Asperger Syndrome: Symptoms, Complaints, Signs

Patients with Asperger syndrome (AS) show abnormalities in at least one of the three core autistic symptoms:

“Social interaction disorder”:
- Loner since childhood
- Lack of empathy in social relationships
“Disruption of communication”
- Fleeting eye contact
- Reduced gestures and facial expressions
- Striking speech melody
- Implicit prompts are not understood
“Restricted interests and repetitive behavior patterns.”
- Intense preoccupation with a specific area of knowledge
- Collective passions without social reference
- Pronounced adherence to unusual habits

Psychosocial impact in at least one area:

Persistent difficulties in education and work
Problems with initiation and maintenance of friendships
Previous or current consultations due to mental health problems or partial performance disorders.
History of developmental disability (e.g., ADHD) or mental illness (e.g., depression, obsessive-compulsive disorder)

One in two people with AS suffers from comorbid anxiety disorders or depression. The following symptoms and complaints may indicate Asperger syndrome:

Delayed motor development
Coordination disorders
Aloofness
Impairment of verbal and nonverbal communication (conspicuous use of language).
Contact deficits, both social and emotional (conspicuous eye contact; socially awkward, maladaptive, or odd behavior)
Irritability
Ritualized routines (as well as time-consuming special interests).
Relatively normal mental development
Relatively normal intelligence

Other clues

Asperger syndrome (AS) can be distinguished from early childhood autism (FA) by the lack of linguistic-cognitive development in the first years of life.
In a “mild” autistic symptom expression, social-communicative and interactional deficits can be compensated by high social-cognitive compensatory performance of the affected person.
In threshold situations (e.g., moving out of the parental home, career change, partnership desire), the non-intuitive compensation mechanisms are often too rigid.

Diagnostic criteria of Asperger syndrome in adults (according to the ADULT Asperger Assessment (AAA)).

Areas	Subtopics
A: Qualitative impairment of social interaction (≥ 3 of 5 domains).	Significant impairments in the area of nonverbal behavior. Does not want to please others or share his/her experiences Unsuccessful in building relationships with peers Lack of social or emotional reciprocity Problems interpreting social situations or other people’s feelings or thoughts.
B: Restricted, repetitive, and stereotyped patterns of behavior and interests (≥ 3 of 5 domains).	Extensive engagement with stereotyped and restricted patterns of behavior. Apparently inflexible pursuit of specific non-functional activities or rituals Stereotypical and repetitive mannerisms. Persistent preoccupation with certain parts of objects/systems. Tendency to “think in black and white” without being able to flexibly consider various other possibilities
C: Qualitative impairment in verbal and nonverbal communication (≥ 3 of 5 areas.	Tendency to talk about oneself or content of interest in every conversation Significant impairment in initiating and maintaining a conversation. Pedantic narrative style or get lost in details Inability to detect interest or boredom in the listener
D: Impairment of imagination (≥ 1 of 3 domains).	Lack of spontaneous, varied role-playing (e.g., playing “so-so” games with children) Inability to tell, write or invent stories. Lack of interest in novels or dramas or limited to z.B. Science, technology, history
E: Necessary conditions (all ranges):	During childhood, there are already abnormalities in each of the areas A to D. Resulting impairments in social, occupational or other important areas of life. In the field of language development, there are no significant delays. Another profound developmental disorder or schizophrenia must be excluded.