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What is high functioning


Symptoms, Tests, Diagnosis, and Treatment

Written by WebMD Editorial Contributors

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  • How You Get a Diagnosis
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When you meet someone who has Asperger's syndrome, you might notice two things right off. They're just as smart as other folks, but they have more trouble with social skills. They also tend to have an obsessive focus on one topic or perform the same behaviors again and again.

Doctors used to think of Asperger's as a separate condition. But in 2013, the newest edition of the standard book that mental health experts use, called The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), changed how it's classified.

Today, Asperger's syndrome is technically no longer a diagnosis on its own. It is now part of a broader category called autism spectrum disorder (ASD). This group of related disorders shares some symptoms. Even so, lots of people still use the term Asperger's.

The condition is what doctors call a "high-functioning" type of ASD. This means the symptoms are less severe than other kinds of autism spectrum disorders.

The DSM-5 also includes a new diagnosis, called social pragmatic communication disorder, which has some symptoms that overlap with Asperger's. Doctors use it to describe people who have trouble talking and writing, but have normal intelligence.

Symptoms

They start early in life. If you're a mom or dad of a kid who has it, you may notice that they can't make eye contact. You may also find that your child seems awkward in social situations and doesn't know what to say or how to respond when someone talks to them.

They may miss social cues that are obvious to other folks, like body language or the expressions on people's faces. For instance, they may not realize that when somebody crosses their arms and scowls, they're angry.

Another sign is that your child may show few emotions. They may not smile when they're happy or laugh at a joke. Or they may speak in a flat, robotic kind of way.

If your child has the condition, they may talk about themselves most of the time and zero in with a lot of intensity on a single subject, like rocks or football stats. And they might repeat themselves a lot, especially on a topic that they're interested in. They might also do the same movements over and over.

They also may dislike change. For instance, they may eat the same food for breakfast every day or have trouble moving from one class to another during the school day.

How You Get a Diagnosis

If you notice signs in your child, see your pediatrician. They can refer you to a mental health expert who specializes in ASDs, like one of these:

Psychologist. They diagnose and treat problems with emotions and behavior.

Pediatric neurologist. They treat conditions of the brain.

Developmental pediatrician. They specialize in speech and language issues and other developmental problems.

Psychiatrist. They have expertise in mental health conditions and can prescribe medicine to treat them.

The condition is often treated with a team approach. That means you might see more than one doctor for your child's care.

The doctor will ask questions about your child's behavior, including:

  • What symptoms do they have, and when did you first notice them?
  • When did your child first learn to speak, and how do they communicate?
  • Are they focused on any subjects or activities?
  • Do they have friends, and how do they interact with others?

Then they'll observe your child in different situations to see firsthand how they communicate and behave.

Treatment

Every child is different, so there isn't a one-size-fits-all approach. Your doctor might need to try a few therapies to find one that works.

Treatments can include:

Social skills training. In groups or one-on-one sessions, therapists teach your child how to interact with others and express themselves in more appropriate ways. Social skills are often best learned by modeling after typical behavior.

Speech-language therapy. This helps improve your kid's communication skills. For example, they'll learn how to use a normal up-and-down pattern when they speak rather than a flat tone. They'll also get lessons on how to keep up a two-way conversation and understand social cues like hand gestures and eye contact.

Cognitive behavioral therapy (CBT). It helps your child change their way of thinking, so they can better control their emotions and repetitive behaviors. They'll be able to get a handle on things like outbursts, meltdowns, and obsessions.

Parent education and training. You'll learn many of the same techniques your child is taught so you can work on social skills with them at home. Some families also see a counselor to help them deal with the challenges of living with someone with Asperger's.

Applied behavior analysis. It's a technique that encourages positive social and communication skills in your child -- and discourages behavior you'd rather not see. The therapist will use praise or other "positive reinforcement" to get results.

Medicine. There aren't any drugs approved by the FDA that specifically treat Asperger's or autism spectrum disorders. Some medications, though, can help with related symptoms like depression and anxiety. Your doctor may prescribe some of these:

  • Selective serotonin reuptake inhibitors (SSRIs)
  • Antipsychotic drugs
  • Stimulant medicines

With the right treatment, your child can learn to control some of the social and communication challenges they face. They can do well in school and go on to succeed in life.

High Functioning Autism and Asperger's: Technical Smarts

Experts explain why some people with autism are good fits for technically demanding jobs.

Written by Martin Downs, MPH

  • Diagnosing Autism
  • Asperger's Syndrome
  • Brain Wiring
  • Spike in Autism Cases
  • Jobs and Autism

The Internet can be a social paradise for high-functioning autistic people and people with Asperger's syndrome. Here, the nonverbal niceties of social interaction that they find so perplexing don't apply. People who might strike others as gauche in person often fit in perfectly well on Internet message boards.

A Web link to an autism screening test posted recently on Digg.com, a tech news site, generated hundreds of comments from users. Many self-described computer geeks took the online test, for which a score of 16 is considered average, and a score of 32 or higher suggests autism.

"Twenty. Not autistic, just plain geek," one user commented.

"Thirty-eight, definitely 38. Time for Judge Wapner," wrote another, a reference to a TV show watched obsessively by an autistic character in the movie The Rain Man.

Diagnosing Autism

Of course, you can't diagnose anything by taking a quiz on the Internet. "It is only a screening instrument. It is not a substitute for a full diagnostic assessment," says the test's author, Simon Baron-Cohen, PhD, a psychology professor and director of the Autism Research Centre at the University of Cambridge, England.

"In addition, the [test] tells you if you have lots of traits but it does not tell you if these traits are causing problems. A diagnosis is only given if the person is suffering in some way," he tells WebMD.

But if nothing else, the lively discussion thread on Digg.com, and similar activity at other online techie hangouts like Slashdot, illustrates that many of them are inclined to identify with autism.

"It's been said that people with autism invented the Internet," Eric Hollander, MD, director of the Seaver and New York Autism Center of Excellence at the Mount Sinai School of Medicine, tells WebMD. "By email you don't have to read people's nonverbal social cues. You don't have to look at body language or facial expressions. It's just the verbal content of communication."

Not only does the Internet downplay autistic social deficits, but the language of computers also allows some people with autism to give full expression to their exceptional abilities.

Asperger's Syndrome

Autism is a developmental brain disorder that includes many different symptoms, with a broad range of severity. People with the disorder are said to fall somewhere along the "autism spectrum." Some are severely disabled, but others may only exhibit mild symptoms. IQ levels can also vary significantly.

Those with normal and above-average intelligence are said to have high-functioning autism. Asperger's syndrome is closely related. Identified for the first time in 1944 by Viennese psychologist Hans Asperger, it wasn't officially classified as a unique disorder until 1994. It shares all the features of high-functioning autism except that people with Asperger's don't have early delays in developing language.

Baron-Cohen studies the relationship between technical smarts and autistic tendencies, and he has developed a new theory about it.

Brain Wiring

The three hallmarks of autism are difficulty communicating, problems with social development, and obsessive, narrow interests. These obsessions are often extremely technical. Baron-Cohen explains it in terms of "empathizing" vs. "systemizing." People on the autism spectrum are limited in their ability to comprehend, or care about, the emotions and motives of other people. But they are intensely interested in how certain things work. Their brains, he says, are wired to "systemize," or to pick out patterns in information and to discern the logical rules that govern systems.

That means people with Asperger's and high-functioning autism often have great talents for creating and analyzing mechanical systems, such as engines, or abstract systems, like mathematics and computer programs. Baron-Cohen recently surveyed undergrads at Cambridge and found significantly more math majors diagnosed with autism compared with students majoring in other disciplines, such as medicine, law, and social science. These are all brainy subjects, but mathematics is best suited to a systemizing mind.

Baron-Cohen's research also found that Cambridge students pursuing math, physics, and engineering were more likely to have autistic family members compared with students of literature.

Spike in Autism Cases

Autism used to be considered a rare disorder, but current estimates place the number of children with autism spectrum disorders somewhere between one in 500 and one in 166. There has been a spike in autism rates over the past two decades, but the cause is unknown and very controversial. Baron-Cohen is now investigating whether what he terms "assortative mating" may play some role in it.

He proposes that people who may carry genes for autism can have strong systemizing traits, which leads them to pursue careers in science and technology, where they meet like-minded mates and have children who turn out to be autistic. To test this idea, he is studying places like California. The California state health department reported in 2003 that autism cases doubled between 1998 and 2002, which coincides with the Internet technology boom.

Jobs and Autism

No one has yet taken a head count of people with high-functioning autism or Asperger's among the ranks of engineers, physicists, and computer programmers. Popular belief holds that places like NASA and Silicon Valley are havens for them.

To Nancy Minshew, MD, professor of psychiatry and neurology at the University of Pittsburgh School of Medicine, that's beside the point. Far too many, she says, are not employed at all. Only about one-third have jobs, and many of them are underemployed.

One of the best-known Asperger's success stories is that of Temple Grandin, who carved out a unique career designing systems for managing livestock and who has written books about her experience. "If she had to go through human resources, she'd be a failure," Minshew tells WebMD. "For some reason, we think that they have to pass socially-based interviews in order to do a technological job. Most of the people with Asperger's and autism are going to fail and never get a job."

Minshew says there are countless jobs -- not just in technology -- that people with autism could do better than anyone else. "A man in construction said, 'I need a tile layer that will lay tile straight,' and I said, 'I'll give you somebody that'll give you a new definition of straight. '"

Evaluation of the functional state and reserve capabilities of students in different periods of study at the university

The problem of preserving and strengthening the health of students is increasingly attracting the attention of researchers, which is associated with the deterioration of their condition, the identification of new risk factors for the development of diseases, a significant decrease in reserve capabilities [1- 3].

The intensification of the educational process, new forms and methods of teaching, changing the regime of work and rest, sleep and nutrition, the need to adapt to the conditions of training place increased demands on the state of health and compensatory-adaptive capabilities of the students' organism. An analysis of the functional state of students showed that any acceleration of the learning process affects their psychophysiological state, and excessive intellectual loads are accompanied by the mobilization of the cardiovascular system with an increase in asthenia, emotional response and tension of adaptive mechanisms [4, 5]. nine0003

According to the literature [6], high pace of life, constant information overload, lack of time have a negative impact on the health of students and often cause various deviations in the normal activity of individual or multiple body systems. In prolonged and continuous stressful situations, there may be a violation of the mechanisms of regulation of autonomic homeostasis and, as a result, the occurrence of various kinds of pathological changes on the part of functional systems [7, 8]. nine0003

Thus, the process of studying at a university can be considered as one of the factors that negatively affect the health of young people, and timely diagnosis of the functional state will allow taking effective measures to preserve and improve the health of students.

The purpose of this work is to assess the functional state and adaptive capabilities of the body of students in different periods of study at the university.

Material and methods

nine0002 The students of the Cherepovets State University, who are engaged in the main physical education group, were examined. The functional state of the cardiorespiratory system was assessed in 85 first-year students (35 boys and 50 girls) and 90 fourth-year students (40 boys and 50 girls). A study and assessment of the vegetative status was carried out in 47 students of the 1st year (26 boys and 21 girls) and 48 students of the 4th year (25 boys and 23 girls). The average age (M±m) of the examined 1st year students was: boys - 18.04±0.13 years, girls - 18.16±0.14 years. Boys and girls of the 4th year had an average age of 20.73±0.12 and 20.27±0.11, respectively. nine0003

Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were recorded by the oscillometric method using a UA-703 semi-automatic blood pressure monitor according to the Korotkov method. To study the parameters of external respiration, a Spiro USB spirometer was used. The study of respiratory function included two stages. At the first stage, the subject took a deep breath and exhaled air into the apparatus. At the second stage, the subject took a deep breath and a sharp exhalation into the mouthpiece of the spirometer, and then blew the air. The following respiratory parameters were determined: vital capacity (VC), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC). nine0003

Assessment of the functional reserves of the cardiovascular and respiratory systems was carried out according to the Skibinskaya index (IS). To calculate this indicator, the time of holding the breath against the background of a deep breath was determined. IP calculation was carried out according to the formula:

IS=0.01 VC/HR,

where VC - vital capacity, ml; ZD - breath holding time on inspiration, s; HR - heart rate, beats / min.

The following criteria for assessing the adaptive reserves of the cardiorespiratory system were used: more than 60 - excellent; 30-60 - good; 10-29- satisfactory; 5-9 - unsatisfactory; less than 5 - very bad.

The study of the vegetative status was carried out on the hardware-software complex Varicard VK-1. This complex provides automatic calculation of statistical parameters of cardiointervalogram. The examination was carried out according to the method generally accepted in physiological practice. In the supine position, the main components of heart rate variability were assessed. The values ​​of mode (Mo), mode amplitude (AMo), variation range (ΔX), and stress index (SI) were used as informative indicators. nine0003

The functional state of the body was determined by the indicator of the activity of regulatory systems (PARS): 1-3 points - physiological norm; 4-5 points - prenosological state; 6-7 points - premorbid state; 8-10 points - failure of adaptation.

Analysis of group values ​​was evaluated by Student's t-test for paired observations at 95% significance level and Fisher's test (φ). Differences between samples were considered significant at p<0.05.

Results and discussion

The assessment of the average group values ​​of cardiorespiratory parameters indicates the ambiguity of the parameters characterizing the functional state of the vital systems of the body of boys and girls (Table 1).

Comparative analysis of the obtained results showed that the heart rate in boys and girls of I and IV courses of study is practically stable at the beginning and at the end of university studies. However, in our opinion, for boys in the 1st and 4th years, this indicator is definitely higher than the permissible values: 87.00±4.01 and 86.90±2.99 beats/min, respectively, which probably reflects the impact on the body in males of numerous environmental factors.

At the same time, girls show a significant increase in DBP during the learning process. So, in girls of the 1st year, DBP is 62.17±1.67 mm Hg, and in girls of the 4th year it is 67.45±1.33 mm Hg. (p<0.05). An increase in DBP indicates the degree of capillary patency, the state of vascular tone in the subjects by the end of their studies at the university and is an unfavorable prognostic sign. nine0003

Considering the indicators of external respiration among students, one can note their noticeable decrease by the end of their studies at the university, both among boys and girls. If in the 1st course in young men the VC is 4.64±0.14 l, then by the 4th course it is 4.14±0.14 l (p<0.05). In girls of the first year, VC is 3.46±0.10 l, in girls of the fourth year - 2.88±0.06 l (p<0.001). In the same way, FEV1 and FVC change. These respiratory parameters are indicative of decreased lung function and expiratory flow restriction.

nine0002 The evaluation of the reserve capacity of the cardiovascular and respiratory systems according to IS showed the following results (Table 2).

A good state of the cardiorespiratory system was found in 28.6% of the first-year boys and 69.2% of the fourth-year boys (p≤0.01), a satisfactory condition - in 71.4% of the first-year boys and 27.0% of the fourth-year boys ( p≤0.01). Most girls of the 1st year (79.0%) and the 4th year (71.0%) have a satisfactory condition of the cardiovascular and respiratory systems. nine0003

So, the results of the study show that in the fourth year, most young men have good functional reserves of the cardiovascular and respiratory systems. The increase in the reserve capacity of young men in the process of learning is probably associated with the expansion of the range of functional manifestations. In most girls during this period, the reserve function is assessed as satisfactory.

The study of the vegetative status of students in terms of heart rate revealed changes in regulatory neurohumoral influences in the body of the subjects (Table 3). The results of the experiment showed that in males there are more significant changes in the rhythmic activity of the heart than in females.

As can be seen from tab. 3 , in young men of I and IV courses, Mo is 0.96±0.02 and 0.73±0.03 s, respectively (p<0.001), i.e. there is a tendency to reduce the activity of the humoral channel for regulating the heart rhythm. At the same time, a decrease in the activity of sympathetic regulation of the heart rhythm was revealed, as evidenced by a significant decrease in AMO in young men (p<0.01). The activity of the vagal regulation of the heart rhythm in this group of individuals is practically unchanged, but SI increases significantly by the end of training. So, if in the first course the IN is 56.25±7.16 arb. units, then by the IV course IN is registered at the level of 165.17±29.34 conv. units (p<0.001). As is known, SI reflects the degree of tension (centralization) of the regulatory mechanisms of the heart rhythm, and one can assume an increase in the role of central (primarily cortical) influences on cardiac activity in the educational process, although this indicator in the subjects is within acceptable limits (the norm is from 50 to 200 arb. units).

Analyzing the indicators of heart rate in girls, one should pay attention to the high values ​​of IN.

In the 1st year of study, the value of IN is 160.20±60.16 arb. units, and by the end of training (IV course) this figure increases to 272.10 ± 72.28 arb. units and exceeds the normal parameter values. nine0003

The data obtained in the study, to a certain extent, are consistent with the results of Yu.D. Karpenko [9], who found that the negative dynamics of indicators is associated with a worsening of reactions to the load of the cardiorespiratory system due to the slow development of autonomic physiological systems.

In this regard, it is extremely important to assess the functional state of students according to PARS in different periods of training (Table 4).

According to our data, about half of the first-year boys (45%) are in a state of physiological norm, and 1 / 4 (25%) - in a premorbid state. In the IV course, only 25% of young men have a physiological state as normal, and half of the males (50%) are in a premorbid state (p≤0.05). In 36% of girls of the first course, the state of the physiological norm is determined, and in 40% - the prenosological state. By the 4th year, only 10% of the examined girls are in a state of physiological norm (p≤0.01). The premorbid state is fixed in 20% of first-year students and 40% of fourth-year students (p≤0.05). In 20% of girls of the fourth year, a breakdown in adaptation and a sharp decrease in the functional reserves of the body are detected. nine0003

Noteworthy is a fairly large number of males and females who are in a premorbid state by the end of training. Apparently, in boys and girls by the fourth year of study, due to increased training loads, stressful situations, lifestyle disturbances, adverse environmental factors of a large industrial city, a state of overstrain of homeostasis regulation mechanisms is formed and, as a result, a decrease in the functional capabilities of the body. The data obtained to a certain extent agree with the results of other authors. nine0003

So, according to the results of the study [10], when assessing the functional state of students, the physiological norm was determined in 30.2%, the prenosological state - in 42.8%, the premorbid state - in 27% of students. It is believed that a pronounced overstrain of regulatory mechanisms and an early manifestation of disadaptation are expressed in the deviation of the basic indicators of the assessment of the functional state. Violation of lifestyle in conditions of physical inactivity and academic stress is an unfavorable factor affecting the functional state of the body of students [11]. nine0003

V.N. Bortanovsky and A.V. Zolotareva [12], on the basis of an integral prenosological assessment of health, identified various types of adaptation and functional capabilities of the body. When assessing the functional state of young students, it was found that the state of the physiological norm was recorded in 20%, borderline with the norm - in 26%, maladaptation - in 31% and pre-pathology - in 23% of persons.

Thus, in the process of studying at a higher educational institution, a certain functional state of the body is formed, which ensures the adaptive activity of students. If the functional reserves of the body are high, then it is possible to adapt to changing learning conditions. If the functional state of the body deteriorates, the reserve capacity is low and the functional stress is high, then the body works with overload, depleting its resource and causing changes in physical health [13]. nine0003

Terminals

1. Studying at a university leads to a change in the functional state of students, characterized by a complex of physiological properties of the body and adaptive reserves that determine learning activities for a long time.

2. In young men, the process of studying at a higher educational institution proceeds with a slightly increased heart rate, there is a decrease in the function of external respiration, a decrease in the activity of the humoral regulation channel and sympathetic influences on the heart, and an increase in the degree of tension of regulatory mechanisms. The distribution of subjects according to IS showed that the majority of fourth-year students have good reserve capacities of blood circulation and respiration, which can be realized in the premorbid state while maintaining homeostasis of the main vital systems of the body. nine0003

3. In the process of training, girls show an increase in DBP, but within acceptable values, a decrease in respiratory function, an increase in the degree of centralization of the regulatory mechanisms of the heart rhythm with satisfactory reserves of the cardiorespiratory system.

By the 4th year, the majority of girls maintain life activity due to higher than normal tension of regulatory systems and functions.

Functional state of highly qualified basketball players in the competitive period

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Functional state of highly qualified basketball players in the competitive period

Cherkashina

1
Candidate of Pedagogical Sciences, Associate Professor V.N. Loginov 2
S.R. Molukova 3
1 North-Eastern Federal University. M.K. Ammosova, Yakutsk
2 Churapcha State Institute of Physical Culture and Sports, Churapcha
3 Arctic State Agrotechnological University, Yakutsk

The purpose of the study is to determine the functional state of professional basketball players based on the analysis of heart rate variability in the competitive period. nine0123 Methodology and organization of the study. 12 professional basketball players playing in CBA (China Basketball Association) were examined. The age of the athletes was 27.67±3.45 years. Monitoring of the functional state was carried out using the diagnostic automated complex "Cardio+". Recorded indicators of heart rate variability at rest. The complex indicator of the functional state was determined by the following complex indicators: heart rate regulation, myocardial state, psycho-emotional state, as well as data on the presence of heart rhythm disturbances. The survey was conducted at the base of the Xinjiang basketball club in Urumqi, China. nine0123 Research results and conclusions. It was determined that 6 out of 12 professional players had a high level of functional state. The complex indicator of heart rate regulation, which characterizes the predominance of the type of vegetative regulation, as well as signaling the presence of fatigue, under-recovery of athletes, in the vast majority of the surveyed basketball players corresponded to a level above the average. In 8 people, the predominance of the sympathotonic type of heart rate regulation was revealed, in 4 professional basketball players - the vagotonic type. All athletes had bradycardia, the average parameter HR=42±6.65 beats min-1, as well as low values ​​SI=21.08±10.09o.u., which indicates the economization of the detail of the cardiovascular system of basketball players. Also, eight people were diagnosed with a state of pronounced tension in the regulatory systems associated with the activation of the sympathetic-adrenal systems and the pituitary-adrenal system. Two players showed moderate tension, which is typical for competitive activity, which is a powerful stress factor. And only two have the optimal tension of regulatory systems.

Keywords: basketball, re-adaptation, physical activity, cardiovascular system, competitive period.

Literature

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