diease

Aspergers syndrome


OVERVIEW OF Aspergers syndrome :

       It was introduced by the Dr.Hans Asperger in 1944.He noticed that the childrens suffering from this disease shows abnormal behavioural patterns,social skills and difficulty in verbal communication.it is  also known as autism spectrum disorder , a type of neurological condition.


EPIDEMIOLOGY :

Aspergers  syndrome is more common among boys when compared to girl child.


CAUSES :

Genetics

Teratogens-when they are consumed within 8 weeks of gestational period

Some researchers says that environmental factors such as air pollution can also have an impact on the asperger’s syndrome.

Pre term babie

Some  suggest that the following resons during the pregnancy time can aggaravate the disease:

Gesatational diabetis in mother

Obesity in mother

Intake of alcochol during pregnant times.

Unbalanced vitamin levels

Exposure to pesticides when mother is conceived.

Parental age:Parents in the age of mid 30s shows higher chances for the disease

Sex:Boys are more prone to the disease when compared to the girls

Birth order:the first born child are more prone for the disease when compared to the other disease.

Malnutrition can aggravate the aspergers syndrome.


PATHOPHYSIOLOGY :

Aspergers syndrome tends to result from damage or mutation in the brain stem.

The following areas of the brain are affected in the aspergers syndrome:

  • cerebellum
  • prefrontal and temporal cortexes
  • hippocampus
  • amygdala

 

Neuroanatomical studies and the associations with Teratogens strongly suggest that the mechanism includes alteration of brain development soon after conception. Abnormal fetal development may affect the final structure and connectivity of the brain, resulting in altered neural circuits controlling thought and behavior. Several theories of mechanism are available; none are likely to provide a complete explanation.


COMMON CLINICAL SIGNS AND SYMPTOMS :

Difficulty in speech

They prefer playing alone and avoid groups

Inability to respond to the situation

Lack of response to their name

Difficulty in learning

Poor eye contact

Doesn’t able to understand their surroundings

Don’t know to express their emotion

Make repetitive movements

Speech that sounds abnormal.


DIAGNOSTIC :

Electroencephalogram(EEG): the doctors might suggest EEG to detect any abnormalities in the brain.

The diagnostic criteria is based on the various scoring as follows:

Diagnostic and statistical manual for mental disorders-revised(DSM-IV):

  1. Qualitative impairement with social interaction, as manifested by at least two of the following:
    1. marked impairment in the use of multiple non-verbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction;
    2. failure to develop peer relationships appropriate to developmental level;
    3. a lack of spontaneous seeking to share enjoyment, interests or achievements with other people (e.g.: by a lack of showing, bringing, or pointing out objects of interest to other people);
    4. lack of social or emotional reciprocity.
  2. Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
    1. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus;
    2. apparently inflexible adherence to specific, nonfunctional routines or rituals;
    3. stereotyped and repetitive motor mannerisms (e.g.: hand or finger flapping or twisting, or complex whole-body movements);
    4. persistent preoccupation with parts of objects
  3. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
  4. There is no clinically significant general delay in language (eg: single words used by age 2 years, communicative phrases used by age 3 years).
  5. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood.
  6. Criteria are not met for another specific Pervasive Developmental Disorder, or Schizophrenia.

                                                The gold standard in diagnosing the aspergers syndrome is judgement with  Autism diagnostic interview revised (ADI-R), a semistructured parent interview; and the Autism     diagnostic observational schedule (ADOS), a conversation and play-based interview with the child. Delayed or mistaken diagnosis can be traumatic for individuals and families; for example, misdiagnosis can lead to medications that worsen behavior.

 

  • 0: "Behavior of the type specified in the coding is not present"
  • 1: "Behavior of the type specified is present in an abnormal form, but not sufficiently severe or frequent to meet the criteria for a 2"
  • 2: "Definite abnormal behavior"
  • 3: "Extreme severity of the specified behavior"
  • 7: "Definite abnormality in the general area of the coding, but not of the type specified"
  • 8: "Not applicable"

9: "Not known or asked"


TREATMENT AND PROGNOSIS :

Treatment of the aspergers syndrome include multidisciplinay approach.

Therapies:

Applied Behavioural analysis including  positive behavioural approach:

Includes training the parents ,trachers,school faculties and other peer group of the child affected with this disease.

Cognitive behavioural therapy:it includes the stress management in the children and also relieve them from their anxiety and obsessive repetative behaviours.This therapy also focuses on the child’s emotional disturbances.

Medications:they are indicated mainly to treat the major depressive disorder and anxiety disorder

Occupational oe physical theyapy:They mainly indulge in sensory processing and motor coordination behaviour of the child.

Social communication therapy:it includes the speech therapy to help pragamatics.

 Inspite of the social skills training and occupational therapy the improvement is purely

Depends upon the individual and their peer groups.

Medications:

 The medications mainly focuses on the emotion control.

atypical antipsychotics medications risperidone,olanzepine

Risperidone can reduce repetitive and self-injurious behaviors, aggressive outbursts, and impulsivity and improves the social pattrens in an individual.

 The selective serotonin reuptake inhibitors(SSRIs) fluoxetine,fluoamine and sertaline -treat restricted and repetative behavour.

  Methylphenidate-It is used to treat inattention.


PROGNOSIS :

They have greater life time expectancy about the major thing is they suffer from psychiatric comorbidities.

There is no pre-natal test or other predictor for Asperger’s Syndrome while a fetus is in utero. Asperger’s is diagnosed via a collection of common traits or symptoms that usually manifest in early childhood development.

The best way to prevent the disease is the early diagnosis of the disease and starting the treatments as soon as possible.

They have greater life time expectancy about the major thing is they suffer from psychiatric comorbidities.

There is no pre-natal test or other predictor for Asperger’s Syndrome while a fetus is in utero. Asperger’s is diagnosed via a collection of common traits or symptoms that usually manifest in early childhood development.

The best way to prevent the disease is the early diagnosis of the disease and starting the treatments as soon as possible.

 


PREVENTION :

Focus on the positive :encourage the child with positive reinforcement

Follow the therapy correctly without fail

Get your child to participate in daiy activities

Provide them care and support

Get the child into the group activities.


Recovery Period :

the recovery  period depends upon  the indivduals mental strength


REFERENCE :

http://autism.in

http://ninds.nih.in

http://healthline.in

http://cdc.gov.in

www.autism society .in

www.psychcentral.com