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Asperger Syndrome and Autism

You've probably heard of autism, but what is Asperger syndrome?

By Sarah Albert
WebMD Feature

Reviewed By Brunilda Nazario

You might remember Dustin Hoffman's powerful portrayal of an adult with autism in the movie Rain Man. Even if he gave you some idea of what it's like to be autistic, you probably have never heard about the many forms autism takes -- or about Asperger syndrome (AS), one of two main types of autism that often goes unrecognized until late in childhood, or is even missed through adulthood.

Like with classic autism, children with Asperger syndrome -- which is getting recognized more frequently later in life now -- often find themselves disconnected from others, seemingly in their own world. While researchers have yet to understand what causes AS, there is likely a genetic component. Some folks with Asperger syndrome obsess over unusual things, and communication can be a great challenge. People with Asperger syndrome are at times especially talented in a certain area, even brilliant but that's not typical. "It depends who you talk to, but it's a fairly low number of cases," says Bobby Newman, PhD, BCBA, the president-elect for the Association for the Science in Autism Treatment (ASAT).

Asperger syndrome is less about having extraordinary talents, and more about having difficulties with three main areas that Newman says are required for you to get diagnosed with any form of autism: socialization, communication, and behavior range. The symptoms of autism would also have to be present, even if missed, within the first three years of life, according to the diagnostic manual.

What Makes Asperger Syndrome Different

There are two main differences between classic autism and Asperger syndrome, according to Simon Baron-Cohen, the co-director of the Autism Research Centre in Cambridge, England. First, folks with autism tend to have a language delay or start talking later in life, and they also have a below average IQ. Whereas people with Asperger syndrome tend to have an average or above average IQ, and they start speaking within the expected age range.

"I think depression may be more of a problem with AS. People with classic autism may be much more focused on their own private world, and unaware of what they are missing out on," says Baron-Cohen. Meanwhile, people with Asperger syndrome might be more aware of what they are not achieving socially.

Potential Causes

There are about nine males with Asperger syndrome for every one female with the disorder. As a result, Baron-Cohen and colleagues are conducting ongoing research about the potential connection between fetal testosterone levels and Asperger syndrome. "There are a whole set of factors that suggest that this hormone might play a role in AS," he says. Yet if what has been referred to as "excessive maleness" pans out, there will be many unanswered ethical questions regarding just how the findings could impact the treatment and diagnoses of people with autism.

How would fetal hormone testing be used if parents could find out ahead of time about the possibility of Asperger syndrome, and might parents consider the termination of a pregnancy based only on this indeterminate possibility?

"I'd certainly be very concerned if the test was used in that way," says Baron-Cohen. "Autism isn't necessarily a condition where quality of life is in any way decreased, especially when it comes to AS. These individuals -- if they are given the right support -- can lead a very valuable life."

Researchers can only speculate for now about how this link, if proven, might impact future treatments. "Some people think we might be able to intervene at the hormonal level," says Baron-Cohen, "by changing the hormones in the womb, but again this is ethically very complex." After all, a lot of people with AS want to be better understood and accepted by others, not treated or cured. "AS is not just a disability. People with AS might have an unusual memory for detail or an ability to focus on things for hours and hours," he tells WebMD regarding the many positive and at times puzzling aspects of this condition.

Treatment and Diagnosis

One of the most important things to remember when talking about Asperger syndrome is how different each case is, says Newman. "To hear that a person is autistic really gives you next to no information. The person's language abilities, their ability to interact with others, their behavioral patterns all vary greatly."

Treatment typically involves behavior modification and therapy, and sometimes medications for other co-existing mental heath conditions. "The best treatment that is available is something called applied behavior analysis," says Newman. "The New York State Department of Health did a test for analyzing all of the available treatments and they came to the conclusion that this is really the only form of treatment that had peer-reviewed data to strongly support its effectiveness."