Autism Spectrum Disorder (ASD) is a phenotypically heterogenous group of neurodevelopmental syndromes characterized by a wide range of impairments in socialcommunication and restricted and repetitive behaviors. (1) The majority of individualswith ASD go through puberty and experience the same physical and psychosexual aspectsof sexual development as their peers. However, there are notable problems with regardsto sexuality especially at the start of puberty when the development of social skillscannot keep up with the increasing social demands, and the difficulties of formingromantic and sexual relationships become evident. (2)The case presented here is a 26-year-old male with a history of engaging in paraphilicactivities that showed the complexities of ASD (Asperger Syndrome) in their sexualbehavior.PJPCASE REPORTTYING IT ALL TOGETHER:CASE OF AUTISM SPECTRUM DISORDER WITH PARAPHILIC ACTIVITIESMELANIE TONGOL, MDTHE MEDICAL CITYDEPARTMENT OF PSYCHIATRY34 · PJP 2023 · Volume 4 (1-2) · ISSN 2980-4884CASE PRESENTATIONChief ComplaintJay was a 26-year-old Filipino male, Christian,single, seeking consult for intrusive thoughts withthemes of bondage & discipline, dominance& submission and sadism &masochism (BDSM).History of Present IllnessJay described himself as curious, ambitious, andpeculiar. Despite trying to be sociable andextroverted, he had difficulty connecting withfriends and he often ended up alone. This hasbeen a recurring experience since childhood.Five years prior to consult, Jay’s excitement washyped, as a female chatmate opened up thetopic of BDSM.He shared his long-term fantasies of tying up agirl and subjecting her to pain, humiliation andsexual stimulation, which was never realizedgiven his Christian belief that it was wrong.After meeting someone who shared his hiddendesires, he was able to muster the strength to liveout his fantasies and met with the said chatmate.They planned their BDSM roles and restrictions,with Jay as the dominant and the chatmate assubmissive. On the day of their meeting, Jaypacked ropes in his bag, as he remembered hispast fascination with them when he was still aboy scout. he met his chatmate at the deliveryarea of a mall and there began his string of novel sexual pursuits. He started binding herhands and legs behind her. Both lying on thefloor, fully clothed, he kept on tying her as if hewas in a trance. Merely having his partner
Autism Spectrum Disorder ; Asperger Syndrome

OBJECTIVE: To study the clinical effect of integrated sandplay therapy in preschool children with Asperger syndrome (AS). METHODS: A total of 44 preschool children with AS were randomly divided into an experimental group and a control group, with 22 children in each group. The children in the control group were given routine training, and those in the experimental group were given integrated sandplay therapy in addition to the routine training. The treatment response was assess by the Social Responsiveness Scale (SRS), emotional recognition tools and changes in sandplay theme characteristics after 6 months of treatment. RESULTS: Before intervention, there were no significant differences between the two groups in the total score of SRS, the score of each factor of SRS, and correct rates of facial expression recognition of the upright position, inverted position, upper face and lower face (P>0.05). After 6 months of intervention, both groups had significant reductions in the total score of SRS and the score of each factor of SRS (P<0.01); the control group had significant increases in the correct rates of facial expression recognition of all positions except the upright position (P<0.05), while the experimental group had significant increases in the correct rates of facial expression recognition of all positions (P<0.05). Compared with the control group after intervention, the experimental group had significantly lower total score of SRS and scores of all factors of SRS except social perception (P<0.01) and significantly higher correct rates of facial expression recognition of all positions (P<0.01). The experimental group had a significant change in the number of sandplay theme characteristics after intervention (P<0.01). CONCLUSIONS Integrated sandplay therapy can improve social responsiveness and emotion recognition ability in preschool children with AS.
Asperger Syndrome ; Child, Preschool ; Emotions ; Facial Expression ; Humans ; Play Therapy

Asperger syndrome is a developmental disorder characterized by difficulties in social interaction and communication. Dental treatment of patients with Asperger syndrome could be challenging due to lack of communication and compliance. This case report described the dental treatment of a patient with Asperger syndrome. A surgeon should be aware of the problems associated with patients with Asperger syndrome and how these can interfere in the surgical treatment. Communication is the key to successful dental treatment in a patient with Asperger syndrome.
Asperger Syndrome

OBJECTIVES: The objective of this study was to investigate the concordance of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5) diagnostic criteria for autism spectrum disorder (ASD). METHODS: We retrospectively reviewed the medical records of 170 subjects (age range: 3–23, 140 boys) with developmental delay or social deficit from January 2011 to July 2016 at the Department of Psychiatry of Asan Medical Center. The Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS), and intelligence tests were performed for each subject. Diagnosis was reviewed and confirmed for each subject with DSM-IV Pervasive Developmental Disorder (PDD) and DSM-5 ASD criteria, respectively. RESULTS: Fifty-eight of 145 subjects (34.1%) who were previously diagnosed as having PDD in DSM-IV did not meet DSM-5 ASD criteria. Among them, 28 (48.3%) had Asperger's disorder based on DSM-IV. Most algorithm scores on ADOS and all algorithm scores on ADI-R were highest in subjects who met both DSM-IV PDD criteria and DSM-5 ASD criteria (the Convergent group), followed by subjects with a DSM-IV PDD diagnosis who did not have a DSM-5 ASD diagnosis (the Divergent group), and subjects who did not meet either DSM-IV PDD or DSM-5 ASD criteria (the non-PDD group). Intelligence quotient was lower in the Convergent group than in the Divergent group. CONCLUSION: The results of our study suggest that ASD prevalence estimates could be lower under DSM-5 than DSM-IV diagnostic criteria. Further prospective study on the impact of new DSM-5 ASD diagnoses in Koreans with ASD is needed.
Appointments and Schedules ; Asperger Syndrome ; Autism Spectrum Disorder* ; Autistic Disorder* ; Chungcheongnam-do ; Diagnosis* ; Diagnostic and Statistical Manual of Mental Disorders ; Intelligence ; Intelligence Tests ; Medical Records ; Prevalence ; Prospective Studies ; Retrospective Studies

People with Asperger's syndrome (AS) have a rather different thinking style. They may create new ideas that the designer can see this awkward thinking style as the driver for developing new and innovative ideas. In this paper, both 'Aspie' and the designer work together to make innovative ideas, by which 'Aspie' could find a new contributive role in communal living. An ideation workshop is composed of two different stages with several ideation methods. Described is an observational study of how the ideation workshop covers their deficits and makes them adapt to generate their different ideas. From the observation, this paper realizes how we start to reestablish the relationship between AS people and the society.
Asperger Syndrome* ; Cross-Over Studies ; Education ; Equipment Design ; Observational Study ; Thinking*

In patients with a language developmental delay, it is necessary to make a differential diagnosis for autism spectrum disorders (ASDs), specific language impairment, and mental retardation. It is important that pediatricians recognize the signs and symptoms of ASDs, as many patients with language developmental delays are ultimately diagnosed with ASDs. Pediatricians play an important role in the early recognition of ASDs, because they are usually the first point of contact for children with ASDs. A revision of the diagnostic criteria of ASDs was proposed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) that was released in May 2013. The autism spectrum describes a range of conditions classified as neurodevelopmental disorders in the fifth edition of the DSM. The new diagnostic criteria encompasses previous elements from the diagnosis of autistic disorder, Asperger disorder, childhood disintegrative disorder, and pervasive developmental disorder-not otherwise specified. An additional change to the DSM includes synthesizing the section on social and communication deficits into one domain. In ASD patients, the appropriate behavioral therapies and rehabilitation treatments significantly affect the prognosis. Therefore, this makes early diagnosis and treatment very important. In conclusion, pediatricians need to be able to recognize the signs and symptoms of ASDs and be attentive to them in order to make an early diagnosis and provide treatment.
Asperger Syndrome ; Autistic Disorder ; Child ; Autism Spectrum Disorder* ; Developmental Disabilities ; Diagnosis ; Diagnosis, Differential ; Diagnostic and Statistical Manual of Mental Disorders ; Early Diagnosis ; Genetics ; Humans ; Intellectual Disability ; Language Development ; Prognosis ; Rehabilitation

OBJECTIVES: The objective of this study was to investigate the relationship between restricted, repetitive behaviors and interests (RRBI) and autistic symptoms in Korean high functioning autism spectrum disorder (ASD) children and to examine the structure of RRBI. METHODS: Participants included 147 high functioning ASD subjects and 181 unaffected siblings. ASD subjects were divided into two groups based on the presence of RRBI. The domain scores of the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R), Korean version of Asperger Syndrome Diagnostic Scale and total scores of Korean translated version of Social Responsiveness Scale, Korean version of Social Communication Scale were used for comparison of ASD symptoms between the groups. Eleven items from the RRBI domain of the K-ADI-R were used in principal axis factor analysis (PAF). RESULTS: A statistically lower nonverbal IQ score was observed for ASD with RRBI than for ASD without RRBIs, and more social deficit, communication deficit, and behavioral and emotional problems were observed for ASD with RRBI compared to ASD without RRBI. Using PAF, two distinct factors were identified. 'Resistance to trivial changes in environment', 'Difficulty with minor changes in personal routine & environment', and 'Compulsion/ritual' were included as one factor. CONCLUSION: Analysis of the data suggests that the presence of RRBI in high functioning ASD is associated with a more severe presentation of autistic disorder. In addition, there appears to be heterogeneity within RRBI in autism except insistence on sameness.
Asperger Syndrome ; Autistic Disorder ; Axis, Cervical Vertebra ; Autism Spectrum Disorder* ; Child* ; Factor Analysis, Statistical ; Humans ; Population Characteristics ; Siblings

OBJECTIVE: Thalamic abnormalities have been reported in people with pervasive developmental disorders (PDD) including Asperger's Disorder (ASP). The aim of the present study was to compare the volume and volume fraction of the thalamus and the metabolite concentrations in children and adolescents with ASP using the magnetic resonance imaging and proton magnetic resonance spectroscopy. Additionally, the relationships between thalamic abnormalities and clinical features were examined. METHODS: Volume and volume fractional and metabolic measurements of bilateral thalamus were collected from 15 boys with ASP with a total IQ over 70 (age range 7-18 years, mean age 11.6+/-3.79 years), and 15 healthy controls matching age, sex and IQ. The thalamic volumes, hemisphere volumes and total brain volumes (TBV) were estimated using the stereological methods on magnetic resonance images. Chemical metabolites of thalamus were evaluated by 1H spectroscopy. RESULTS: No differences in thalamic volumes, volume fractions and metabolites were observed between the groups. There were significant correlation between thalamic volume and total brain volume in both groups. The ASP group showed a significant left-minus-right thalamus difference as well as a significantly greater laterality index. In addition, a significant correlation between the laterality index and Autism Behavior Checklist language scores was observed. CONCLUSION: Findings from this investigation point to a significant increase in laterality of the thalamus and a relationship with language problems in individuals with ASP. Our findings suggest that thalamic abnormalities may be related to mild language problems observed in ASP.
Adolescent* ; Asperger Syndrome* ; Autistic Disorder ; Brain ; Checklist ; Child* ; Humans ; Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy ; Protons* ; Spectrum Analysis* ; Thalamus* ; Viperidae

OBJECTIVE: Thalamic abnormalities have been reported in people with pervasive developmental disorders (PDD) including Asperger's Disorder (ASP). The aim of the present study was to compare the volume and volume fraction of the thalamus and the metabolite concentrations in children and adolescents with ASP using the magnetic resonance imaging and proton magnetic resonance spectroscopy. Additionally, the relationships between thalamic abnormalities and clinical features were examined. METHODS: Volume and volume fractional and metabolic measurements of bilateral thalamus were collected from 15 boys with ASP with a total IQ over 70 (age range 7-18 years, mean age 11.6+/-3.79 years), and 15 healthy controls matching age, sex and IQ. The thalamic volumes, hemisphere volumes and total brain volumes (TBV) were estimated using the stereological methods on magnetic resonance images. Chemical metabolites of thalamus were evaluated by 1H spectroscopy. RESULTS: No differences in thalamic volumes, volume fractions and metabolites were observed between the groups. There were significant correlation between thalamic volume and total brain volume in both groups. The ASP group showed a significant left-minus-right thalamus difference as well as a significantly greater laterality index. In addition, a significant correlation between the laterality index and Autism Behavior Checklist language scores was observed. CONCLUSION: Findings from this investigation point to a significant increase in laterality of the thalamus and a relationship with language problems in individuals with ASP. Our findings suggest that thalamic abnormalities may be related to mild language problems observed in ASP.
Adolescent* ; Asperger Syndrome* ; Autistic Disorder ; Brain ; Checklist ; Child* ; Humans ; Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy ; Protons* ; Spectrum Analysis* ; Thalamus* ; Viperidae

OBJECTIVETo investigate and summarize the clinical features and comorbidities of Asperger syndrome (AS) in children and to provide a theoretical basis for improving the understanding and diagnosis of AS.

METHODSInquiry of medical history, physical examination, behavioral observation, psychiatric examination, questionnaire survey, and the Wechsler Intelligence Scale were used to summarize and analyse the clinical data of 95 children with AS, including chief complaint, symptoms, perinatal and familial conditions, family genetic history, and common comorbidities.

RESULTSAS was more common in male children, with hyperactivity, inattention, and social withdrawal as frequent chief complaints. The main clinical manifestations included poor communication skills (95%), restricted interest (82%), repetitive and stereotyped patterns of behavior (77%), semantic comprehension deficit (74%), and indiscipline (68%). Verbal IQ was higher than performance IQ in most patients. The comorbidities of AS included attention deficit hyperactivity disorder (ADHD) (39%), emotional disorder (18%), and schizophrenia (2%); emotional disorder was more common in patients aged 13-16 years, while ADHD was more common in patients aged 7-16 years. Among these patients, 61% had fathers with introverted personality, 43% had mothers with introverted personality, and 19% had a family history of mental illness.

CONCLUSIONSAS has specific clinical manifestations. It is essential to know more about the clinical features and comorbidities of AS, which is helpful for early identification and diagnosis of AS.

Adolescent ; Asperger Syndrome ; complications ; diagnosis ; psychology ; Child ; Child, Preschool ; Comorbidity ; Female ; Humans ; Intelligence ; Male