Syndrome To sprinkle

The syndrome To sprinkle is a disorder of the development located in the high part of the autistic spectrum. It affects the social life of the person, her sensory perceptions, but also its motricity.

As a Disorder invading of the development (TED), the syndrome To sprinkle made its entry in the international Classification of the diseases in 1993 then in the diagnostic manual and statistics of the mental diseases ( DSM-IV ) in 1994.

Its most outstanding characteristic are passions out-standard in their type and their intensity (“special interests”) of the person with the syndrome To sprinkle, relating for example to sciences and data processing. The person can become expert of a restricted field.

The syndrome To sprinkle is often accompanied by features such as: over-sensitiveness with certain noises or food, Dysgraphia, very particular elocution (your of the voice, prosody, tendency to language very formalized even in the children), propensity with the repetitive routines.

Several conceptual representations were recently proposed to give an account of the syndrome To sprinkle. Among them:

an anomaly of the Theory of the spirit: the syndrome To sprinkle would be a difficulty of representing the intentions of others (ATU Frith and Simon Baron-Cohen).
a brain " hypermasculin" : the syndrome To sprinkle would be marked by a strong amplification of the usual features of the male brain (Simon Baron-Cohen).

By convenience of language, a person reached of the syndrome To sprinkle is also designated by the term “To sprinkle” or more familiarly: a “Aspie”.

History

The syndrome was named by Lorna Wing, an English psychiatrist who published a study on 34 cases in 1981, in reference to the Austrian psychiatrist Hans Asperger which had described the particular behavior of four children (ISBN 052138608X).

Since a famous article of Steve Silberman in Wired, The Geek Syndrome , the name of “Syndrome Geek” is also employed in an inappropriate way in reference to the syndrome To sprinkle.

Diagnosis

The syndrome To sprinkle is regarded as being in the high part of the spectrum of the autistic disorders , unlike the autism of Kanner, still called autism " classique". The principal difference between the autism of Kanner and the syndrome To sprinkle is the absence of intellectual delay, which facilitates the therapies.

With the center even of the high part of the autistic spectrum, there does not exist consensus on the criteria which would distinguish the syndrome To sprinkle high level Autisme, nor even on the need for distinguishing autism and syndrome To sprinkle. In a good number of cases, it proves to be difficult to slice between the high level autism and the syndrome To sprinkle (this is for example the case of the lecturer and author of books on the syndrome To sprinkle Stephen Shore). The criteria of distinction between the high level autism and the syndrome To sprinkle could be:

One to sprinkle introduces to a IQ verbal superior to the IQ performance, contrary to a high level autist;
One to sprinkle would suffer less difficulties in the daily life. This assertion is actually incorrect.

The prevalence of the syndrome To sprinkle is according to the most recent estimates of 1 out of 150. For reasons still rather mysterious, this rate tends to increase with the wire of time. Various explanatory assumptions are currently studied (pesticides, influence of the testosterone rate during the pregnancy, presence of mercury traces, vaccinations, etc).

The syndrome assigns more boys than girls, with a ratio from approximately 8 against 1. Simon Baron-Cohen supports that the syndrome To sprinkle would be the demonstration of a " brain hypermasculin" , which would explain the strongest prevalence of the syndrome To sprinkle among boys. Recent studies on the testosterone rate in the blood of the child to be born accredit this thesis partially.

Carol Gray and Tony Attwood recently emitted criteria of diagnosis, not recognized officially, taking account of the recent discoveries.

By areas

With the Quebec

Contrary to the situation which prevails in France, the syndrome To sprinkle is well-known general public in Canada, which makes say to some that there were abusive diagnoses. Laurent Mottron writes in the autism, a different intelligence : “An epidemic of syndrome To sprinkle dependant on the capacity of the diagnosis of TED to generate services, and on its media notoriety, was thus spread in Quebec these last years”. According to him, this rise of the number of diagnoses resulted in revising the file of many people, attacks of the syndrome, profiting from social security benefits.

In France

The syndrome had evil to be recognized, and is not it yet completely. It can be been unaware of by the professionals; moreover, to emit such a diagnosis can sometimes be dangerous with respect to the pars. There did not exist as an entity distinct in the preceding versions from the French Classification of the mental disorders of the child and the teenager (CFTMEA), and was individualized there only in the last version (year 2000).

That is due partly to an approach of the French experts different from that stated by WHO: the French approach calls partially into question the existence of this syndrome, at least as an entity distinct from the autism.

Official definitions

Definition of the CIM-10

The reference is that of the classification of WHO, CIM-10 F84.5 SYNDROME TO SPRINKLE: syndrome of dubious validity Nosologique, characterized by a qualitative deterioration of the reciprocal social interactions, similar to that observed in the autism, associated with a repertory of interests and activities restricted, stereotyped and repetitive. It is different from the autism primarily by the fact that it is not accompanied by a delay or a deficiency of the language or cognitive development. The majority of the subjects presenting this disorder have a normal intelligence, but they are usually very awkward. The disorder is much more frequent among boys than in the girls (approximately 8 boys for 1 girl). It is very probable that at least certain cases of syndrome To sprinkle represent in fact of the attenuated forms of autism; it is not certain however that it is always the case. The anomalies often persist with adolescence and at the adulthood and hardly seem influenced by the environment. At the beginning of the adulthood, the disorder is accompanied sometimes by episodes psychotics.

The diagnosis rests on the presence of qualitative deteriorations of the social interactions and an aspect restricted, repetitive and stereotyped behavior, interests and activities (as in the autism), but without clinically significant delay of the language or the cognitive development. The disorder can be accompanied by difficulties of communication similar to those observed in the autism, but the presence of a significant delay of the language eliminates the diagnosis.

To include: autistic psychopathy; schizoid disorder of childhood.

To exclude: simple Schizophrenia (F20.6); anankastic personality (F60.5); disorder of the attachment of childhood (F94.1 and F94.2); compulsif obsessional Disorder (F42); hoop net schizotypic (F21)

Definition of the DSM-IV

DSM-IV is a very general classification of the psychiatric disorders and related, made by the American Association of psychiatry. One more often uses the DSM-IV for the statistics (a posteriori) that for trackings. It is however the reference most often indicated to define this syndrome, DSM-IV F84.5 Syndrome To sprinkle:

A. qualitative Altération of the social interactions, as at least two testify some to the following elements:

deterioration marked in the use, to control the social interactions, of behaviors nonverbal multiples, such as the ocular contact, facial mimicry, the body postures, the gestures

incapacity to establish relationships to the pars corresponding to the level of the development

the subject spontaneously does not seek to share its pleasures, its interests or its successes with other people (p.ex. it does not seek to show, indicate finger or to bring the objects which interest it)

lack of social or emotional reciprocity

B. restricted, repetitive and stereotyped Character, of the behaviors, the interests and the activities, as at least one testifies some to the following elements:

concern circumscribed in one or more stereotyped and restricted centers of interest, abnormal either in its intensity, or in its orientation

apparently inflexible adhesion with practices or ritual specific and nonfunctional

stereotyped and repetitive driving mannerisms (p.ex. beats or torsions of the hands or fingers, complex movements of all the body)

C. the disturbance involves a clinically significant deterioration of operation social, professional, or in other important fields.

D. There does not exist general delay of the significant language on the clinical level (p.ex. the subject used words isolated towards the 2 years age and sentences with value from communication towards age the 3 years).

E. During childhood, it did not have significant delay there on the clinical level in the cognitive development nor in the development, according to the age, of the capacities of autonomy, the adaptive behavior (except in the field of the social interaction) and of curiosity for the environment.

F. the disorder does not answer the criteria of another invading Disorder of the specific development, nor with those of a Schizophrenia.

The criteria of diagnosis of the DSM-IV caused some technical reserves. In particular, Tony Attwood formulates two criticisms principal of these criteria. Firstly, the made DSM-IV of the autism and the syndrome To sprinkle two incompatible diagnoses (with a hierarchical rule making that in the event of double diagnosis of autism and syndrome To sprinkle, the diagnosis of autism carries it). The DSM-IV distinguishes the autism from the syndrome To sprinkle on the basis of delay of the language, a fragile criterion and which loses any relevance in the teenagers and the adults.

The second reserve of Tony Attwood relates to the point D, which excludes the children having a delay from the language of the diagnosis of the syndrome To sprinkle. In the facts, much of children with the syndrome To sprinkle had a delay of the language. Moreover, the example which the DSM-IV gives corresponds indeed to a child having a delay of the language.

In any case, the criteria of the DSM are regularly updated, and the next edition will undoubtedly take into account these technical reserves.

Definition of the CFTMEA

The French reference, 1.03 Syndrome To sprinkle:

Presence of an autistic syndrome without delay of the cognitive development and especially of the development of the language. The autonomy of this syndrome compared to the infantile autism, and in particular to the forms of “high level” autism known as is discussed. It is in particular in such cases that have described particular capacities in certain fields (memory, calculation, etc), isolated from the whole of psychic operation.

Correspondence CIM 10: F 84.5 - syndrome To sprinkle

References

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