Asperger Syndrome
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Asperger syndrome is a term applied to a condition characterized by persistent impairment in social interactions and by repetitive behavior patterns and restricted interests. Once generally regarded as a discrete disorder, it is categorized as a form of autism spectrum disorder (ASD) in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). [1]
In DSM-5, ASD encompasses the following 4 previously separate diagnoses [1] :
Autism
Asperger disorder
Childhood disintegrative disorder
Pervasive developmental disorder not otherwise specified
These are now considered forms of a single disorder characterized by different levels of severity in the following 2 core symptom areas, both of which are required for a diagnosis of ASD:
Impairments in social communication and social interaction
Restricted, repetitive patterns of behavior, interests, or activities
Individual clinical characteristics are denoted through the use of specifiers, as follows:
With or without accompanying intellectual impairment
With or without accompanying language impairment
Associated with a known medical or genetic condition or environmental factor
Associated with another neurodevelopmental, mental, or behavioral disorder
With catatonia [2, 3, 4, 58, 75]
By the current DSM-5 criteria, individuals previously diagnosed with Asperger syndrome would be diagnosed as having ASD without language or intellectual impairment.
The history is likely to elicit the following:
Social problems
Communication abnormalities
Speech and hearing abnormalities
Sensory sensitivity
Typical physical findings in children with Asperger syndrome may include the following:
Lax joints (eg, an immature or unusual grasp for handwriting and other fine hand movements)
Clumsiness
Anomalies of locomotion, balance, manual dexterity, handwriting, rapid movements, rhythm, and imitation of movements
Impaired ball-playing skills
Screening for a theory of mind can help identify some of the core behavioral symptoms of Asperger syndrome. Such screening has the following 2 main components:
Doll-play paradigm
Imagination task
See Presentation for more detail.
Neuropsychological testing should focus on simple and complex problem-solving tasks, using tests and scales such as the following:
Wisconsin Card Sorting Test
Trail-Making Test
Stanford-Binet Scale
The Autism Screening Checklist (see the image below) is helpful in identifying children with characteristics of autism spectrum disorder (ASD) and in differentiating children with these disorders from children with schizophrenia and other psychoses.
Magnetic resonance imaging (MRI) is not required for diagnosing Asperger syndrome but may demonstrate the following:
Hypoplasia of the inferior precentral gyrus and the anterior portion of the superior temporal gyrus, resulting in a widening of the sylvian fissure and a partial exposure of the insular cortex
Hypoplasia of the right temporo-occipital cortex
Small gyri of the posterior parietal lobes
Enlargement of the right lateral ventricle
Diminished size of the midbrain and medulla oblongata
Magnetic resonance spectroscopy (MRS) provides a tool to measure the concentration of chemicals in regions of interest (ROIs) of the brain. Several findings suggest an excitatory/inhibitory imbalance in Asperger syndrome.
Other tests that, though not required for diagnosis, may add useful information are as follows:
Event-related brain potential testing via electroencephalography (EEG)
Computed tomography (CT) of the head
Genetic tests that may be useful include the following:
Chromosomal microarray (CMA), or array comparative genomic hybridization (aCGH)
Karyotyping
Fragile X (FMR1 molecular studies)
Methylation studies
Methyl-CpG-binding protein (MECP2) analysis [5]
Phosphatase and tensin (PTEN) homolog testing [6]
Specific gene sequencing when a particular syndrome is suspected
See Workup for more detail.
Treatment of people with Asperger syndrome consists primarily of instruction and counseling, focusing on the following areas:
Reinforcement of appropriate social behaviors [56]
Implementation of communication and language strategies [56]
Development of social skills [56]
Relaxation therapy [57]
Encouragement of special skills (eg, music or mathematics)
Career counseling and orientation
In addition, any comorbid conditions should be managed as appropriate, including the following:
Depression
Behavioral disorders
Drugs to treat the core characteristics of Asperger syndrome have not yet been identified. Pharmacologic interventions are used to treat comorbid disorders but should not be prescribed in the absence of an indication. Vigilance for drug toxicity must be maintained.
See Treatment for more detail.
Asperger syndrome (also referred to as Asperger disorder) is a term applied to a form of autism spectrum disorder (ASD) [7, 1] It is characterized by persistent impairment in social interactions and by repetitive behavior patterns and restricted interests. Although in the past this syndrome was commonly considered a separate diagnosis, it is now subsumed under the diagnosis of ASD in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). [1]
Asperger syndrome is generally evident in children older than age 3 years and occurs most often in males. (See Etiology and Epidemiology.) Children with this syndrome typically exhibit a limited capacity for spontaneous social interactions, a failure to develop friendships, and a limited number of intense and highly focused interests.
People with Asperger syndrome may have certain communication problems, including poor nonverbal communication and pedantic speech, but many of them have good cognitive and verbal skills. Physical symptoms may include early childhood motor delays, clumsiness, fine motor difficulty, gait anomalies, and odd movements. (See Presentation.)
Standard early childhood development surveillance can identify some children who should receive further testing for Asperger syndrome. An ASD-specific tool should be used at 18 and 24 months. [8] In children with possible developmental issues, screening for a theory of mind (ie, determining whether these children have the ability to impute mental states to themselves and others) is an important process a clinician can use to identify some of the core behavioral symptoms of Asperger syndrome. (See Presentation.)
Individuals with Asperger syndrome have normal, or even superior, intelligence while demonstrating social insensitivity or even apparent indifference toward loved ones. Indeed, individuals with Asperger syndrome have accomplished cutting-edge research in computer science, mathematics, and physics, as well as outstanding creative work in art, film, and music. Many prominent individuals (eg, Albert Einstein) have demonstrated traits suggesting Asperger syndrome.
Additionally, some individuals with Asperger syndrome devote sustained daily concentration to the development of musical, mathematical, and other skills. This may facilitate the refinement of highly specialized tasks that would be beyond reach for many people without the syndrome.
Neuropsychological testing and event potential studies can be used to uncover characteristics of Asperger syndrome. Magnetic resonance imaging (MRI) and positron emission tomography (PET) can reveal brain anomalies associated with the condition. (See Workup.) None of these studies are required for diagnosis, but the results can help guide treatment planning.
If Asperger syndrome is diagnosed, social skills training and other psychological interventions may be provided. Although the deficits manifested by people with Asperger syndrome are often debilitating, many of these individuals experience positive outcomes, especially those who excel in areas not dependent on social interaction. (See Treatment.)
Since some people with Asperger syndrome exhibit acute awareness of environments and highly developed adaptive skills, they may escape detection in childhood. Thus, children, adolescents, and adults with Asperger syndrome may never be recognized as having Asperger syndrome. In particular, the ability of women with Asperger syndrome to conform with behavioral expectations of women may result in their integration into society without awareness of their condition. Thus, the reported male predominance in populations of people with Asperger disorder may reflect a high threshold to detect the condition in women. The stress of environmental changes and life events may cause adolescents and adults to seek diagnosis. An unknown number of adults with Asperger syndrome may be undiagnosed for their entire lives. There may exist many individuals with Asperger syndrome who are unaware of their condition.
In DSM-5, the diagnosis of ASD encompasses the following 4 previously separate diagnoses [1] :
Autism
Asperger disorder
Childhood disintegrative disorder
Pervasive developmental disorder not otherwise specified
This change in nosology reflects a scientific consensus that these are not separate disorders but, rather, forms of a single disorder characterized by different levels of severity with respect to the following 2 core symptom areas, both of which are required for a diagnosis of ASD:
Impairments in social communication and social interaction, including all three of the following:
Deficits in social-emotional reciprocity
Deficits in developing and maintaining relationships
Deficits in nonverbal communicative behaviors in social interactions
Restricted, repetitive patterns of behavior, interests, or activities, including two or more of the following:
Repetitive movement or speech or use of objects
Insistence on sameness, unwavering adherence to routines, or ritualized patterns of behavior
Highly restricted, fixated interests with abnormal strength or focus
Increased or decreased response to sensory input
These symptoms are present from early childhood and limit or impair everyday functioning.
Individual clinical characteristics are denoted through the use of specifiers, as follows:
With or without accompanying intellectual impairment
With or without accompanying language impairment
Associated with a known medical or genetic condition or environmental factor
Associated with another neurodevelopmental, mental, or behavioral disorder
By the current DSM-5 criteria, individuals previously diagnosed with Asperger syndrome would be diagnosed as having ASD without language or intellectual impairment. [1]
In Asperger syndrome, the clinical manifestations presumably reflect alterations in brain development resulting from interactions between multiple genes, epigenetic factors affecting gene expression, and exposure to environmental factors. [9] Gaigg and Bowler hypothesized that impairments in the connections between the amygdala and associated structures of the brain may play a role in the pathogenesis of Asperger symptoms. [10]
People with Asperger syndrome demonstrate problems analyzing configurations. These deficits probably contribute to these individuals’ difficulty with facial recognition. [11] Bowler et al reported that people with Asperger syndrome have fewer memories than healthy control subjects do. [12]
Dyslipidemia may play a role in Asperger syndrome as well. Dziobek et al. reported elevations of total cholesterol and low-density lipoprotein in people with Asperger syndrome. [13]
The etiology of Asperger syndrome is unknown. Some individuals with the syndrome have a history of complications in the prenatal and neonatal periods and during delivery, [14, 15, 16, 17, 18] but the relationship between obstetric complications and Asperger syndrome is unclear. [15, 16]
Unfavorable experiences in the prenatal, perinatal, and postnatal periods may increase the likelihood of Asperger syndrome. [14, 15, 16, 19, 20, 17, 18] In a Swedish study, adverse perinatal events were recorded for about two thirds of 100 males with Asperger syndrome, and the mothers experienced infection, vaginal hemorrhage, preeclampsia, and other adverse events during pregnancy at an above-average rate. [18] Whether the syndrome is a consequence or a cause of perinatal complications in such cases is unknown.
Studies have shown that there might be a link between disturbed metabolism of N-acetylaspartate and glutamine in cingulate and Asperger syndrome. [60]
Reports of families with multiple members meeting the criteria for Asperger syndrome suggest a genetic contribution to development of the disorder. The past few years have seen a flood of research and insight into the underlying genetic contribution to Asperger syndrome, as well as to other forms of ASD. Hundreds of candidate genes and copy number variation (CNV) loci have been associated with ASD (see Genetics of Autism Spectrum Disorders).
The neurobiology and genetics are complicated. [21, 22] Genes involving the neuronal synaptic pathways are under particular investigation. Whereas most genome-wide association studies (GWAS) look at the entire range of ASD, some chromosomal regions have been associated specifically with Asperger syndrome, including 5q21.1, 3p14.2, 3q25, and 3p23. [23] Also the maternal duplication at the 15q11-13 locus and the deletions or duplications at the 16p11 locus have been observed in 1% to 3% of patients with ASD. [61] It has been reported that reduced expression of α5GABAAreceptors can cause autism-like behavior in mice. [62] In general, more than 15% of all cases of ASD can be explained by genetic causes. [63]
Because of the divergent diagnostic criteria used, estimates of the prevalence of Asperger syndrome vary widely. [24] In various studies from the United States and Canada, for example, reported rates have ranged from 1 case in 250 children to 1 case in 10,000. Additional epidemiologic studies are needed, using widely accepted criteria and a screening instrument that targets these criteria.
A population study in Sweden estimated the prevalence of Asperger syndrome as 1 case in 300 children. [25] This estimate is convincing for Sweden because complete medical records are available for all citizens in that country and the population is highly homogeneous. However, in other parts of the world, where neither of these factors may apply, prevalence may be quite different.
Like Sweden, other Scandinavian countries keep complete medical records for their populations and thus are uniquely suitable locations for conducting pristine epidemiologic studies. Comparable studies cannot always be readily carried out in other parts of the world. For example, in New York City, many inhabitants are immigrants, and it is not always possible to obtain health records from their country of origin.
To extrapolate from the Swedish study, Asperger syndrome may be more common than clinicians once thought. Pediatricians, family physicians, general practitioners, and other health professionals in North America may underdiagnose this disorder. Family members and friends may have a tendency to ascribe the signs of Asperger syndrome to individual idiosyncrasies.
Asperger syndrome has no apparent racial predilection. The estimated male-to-female ratio is approximately 4:1. However, investigations show that autism should not be considered a male condition; females have different biological characteristics in comparison with males with autism. [64, 65]
The syndrome is commonly diagnosed in the early school years and less frequently identified during early childhood or in adulthood. However, there may exist an unknown number of adults with excellent awareness and adaptation skills who are never diagnosed during their lifetimes. There may be a cohort of women with Asperger syndrome who conform with the behavioral expectations of society and are never diagnosed.
People with Asperger syndrome tend to have a better prognosis when they receive support from family members who are knowledgeable about the disorder. These individuals may be taught specific social guidelines, but the underlying social impairment is believed to be lifelong.
Individuals with Asperger syndrome appear to have a normal lifespan; however, they seem to endure an increased prevalence of comorbid psychiatric maladies (eg, depression, mood disorders, obsessive-compulsive disorder [OCD], and Tourette disorder). Comorbid psychiatric disorders, when present, significantly affect the prognosis.
Depression and hypomania are especially common among adolescents and adults with Asperger syndrome, particularly those with a family history of these conditions. (Caregivers of persons with Asperger syndrome may be prone to depression as well.)
An increased risk of suicide is observed in persons with this syndrome, with risks possibly rising in proportion to the number and severity of comorbid maladies. Asperger syndrome is probably undiagnosed in many suicide cases, both because the level of awareness of the condition is often low and because the tools used to identify it are often ineffective and unreliable. Consequently, people with Asperger syndrome who commit suicide are frequently reported as having other or undiagnosed psychiatric problems.
Individuals with Asperger syndrome and related conditions—as well as their families, teachers, and communities—can benefit from the experiences of other individuals with this disorder and from the experiences of their advocates. The following organizations provide information and advice to persons with Asperger syndrome and related conditions:
ASPEN (Asperger Syndrome Education Network, Inc), 9 Aspen Circle, Edison, NJ 08820; 732-321-0880; info@aspennj.org
Asperger Norfolk, Old Lion Cottage, Thurne, Great Yarmouth NR29 3AP, United Kingdom; +44 01 692 670 864
Jessica Kingsley Publishers, 400 Market Street, Suite 400, Philadelphia, PA 19106; 866-416-1078 (toll-free ordering), 215-922-1161 (main), 215-922-1474 (fax); orders@jkp.com; 116 Pentonville Road, London N1 9JB, United Kingdom; +44 (0)20 7833 2307 (main), +44 (0)20 7837 2917 (fax); post@jkp.com
The organizations above may also be contacted for information about assessment and treatment facilities located near the patient. People with Asperger syndrome and their families benefit from intensive assessments and treatment interventions.
Several other resources have been recorded in a manual entitled A Parent’s Guide to Asperger Syndrome and High-Functioning Autism: How to Meet the Challenges and Help Your Child Thrive. [26] This excellent guide for lay people who encounter people with Asperger syndrome provides practical suggestions for day-to-day life.
People with developmental disabilities, including those with Asperger syndrome, are vulnerable to sexual abuse, and the most severely disabled are at the greatest risk. For this reason, parents and caregivers must be alert to avoid situations inviting sexual abuse. Additionally, children with Asperger syndrome must be trained to recognize impending sexual abuse and to develop plans of action for preventing it. [27]
For patient education information, see the Brain and Nervous System Center, as well as Asperger Syndrome.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 5th ed. Arlington, VA: American Psychiatric Association; 2013. 50-9.
Brasic JR, Zagzag D, Kowalik S, et al. Progressive catatonia. Psychol Rep. 1999 Feb. 84(1):239-46. [Medline].
Brasic JR, Zagzag D, Kowalik S, et al. Clinical manifestations of progressive catatonia. German J Psychiatry. 2000. 3(2):13-24. [Full Text].
Brasic JR, Barnett JY, Will MV, et al. Dyskinesias differentiate autistic disorder from catatonia. CNS Spectr. 2000 Dec. 5(12):19-22. [Medline].
Brašic JR, Bibat G, Kumar A, et al. Correlation of the vesicular acetylcholine transporter densities in the striata to the clinical abilities of women with Rett syndrome. Synapse. 2012 Jun. 66(6):471-82. [Medline]. [Full Text].
Soares NS, Patel DR. Office screening and early identification of children with autism. Pediatr Clin North Am. 2012 Feb. 59(1):89-102, x-xi. [Medline].
De Spiegeleer N, Appelboom J. Le syndrome de l’Asperger existe-t-il? [Article in French]. Neuropsychiatrie de l’enfance et de l’adolescence. June 2007. 55:137-43.
American Academy of Pediatrics. Management of Children With Autism Spectrum Disorder. Pediatrics. 2007 Nov. 120(5):1183-1215. [Full Text].
Hallmayer J, Cleveland S, Torres A, Phillips J, Cohen B, Torigoe T, et al. Genetic heritability and shared environmental factors among twin pairs with autism. Arch Gen Psychiatry. 2011 Nov. 68(11):1095-102. [Medline].
Gaigg SB, Bowler DM. Differential fear conditioning in Asperger’s syndrome: implications for an amygdala theory of autism. Neuropsychologia. 2007 May 15. 45(9):2125-34. [Medline].
Rondan C, Deruelle C. Global and configural visual processing in adults with autism and Asperger syndrome. Res Dev Disabil. 2007 Mar-Apr. 28(2):197-206. [Medline].
Bowler DM, Gardiner JM, Gaigg SB. Factors affecting conscious awareness in the recollective experience of adults with Asperger’s syndrome. Conscious Cogn. 2007 Mar. 16(1):124-43. [Medline].
Kujala T, Aho E, Lepisto T, Jansson-Verkasalo E, Nieminen-von Wendt T, von Wendt L, et al. Auditory cortical change detection in adults with Asperger syndrome. Neurosci Lett. 2007 Mar 6. 414(2):136-40. [Medline].
Brasic JR, Holland JA, Alexander M. The increased likelihood of obstetric complications in autistic disorder [abstract]. South Med J. 2003. 96 (10 supplement):S34.
Brasic JR, Holland JA. Reliable classification of case-control studies of autistic disorder and obstetric complications. J Dev Phys Disabil. 2006. 18:355-81.
Brasic JR, Holland JA. A qualitative and quantitative review of obstetric complications and autistic disorder. J Dev Phys Disabil. 2007. 19:337-64.
Glasson EJ, Bower C, Petterson B, de Klerk N, Chaney G, Hallmayer JF. Perinatal factors and the development of autism: a population study. Arch Gen Psychiatry. 2004 Jun. 61(6):618-27. [Medline].
Cederlund M, Gillberg C. One hundred males with Asperger syndrome: a clinical study of background and associated factors. Dev Med Child Neurol. 2004 Oct. 46(10):652-60. [Medline].
Gillberg C, Cederlund M. Asperger syndrome: familial and pre- and perinatal factors. J Autism Dev Disord. 2005 Apr. 35(2):159-66. [Medline].
Larsson HJ, Eaton WW, Madsen KM, Vestergaard M, Olesen AV, Agerbo E, et al. Risk factors for autism: perinatal factors, parental psychiatric history, and socioeconomic status. Am J Epidemiol. 2005 May 15. 161(10):916-25; discussion 926-8. [Medline].
State MW, Levitt P. The conundrums of understanding genetic risks for autism spectrum disorders. Nat Neurosci. 2011 Oct 30. 14(12):1499-506. [Medline].
Mefford HC, Batshaw ML, Hoffman EP. Genomics, intellectual disability, and autism. N Engl J Med. 2012 Feb 23. 366(8):733-43. [Medline].
Salyakina D, Ma DQ, Jaworski JM, Konidari I, Whitehead PL, Henson R, et al. Variants in several genomic regions associated with asperger disorder. Autism Res. 2010 Dec. 3(6):303-10. [Medline].
Sharma S, Woolfson LM, Hunter SC. Confusion and inconsistency in diagnosis of Asperger syndrome: a review of studies from 1981 to 2010. Autism. 2012 Sep. 16(5):465-86. [Medline].
Ehlers S, Gillberg C. The epidemiology of Asperger syndrome. A total population study. J Child Psychol Psychiatry. 1993 Nov. 34(8):1327-50. [Medline].
Ozonoff S, Dawson G, McPartland J. A Parent’s Guide to Asperger Syndrome and High-Functioning Autism: How to Meet the Challenges and Help Your Child Thrive. New York, NY: The Guilford Press; 2002.
Mahoney A, Poling A. Sexual Abuse Prevention for People with Severe Developmental Disabilities. J of Developmental and Physical Disabilities. May 2011. 23(4):369-76.
Loukusa S, Leinonen E, Jussila K, Mattila ML, Ryder N, Ebeling H, et al. Answering contextually demanding questions: pragmatic errors produced by children with Asperger syndrome or high-functioning autism. J Commun Disord. 2007 Sep-Oct. 40(5):357-81. [Medline].
King BH, Hollander E, Sikich L, McCracken JT, Scahill L, Bregman JD, et al. Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism. Arch Gen Psychiatry. 2009 Jun. 66(6):583-90. [Medline]. [Full Text].
Allison C, Williams J, Scott F, Stott C, Bolton P, Baron-Cohen S, et al. The Childhood Asperger Syndrome Test (CAST): test-retest reliability in a high scoring sample. Autism. 2007 Mar. 11(2):173-85. [Medline].
Williams J, Scott F, Stott C, Allison C, Bolton P, Baron-Cohen S, et al. The CAST (Childhood Asperger Syndrome Test): test accuracy. Autism. 2005 Feb. 9(1):45-68. [Medline].
American Academy of Pediatrics. Identification and Evaluation of Children With Autism Spectrum Disorders. Pediatrics. 2007 Nov;. 120(5):1183-1215. [Full Text].
Baron-Cohen S. The autistic child’s theory of mind: a case of specific developmental delay. J Child Psychol Psychiatry. 1989 Mar. 30(2):285-97. [Medline].
Baron-Cohen S. The theory of mind deficit in autism: how specific is it?. Br J Dev Psych. 1991. 9:301-14.
Baron-Cohen S. The theory of mind hypothesis of autism: a reply to Boucher. Br J Disord Commun. 1989 Aug. 24(2):199-200. [Medline].
Benson G, Abbeduto L, Short K, Nuccio JB, Maas F. Development of a theory of mind in individuals with mental retardation. Am J Ment Retard. 1993 Nov. 98(3):427-33. [Medline].
Ozonoff S, Miller JN. Teaching theory of mind: a new approach to social skills training for individuals with autism. J Autism Dev Disord. 1995 Aug. 25(4):415-33. [Medline].
Baron-Cohen S. “Without a theory of mind one cannot participate in a conversation”. Cognition. 1988 Jun. 29(1):83-4. [Medline].
Baron-Cohen S. Autism and symbolic play. Br J Dev Psych. 1987. 5:139-48.
Baron-Cohen S, Leslie AM, Frith U. Does the autistic child have a “theory of mind”?. Cognition. 1985 Oct. 21(1):37-46. [Medline].
Baron-Cohen S. The development of a theory of mind in autism: deviance and delay?. Psychiatr Clin North Am. 1991 Mar. 14(1):33-51. [Medline].
Deeley Q, Daly EM, Surguladze S, Page L, Toal F, Robertson D, et al. An event related functional magnetic resonance imaging study of facial emotion processing in Asperger syndrome. Biol Psychiatry. 2007 Aug 1. 62(3):207-17. [Medline].
Ashwin C, Baron-Cohen S, Wheelwright S, O’Riordan M, Bullmore ET. Differential activation of the amygdala and the ‘social brain’ during fearful face-processing in Asperger Syndrome. Neuropsychologia. 2007 Jan 7. 45(1):2-14. [Medline].
Herrington JD, Baron-Cohen S, Wheelwright SJ, et al. The role of MT+/V5 during biological motion perception in Asperger Syndrome: an fMRI study. Res Autism Spectrum Dis. 1. January-March 2007:14-27.
Lepisto T, Nieminen-von Wendt T, von Wendt L, Naatanen R, Kujala T. Auditory cortical change detection in adults with Asperger syndrome. Neurosci Lett. 2007 Mar 6. 414(2):136-40. [Medline].
O’Connor K, Hamm JP, Kirk IJ. Neurophysiological responses to face, facial regions and objects in adults with Asperger’s syndrome: an ERP investigation. Int J Psychophysiol. 2007 Mar. 63(3):283-93. [Medline].
Miller DT, Adam MP, Aradhya S, Biesecker LG, Brothman AR, Carter NP, et al. Consensus statement: chromosomal microarray is a first-tier clinical diagnostic test for individuals with developmental disabilities or congenital anomalies. Am J Hum Genet. 2010 May 14. 86(5):749-64. [Medline]. [Full Text].
Goin-Kochel RP, Mackintosh VH, Myers BJ. Parental reports on the efficacy of treatments and therapies for their children with autism spectrum disorders. Research in Autism Spectrum Disorders. 2009 April–June. 3(2):528-537.
Mayo Clinic. Asperger’s Syndrome: Treatments and Drugs. Available at http://www.mayoclinic.com/health/aspergers-syndrome/DS00551/DSECTION=treatments-and-drugs. Accessed: November 28, 2012.
Brasic JR, Young JG, Furman J, Conte RM, Baisley WE, Jaslow RI. Psychoactive Medication Quality Assurance Rating Survey (PQRS). J Develop Physical Disabilities. 1997. 9(4):311-36.
Brasic JR, Furman J, Conte RM, Baisley WE, Jaslow RI. Assuring the quality of the utilization of psychoactive medication by people with mental retardation and developmental disabilities by assessing dosages. German J Psychiatry. 2000. 3(3):7-12. [Full Text].
Brasic JR, Furman JW, Conte RM, Baisley WE, Jaslow RI. Assessing the quality of the administration of psychoactive medication. J Develop Physical Disabilities. 2003. 15(3):185-205.
Brasic JR, Furman JW, Conte RM, Baisley WE, Jaslow RI. Psychoactive Medication Quality Assurance Rating Survey (PQRS) Screening Criteria. J Develop Physical Disabilities. 2003. 15(3):231-54.
Brasic JR. Treatment of movement disorders in autism spectrum disorders. Hollander E, ed. Autism Spectrum Disorders. 1st ed. New York, NY: Marcel Dekker; 2003. Vol 24 Medical Psychiatry: 273-346.
Lang R, Shogren KA, Machalicek WA. Research in Autism Spectrum Disorders. 2009. Vol 3.: 483-88.
Attwood T. Asperger’s syndrome: a guide for parents and professionals. London, England: Jessica Kingsley Publishers; 1998.
Herbert Benson with Miriam Z. Klipper. The relaxation response. New York, NY: Avon Books; 1975.
Brasic JR. A 20-Year-Old Man Who Stopped Speaking. Medscape. Available at http://reference.medscape.com/viewarticle/883207. July 31, 2017; Accessed: January 22, 21018.
Tebartz van Elst L, Maier S, Fangmeier T, Endres D, Mueller GT, Nickel K, et al. Disturbed cingulate glutamate metabolism in adults with high-functioning autism spectrum disorder: evidence in support of the excitatory/inhibitory imbalance hypothesis. Mol Psychiatry. 2014 Dec. 19 (12):1314-25. [Medline].
Kumar RA, Christian SL. Genetics of autism spectrum disorders. Curr Neurol Neurosci Rep. 2009 May. 9 (3):188-97. [Medline].
Zurek AA, Kemp SW, Aga Z, Walker S, Milenkovic M, Ramsey AJ, et al. α5GABAA receptor deficiency causes autism-like behaviors. Ann Clin Transl Neurol. 2016 May. 3 (5):392-8. [Medline].
Betancur C. Etiological heterogeneity in autism spectrum disorders: more than 100 genetic and genomic disorders and still counting. Brain Res. 2011 Mar 22. 1380:42-77. [Medline].
Kirkovski M, Enticott PG, Fitzgerald PB. A review of the role of female gender in autism spectrum disorders. J Autism Dev Disord. 2013 Nov. 43 (11):2584-603. [Medline].
Lai MC, Lombardo MV, Auyeung B, Chakrabarti B, Baron-Cohen S. Sex/gender differences and autism: setting the scene for future research. J Am Acad Child Adolesc Psychiatry. 2015 Jan. 54 (1):11-24. [Medline].
Hazlett HC, Gu H, Munsell BC, Kim SH, Styner M, et al. Early brain development in infants at high risk for autism spectrum disorder. Nature. 2017 Feb 15. 542 (7641):348-351. [Medline].
Hwang BJ, Mohamed MA, Brašić JR. Molecular imaging of autism spectrum disorder. Int Rev Psychiatry. 2017 Dec. 29 (6):530-554. [Medline].
Lyra L, Rizzo LE, Sunahara CS, Pachito DV, Latorraca COC, Martimbianco ALC, et al. What do Cochrane systematic reviews say about interventions for autism spectrum disorders?. Sao Paulo Med J. 2017 Mar-Apr. 135 (2):192-201. [Medline].
Kasari C, Gulsrud AC, Wong C, Kwon S, Locke J. Randomized controlled caregiver mediated joint engagement intervention for toddlers with autism. J Autism Dev Disord. 2010 Sep. 40 (9):1045-56. [Medline].
Matson JL and Sipes M. Methods of Early Diagnosis and Tracking for Autism and Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS). J Dev Phys Disabil. August 2010. 22:4:343-358. [Full Text].
Allen-Meares P, MacDonald M, McGee K. Autism Spectrum Disorder Updates – Relevant Information for Early Interventionists to Consider. Front Public Health. 2016. 4:236. [Medline].
Kouo JL and Egel AL. The Effectiveness of Interventions in Teaching Emotion Recognition to Children with Autism Spectrum Disorder. Rev J Autism Dev Disord. September 2016. 3:3:254-265. [Full Text].
Fridenson-Hayo S, Berggren S, Lassalle A, Tal S, Pigat D, Bölte S, et al. Basic and complex emotion recognition in children with autism: cross-cultural findings. Mol Autism. 2016. 7:52. [Medline].
Kabat-Zinn J. Full Catastrophe Living. New York: Bantam Books; 2013.
Brasic J, Barnett J, and Zagzag D. Twenty-four-year unremitting course of facial tics in progressive catatonia complicating autism spectrum disorder. Scullin M. 1st World Congress on Tourette Syndrome and Tic Disorders. London: Frontiers Media SA; 2015.
Goji A, Ito H, Mori K, Harada M, Hisaoka S, Toda Y, et al. Assessment of Anterior Cingulate Cortex (ACC) and Left Cerebellar Metabolism in Asperger’s Syndrome with Proton Magnetic Resonance Spectroscopy (MRS). PLoS One. 2017. 12 (1):e0169288. [Medline].
van Elst LT, Maier S, Fangmeier T, Endres D, Mueller GT, Nickel K, et al. Magnetic resonance spectroscopy comparing adults with high functioning autism and above average IQ. Mol Psychiatry. 2014 Dec. 19 (12):1251. [Medline].
Drenthen GS, Barendse EM, Aldenkamp AP, van Veenendaal TM, Puts NA, Edden RA, et al. Altered neurotransmitter metabolism in adolescents with high-functioning autism. Psychiatry Res. 2016 Oct 30. 256:44-49. [Medline].
Doyle-Thomas KA, Card D, Soorya LV, Wang AT, Fan J, Anagnostou E. Metabolic mapping of deep brain structures and associations with symptomatology in autism spectrum disorders. Res Autism Spectr Disord. 2014 Jan. 8 (1):44-51. [Medline].
Fatemi SH. The hyperglutamatergic hypothesis of autism. Prog Neuropsychopharmacol Biol Psychiatry. 2008 Apr 1. 32 (3):911, author reply 912-3. [Medline].
Budimirovic DB, Kaufmann WE. What can we learn about autism from studying fragile X syndrome?. Dev Neurosci. 2011. 33 (5):379-94. [Medline].
Brasic JR. A 33-year-old woman with rigidity and stereotypies. Medscape. Available at http://reference.medscape.com/viewarticle/878930. 2017 April 25; Accessed: February 13, 2018.
James Robert Brasic, MD, MPH Assistant Professor, Russell H Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine, Johns Hopkins University School of Medicine; Active Staff, Department of Radiology and Radiological Science, Division of Nuclear Medicine, Johns Hopkins Hospital; Courtesy Staff, Department of Radiology, Johns Hopkins Bayview Medical Center
James Robert Brasic, MD, MPH is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, American Academy of Neurology, International Parkinson and Movement Disorder Society
Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Johns Hopkins University School of Medicine<br/>Received research grant from: National Institutes of Health<br/>Received income in an amount equal to or greater than $250 from: Brand Institute, Inc.<br/>Received royalty from Medscape for other; Received royalty from Neuroscience-Net, LLC for other; Received grant/research funds from National Institutes of Health for other.
Farzaneh Farhadi, MD
Disclosure: Nothing to disclose.
Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine
Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, Physicians for Social Responsibility
Disclosure: Nothing to disclose.
Hongzhu Deng, MD, PhD Associate Professor, Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University of Medical Sciences, China
Disclosure: Nothing to disclose.
Gregory N McKay Johns Hopkins University School of Medicine
Disclosure: Nothing to disclose.
Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Asperger Syndrome
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