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Asperger syndrome
BY
Ami Klin, Fred R. Volkmar
Child and Adolescent Psychiatric Clinics of North America
January 2003
Ami Klin, Fred R. Volkmar
Child and Adolescent Psychiatric Clinics of North America
January 2003
Originally described in 1944, Asperger syndrome (AS) was included in ICD-10 and DSM-IV almost 50 years after its description by Hans Asperger, a pediatrician from Vienna with interest in mental retardation. Considered to be a variant of autism, AS is defined as a pervasive developmental disorder (PDD) characterized by marked difficulties in socialization, one-sided communication style, and rigid patterns of interest typically focused on rote memorization of factual information about, at times, unusual topics. Since the introduction of the concept to English-speaking readership by Van Krevelen and Kuipers from the Netherlands, and most influentially, by Lorna Wing from the United Kingdom, research discussions on AS have focused on its validity relative to autism without accompanying mental retardation, and relative to other diagnostic concepts such as PDD not otherwise specified (PDD-NOS) and schizoid personality disorder. Its tentative inclusion in ICD-10 and DSM-IV was guided by an attempt to bring this condition to the attention of nosologic investigators. Almost a decade later, the nosologic status of AS is still uncertain. What is not equivocal, however, are the significant needs of the population to whom this diagnosis is being assigned. Although the research on the condition is still of dubious quality, there has been an exponential increase in the number of individuals diagnosed with AS, a proliferation of parent support groups coalescing around this concept, and a steady growth in the educational literature, web sites, and media coverage associated with it. Some of this attention still provides a narrow perspective, sometimes deceiving, of highly intellectual individuals with eccentric manners and all-absorbing esoteric interests. Although this may be true of some individuals, it is also true that beyond the curious intersection of intellectual capabilities and quaint interests, there are also patients with major socialization deficits that result in significant hardships to the individuals and the family, including inability to meet the demands of everyday life and to fulfill their vocational and social relationship aspirations. The clinical reality is that regardless of the fine nosologic points of syndrome validity that are of so much importance for research, there is an increasing need to provide these individuals and their families with adequate psychiatric and educational care to address their socialization deficits while capitalizing on the many strengths they typically possess. Deprived of this help, their outcome can be, and often is, severely compromised.
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