Riva Ariella Ritvo PhD- a perspective on Asperger's Syndrome
Riva Ritvo PHD OTR/L - child therapist in Los Angeles, CA
What is Asperger's syndrome? Asperger's Syndrome is a very mild form of autism. In 1944 Hans Asperger, a Viennese pediatrician described patients who had social difficulties and were unable to decode nonverbal communication. He noted that they had idiosyncratic verbal communication and preoccupation with unusual interests. He also noted that these individuals had deficits with empathy and intuition and that they were clumsy. At that time, no one associated this description with autism. The patients Asperger's described could talk and had normal intelligence. At the same time, Dr. Leo Kanner (an American psychiatrist) described autism for the first time in medical literature. Kanner's patients were either mute or had delayed speech, most were retarded and had many self stimulatory behaviors like rocking, hitting themselves and spinning. In 1981, Lorna Wing a British psychiatrist suggested for the first time that the two conditions may be related. As with every disease, the most severe cases are described in the literature first, followed by recognition of the milder cases. So it was with autism and Asperger's syndrome. In 1994 Dr. Edward Ritvo, I and our UCLA research team first reported on parents of autistic children who had a very mild form of the disorder. We now know these parents have Asperger's syndrome. What this means is that Autism and Asperger's syndrome are on a continuum from severe to mild with Asperger's being the mildest expression of the autism spectrum.
What are people with Asperger's syndrome like? The hallmark symptoms of Asperger's syndrome manifest in developmental spurts and plateaus in three major areas: social relatedness, language use and sensory motor modulation. The child begins talking on time but her use of language is concrete. She has trouble reading social cues, gestures and "between the lines". Most "Aspies" (as they call themselves) have unusual special interests which they excel in. They have excellent rote memory and some get married and have children. Others would like to but have difficulty knowing "how to become intimate". Their intelligence varies from average to superior. Most report sensory motor disturbances. They fluctuate from being super sensitive to tuned out to sounds or textures for example.
I just developed a diagnostic scale for adults with Asperger's syndrome (the RAADS) with Dr. Edward Ritvo. The volunteers for the study shared that they like to call themselves neurodiverse and are happy being the way they are. Most said they would not trade places with me, Riva Ritvo.
What causes Asperger's syndrome? One is born with it. You don't catch it or get it from tuna or vaccines. It is a neurological (brain) disorder with a genetic basis. For instance, we see many families with two or more individuals with Asperger's syndrome and one or more with autism. We know that there are variations in how the brain looks and function. Our best guess is that the genetic disturbance is in the micro- RNA which is the blueprint for when brain cells turn on and off and what direction they go in. In other words, the instructions for brain development are off.
Written by Dr. Riva Ariella Ritvo, PhD, OTR/L
