Dilemma's Work with Asperger Syndrome

What is Asperger syndrome?

Asperger syndrome was first described by a Viennese child psychiatrist, Hans Asperger in 1944. The diagnosis was incorporated into the tenth edition of the International Classification of Disease and into the fourth edition of the Diagnostic and Statistical Manual of the American Psychiatric Association during the 1990s. Asperger syndrome is one of the autistic spectrum disorders, or pervasive developmental disorders, to use the alternative term preferred by North American colleagues. People with autism spectrum disorders all have profound social impairments, which often lead to emotional difficulty and social handicap. In addition, they have impairments of nonverbal communication, and unusual interests.

Estimates indicate that 1 in 150 people have an autistic spectrum disorder. The more able a person with an autism or Asperger syndrome is, the more likely that they are to receive mainstream schooling and to remain undiagnosed in childhood. Even if a diagnosis is made in childhood, this may get lost in the transfer to services for adults. This is a particular problem for people with Asperger syndrome, since they do not have learning difficulties or language abnormalities.

So far only a minority of general psychiatrists have any familiarity with Asperger syndrome. As a result, many adults with these problems have difficulty in getting a diagnosis or accessing services.

What will happen at an assessment?

The Dilemma Developmental Disorders assessment service is one of a small number of super-specialist referral centres which has the expertise not only to diagnose Asperger syndrome and other autistic spectrum disorders, but to assess for other developmental problems in adults including dysexecutive syndrome, dysphasia and physical disorders associated with autistic spectrum disorders.

An assessment at Dilemma normally takes two to two and a half hours, usually with the client, his or her parents or carers, and professional care staff. Parents are also asked to complete a detailed developmental questionnaire (click here to download a copy). A detailed report is written and sent to the client and to the referring doctor. It covers diagnosis, any further investigations that may be needed, recommendations for treatment including drug treatment of associated psychiatric or physical disorders, and prognosis. Follow-up appointments are made when there is a need for continued assessment, or the parents or client request it.

Staff may also help with applications for Disability Living Allowance. For further information about this allowance, have a look at the very useful guidance document published by the National Autistic Society and, if you think you are likely to make a claim, complete the diary that the NAS has designed.

You might also want to consider whether your or your carers are eligible for other benefits. You can use the benefit calculator provided by Ferret Information Systems for free.

Examples of recent cases include...

• A man of 45 living in a psychiatric hostel who had a brief psychotic episode at the age of 18 and has continued to receive antipsychotic medication ever since. He had never been psychotic subsequently and in fact suffered from Asperger syndrome rather than the schizophrenia that had been diagnosed.
• A man of 27 who had cut off contact with local psychiatric services at his parents' insistence because they thought that he had Asperger syndrome which was not being recognized locally. In fact, he had a disabling schizophrenic disorder and the Service helped re-establish the relationship with the local service which led to the client re-instituting medication. At follow-up, there was considerable improvement and he was back at work. An able University lecturer whose marital relationship had foundered over his lack of empathy for his wife. His diagnosis of Asperger syndrome led to better communication between the couple who decided to continue their relationship but to live separately.
• A young woman with autism who had deteriorated in her social function and was found to have an anxiety disorder which responded to treatment.
• A young man suspected of having Asperger syndrome who was under the care of urologists and gastro-enterologists. On examination during his assessment at the service, he was found to have upgoing plantar reflexes. A phone call to the GP led to referral on to a neurologist led to a diagnosis of demyelinating disorder.

Making an Appointment

You can read more information about appointments and contact our administrator at Dilemma consultancy to clarify any queries or make an booking.