Ren Liang (pseudonym) is a boy in his second year of school. He seeks medical attention because he “does not fit in, is isolated by his classmates, is depressed all day, and does not go to school”. In most cases, this phenomenon would be treated as “depression or anxiety”. However, when reviewing his entire upbringing, it is clear that Ren Liang had a lot of “unusual” features: he was very smart in mathematics since childhood, and at the age of 3, he was skilled in adding and subtracting within 10,000, and in elementary school he was known as a “prodigy” for his excellent math scores. He usually did not have any friends, sometimes was stubborn, only ate a few kinds of food that he liked since he was young, and often could not follow the “rules of the game” in sports activities, which his family and teachers thought was due to his personality and that he would get better when he grew up. When he entered junior high school, his behavior and speech became more and more “strange”, often taking a joke seriously, standing up and “arguing” with the teacher for half a day if the teacher accidentally said a word wrong, sometimes suddenly shouting in study hall to attract others’ attention. He was so eager to have friends but did not know how to make friends that his classmates and teachers commented that he had a low EQ, did not understand human affairs, did not fit in with others, and was like an alien, so he was isolated by his classmates and was depressed all day long, and finally did not want to go to school. This bright child was finally diagnosed by the doctor as “Asperger’s syndrome”. Since these patients have normal language and IQ, they are not as easily noticed and recognized as autism. It is often thought of as a personality disorder in elementary school, and most are not identified by experienced professionals until after middle school. With the advancement of psychiatric clinical practice in recent years, Asperger’s syndrome has attracted more and more attention from doctors and society. What kind of disorder is it? Asperger’s syndrome belongs to the same autism spectrum disorder or pervasive developmental disorder as autism, but differs from autism in that there is no significant language or intellectual impairment in this disorder. It was first described by the Viennese physician Hans Asperger in 1944. Asperger’s was first described in 1944. As with autism, the cause and pathogenesis of the disorder are still unknown. Most textbooks would describe Asperger’s syndrome as a pervasive developmental brain disorder characterized by normal vocabulary and cognitive functioning, difficulties with social interaction, and restricted, stereotyped patterns of interest and activity, often accompanied by significant motor clumsiness. However, this boxed description is far less profound than our understanding and appreciation in clinical practice: 1. These children have a late development of social maturity and social reasoning and analysis, they lack interaction skills, do not understand non-verbal expressions such as facial expressions and body movements, have difficulty reading information from the eyes of others, and adopt a stereotyped, rigid, and programmed approach to interaction, making it difficult to form and Therefore, it is difficult to form and maintain good interpersonal relationships, cannot develop friendship, cannot respond flexibly to different situations, is often isolated by peers, and is even often molested and bullied by other children. 2. Although children with Asperger’s syndrome have normal language development and are fluent in expression, they have poor ability to use language to communicate, poor ability to read each other’s words in the process of conversation, do not pay attention to each other’s reaction, do not care whether the other party is interested in the content of the conversation, and do not care about other people’s feelings. During the conversation, the patient uses more written language and bites words, giving the impression of being old-fashioned, rigid and exaggerated. For the other party’s conversation, patients can only understand short, clear and concise statements or literal meanings, and have difficulty in comprehending humorous, metaphorical, and double-meaning statements. Because of their limited comprehension of language, they have more problems as they move into higher grades when language becomes more complex. Because of their lack of conversational skills, they tend to change the subject to topics that interest them, such as their special hobbies, and do not allow others to interrupt or change the subject, making the conversation self-centered and thus difficult to interact well with others. 3. Children with Asperger’s syndrome are often stubborn about certain things or routines around them, they insist on doing something in the same way, do not allow any change, and keep repeating this. They are often very immature in negotiating and compromising and do not know when to give in or apologize. If a school rule is found to be unreasonable, they will not only not accept it, but perhaps will fight it as if they were defending an ideal. This, of course, can lead to many conflicts with teachers and school authorities. Children with Asperger’s syndrome have a harder time fitting in with their peers, which is further complicated if they have a high IQ – those with a high IQ may become arrogant and self-centered, and it can be very difficult to get them to admit to making mistakes. Such children may be sensitive to any suggestion of criticism, yet often go on to criticize others, including teachers, parents, and people in government agencies. Schools or parents may send such a child for evaluation of behavioral and attitudinal problems as a result. 4. Children with Asperger’s syndrome are as distinctive in the way they move as they are in the way they think. At least 60% of children with Asperger’s syndrome are clumsy, however, some studies using specialized assessment tests point out that almost all children with Asperger’s syndrome exhibit specific motor deficits. Children with Asperger’s syndrome walk or run with immature coordination, while adults with Asperger’s syndrome often have strange or even unique gait patterns that lack fluency and efficacy. Teachers also notice fine motor problems, such as the ability to write and use scissors, and are often unable to keep up with everyone in physical education class. 5. Some young children with Asperger’s syndrome enter school with better learning abilities than children of the same age. There are more children with Asperger’s syndrome whose cognitive abilities fall at both extremes. Children with Asperger’s syndrome often have a unique learning style, they are good at understanding logic and natural areas, pay attention to details, memorize and organize factual information in a systematic way, and often show an extraordinary obsession with things they like, so they can easily become “experts” in the field, such as the one that spread online some time ago that only A typical example is a 7-year-old boy who only watches news broadcasts and talks about U.S.-Russian relations. However, these children are easily distracted, especially in the classroom, and when they do solve problems, they are often fixated on a particular idea and fear failure. These children are clearly unable to follow directions or learn from mistakes. Report cards for the school year will show that their academic performance is very uneven, with some areas of performance being particularly strong and others requiring remediation. 6. Children with Asperger’s syndrome are typically three years behind their peers in terms of emotional maturity. They have a very limited vocabulary for describing emotions and lack the subtlety and variety of emotional expression, and are unable to effectively identify and understand their own emotions and those of others. Some children can fall into mental depression because they are aware of the difficulties they have in integrating with society. That is why about one-third of children with Asperger’s syndrome show clinical depressive symptoms. Why is it easy to ignore at the elementary school level and only be detected after middle school? At the elementary school level, this child has only one teacher and a few teachers with his class for the whole year, and both teachers and students have gotten to know each other, can understand each other’s cues, and work well together. The teacher provides more academic tutoring, adjustment, and is more tolerant of the child and can allow for social and emotional immaturity. Life is simpler then, and children are more innocent. This child does not yet feel the gap between him or herself and others so obviously, and does not yet seem so out of place in the classroom or on the playground. And in elementary school, if they do well in school or excel in a certain area, they will easily earn the respect of everyone. As a child enters the teenage years, learning and social activities also become more complex and he has to be more independent and self-reliant. In social play in elementary school, there will be more action than words, friendships are usually short-lived, and the rules of the game are simple and clear; but in adolescence, friendship is suggested in more complex relationships than just practical needs, and they look for friends to find a soulmate, not just a ballplayer. Adolescence is the age of a lifetime when self-esteem is at its highest, when they care more about what others say and desire to be respected. And the reasons for gaining respect go far beyond academics or simply excelling in a particular area. That’s why children at this stage are more likely to show “symptoms” of being different. Response and prognosis of Asperger’s syndrome Asperger’s syndrome is often overlooked, so it is recommended that psychiatrists and related professionals develop the habit of scrutinizing medical history from an early age and establish the concept of growth and development in order to identify and correctly diagnose Asperger’s syndrome at an early stage. The overall goal of treatment for Asperger’s syndrome is to manage the patient’s adverse symptoms, educate and train him/her to acquire age-appropriate social, communication and vocational skills to compensate for skills that were not naturally acquired during the development of the Asperger’s patient; and to develop interventions based on the characteristics of each individual through a multifaceted assessment of the patient. The ideal treatment focuses on improving the core symptoms of Asperger’s syndrome, including improving communication skills or stereotypical behavior patterns. The earlier the treatment, the better the overall prognosis. At present, the treatment of Asperger’s syndrome worldwide is mainly based on education and training, in which the following 3 principles should be reflected and implemented: understanding and tolerance of the child’s behavior; correction of abnormal behavior; and discovery, development and transformation of special abilities. No medication can directly treat the core symptoms of Asperger’s syndrome. Medications can be used as adjunctive treatment, mainly for some behavioral problems and emotional disorders. Compared with autism, Asperger’s syndrome has a better prognosis. With age, symptoms can be improved to varying degrees with ideal family and school cooperation and appropriate early educational treatment, but many patients still have some difficulties in communication and interaction. Most of the Asperger’s syndrome adults can get married, have children, have their own careers, and a small percentage of them can also make achievements in their own specialties. Individuals even do extremely well. The important thing is to face Asperger’s syndrome with a good attitude. The famous Taiwanese cartoonist Chu Teh-Yong, when he was diagnosed with Asperger’s Syndrome at the age of 53, was relieved because he felt that many of the mysteries of his life had been solved. For the first half of his life, the disease made him a man living in a glass ball, watching in silence as time and people rushed by. Painting became the outlet for all his pent-up frustrations, and he did not let go of them for a full 30 years. As Liana wrote in his “Asperger’s Syndrome Declaration of Confidence”: “I am not an inferior human being, I am just different. I will not sacrifice my dignity to be accepted by my peers. I am a fun, good person. I will be proud of myself. I can live in peace with this community. I will ask for help if I need it. I am a person who deserves respect and acceptance from others. I will find a career that suits my interests and abilities. I will be patient with those who need a certain amount of time to understand me. I will never give up on myself. I will accept the person I am, the person I am.