Asperger Syndrome - Essay Example

Running Head: ASPERGER SYNDROME Asperger Syndrome SCHOOL In 1944, Asperger syndrome, a neuro-developmental disorder, was d after Austrian physician, Hans Asperger. Asperger syndrome is under the categorization of Autism Spectrum Disorder or Pervasive Developmental Disorder. The brain functioning of an Asperger syndrome individual develops at a usual range but with marked deficits in social interaction and communication. Asperger syndrome, which is more prevalent in boys, is rarely diagnosed and often mistaken as high-functioning autism. Because the cause is uncertain, there is no precise remedy for the disorder. Treatment approaches are primarily for improvement, rehabilitation and education on appropriate social, vocational, and communication skills (Attwood, 2003). In this paper, the literature on Asperger syndrome will be reviewed and contributing factors will be highlighted. Treatment and management will also be discussed. I. Introduction Asperger Syndrome was initially recognized in the early 1940s by Austrian pediatrician, Hans Asperger. In his practice, he observed four of his young male patients with typical intellect and verbal communication development but demonstrating autistic traits. Abnormalities in social interaction and communication, together with restrictive and repetitive behavioral patterns were noted. It was 1944 when the disorder was officially named Asperger Syndrome. Having parallel characteristics, both high-functioning autism and Asperger Syndrome fall under “Pervasive Developmental Disorders,” as stated in Diagnostic Manual of Mental Disorders, 4th Edition (DSM-IV) of the American Psychiatric Association (1994) (Myles et al, 2005). The escalating incidence of Asperger Syndrome in children may be due to the medical world’s improved understanding of the disorder or the actuality of more children exhibiting Asperger Syndrome characteristics, resulting to incorrect statistics on the prevalence of the disorder. However, some studies approximated that in 10,000 children, there are 48 who may have Asperger Syndrome (Myles et al, 2005). What is Asperger Syndrome? Asperger Syndrome (AS) is a developmental disorder that falls under the umbrella of Autistic Spectrum Disorder (ASD). AS individuals generally have normal or superior intellect. The disorder is typified by qualitative impairment in communication, social interaction and cognition; peculiarities in sensory input; restrictive number of extreme and highly focused interests; and difficulties in organization and motor movements (Attwood, 2003). Asperger Syndrome characteristics may be manifested to a bigger or smaller extent. AS individuals may have a tendency to experience exclusion and isolation and may have difficulty understanding the world around them, eventually resulting in disappointment, despair, resentment and self-disrespect (Attwood, 2003). What is Pervasive Developmental Disorder? Pervasive Developmental Disorder is also referred to as Autism Spectrum Disorders. Covering this spectrum are Classic Autism, Asperger Syndrome, Childhood Disintegrative Disorder, Pervasive Developmental Disorder – Not Otherwise Specified, and Rett Syndrome. The disorder presents a delay in the speech and language development and impairment in communication skills. Symptoms may be seen before the age of three. Warning signs may consist of the child’s difficulty with using and understanding language; trouble relating to family and peers; weird play; resistance to changes; unusual behavior; and repetitive body movements. However, symptoms may vary in every child (Quinn & Malone, 2000). II. Asperger Syndrome’s Relationship to Autism Spectrum Disorder Asperger Syndrome (AS) and High-functioning Autism (HFA) have overlapping symptoms, such as average or above average intellect and standard or superior language skills. The two disorders are mistakenly confused with the other. There are some debates between health professionals as to whether AS is a unique disability with symptoms that are not present in any other disorder or merely an autism with superior intelligence quotient. However, the distinction between Asperger Syndrome and High-Functioning Autism is detected in the patient’s ability to communicate. AS individuals develop early and typical language and cognitive skills which are not apparent in individuals with Autism (Exkorn, 2006). Autistic children show impairments in cognitive development from infancy and can be diagnosed as early as the age of 18 months up to 5 years. However, because Asperger Syndrome children do not show warning signs, these children are often diagnosed at school age with a mean diagnosis age of 11 years. HFA and AS adults both manifest similar behavior presentations, therefore, both groups may benefit from the same behavioral treatment approaches (Howlin & Asgharian, 1999). III. Clinical History of Asperger Syndrome Common Characteristics of Asperger Syndrome AS children frequently display a restricted ability for natural social communications, difficulty in initiating and maintaining friendships, repetitive behavioral patterns, and a narrow topic of interests. While a few AS individuals may exhibit definite communication dilemmas, such as poor nonverbal communication and obscure speech, several of these individuals demonstrate good and even higher cognition and verbosity. Asperger Syndrome comprises delays in gross and fine motor development, including walking abnormalities and peculiar gestures (Brasic, 2009). Individuals with Asperger Syndrome have normal or above average intellectual capacity but may not show social sensitivities or sympathy towards family and friends. Evidences were reported that AS individuals manifest excellence in the fields of music, mathematics, physics, and computer science. Whereas the delays demonstrated are usually devastating, several of these individuals experience optimistic results, particularly those performing extremely well in matters independent on social interaction. Some Aspies (people with Asperger Syndrome) are proud to be diagnosed with the disorder. Who does not want to be associated with Albert Einstein who was believed to have AS? (Brasic, 2009). Some Developmental Disorders Associated with Asperger Syndrome Schizophrenia is a brain disorder with psychotic indications of fantasies or deliriums; attention disorder; and depressing symptoms resulting in socio-occupational malfunctions. Asperger Syndrome symptoms of typical cognitive capacity, limited and repetitive behaviors and difficulties in social interaction and communication are often misconstrued as proof of schizophrenia. AS individuals may have trouble recognizing acceptable behavior, understanding how other minds perceive, and interpreting social connections. They may have wrong interpretations of what they actually see and hear, and may occasionally verbalize their thoughts. However, these symptoms are not indicative of schizophrenia (Fitzgerald & Corvin, 2001). Individuals with Schizoid personality disorder or Asperger Syndrome both have the following characteristics: disinterest in building social relationships; paranoia; heightened sensitivity; emotional aloofness; and a tendency towards solitude and secrecy. In accordance to Wolffs (1998) argument on schizoid personality in childhood, schizotypal personality disorder and schizoid personality have considerable related symptoms of odd visions or fixations; strange perception and verbal communication; magical beliefs; odd, unconventional or atypical manners; and social apprehension. Every one of these symptoms can be exhibited by Asperger syndrome individuals. Wolff (1998) stated that "Asperger syndrome and schizoid/schizotypal disorders are interchangeable terms that identify roughly the same group of children" (Fitzgerald & Corvin, 2001). Attention-deficit hyperactivity disorder (ADHD) individuals have short attention span, easily distracted, fidgety, hyperactive, and impulsive. HFA individuals may exhibit some ADHD traits such as impulsivity, hyperactivity, and inattention. On the other hand, those diagnosed with ADHD do not have deficits in mutual social interaction, limited interests, monotonous rituals and non-verbal difficulties which are apparent in Asperger syndrome individuals. Asperger syndrome is frequently misdiagnosed as ADHD due to shared traits of distractibility, impulsivity and social detachment (Fitzgerald & Corvin, 2001). Obsessive–compulsive disorder (OCD) characteristics are repetitive and unrelenting thoughts, urges or illustrations experienced during the disorder as invasive and improper and may result in obvious nervousness or pain. Compulsions include manifestations of cyclic behaviors or mental actions performed by OCD individuals to relieve themselves of anxiety. While OCD adults can distinguish that these traits are unnecessary or irrational, children with obsessive-compulsive disorder cannot (American Psychiatric Association, 1994). The desire to count and to repeat the same rituals are observed in Asperger Syndrome individuals. OCD and AS individuals both display “repetitive activities” and resistance to adjustments or modifications. Szatmari (1998) stated that OCD usually can be detected at a later age and it does not possess Asperger syndrome symptoms of social skills deficits; compassion problems; and deficiency in responding to social emotions (Szatmari, 1998). Semantic pragmatic disorder (Rapin & Allen, 1983) is a disorder set apart by "near-normal vocabulary, grammar, and phonology, but language use is abnormal in content and function and comprehension is also impaired. There are considerable difficulties in initiating or sustaining a conversation, making cohesive links in conversation from topic to topic, and words are used out of context" (Szatmari, 1998: p. 71). According to Wing (1981), these are the language dilemmas of individuals with Asperger Syndrome. Language problems include nonsense talk and speech delay. The semantic pragmatic disorder is not inclusive of problems in socio-emotional aspects or cyclic and labeled behavioral patterns (Fitzgerald & Corvin, 2001). IV. Epidemiology of Asperger Syndrome Asperger syndrome is a rare condition which is usually detected in the early school age (3 to 9 years of age) and less often during pre-childhood or adulthood. In 1993, 36 per 10 000 children are diagnosed with Asperger syndrome while 5 per 10 000 children are detected with autism (Ehlers & Gillberg, 1993). AS is commonly misdiagnosed or diagnosed more than a few years later than for autism (Gillberg, 1989), which can be upsetting for the AS individuals and their families. Moreover, it is most effective when early intervention is given to reduce behavioral issues later in life (Howlin, 1998). With regards to gender, there are more boys diagnosed with Asperger Syndrome than girls. AS has no predilection on races (Brasic, 2009). It is not deadly and has no influence on the regular life expectancy (“Asperger Syndrome,” 2009). V. Etiology of Asperger Syndrome Asperger Syndrome is most likely due to factors that influence the development of the brain. It may not be caused by emotional withdrawals or some genetic reasons (Attwood, 2003). Neurological Factors of Asperger Syndrome Brain Functions There is a probability that Asperger syndrome results from alteration in the executive functions of the brain caused by certain irregular adjustments in “embryonic cells.” Aspects on the environment and genetics are accountable for brain development modifications. Modern studies through the use of sophisticated imaging procedures have disclosed structural defects in the AS individual’s brain. Taken into consideration is the possibility of nonstandard presence of “embryonic cells” while the fetus is still developing, causing malformations in brain systems and circuits, whose function is to manage behavioral and perceptive patterns. Such modifications are contributory to AS symptoms (Jirage, 2009). According to Jirage (2009), as seen in Asperger syndrome children, a decrease in brain functions was observed upon instructions to these children to do a job using their own decisions. However, in AS adults, researches exposed irregular protein levels are present in the brain causing compulsive and cyclic behaviors (Jirage, 2009). Social Factors of Asperger Syndrome A. Qualitative Impairments in Reciprocal Social Interaction Social standards for AS and autism are indistinguishable. Asperger syndrome has lesser indications and diverse manifestations than autism. AS individuals are usually socially detached; not sensitive to the feelings of others; and obsessed in one-sided conversations about limited and specific subjects. These AS characteristics make them unsuccessful to engage in friendships and family relations and incapable of adjusting to real-life situations. They are literal and unable to get cues in other’s signals of obvious boredom, need to depart, and need to be alone. Due to frequent disappointments in building social relations, Asperger Syndrome individuals often develop feelings of severe depression that eventually may need cure or treatment (Klin & Volkmar, 1995). Some noticeable manifestations seen in AS individuals are deficits in the use of non-verbal behaviors including eye contact; facial and bodily expressions; and a lack of shared interests with the people around them (Klin & Volkmar, 1995). B. Qualitative Impairments in Communication AS individuals usually develop speech at a normal level. However, there are three aspects of some peculiarities in their communication patterns. They may deliver inappropriate prosodic speech such as thin variety of modulation patterns with no considerations on communicative execution on declarations of detail and witty comments. AS individuals often engage in one-sided, long speeches with no connections, reciprocity, and rationality; and frequently obsessed in monologues about narrow subjects such as train schedules, baseball statistics, historical people, names and codes. They talk continuously without considering if the other person is fascinated, bored, or wanting to shift to another topic. Despite the long one-sided speech, the AS individual still fails to prove a position or make a finale (Klin & Volkmar, 1995). Biological Factors of Asperger Syndrome A. Difficulties with Movement Other symptoms of Asperger syndrome include postponed development of motor skills and poor coordination in motor movements. AS individuals may sometimes have trouble doing simple things such as ball-catching and bike-pedaling. They are noticeably awkward, showing stiff walking patterns, funny posture, poor control skills, and impaired movement synchronization (Klin & Volkmar, 1995). B. Speech and Hearing Peculiarities Persons with Asperger syndrome exhibit quite a few irregularities in verbal communication, such as strangeness in manner, tone, sound, and pace. They often engage in one-sided speech with concern in detail and technical knowledge. Incapacity to use proper speech in social situations; inappropriate remarks; strangely ceremonial speech; and inability to repress thoughts are observed in AS individuals. Moreover, some may exhibit “selective mutism,” not talking to some people and yet exceptionally engaging in one-sided conversation with other people about a desired specific topic. They may speak metaphorical language that is only significant to them and may demonstrate audio discrimination when more than two people are talking at the same time (Brasic, 2009). C. Communication Abnormalities Failure to use appropriate gestures and signals; improper body movement messages or nonverbal exchange; lack of eye contact; inappropriate and irrelevant remarks; and deficiency in conveying messages through proper facial expressions are symptomatic of individuals with Asperger syndrome (Brasic, 2009). D. Non-verbal Problems: Restrictive, Repetitive, and Stereotyped Patterns of Behavior, Interests, and Activities AS individuals exhibit persistent preoccupations or obsessions on limited interests and cyclic behavioral prototypes, usually dominating their lives. These individuals master full and detailed knowledge of their preferred confined interest, without necessarily understanding the topic. Such interests may be a fascination for cars, dinosaurs, maps, train schedules, flags, or television guides. They may often engage the whole family with a single topic for an unusually extended time (Klin & Volkmar, 1995). Sensitivity to Sensory Information Evident in AS individuals are sensory issues of hypersensitivity or hyposensitivity to pain, sight, smell, touch, sound, taste, and temperature. An individual may feel or may not feel pain; may show preferences for some food textures; may feel more comfortable with hot temperature than with cold; may show dislike for certain sounds; or may have aversion to touch. Some may demonstrate abnormal response to a particular environment setting (Brasic, 2009). Psychological Factors of Asperger Syndrome A. Behavioral Challenges Frequently experienced by AS individuals are concentration and security dilemmas such as discriminating attention and hyperactivity in certain situations. They may be extremely obsessed with circumscribed subjects and may exhibit carelessness and restricted responsiveness to safety. AS individuals are usually ignorant to risks and threats such as swallowing objects, going out on the streets, playing with or near water, climbing high places, wandering around, or pulling electric cords (Prior, 2003). B. Sleep Disturbances Insomnia is very common for individuals with Asperger syndrome. Troubled sleep such as beginning and sustaining sleep are strong indications of insomnia. Wakefulness is a consequence of sleep interruptions. In some studies, it was revealed that interruptions in the biological 24-hour rhythm and stress-related issues of the AS individual may cause insomnia. Moreover, it was established that individuals having mental disorders, standard intellect and Pervasive Developmental Disorders complained of troubled sleep (“Insomnia in School-age Children with Asperger Syndrome or High-functioning Autism,” 2010). C. Socio-Emotional Factors Affecting Behavior Asperger syndrome individuals may have problems initiating social relations with family and peers; may lack emotional attachment to parents; may have socially unacceptable behaviors and may not be perceptive of other’s thoughts and feelings. Because of these symptoms, AS individuals have greater risk of dismissal, solitude, hopelessness, and solitude. The Asperger syndrome adult may even demonstrate suicidal tendencies after an apparent rejection in courtship, dating, or marriage (Brasic, 2009). VI. Cultural Aspects of Asperger Syndrome Asperger syndrome is a neurological disorder overstated as male mental patterns that cause emotional detachment and a negative response to social standards. In accordance to the Diagnostic and Statistical Manual of Mental Disorders ( DSM IV ), AS individuals are strongly focused on limited interests; exhibit rhythmic behaviors; and impaired in building relationships on the usual development patterns. Mild autism characteristics often overlap with Asperger syndrome traits. AS individuals have strong preference for privacy, aversion to masses, and a propensity towards self-absorption. It is assumed by psychologists and a group of commoners that AS is correlated with above average scholarly quotient that pop culture accounts label as genius. Different critics assumed that famous highly intellectual people such as Michelangelo, Glenn Gould, Wolfang Amadeus Mozart, Thomas Edison and Albert Einstein belong to the AS group. Feminists have meticulously disputed the idea of “male genius”. Questions were raised as to why modern women critics aspire for the phenomenal endowments coupled with strange but talented men (Bombaci, 2005). According to psychiatrists of the American Psychiatric Association (1994), Asperger syndrome is merely a type of autism and is not supposed to be eliminated from the diagnostic manual (Hamilton, 2010). Both Asperger syndrome and Autism possess similar features of impairment in social interaction and communication, and restricted, persistent behaviors. Asperger syndrome is often referred to as high-functioning autism, however, it is not recorded as belonging to the autism spectrum in the Diagnostic and Statistical Manual, or DSM. The DSM provides a guide for mental health experts and government bureau. On the other hand, Asperger syndrome formally listed as autism in the fifth edition of American Psychiatric Association which is to be published in May 2013. This declaration infuriated AS people because they do not want to be branded as autistic (Hamilton, 2010). Majority of AS individuals are actually proud to be diagnosed with the disorder. It is strongly believed that famous men of history such as Albert Einstein and Thomas Edison both have Asperger syndrome features (Hamilton, 2010). VII. Treatment and Management At the moment, there is no known cure for Asperger syndrome. However, an extensive assortment of useful treatments and management of the disorder are now available to AS patients. Medications such as psychostimulants, antidepressants, SSRIs, and mood stabilizers are among the pharmacotherapy treatments widely used today. Another effective AS management is through psychotherapy which is helpful in improving social skills, coping with depression, modifying behavior, and leading normal lives (Benjamen, 2007). A. Psychiatric Medications Recommended drugs For AS patients consist of the following: - For hyperactivity, impulsivity and inattention: Psychostimulants (methylphenidate, metamphetamine, pemoline, dextroamphetamine), clonidine, Strattera (atomoxetine), Tricyclic Antidepressants (TCAs) (nortriptyline, desipramine). - For irritability and aggression: Beta blockers (propranolol, nadolol), naltrexone, clonidine, Neuroleptics (quetiapine, haloperidol, ziprasidone, risperidone, olanzapine) Mood Stabilizers (carbamazepine, valproate, lithium). - For preoccupations, compulsions, and rituals: Selective Serotonin Reuptake Inhibitors (SSRIs) (fluvoxamine, paroxetine, fluoxetine), Tricyclic Antidepressants (TCAs) (clomipramine). - For anxiety symptoms: Selective Serotonin Reuptake Inhibitors (SSRIs) (fluoxetine, sertraline), Tricyclic Antidepressants (TCAs) (imipramine, nortriptyline, clomipramine) (Benjamen, 2007). - Administered to some AS patients is a herbal drug called St. John’s Wort (Frey, 2002). B. Psychotherapy Psychotherapy is a psychosocial intervention for Asperger syndrome. This treatment is especially beneficial to adolescent individuals to assist in surviving emotional and mental stresses caused by social complexities (Frey, 2002). Psychotherapy is a way of managing psycho-emotional problems of psychosis or disorder in an AS individual’s personality. Skilled and licensed psycho-therapists may help in managing mental sufferings through verbal communication with the AS patient. Psychotherapy is an alternative to psychiatric medication. It not only relieves temporary distress but modifies behavioral patterns as well. Psychotherapy is centered on assisting the patient to learn more positive ways in dealing with emotional difficulties and increased pressures. It is implemented by helping the AS individual in enhancing knowledge of self and improving social relationships with the people around them. Psychotherapy focuses on transforming negative behavioral patterns into positive ones (Frey, 2002). Different Approaches to Psychotherapy in AS Adults The psychodynamic approach originated from psychoanalysis which covers “Gestalt therapy”, “client-centered therapy”, and “somatic or body therapies.” “Psychoanalytic therapy” centers on the ideal that the behavioral growth and personality development are connected to subconscious desires and inconsistencies in the upbringing of the Asperger syndrome individual. “Gestalt therapy” highlights the standards of egotistical consciousness and understanding accountability of the patient’s personal actions. In the “Client-centered therapy,” individuals have their own sources for understanding and modifying their behaviors. “Somatic or body therapies” comprise: rhythmic dance approach, holotropic breathing exercises, and “Reichian therapy” (Frey, 2002). The behavioral approach includes different “behavior modification techniques” or BMTs and principles, such as social skills instruction, dream therapy, sex psychoanalysis, and desensitization method. Desensitization technique blends muscular stress release and strong release of emotions through visual-metaphorical work outs. The AS patient loosens up and the therapist vocally puts imaginative scenes, involving sights of the patient’s apprehensions (Frey, 2002). Controlling behavior is the main point in the cognitive approach. There are two types of this approach, namely the “rational-emotive therapy” and “reality therapy”. “Rational-emotive therapy” is formed on the idea that episodes within Asperger syndrome individuals do not cause distress in people although disappointment is caused by their outlook on such episodes. On the other hand, “reality therapy,” is founded on the belief that individuals search for personal fulfillment, and their learned behaviors are used to achieve that fulfillment. When humans gain satisfaction, happiness is likewise achieved, whereas some people may feel discouraged and enraged when goals are not achieved (Frey, 2002). The family systems approach, a commonly used and greatly valued therapy, focuses on improving social relations in the family. This approach sees behavioral problems as the contributing factor in family disintegration or integration. Another principle of family therapy lies in self-differentiation and sibling-differentiation. This approach aims to develop individuality in the family and at the same time maintaining close relations within the family. In general, family therapy does not deal with domestic issues alone; it also enhances constructive interactions between each member (Frey, 2002). Counseling, the most fundamental form of management, offers guidance and psychological/moral support to the Asperger syndrome adult. Short-term counseling helps the individual in coping with typical problems involving marital issues, family planning, drug and alcohol abuse, bereavement, or life-threatening sickness. Long-term counseling focuses on dealing with the AS individual’s emotions and outlook in life which hinders accomplishments and progress (Frey, 2002). Group psychotherapy is less costly because it does not need the regular presence of the therapist during sessions. The therapist comes once in a while to provide encouragement and organize the group interactions. Sharing alike emotional issues within the group proved to be therapeutic. Through exchanged communication, members of the group learn from each other’s advice and experiences. In a group therapy, members are encouraged to implement learned behaviors (Frey, 2002). All of the discussed types of psychotherapy call for an ambiance of complete shared trust and privacy. Loss or lack of any of this overall security, may make victory evasive (Frey, 2002). Intervention Programs for Children with Asperger Syndrome Occupational Therapy (OT) gives support for AS children with impairments in sensory, neuromuscular, motor, and visual skills. OT teaches a child to learn new skills such as balancing body weight, responding to touch, learning self-help skills, playing appropriately and communicating with others. Physical Therapy (PT) can treat problems such as little muscle tone, poor balance, coordination and posture. PT trains AS children in developmental and functional skills, through the use of exercise balls, balance beams, trampolines, and swings. Sensory Integration Therapy (SI) focuses on assisting AS children to understand and practice sensory input. SI centers on the following senses, namely hearing, touch, body position, and sense of movement. Social Skills Training involves peer modeling, one-on-one social skills therapy, and video modeling. It is aimed at teaching children proper social interactions, and establishing social relations. During social skills training, Asperger syndrome children are encouraged to participate in role-playing, story-telling, activities, games, and group discussions (Exkorn, 2006). VIII. Conclusion Asperger Syndrome individuals are unique individuals. They are often called “Little Professors” because of their impressive photographic memory. Asperger syndrome and High-Functioning Autism have overlapping characteristics which makes them indistinguishable from the other. Odd symptoms of Asperger syndrome are: obsession towards a confined subject; uncoordinated motor movements; difficulty in forming social relations; repetitive strange behaviors; and deficits in non-verbal communication. Several treatments are available for AS children and AS adults. With AS adults, approaches such as behavioral approach, family therapy, counseling, cognitive approach and group psychotherapy are beneficial. However, in AS children, there is no single approach that can treat all three important symptoms at the same time. Indications such as physical awkwardness, obsessive and persistent activities, and impairment in communication skills and social interaction can be effectively managed through occupational therapy, sensory integration programs, behavior modification techniques; social skills training; speech and language therapy; and medications. Asperger Syndrome is a developmental disorder that distresses some developmental regions where talents camouflage complexities. Asperger syndrome individuals should not be judged through a psychological view, rather they should be observed through a neurological view. They are actually proud to be called Aspies (the term they call themselves). It is assumed by many researchers that Albert Einstein and Thomas Edison were indeed Asperger syndrome individuals. Who would not want to be associated with these famous people? References American Psychiatric Association. (1994). Diagnostic Manual of Mental Disorders (4th Edn.)(DSM-IV). Washington DC. APA, 77 Asperger Syndrome. (2009). Autism EMed TV. Retrieved 15 February 2010 from http://www.autism.emedtv.com/asperger-syndrome/asperger-syndrome-p2.html Attwood, T. (2003). Asperger Syndrome. Orphanet Encyclopedia. Retrieved 16 February 2010 from http://www.orpha.net/data/patho/GB/uk-asperger.pdf Benjamen, M. (2007). Treatment for Asperger’s Disorder. Psych Central. Retrieved 14 February 2010 from http://www.psychcentral.com/lib/2007/treatment-for-aspergers-disorder/ Bombaci, N. ( 2005). Gods Among Men: Asperger’s Syndrome and the Gender of Genius. Autism and Representation. Retrieved 14 February 2010 from http://www.cwru.edu/.../Autism%20and%20Representation%20Bombaci.htm Brasic, J. R. (2009). Asperger’s Syndrome: Developmental and Behavioral. eMedicine Pediatrics. Retrieved 14 February 2010 from http://www.emedicine.medscape.com Ehlers, S. & G Gillberg, C. (1993). The Epidemiology of Asperger Syndrome: A Total Population Study. Journal of Child Psychology and Psychiatry, 34, 1327–1350 Exkorn, A.S. (2006). The Autism Source Book. New York: Harper Collins Publishers Inc., 21 Fitzgerald, M. & Corvin, A. (2001). Diagnosis and Differential Diagnosis of Asperger Syndrome in Advances in Psychiatric Treatment. Royal College of Psychiatrists, 7, 310-318 Frey, R.J. (2002). Asperger Syndrome Information. Health Line. Retrieved 13 February 2010 from http://www.healthline.com/galecontent/asperger-syndrome Gillberg, C. (1989). Asperger Syndrome in 23 Swedish Children. Developmental Medicine and Child Neurology, 31, 520–531 Hamilton, J. (2010). Asperger’s Officially Placed Inside Autism Spectrum. National Public Radio. Retrieved 14 February 2010 from http://www.npr.org/templates/story/story.php?storyId=123527833 Howlin, P. (1998). Practitioner Review: Psychological and Educational Treatments for Autism. Journal of Child Psychology and Psychiatry, 39, 307–322 Howlin, P. & Asgharian A. (1999) The diagnosis of autism and Asperger syndrome: findings from a survey of 770 families. Developmental Medicine and Child Neurology, 41, 834-839 Insomnia in School-Age Children with Asperger Syndrome or High-Functioning Autism. (2010). Asperger Syndrome Behavior. Retrieved 15 February 2010 http://www.aspergersyndromebehavior.com/asperger-syndrome/insomnia-in- school-age-children-with-asperger-syndrome-or-high-functioning-autism/ Jirage, R. (2009). Causes of Asperger Syndrome. Buzzle.com. Retrieved 15 February 2010 from http://www.buzzle.com/articles/causes-of-asperger-syndrome.html Klin, A. & Volkmar, F. R. (!995). Asperger Syndrome: Guidelines for Assessment and Diagnosis. Yale Child Study Center. Retrieved 14 February 2010 from http://www.med.yale.edu/chldstdy/autism/asdiagnosis.html Myles, B. S. et al. (2005). Life Journey Through Autism: An Educator’s Guide To Asperger Syndrome. Organization for Autism Research. Retrieved 15 February 2010 from http://www.researchautism.org Prior, M. R. (2003). Learning and Behavioral Problems in Asperger Syndrome. New York: The Guilford Press, 29 Quinn, B. & Malone, A. (2000). Pervasive Developmental Disorder: An Altered Perspective. London: Jessica Kingsley Publishers, 22 Rapin, I. & Allen, D. (!993). Developmental Language Disorders: Nosological Considerations. Neuropsychology of Language, Reading, and Spelling (ed. U. Kirk). New York: Academic Press. Szatmari, P. (1998). Differential Diagnosis of Asperger’s Disorder. Aspergers Syndrome or High Functioning Autism? (eds E. Schopler, G. Mesibov, & L. Kunce), p. 71. New York: Plenum. Wing, L. (1981). Asperger Syndrome: A Clinical Account. Psychological Medicine, 11, 115–130. Wolff, S. (1998). Schizoid Personality in childhood: the links with Aspergers syndrome, schizophrenia spectrum disorders, and elective mutism. In Aspergers Syndrome or High Functioning Autism (eds E. Schopler, G. Mesibov & L. Kunce), pp. 123– 145. New York: Plenum. Read More