people with Asperger syndrome are nearly normal in their ability to read and use facial expressions and other subtle forms of communication. However, this ability does not come naturally to most people with Asperger syndrome. Such people must learn social skills intellectually, delaying social development. Some people feel that much of the social difficulties in Asperger Syndrome are more accurately characterized as "mutual misunderstanding", in that neither the "aspie" nor the neurotypical understands each other. Some autistics assert that they have a much easier time reading body language of other autistic people, and that neurotypicals have difficulties interpreting autistic body language. Comparing the nonverbal communication problems that often occur between people from different cultures is a common defense given for this theory. [edit] Narrow, intense interests Asperger syndrome can involve an intense and obsessive level of focus on things of interest. For example, one person might be obsessed with 1950s professional wrestling, another with national anthems of African dictatorships, or another with building models out of matchsticks. Particularly common interests are means of transport (such as trains), computers, maths (particularly specific aspects, such as pi), astronomy, geography, and dinosaurs. Note that all of these last items are normal interests in ordinary children; the difference in Asperger children is the unusual intensity of their interest. Sometimes these interests are lifelong; in other cases, they change at unpredictable intervals. In either case, there are normally one or two at any given time. In pursuit of these interests, the person with Asperger's often manifests extremely sophisticated reason, an almost obsessive focus, and great memory for apparently trivial facts (occasionally even eidetic memory). Hans Asperger called his young patients "little professors" because he thought his thirteen-year-old patients had as comprehensive and nuanced an understanding of their field of interest as university professors. Some clinicians would not entirely agree with this description; for example, Wing and Gillberg both argue that there is often more rote memorization than real understanding of these areas of interest, despite occasional appearances to the contrary. However, such a limitation is not required for diagnosis, even under Gillberg's criteria. Children and adolescents with Asperger syndrome often have little patience for things outside these areas of interest. During the school years, many are perceived as highly intelligent underachievers or overachievers, clearly capable of outperforming their peers in their field of interest yet persistently unmotivated to do regular homework assignments (sometimes even in their areas of interest). Others, in contrast, may be hypermotivated to outperform peers in school. This adds to the difficulties of diagnosing the syndrome. In more serious cases, the combination of social problems and intense interests can lead to unusual behavior, such as greeting a stranger by launching into a lengthy monologue about a special interest rather than introducing oneself in the socially-accepted way. However, in many cases adults can outgrow this impatience and lack of motivation and develop more tolerance to new activities and meeting new people. [edit] Speech and language peculiarities People with Asperger syndrome often are noted for having
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