Asperger syndrome (AS), also referred to as Asperger’s, is a developmental disorder characterized by deficiencies in social and communication skills. The exact cause of Asperger’s is unknown and the prevalence is not firmly established, due partly to the use of differing sets of diagnostic criteria.

Asperger’s is often not identified in early childhood, and many individuals do not receive diagnosis until after puberty or when they are adults.

Teens with Asperger’s are usually aware of their differences and recognize when they need support from family. There are instances where teens do not know they have Asperger’s personalities until they are having difficulties with relationships in adult life.

Asperger’s is a condition in which there is:

1. Impairment in social interaction

2. The presence of restricted, repetitive and stereotyped behaviors and interests

3. Significant impairment in important areas of functioning

4. No significant delay in language

5. No significant delay in cognitive development, self-help skills, or adaptive behaviors (other than social interaction)

6. The symptoms must not be better accounted for by another specific pervasive developmental disorder or schizophrenia

Asperger’s is characterized by:

1. Limited interests or preoccupation with a subject to the exclusion of other activities

2. Repetitive behaviors or rituals

3. Peculiarities in speech and language

4. Socially and emotionally inappropriate behavior and interpersonal interaction

5. Problems with nonverbal communication

6. Clumsy and uncoordinated motor movements

Most adolescents with moderate to severe Asperger’s will show little or no interest in others. They may seem to be totally unaware of their peers’ presence, or they may appear indifferent when peers try to interact.

Some youngsters with Asperger’s get very nervous just with the thought of approaching others and may choose to avoid it at all costs. Their avoidance may appear as if they are not interested in others.

Yet some adolescents with Asperger’s will not avoid interacting with others. They are eager to communicate, though, often in a clumsy, in-your-face way.

Children with Asperger’s are often the target of bullying at school due to their “strange” behavior, language, interests, and impaired ability to interact in socially expected ways to nonverbal cues, particularly in interpersonal conflict. Children with Asperger’s may be extremely literal and may have difficulty interpreting and responding to sarcasm or banter.

Most children with Asperger’s want to be social, but fail to socialize successfully, which can lead to later withdrawal and asocial behavior, especially in adolescence. Teens with Asperger’s often get along a lot better with those considerably older or younger than them, rather than those their own age.

A child with Asperger’s might be regarded by teachers as a "problem child" or a "poor performer." The child’s extremely low tolerance for “ordinary” and “mediocre” tasks (e.g., homework) can easily become frustrating.  A teacher may consider the child arrogant, spiteful, and insubordinate. This misunderstanding, in combination with the child's anxieties, can result in problematic behavior (e.g., violent and angry outbursts, withdrawal).

Although there is no single feature that all teens with Asperger’s share, difficulties with social behavior are nearly universal and are one of the most important defining criteria. Teens with Asperger’s have difficulty empathizing with others (i.e., putting themselves in someone else’s shoes), and may lack the ability to communicate their own emotional state, resulting in well-meaning remarks that may offend, or finding it hard to know what is "acceptable".

Teens with Asperger’s may have trouble understanding the emotions of other people (e.g., messages conveyed by facial expression, eye contact and body language). Thus, teens with Asperger’s might be seen as egotistical, selfish or uncaring. In most cases, these are unfair labels because they are neurologically unable to understand other people's emotional states. They are usually surprised, upset or remorseful when told that their actions are hurtful or inappropriate.

Individuals with Asperger’s do NOT lack emotions. However, the concrete nature of emotional attachments they have (i.e., to objects rather than to people) often seems curious or can even be a cause of concern to people who do not share their perspective.

Teens with Asperger’s may have little patience for things outside their narrow interests. In school, they may be 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.

Some children with Asperger’s experience varying degrees of sensory overload and are extremely sensitive to touch, smells, sounds, tastes and sights. Sensory overload may exacerbate problems faced by such children at school, where levels of noise in the classroom can become intolerable for them. A child with Asperger’s can become distracted, agitated, or even aggressive if unwanted touch, sounds, smells, etc. persist.

Treatment for Asperger’s consists of therapies that apply behavior management strategies and address poor communication skills, obsessive or repetitive routines, and physical clumsiness.

Currently, the most effective treatment involves a combination of psychotherapy, special education, behavior modification, and support for families. Some children with Asperger's Disorder will also benefit from medication.

A typical treatment program generally includes:

· Social skills training, to teach the skills to more successfully interact with others

· Cognitive behavioral therapy to help in better managing emotions that may be explosive or anxious, and to cut back on obsessive interests and repetitive routines

· Medication for co-existing conditions such as depression and anxiety

· Occupational or physical therapy to assist with poor motor coordination

· Speech therapy to help with the trouble of the "give and take" in normal conversation

· Parent training and support, to teach parents behavioral techniques to use at home

Children with Asperger’s can learn to manage their differences, but they may continue to find social situations and personal relationships challenging. Many adults with Asperger’s are able to work successfully in mainstream jobs, although they may continue to need encouragement and moral support to maintain an independent life.

Teens with Asperger’s report a feeling of being unwillingly detached from the world around them. As an adult, they may have difficulty with getting married due to poor social skills.

On the other hand, some adults with Asperger’s do get married, get graduate degrees, become wealthy, and hold jobs. The intense focus and tendency to work things out logically often grants those people with Asperger’s a high level of ability in their field of interest. When these special interests coincide with a materially or socially useful task, the person with Asperger’s often can lead a profitable life. For example, the child obsessed with a particular computer game may grow up to be an accomplished computer programmer.

The outcome for children with Asperger's Disorder is generally more promising than for those with autism. Due to their higher level of intellectual functioning, many of these children successfully finish high school and attend college. Although problems with social interaction and awareness persist, they can also develop lasting relationships with family and friends.

Mark Hutten, M.A., is a family therapist who works with teens and pre-teens experiencing emotional/behavioral problems associated with Oppositional Defiant Disorder and Conduct Disorder.  He works with these children and their parents – in their homes. You may visit his website here: http://www.MyOutOfControlTeen.com/sl

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