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June 2002
Vol. 5, No. 6, p 48.
diseases and disorders
Julie L. McDowell

Asperger’s syndrome

Frankie When Frankie D’Erasmo was 3 years old, he taught himself how to use the family computer. He also read and did math problems. But his mother, Sandy, was concerned because he wasn’t interested in playing with the toys that entertained his older sister Lisa at that age. Three-year-olds play with dolls and dump trucks, but Frankie preferred calculators.

Sandy had other serious concerns about her little boy, and she took him to one doctor after another all over New York in search of answers. For instance, Frankie gurgled and giggled by the time he was a year old, but grew silent a few months later—only to start speaking full sentences when he turned 3. Then there was his devotion to routine—he was frustrated with any changes or disruptions. And while their Bronx apartment was noisy, the urban noise outdoors repulsed Frankie. “I remember pushing him along the sidewalk in a stroller and he would become petrified when he heard a motorcycle,” says Sandy. “He would scream bloody murder.”

Brain cell defects. Research shows stunted nerve cell branches in the brains of some autism patients.
Brain cell defects. Research shows stunted nerve cell branches in the brains of some autism patients.
When Frankie was 4 years old, Sandy finally got some answers. Frankie was initially diagnosed with ADHD (attention-deficit hyperactivity disorder), but Sandy kept looking for other opinions to explain her son’s behavior. About a month later, she took Frankie to see Kaitlin Schmidt, a child psychiatrist at Jacobi Medical Center in the Bronx, who said he had a form of autism known as Asperger’s syndrome (AS), a disorder that started getting attention in schools and doctors’ offices during the early 1990s.

In 1943, Leo Kanner, a Johns Hopkins University psychiatrist, identified autism as a neurological or brain-centered condition that impairs behavioral and language development. A year later, a pediatrician from Vienna named Hans Asperger analyzed a group of four boys who displayed odd social, language, and cognitive behaviors. He noted that these boys struggled to form and maintain friendships, and they lacked empathy and appeared naïve when dealing with others. Asperger also noted their pedantic, repetitive speech and intense obsession with certain subjects, such as trains or weather, prompting him to call them “little professors”. His research was ignored until recent years, and it wasn’t until the past decade that AS was accepted by the medical profession as a high-functioning form of autism (high-functioning means that patients have average or above-average intelligence).

In 1994, the Diagnostic and Statistical Manual of Mental Disorders (a reference manual for diagnosing mental illness) defined AS as a pervasive developmental disorder marked by “severe and sustained impairment in social interaction” in addition to “restricted repetitive and stereotyped patterns of behavior.” Psychological jargon aside, AS patients are distinguished by their lack of social insight—they can’t comprehend nonverbal communication, such as hand gestures, body language, or facial expressions.

Even though AS patients have average or above-average IQs, they don’t have the tools to interact appropriately with peers, and consequently have trouble making friends and fitting in socially at school. “They lack the social intuition that all of us are typically born with,” says Elaine Williams, a pediatric psychology associate for children with developmental disorders at Maryland’s Mt. Washington Pediatric Hospital. “They are sort of mind-blinded. They don’t understand that other people have thoughts and feelings that are different from their own that can influence behavior.” They may learn that hitting another child lightly on the back is fun when on the playground during recess, but they will not understand that this behavior is inappropriate when in the classroom.

Frankie is now 15 and lives with his parents in Arnold, MD, outside Baltimore. (Mr. D’Erasmo relocated the family for career reasons when Frankie was in the fourth grade.) He is in the ninth grade at Hannah More School, which specializes in academic and therapeutic programs for emotionally disabled, autistic, and learning disabled students. Medication has also helped Frankie succeed in school. He’s on a small dosage of Prozac (an antidepressant that helps alleviate anxiety) and Ritalin, which helps him focus on schoolwork rather than outside distractions. He attends three therapy groups a week: On Fridays, he has art therapy and a “games group” where he and other students work on social skills such as sharing and taking turns while playing games. And on Mondays, he has one-on-one counseling with a social worker to address any problems he is experiencing socially or academically.

“I just feel very blessed to have him exactly as he is,” his mom says. “He’s truly a gift.”

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