Symptoms of Asperger’s Syndrome
Because Asperger’s syndrome is now diagnosed as ASD, it shares the developmental condition’s core symptoms. But every person with ASD has unique symptoms and experiences.
“Autism, including what was once called Asperger’s syndrome, is a spectrum, meaning no two people have the same exact experience,” says Andy Shih, PhD, New York-based chief science officer of the nonprofit Autism Speaks.
People who would have once been diagnosed with Asperger’s typically don’t have delays in language or intellectual development, however. On average, diagnosis may come later in childhood than is typical for ASD, although symptoms may start between ages 1 and 3.
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Symptoms may seem to improve with age. This may be because of early interventions that help with recognizing and shifting behaviors, thinking, and social skills.
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It also may come from gaining the ability to “mask” (or conceal) common symptoms, which may lead to a delay in diagnosis for some people.
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Asperger’s syndrome historically has been linked with symptoms related to social interactions, speech and language, cognitive and behavioral traits, and physical and sensory experiences.
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Social Symptoms
Symptoms of Asperger’s that may show up in social situations include:
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- Challenges with building friendships and other relationships
- Trouble adjusting actions to different social settings and situations, which may lead to inappropriate behavior
- Difficulty understanding humor, sarcasm, and metaphors
- Not being able to hold a back-and-forth conversation
- Lack of spontaneous sharing of things they find enjoyable or interesting
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- Less interest in imaginative play than peers
- Limited or no eye contact with others
- No or limited interest in social interactions
- Tendency to engage in self-centered or one-sided interactions
- Trouble using nonverbal communication, such as facial expressions and body language, and difficulty recognizing social cues
Language and Speech Symptoms
Language delay hasn’t been a typical symptom for people with Asperger’s, although language is usually absent or develops gradually in ASD.
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Language-related symptoms linked with Asperger’s syndrome may include:
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- Flat, unemotional tone of voice
- Long-winded or dense monologues
- Speech that may be loud, high-pitched, or choppy
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- Repetitive speech
- Rote or scripted speech patterns
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Cognitive and Behavioral Symptoms
Cognitive traits of Asperger’s syndrome include:
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- Challenges with practicing empathy and adopting other perspectives
- Trouble managing emotions, which may lead to outbursts, violence, or self-injury
- Highly specific interests and intense focus on those interests
- Inflexibility and resistance to changing routines
- Literal, concrete, or rigid thinking
- Sex-related obsessions, compulsions, or fears, due to interrupted sexual development
- Tendency to focus on parts of things rather than the whole
- Trouble focusing or issues with attention span
- Visual thinking and recognition of patterns
“Another challenge is difficulty breaking out of a routine or habit and not knowing how to handle change,” says Eric Williams, MD, clinical associate professor of neuropsychiatry and behavioral science at the University of South Carolina School of Medicine Columbia.
Symptoms may show up in behavior, as well. These include restricted or repetitive movements, such as flapping hands or walking on tiptoes, and restricted or repetitive use of objects.
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Motor Skills and Sensory Symptoms
Asperger’s syndrome may involve issues with motor skills, such as:
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- Awkward or clumsy movements
- Delayed motor milestones in childhood
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- Trouble with handwriting
- Uncoordinated gait and posture
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More than 90 percent of people with Asperger’s have a sensitivity to certain stimuli, such as foods, smells, tastes, and temperature. This may cause severe anxiety and can lead to behaviors such as avoiding crowded environments or eating only certain foods.
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Other Conditions With Similar Symptoms
ASD symptoms may resemble those of other health conditions or vice versa.
For example, Asperger’s symptoms such as challenges with social interaction, a lack of interest, and a lack of expressions and gestures are also symptoms of schizophrenia.
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”ADHD can affect self-regulation, executive functioning, and social interactions — all common signs of autism — which can make getting a diagnosis for people with ADHD and autism more complex,” Dr. Shih says.
Other conditions with symptoms similar to those of Asperger’s syndrome include:
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Overlapping symptoms can sometimes make ASD hard for doctors to diagnose, especially considering how similar conditions can happen along with autism.
