Asperger Syndrome

Asperger Syndrome is commonly thought of as a form of high-functioning autism. In very

broad terms, individuals with Asperger's have normal or above average intellectual capacity,
and atypical or poorly developed social skills, often with emotional/social development or
integration happening later than usual as a result.

Characteristics

The most common and important characteristics of Asperger syndrome can be divided into
several broad categories: social impairments, narrow but intense interests, and speech and
language peculiarities. Other features are commonly associated with this syndrome but not
always held to be necessary for diagnosis.

Social impairments Difficulties with social behavior are nearly universal and are
perhaps the most important criteria that define the condition. People with Asperger
syndrome lack the natural ability to see the subtexts of social interaction (sometimes
resulting in well-meaning remarks that may offend and so on, finding it hard to know what
is "acceptable") and also tend to lack the ability to broadcast their own emotional state.

Non-autistics are able to gather a host of information about other people's cognitive and
emotional states based on clues gleaned from the environment and the other person's facial
expression and body language, but people with Asperger syndrome have an impairment in
this ability, sometimes called mind-blindness. To be mind-blind is to find it difficult or even
impossible to figure out things a person implies but does not say directly. This is not
because they cannot imagine the answer but because they cannot choose between the
possibilities.

Most people with Asperger's have difficulty expressing their own emotional state via body
language, facial expression, and nuances as most people do. Some such people have
emotional responses as strong as, or perhaps stronger than, those of most people, although
what generates an emotional response might not always be the same; the difficulty is in
expressing these feelings (although it sometimes comes across as lacking them). Other
people with Asperger’s do truly have reduced levels of emotions.

Many people with Asperger syndrome have difficulty with eye contact: some make very little
eye contact because they find it overwhelming, whereas others have unmodulated, staring
eye contact that can cause discomfort to other people. Similarly, the use of gestures may
be almost nonexistent or may seem exaggerated and differ from what would normally be
considered appropriate for a situation.

Some people with Asperger syndrome are nearly normal in their ability to read and use
facial expressions and other subtle forms of communication. This ability does not come
naturally to most people with Asperger syndrome; such people learn social skills
intellectually (thus delaying social development).
Much of the social difficulties in Asperger Syndrome are characterized as "mutual
misunderstanding", in that neither the "Aspie" nor the neuro-typical understands each
other. Some autistics assert that they have a much easier time reading body language of
other autistic people, and that neurotypicals have difficulties interpreting autistic body
language. Comparing the nonverbal communication problems that often occur between
people from different cultures is a common defense given for this theory.

Narrow, intense interests Asperger syndrome can involve an intense and obsessive
level of focus on things of interest. Particularly common interests are means of transport
(such as trains), computers, math (particularly specific aspects, such as pi), astronomy,
geography, and dinosaurs. (Note that all of these items are normal interests in ordinary
children; the difference with Asperger children is the unusual intensity of their interest.)

Sometimes these interests are lifelong; in other cases, they change at unpredictable
intervals. In either case, there are normally one or two at any given time. In pursuit of
these interests, the person with Asperger's often manifests extremely sophisticated reason,
an almost obsessive focus, and great memory for apparently trivial facts.

Children and adolescents with Asperger syndrome often have little patience for things
outside these areas of interest. During the school years, many are perceived as highly
intelligent underachievers, clearly capable of outperforming their peers in their field of
interest yet persistently unmotivated to do regular homework assignments (sometimes even
in their areas of interest). Others may be hyper motivated to outperform peers in school;
this adds to the difficulties of diagnosing the syndrome. The combination of social problems
and intense interests can lead to unusual behavior, such as greeting a stranger by
launching into a lengthy monologue about a special interest rather than introducing oneself
in the socially-accepted way. However, in many cases adults can outgrow this impatience
and lack of motivation and develop more tolerance.

Speech and language peculiarities People with Asperger syndrome often are
noted for having a highly pedantic way of speaking, i.e., using language far more formal
and structured than the situation would call for.

Literal interpretation is another common but not universal hallmark of this condition.
Attwood gives the example of a girl with Asperger syndrome who answered the telephone
one day and was asked "Is Paul there?” Although the Paul in question was in the house, he
was not in the room with her, so after looking around to ascertain this, she simply said "no"
and hung up. The person on the other end had to call back and explain to her that he
meant for her to find him and get him to pick up the telephone.

Many people with Asperger syndrome also make idiosyncratic use of words, including new
coinages and unusual juxtapositions. This can develop into a rare gift for humor (especially
puns, wordplay, doggerel, satire) or writing. Another potential source of humor is the
eventual realization that their literal interpretations can be used to amuse others. Some are
so proficient with written language as to qualify as hyperlexic.
Other characteristics Children with Asperger's may evidence a delay in the
development of fine motor skills. In some cases, people with AS may have an odd way of
walking, or display compulsive finger, hand, or arm movements.

In general, orderly things appeal to people with Asperger's. Some researchers mention the
imposition of rigid routines (on self or others) as a criterion for diagnosing this condition. It
appears that changes to their routines cause inordinate levels of anxiety for some people
with this condition.

Some people with Asperger's are extremely sensitive to touch, smells, sounds, tastes, and
sights. They may prefer soft clothing, familiar scents, or certain foods. Some may even be
pathologically sensitive to loud noises or strong smells or dislike being touched. Sensory
overload may exacerbate problems faced by such children at school, where levels of noise
in the classroom can become intolerable for them. Some are also unable to block out
certain repetitive stimuli, such as the constant ticking of a clock.

There seems to be a strong correlation between those with Asperger syndrome and the
INTP type of the Myers-Briggs Type Indicator. One theory states that Asperger's correlates
to the INTP personality type, whereas high functioning autism correlates to the INFJ
personality type.

Prevalence

A 1993 total population study carried out in Sweden found that, at a minimum, 3.6 per
1000 school-aged children definitely meet the criteria for Asperger syndrome. If merely
suspected cases are included, the prevalence becomes approximately 7.1 per 1000.
Like other conditions classified as autism spectrum disorders, Asperger syndrome appears
to be more prevalent among males than females, with males making up approximately 75–
80 percent of diagnoses. Many clinicians believe that this may not reflect the actual
incidence among females; well-known Asperger syndrome expert Tony Attwood suggests
that females learn to better compensate for their impairments because of differences in
socialization. Some preliminary evidence for this is found in the Ehlers & Gillberg study,
which found a 4:1 male to female ratio in the people they thought definitely had Asperger's
but a much less lopsided 2.3 to 1 ratio when merely suspected or otherwise borderline
cases were included.

It is thought that most people with Asperger syndrome learn to cope with their social
impairments later in life. However, there is no "cure" as such, and some people would
strenuously argue that a cure is neither possible nor desirable; this remains a highly
controversial area.
Living with Asperger syndrome

Asperger syndrome usually leads to problems in social interaction with peers. Children with
Asperger syndrome often are the target of teasing and bullying at school because of their
idiosyncratic behavior, language, interests, and their lowered ability to perceive and
respond in socially expected ways to nonverbal cues, particularly in interpersonal conflict.
Even later in life, many people with Asperger's report a feeling of being unwillingly detached
from the world around them.

Children with Asperger syndrome often display advanced abilities for their age in language,
reading, mathematics, spatial skills, and/or music, sometimes into the "gifted" range, but
this may be counterbalanced by appreciable delays in other developmental areas. This
combination of traits can create problems with teachers and other authority figures.

One of the social conventions many people with Asperger's syndrome ignore is respect for
authority; there is a tendency to feel that everyone should be treated much the same
regardless of what social position they occupy. The student with Asperger's syndrome may
not give respect to an authority figure until he or she feels it has been earned, an attitude
many teachers either do not understand or take strong exception to. The child’s extremely
low tolerance for what they perceive to be mundane and mediocre tasks (such as typical
homework assignments) can easily become frustrating; the teacher may well consider the
child arrogant, spiteful, and insubordinate.

Asperger syndrome does not guarantee one will have a miserable life. The intense focus
and tendency to work things out logically, a characteristic of Asperger syndrome, often
grants people with the syndrome a high level of ability in their fields of interest. When these
special interests coincide with a materially or socially useful task, the person with Asperger's
often can in fact lead a profitable life.

Although many people with Asperger's are not considered socially successful by common
standards, it is certainly possible for them to find understanding people with whom they can
have close relationships. Also, many people with Asperger syndrome recognize that there is
a problem and try to adapt to living among people without the syndrome. Many autistics
have children, in which case their children may or may not have an autism spectrum
disorder. It is possible with training and self-discipline for a child with Asperger's to end up
as an adult who, though still having Asperger's, is able to interact well with others.
However, because of their delayed social development, it is not unusual for people with
Asperger's to feel most comfortable with people much younger or older than they are.

For a partner of a person with Asperger’s, when describing emotions, it can be helpful to be
direct and to avoid vague terms such as "upset" when the emotion being described is anger
(some individuals with Asperger's would interpret "upset" as mere annoyance, or even
nausea). It is often effective to lay out in clear language what the problem is and to ask the
partner with Asperger's to describe what emotions are being felt or ask why a certain
emotion was being felt.
Definitions and diagnostic criteria

Asperger syndrome is defined in the Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV) as:

 Qualitative impairment in social interaction, as manifested by at least two of the

following: Marked impairments in the use of multiple nonverbal behaviors such as
eye-to-eye gaze, facial expression, body posture, and gestures to regulate social
interaction

 Failure to develop peer relationships appropriate to developmental level

 A lack of spontaneous seeking to share enjoyment, interest or achievements with

other people (e.g., of showing, bringing, or pointing out objects of interest to other
people)

 A lack of social or emotional reciprocity

 Restricted repetitive and stereotyped patterns of behavior, interests, and activities,

as manifested by at least one of the following:
o Encompassing preoccupation with one or more stereotyped and restricted
patterns of interest that is abnormal in either intensity or focus
o Apparently inflexible adherence to specific, nonfunctional routines or rituals

 Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or

twisting or complex whole-body movements)

 Persistent preoccupation with parts of objects

The disturbance causes clinically significant impairments in social, occupational, or other

important areas of functioning.
The diagnostic criteria of the Diagnostic and Statistical Manual are criticized for being vague
and subjective; a condition that one psychologist might define as a significant impairment
might be defined by another psychologist as merely insignificant.

Gillberg's criteria are as follows (All six criteria must be met for confirmation of diagnosis;
however, self-diagnosis is not recommended):

 Severe impairment in reciprocal social interaction (at least two of the following)
o Inability to interact with peers
o Lack of desire to interact with peers
o Lack of appreciation of social cues
o Socially and emotionally inappropriate behavior
 All-absorbing narrow interest (at least one of the following)
o Exclusion of other activities
o Repetitive adherence
o More rote than meaning
 Imposition of routines and interests (at least one of the following)
o On self, in aspects of life
o On others
 Speech and language problems (at least three of the following)
o Delayed development
o Superficially perfect expressive language
o Formal, pedantic language
o Odd prosody, peculiar voice characteristics
o Impairment of comprehension including misinterpretations of literal/implied
meanings
 Non-verbal communication problems (at least one of the following)
o Limited use of gestures
o Clumsy/gauche body language
o Limited facial expression
o Inappropriate expression
o Peculiar, stiff gaze
 Motor clumsiness: poor performance on neurodevelopment examination
Further reading

Haddon, Mark (2003). The Curious Incident of the Dog in the Night-time: A Novel, New
York: Doubleday. ISBN 0385509456.

Ratey, John J., and Catherine Johnson (1997). Shadow Syndromes: The Mild Forms of
Major Mental Disorders That Sabotage Us, New York: Bantam. ISBN 0553379593.

Lawson, Wendy (2001). Understanding and Working With the Spectrum of Autism: An
Insider's View, London: Jessica Kingsley. ISBN 1853029718.

Organizations

WrongPlanet - International Asperger's Syndrome Organization - Largest online support site

for individuals with Asperger's
ASPECT Australia - 'Autism Spectrum Australia, for people on the autism spectrum and their
families'
ASPEN Asperger Syndrome Education Network - 'New Jersey non-profit organization that
provides education, support, and advocacy for families and individuals for people with
Asperger's syndrome'
Autism Society of America - 'ASA is dedicated to increasing public awareness about autism
and the day-to-day issues faced by individuals with autism, their families and the
professionals with whom they interact (one of the oldest and well-known organizations)'
GRASP, The Global and Regional Asperger Syndrome Partnership, Inc. - 'GRASP, the Global
and Regional Asperger Syndrome Partnership, is the largest organization in the world of
adults diagnosed along the autism spectrum with either Asperger Syndrome, Autism, or
PDD'

Informational

Online Asperger Syndrome Information and Support - 'Rather large collection of links of
pretty much anything to do with Asperger's syndrome'
Dallas Asperger Network for Information, Support and Help - 'D.A.N.I.S.H. is a support
group for families struggling with Asperger Syndrome'
Autism Research Center - 'Collaboration of scientists at Cambridge University and elsewhere
to find new and validated methods for assessment and intervention of autism spectrum
conditions'
Autistics.org - 'Resources by and for those on the autistic spectrum'
Weird Not Stupid - A website created from the perspective of a person who has two siblings
who are on the Autism Spectrum with the goal of giving information to anybody who is
seeking it.
The Geek Syndrome test - Online test for Asperger's Syndrome.
Institute for the Study of the Neurologically Typical - 'Well-known parody of non-autistics by
some people from the autism spectrum'