| Despite what the Merck Manual says, FAM believes that Asperger Syndrome is a neurological difference, not a disease, not a disorder. In other words, there is, at present, no scientific evidence to suggest that AS, or autism for that matter, is caused by a neurochemical imbalance, and so it would seem that drugs and other chemically derived therapies are useless at best, detrimental at worst. Nor is there any scientific evidence that suggests that AS or autism is the result of learned behaviors that run contrary to "normal" behavioral function, thus behavioral therapies in the traditional sense would seem to have very little value. That is not to say cognitive and behavioral therapy for AS and autism is entirely useless. The AS person and the autistic person would do well to learn "coping mechanisms" to better function in a world not designed for him or her and one should hope that the self esteem of those on the autistic spectrum would rise as a result of demonstrable and observable successes resulting from cognitive and behavioral therapies. Again: If the physical structure of the autistic brain is different from that of the neurologically typical brain, than it follows logically that autism and AS are merely differences, not diseases, not disorders. Restated: A perfectly happy and secure autistic individual would be one that cogitates and functions optimally with the brain that he or she is given. A disordered autistic would be one that functions inadequately, for reasons unknown, despite the possession of significant functional aptitude. A diseased autistic would be one who's brain was impaired or degenerative due to physical injury, physical abnormality or neurochemical imbalance. This philosophy should not in any way seem shocking since by inserting the words "normal brain" for "autistic brain" one would have definitions of "disorder" and "disease" that are commonly recognized by many in the psychological profession. It should also be noted that the Merck Manual only talks about AS in terms of children and childhood, not adults and adulthood. Like autism, AS is not something that goes away with physical maturity but stays with someone throughout their lives. And the Merck Manual fails to acknowledge that many people with AS have intelligence quotients that range from average to well above average as do people in the neurotypical segment of the population. While the opinions of FAM regarding statements published in DSM IV and commonly disseminated statements in medical manuals are conjectural, it is nevertheless the stance that FAM takes on AS and autism. There is admittedly no scientific evidence to suggest that FAM's philosophy regarding these issues are valid, nor should anything written here be taken as medical advice or as coming from a medical authority. But the feeling of FAM is that the labeling of AS and autism as a disorder or a disease obscures the true definition of what AS and autism actually are and clouds understanding of their traits. |
| The Merck Manual of Medical Information, Second Home Edition (2003) has the following to say about "Asperger's Disorder and Pervasive Developmental Disorder Not Otherwise Specified": "These pervasive developmental disorders are closely related to autism but are less severe. "Children with Asperger's disorder have impaired social interactions similar to those of children with autism, as well as stereotyped or repetitive behaviors and mannerisms and mon-functional rituals. However, language skills are normal and sometimes superior to those of an average child, and IQ is normal. "Children who have significantly impaired social interactions or stereotyped behaviors without all the features of autism are considered to have pervasive developmental disorder not otherwise specified (abbreviated as PDD-NOS). Children with Asperger's disorder or PDD-DOS tend to function at a higher level than children with autism and may be able to function independently. Children with Asperger's disorder often respond well to psychotherapy" (p. 1631). Regarding social relationships, language, and behavior in autistics, the Merck Manual says: "Social relationships: An autistic infant does not cuddle and avoids eye contact. Although some autistic infants become upset when separated from their parents, they may not turn to parents for security as do other children. Older autistic children often prefer to play by themselves and do not form close personal relationships, particularly outside of the family. When interacting with other children, they do not use eye contact and facial expressions to establish social contact, and they are not able to interpret moods and expressions of others. "Language: About 50% of autistic children never learn to speak. Those who learn do so much later than normal and use words in an unusual way. They often repeat words spoken to them (echolia) or reverse the normal use of pronouns, particularly using 'you' instead of 'I' or 'me' when referring to themselves. These children rarely have an interactive dialogue with others. Autistic children often speak with an unusual rhythm and pitch. "Behavior: Autistic children are very resistant to changes, such as new food, toys, furniture arrangement, and clothing. They often become excessively attached to particular inanimate objects.They often repeat acts, such as rocking, hand flapping, or spinning objects in a repetitive behaviors such as head banging or biting themselves" (pp. 1630-1631). |
| What Merck and FAM Have to Say About Asperger Syndrome |
| (There are some differences.) |
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