Aspergers

I get a lot of referrals of persons with Asperger’s diagnoses.  Current estimates indicate a prevalence of Asperger’s of about 2.5 per 10,000 compared to 60 per 10,000 for all Autism Spectrum Disorders.  Asperger’s is an easy diagnosis to make in childhood but not so easy in Adulthood because many early behaviours have ceased.  Introverts who comprise 60% of the population typically have some Asperger traits notably poor eye contact and limited social skills. Hence there is an overdiagnosis  of the condition.There is a symptom self-report called the RAADs which helps somewhat.

There are often comorbid disorders:

Social Anxiety 8%

Phobic Anxiety 8%

Depression 10%

OCD 3%

ADHD 30%

Its also a good idea to do a full neuropsychological assessment looking for comorbid learning disorders particularly problems with visual or auditory perception especially if there is history of  sensory overstimulation.

Neuroimaging shows grey matter reductions in the limbic system, temporal lobe, and basal ganglia that are not unlike the hypo-connection pattern found in schizophrenia. Autism patients show similar patterns but with additional abnormalities in the cerebellum and in the right hemisphere in the areas associated with language.

Management:

Depends on careful assessment of the range of disabilities.

Treatment of any comorbid disorders especially  social anxiety.

Behavioural training introducing the idea of “the emotional toolbox ” ie: emotions have tools which  (a) can be used to recognise and  express them (d) to release them in socially appropriate ways.

Encouraging a graded social exposure programme with homework exercises

Efforts to establish the person in volunteer work – study – a casual job – fulltime work.

Dexamphetamine is sometimes useful for comorbid  social anxiety and ADD

Inositol  800mg/d and Fluvoxamine are helpful for obsessive behaviour.

RAAD QUESTIONAIRRE ( FOR DOWNLOAD)   raddquest-pdf

A  SCORE OF 77 OR HIGHER  IS DIAGNOSTIC OF AUTISM SPECTRUM DISORDER INC ASPERGERS.

A SCORE LESS THAN 64 INDICATES YOU DO NOT HAVE ASPERGERS

A SCORE 65-76 IS INDECISIVE.  ( Introverts are likely to score in the 30-50 range.  The next stop would be to see a psychologist and do a Myer Briggs Inventory which gives guidance on  career and relationship choice)

toon974

 

 

 

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