Pervasive developmental disorder - Asperger syndrome

The cause is unknown. Hans Asperger labeled this disorder "Autistic Psychopathy" in 1944, and the cause is still unknown. There is a possible link to autism, and genetic factors may play a role. The condition appears to be more common in boys than in girls.

The child with Asperger shows below-average nonverbal communication gestures, fails to develop peer relationships, has an inability to express pleasure in other people's happiness, and lacks the ability to reciprocate emotionally in normal social interactions.

While people with Asperger syndrome are frequently socially inept, many have above-average intelligence, and they may excel in fields like computer programming and science. There is no delay in cognitive development, in the development of age-appropriate self-help skills, or in curiosity about the environment.

• Abnormal nonverbal communication such as problems with eye contact, facial expressions, body postures, or gestures
• Being singled out by other children as "weird" or "strange"
• Failure to develop peer relationships
• Inability to return social or emotional feelings
• Inflexibility about specific routines or rituals
• Lack of showing, bringing, or pointing out objects of interest to other people
• Markedly impaired expression of pleasure in other people's happiness
• Preoccupation with parts of whole objects
• Repetitive behaviors, including repetitive self-injurious behavior
• Repetitive finger flapping, twisting, or whole body movements
• Unusually intense preoccupation with narrow areas of interest such as obsession with train schedules, phone books, or collections of objects

Physical, emotional, and mental evaluations are usually performed to rule out other causes.

Treatment depends on the patient's level of adaptive functioning. A high IQ will bring a better outlook than a below-average one. Because the patient may have average or above average intelligence, improvements in social function are particularly important.

For patients with severe impairment, treatment is similar to autism therapy.

Medications such as selective serotonin reuptake inhibitors (SSRIs), antipsychotics, and stimulants may be used to treat problems such as anxiety, depression, and aggression.

As with most developmental disorders, the long-term outcome will vary according to the nature of the underlying problem and therapies used to support continued development.

Call for an appointment with your provider if your child does not respond to people, has odd or peculiar speech, or has behavior that may lead to self-harm.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.

McPartland J. Asperger's syndrome. Adolesc Med Clin. Oct 2006; 17(3): 771-88; abstract xiii.