Consultation with the Specialist: Asperger Syndrome

Abstract

1. Louis Pellegrino, MD* 2. Gregory S. Liptak, MD† 1. *Assistant Professor of Pediatrics, Upstate Medical University, Syracuse, NY. 2. †Professor of Pediatrics., Upstate Medical University, Syracuse, NY. After completing this article, readers should be able to: 1. Define Asperger syndrome and review the history and prevalence of the condition. 2. Describe the clinical characteristics of Asperger syndrome and comorbid conditions. 3. Review the major elements in the management of Asperger syndrome. 4. Describe the role of the primary care physician or practitioner (PCP) and medical home in the lives of children who have Asperger syndrome. 5. Describe current controversies relevant to the diagnosis and treatment of Asperger syndrome. Asperger syndrome (AS) is one of a group of conditions referred to as autism spectrum disorders (ASDs). Children on the autism spectrum demonstrate impairments in socialization and communication (especially social and nonverbal aspects of communication) and have atypical and repetitive behaviors and interests. However, individuals on the spectrum vary widely in the manifestations of these impairments. Kanner first described “early infantile autism” in 1943. He described a group of children who had a profound disturbance in social responsiveness and pronounced language deficits associated with evidence of intellectual disability. A year later, Hans Asperger, an Austrian pediatrician, described four children who had intact intellectual ability but nonetheless showed marked impairments in socialization, notable difficulties with nonverbal and social communication (despite intact general language ability), and unusual, all-consuming interests. Some of these children showed a tendency to engage in long-winded recitations of their favorite subjects, leading Asperger to describe them as “little professors.” Unaware of Kanner's previous work, Asperger referred to this condition as “autistic psychopathy” and conceptualized the condition as a personality disorder with a strong genetic basis. In 1981, Lorna Wing published a case series and coined the term “Asperger's syndrome” to characterize the features …