Asperger's syndrome in adults: table of diagnostic criteria

When it comes to autism, the imagination of the common man draws a portrait of a beautiful, silent boy, looking in one direction and making the same type of rhythmic movements. But in fact, both children and adults can suffer from autism, regardless of gender. In addition, autism has a large number of forms, so in modern psychiatry this pathology is called autism spectrum disorder (ASD).

The mildest and most common form of ASD is Asperger's syndrome. This disorder is congenital and its first signs can be detected at an early age. Despite the fact that a large number of people suffer from this syndrome, it is rarely diagnosed, especially in our country. The fact is that in Russia this diagnosis is usually given only to children. Until now, many psychiatrists are of the opinion that by the age of 18, mild forms of autism should either disappear or develop into more severe pathologies. This statement has long been refuted, because Asperger syndrome is a congenital pathology that cannot be treated. However, in adult patients this diagnosis is changed to classic autism (Kanner syndrome) or a similar disorder, such as schizoid.

As for children, their parents rarely bring them to see specialists because they do not see the problem. Such children have a fairly high intelligence, and their isolation and reluctance to communicate with peers is often explained by their character traits. This is why in our country a large number of people are left alone with their problem.

Description of the pathology

Mental disorders occur differently in different people. However, people with Asperger's syndrome share a number of common characteristics. This concerns interaction with society, behavior, thinking with a special cognitive style, perception of the world, the functioning of the senses, etc. How pronounced the symptoms will be depends on the individual characteristics of the person. But neither age, nor gender, nor belonging to a particular race has an impact on the process of pathology formation.

So, a person with Asperger's syndrome can be recognized by the following signs:

1. Difficulties in building a system of interaction with society. People with this form of ASD show varying degrees of interest in social interaction. The vast majority strive to reduce contact with society to a minimum. To some extent, this can be explained by society’s misunderstanding and rejection of people with similar problems. Negative life experiences and the need to make enormous efforts to maintain relationships lead to the fact that people with this disorder often lead a secluded lifestyle. Although among them there are those who want to interact with other people, despite difficulties and failures. The syndrome leads to the fact that a person is unable to understand allegorical speech, jokes, and ambiguous statements. He does not understand sign language, he does not perceive differences in the tone of voice, and cannot distinguish emotions from facial expressions. The experiences of other people and their feelings are inaccessible to a person with this type of ASD. He builds interactions with others on his own terms, and nothing more. Rejection of these rules leads to complete detachment and refusal to interact with society.
2. Narrow interests, fixation on one type of activity. Autism spectrum disorders are characterized by the need to have a clear routine, work schedule, detailed plan and specific instructions. In order to somehow organize the surrounding space, people with Asperger's syndrome become deeply immersed in certain activities. As a result, they receive peace and satisfaction, and also get rid of background anxiety. If interests have applied value, then they can subsequently become part of professional activity. The duration of fixation on one type of activity can be different, it ranges from several days to years.
3. Features of speech development. Many diagnostic methods contain instructions that the syndrome should be excluded if the patient does not have clinically significant delays in speech development. However, with this syndrome there are still some speech features. Such people use it only as a tool for exchanging information, and not for building relationships with others. That is, the conversation has no emotional overtones, there is no humor in the speech, etc. A person with pathology will interpret the words of his interlocutor in a literal sense, so the general meaning of the statement may be distorted or not understood at all. Figurative speech and metaphors are perceived only when reading works of fiction, but in conversation this will cause great difficulties.
4. Sensory perception. People with ASD process incoming and outgoing sensory information differently than others. Asperger syndrome involves either low or high sensitivity in one or more senses. For example, when talking with several interlocutors, so-called audio confusion may occur. A person may also be unable to distinguish certain patterns, smells, textures, and textures of food.
5. Motor function disorder. The syndrome is often accompanied by some clumsiness. The individual may have difficulty fastening buttons, going up and down stairs, spatial orientation, etc. But this symptom is not the main one when making a diagnosis, since not all patients have problems with movement.
6. Thinking. Such people are distinguished by a special type of cognitive activity. In the specialized literature they often write that such people have a special cognitive style of thinking. Attention is usually focused not on the main thing, but on details or unimportant stimuli. More preference is given to abstract things rather than precise technical information.

A person with a combination of all these signs experiences great difficulties when communicating with people around him. But the presence of this pathology is not a death sentence. Life with Asperger syndrome can be quite normal; such people can successfully lead social activities, work, and have families. Experienced psychotherapists provide assistance in socialization.

There are psychotherapy methods that can improve the quality of life of people with autism spectrum disorders. But this is only possible by contacting specialists and making an appropriate diagnosis.

Forms of the disease

Each type has identical symptoms, but they also have some differences.

Experts identify several of the most common forms of autism:

• Kanner's syndrome. Severe lesions of the cerebral cortex are typical, leading to communication problems. Patients suffer from speech disorders, there is aggressiveness, and weak intelligence. It is almost impossible to find an approach to such an autistic person. This is the most complex autistic form, which is characterized by the presence of almost all manifestations of pathology;
• Asperger's syndrome. It has similar symptoms, but manifests itself in a complex or mild form, and often proceeds more mildly. Symptoms of mild autism in adults do not prevent an autistic person from becoming a full-fledged member of society if he can overcome fear and timidity. Such patients are able to perform the activities necessary for work and a full life. But sometimes they get very fixated on work, they have no hobbies, they try to spend all their time in isolation;
• Rett syndrome. The most dangerous form is transmitted through female inheritance. Behavioral symptoms are easily relieved by drug treatment, however, speech and external abnormalities cannot be removed with drugs. The disease takes a long time to develop and is rare. Signs of autism in adult women typically involve a lack of communication, unsociability, and symbolization. Such patients usually live only about 30 years;
• Atypical form. This autism is typically characterized by the absence of one of the characteristic signs, which complicates diagnosis. There are speech and motor disorders, and motor function disorders.
• High functioning autism. This form of pathology is diagnosed when the patient has relatively high intelligence scores (more than 70). This autistic form is manifested by dull or acute sensory perception, weakened immunity. High-functioning autism in adults is accompanied by irritable bowel movements, periodic attacks of convulsive muscle contractions, and disturbances in the functioning of the pancreas. Signs of high-functioning autism in adults are characterized by behavioral stereotypes, a narrow range of interests, sudden outbursts of aggression and difficulties in socialization.

Article on the topic: Detailed description of all types and classification of autism

Only a specialist can determine an accurate diagnosis, since identifying autism of any form requires a face-to-face consultation with a specialist and a sufficiently long observation of the patient.

Diagnostic criteria

The symptoms described above are common to most autism spectrum disorders. Various techniques used by specialists around the world help diagnose Asperger syndrome. The main criteria are presented in the table:

Diagnosing Asperger's syndrome is quite difficult; for this, a psychiatrist or psychotherapist must have certain experience and knowledge.

To make a diagnosis, it is necessary to carefully study the patient’s life history, analyze his behavior, and conduct a conversation with relatives and loved ones. The vast majority of symptoms fit the description of the character traits of an introvert, so experts use special medical tests to identify or exclude neurological disorders.

Recommendations for family members of an autistic person

It is quite possible to improve the quality of life with such a pathology if loved ones actively participate in the process of adaptation of the autistic person to society. The main role in these processes is given to parents, who must thoroughly study the characteristics of the disease. You can visit autism centers; there are special schools for children.

Relevant literature will also help, from which the patient’s family will learn all the intricacies of building relationships and living together with such a person.

Here are some more useful tips:

• If an autistic person is prone to running away from home, but cannot find his way back on his own, it is advisable to attach a tag with a phone number and address to his clothes;
• If there is a long trip ahead, it is recommended to take something from the patient’s favorite things, which helps him calm down;
• Avoid long lines, as autistic people often start to panic in them;
• You should not violate the patient’s personal space; he should have his own room, where he will arrange things and objects at his own discretion, while household members are not allowed to touch, move, rearrange, or rearrange anything.

The family should accept that their loved one is special, so they must learn to live taking this circumstance into account.

Is it possible to get disability

According to current legislation, an adult with autism is entitled to disability. For this:

1. You need to go to the clinic at your place of registration to confirm the diagnosis. You can contact a psychiatrist or neurologist.
2. After the examination, the doctor will issue a referral for a medical examination and give recommendations regarding additional examinations and specialists who will need to be examined.
3. When the examination is completed, all results are transferred to the doctor (psychologist, psychiatrist) who issued the appropriate referral. It is he who will prepare the documentation for the commission.
4. All that remains is to come to the ITU with the finalized documents.

Article on the topic: How to apply for disability due to autism

Asperger's syndrome in women

Statistics show that Asperger's syndrome and other autism spectrum disorders are more common in boys. However, girls can also have autism or one of its variants.

Relatively recently, a study was conducted in Scotland (Rutherford et al, 2016), the results of which were very interesting. It turns out that among young children with Asperger's syndrome the ratio of boys to girls is 5.5:1, for teenagers the ratio is 2.3:1, and for adults it is 1.8:1. Based on this, we can conclude that this pathology does not occur less frequently in women, it is simply diagnosed later. While boys are brought to doctors by their parents, girls turn to specialists on their own when they become adults.

This state of affairs is partly due to the fact that some symptoms in girls occur differently than in boys. Parents should be wary of their daughter's behavior:

• subtle behavioral problems. They are not, according to parents and teachers, something destructive. Therefore, they are often not taken into account. Well, is it really worth taking a girl to a psychiatrist if she doesn’t want to communicate with her classmates? But if a child is too withdrawn and shy, and is constantly alone, then you should think about it and take a closer look at him;
• selective mutism. This symptom means that the girl cannot speak in some situations, and she cannot choose when exactly she can speak and when not. That is, this week she will be able to answer in school, but next week she will not. It is impossible to predict the incidence of mutism;
• communicates mainly with boys. Such girls are usually called “tomboys”. Girls with ASD do not share their peers’ passion for fashionable clothes and hairstyles; they simply do not understand why this is necessary. The moment of puberty can come as a shock for them; they are completely devoid of sexuality and do not experience sexual desire. Young women on the autism spectrum may want to have children, but they find adoption more acceptable than having their own due to their reluctance to be intimate with a man;
• being in a fantasy world. Children tend to immerse themselves in made-up stories and become captivated by fairy-tale characters. As you grow older, such passion recedes, and more real things come to the fore. However, girls with Asperger's syndrome continue to live in fantasy worlds. Psychotherapists explain this by saying that in reality people with ASD feel out of place, but in a fictional world they are loved for who they are.

Asperger syndrome cannot be cured, but identifying it and understanding the characteristics of a person with this pathology allows you to build normal relationships in the family. This applies to both parents with children and spouses. Quite often, women with ASD refuse intimate intimacy, although they sincerely love their spouse. Impaired sensory perception leads to the fact that touching the body (especially in sensitive areas) is perceived as unpleasant or painful. The desire to live according to a routine can turn intimacy into a clearly planned ritual, which a neurotypical partner will quickly get bored with. Understanding what Asperger's syndrome is will help save the family.

Girls with this pathology feel unhappy; they often want to have a loved one and a family, but it is extremely difficult for them to build relationships with the opposite sex. In addition to problems associated with ASD, girls and young women experience depression, gender dysphoria, anorexia nervosa and anxiety disorders due to emotional distress. All this, as well as the desire to understand themselves and the causes of their problems, brings them to the psychotherapist’s office. And only after receiving information about Asperger's syndrome do they accept themselves and learn to live with their innate “peculiarities.” There is no need to fear that you will be misunderstood or forever labeled as “abnormal.” Awareness of the problem is the first step towards improving your own life.

Rehabilitation

Typically, autistic disorders are diagnosed in childhood, but it also happens otherwise, when the clinical picture is erased, the patient can live until adulthood and even adulthood, not knowing about his psychopathological characteristics. According to statistics, about a third of autistic people with Asperger's disease have never been diagnosed with Asperger's disease.

Ignorance of the disease contributes to serious problems in all areas of the patient’s life from family to professional activity. They are often treated as strange, mentally ill people or even discriminated against. Therefore, such patients try to avoid society, choosing a lonely life.

In specialized institutions, autistic people can undergo rehabilitation, which will help reduce anxiety, increase attention and concentration, normalize psychophysical fitness, etc. This may include music therapy, hydrotherapy, classes with a speech therapist or a theater group.

The sooner correction is started , the higher the socialization of the patient will be in adulthood. In special schools, adolescents are improved in self-care and independent action, planning their activities, and social skills. They study according to special programs like ABA, FLOOR TIME, RDI, TEACH system, etc.

Some states even practice the creation of special apartments where caregivers will help patients, but the patients will not be deprived of their independence. If the disease has developed to its full extent, then such a patient will need constant care from relatives, since they are not capable of independent life.

Frequency of symptoms of autism

This table was compiled using only 100 patients, so results may vary slightly in a larger study.

Diagnosis of the disease in honey

If you notice symptoms of Asperger's syndrome in a boy or a close adult male, contact a psychiatrist at our clinic. The diagnosis is made based on a survey of the patient and subsequent observations of him. In particular, he will be interested in:

• symptoms that bother you when you first notice them;
• when did a boy or man learn to speak and how does he communicate now;
• is there a focus on any subjects or activities;
• presence of friends and forms of communication with them.