What is Asperger's Syndrome?
What is Asperger's Syndrome?
Children with Asperger’s syndrome have the following characteristics:
- Delayed social maturity and social reasoning.
- Difficulty making friends and often teased by other children.
- Difficulty with the communication and control of emotions.
- Unusual language abilities that include advanced vocabulary and syntax but delayed conversation skills, unusual prosody and a tendency to be pedantic.
- A fascination with a topic that is unusual in intensity or focus.
- An unusual profile of learning abilities.
- A need for assistance with some self-help and organizational skills.
- Clumsiness in terms of gait and coordination.
- Sensitivity to specific sounds, aromas, textures or touch.
The advantages of a diagnosis can be:
- Being recognized as having genuine difficulties coping with experiences that others find easy and enjoyable.
- A positive change in other people’s expectations, acceptance and support.
- Compliments rather than criticism with regard to social competence.
- Acknowledgement of confusion and exhaustion in social situations.
- Schools can access resources to help the child and class teacher.
- An adult can access specialized support services for employment and further education.
- Greater self-understanding, self-advocacy and better decision making with regard to careers, friendships and relationships.
- A sense of identification with a valued ‘culture’.
- The person no longer feels stupid, defective or insane.
Aspects of the Diagnosis
- A diagnosis can be made with some confidence for a child after the age of five years, but cannot yet be made with sufficient confidence in pre-school children.
- We now have an assessment instrument and diagnostic criteria specifically for adults.
- The confidence in the diagnostic assessment of adults can be affected by the honesty and accuracy in the responses to questions and questionnaires.
- Some adults referred for a diagnostic assessment may have the signs but not the clinically significant impairment in functioning necessary for a diagnosis.
- It is not the severity of expression that is important but the circumstances, expectations and coping and support mechanisms.
Characteristics of Asperger’s Syndrome
Theory of Mind
- Effects of impaired Theory of Mind abilities in daily life
- Difficulties reading the messages in someone’s eyes.
- A tendency to make a literal interpretation of what someone says.
- A tendency to be considered disrespectful and rude.
- Remarkable honesty.
- Delay in the development of the art of persuasion, compromise and conflict resolution.
- A different form of introspection and self-consciousness.
- Problems knowing when something may cause embarrassment.
- A longer time to process social information, due to using intelligence rather than intuition.
- Physical and emotional exhaustion from socializing.
The Understanding and Expression of Emotions
- The emotional maturity of children with Asperger’s syndrome is usually at least three years behind that of their peers.
- There can be a limited vocabulary to describe emotions and a lack of subtlety and variety in emotional expression.
- There is an association between Asperger’s syndrome and the development of an additional or secondary mood disorder, including depression, anxiety disorder, and problems with anger management and the communication of love and affection.
- People with Asperger’s syndrome appear vulnerable to feeling depressed, with about one in three children and adults with Asperger’s syndrome having a clinical depression.
- We do not know how common anger management problems are with children and adults with Asperger’s syndrome, but we do know that when problems with the expression of anger occur, the person with Asperger’s syndrome and family members are very keen to reduce the frequency, intensity and consequences of anger.
- A person with Asperger’s syndrome may enjoy a very brief and low intensity expression of affection, and become confused or overwhelmed when greater levels of expression are experienced or expected.
- The emotion management for children and adults with Asperger’s syndrome can be conceptualized as a problem with ‘energy management’, namely, an excessive amount of emotional energy and difficulty controlling and releasing the energy constructively.
- One of the distinguishing characteristics between a hobby and a special interest that is of clinical significance is an abnormality in the intensity or focus of the interest.
- Unusual or special interests can develop as early as age two to three years and may commence with a preoccupation with parts of objects such as spinning the wheels of toy cars, or manipulating electrical switches.
- The next stage may be a fixation on something neither human nor toy, or a fascination with a specific category of objects and the acquisition of as many examples as possible.
- A subsequent stage can be the collection of facts and figures about a specific topic.
- Much of the knowledge associated with the interest is self-directed and self-taught.
- In the pre-teenage and teenage years the interests can evolve to include electronics and computers, fantasy literature, science fiction and sometimes a fascination with a particular person.
- There appear to be two main categories of interest: collections, and the acquisition of knowledge on a specific topic or concept.
- Some girls with Asperger’s syndrome can develop a special interest in fiction rather than facts.
- Sometimes the special interest is animals but can be to such an intensity that the child acts being the animal.
- The special interest has several functions:
- To overcome anxiety.
- To provide pleasure.
- To provide relaxation.
- To ensure greater predictability and certainty in life.
- To help understand the physical world.
- To create an alternative world.
- To create a sense of identity.
- To facilitate conversation and indicate intellectual ability.
- The interest can be a source of enjoyment, knowledge, self-identity and self-esteem that can be constructively used by parents, teachers and therapists.
- When one considers the attributes associated with the special interests, it is important to consider not only the benefits to the person with Asperger’s syndrome, but also the benefits to society.
- Some young children with Asperger’s syndrome start school with academic abilities above their grade level.
- There seem to be more children with Asperger’s syndrome than one might expect at the extremes of cognitive ability.
- Profile of learning abilities at school
- At school, teachers soon recognize that the child has a distinctive learning style, being talented in understanding the logical and physical world, noticing details and remembering and arranging facts in a systematic fashion.
- Children with Asperger’s syndrome can be easily distracted, especially in the classroom. When problem solving, they appear to have a ‘one-track mind’ and a fear of failure.
- As the child progresses through the school grades, teachers identify problems with organizational abilities, especially with regard to homework assignments and essays.
- If the child with Asperger’s syndrome is not successful socially at school, then academic success becomes more important as the primary motivation to attend school and for the development of self-esteem.
Movement and Coordination
- There is an impression of clumsiness in at least 60 per cent of children with Asperger’s syndrome, but several studies using specialized assessment procedures have indicated that specific expressions of movement disturbance occur in almost all children with Asperger’s syndrome.
- When walking or running, the child’s coordination can be immature, and adults with Asperger’s syndrome may have a strange, sometimes idiosyncratic gait that lacks fluency and efficiency.
- Some children with Asperger’s syndrome can be immature in the development of the ability to catch, throw and kick a ball.
- Poorly planned movement and slower mental preparation time may be a more precise description than simply being clumsy.
- Teachers and parents can become quite concerned about difficulties with handwriting.
- The movement disturbance does not appear to affect some sporting activities such as swimming, using the trampoline, playing golf and horse riding.
- Some adults with Asperger’s syndrome consider their sensory sensitivity has a greater impact on their daily lives than problems with making friends, managing emotions and finding appropriate employment.
- The most common sensitivity is to very specific sounds but there can also be sensitivity to tactile experiences, light intensity, the taste and texture of food and specific aromas. There can be an under or over reaction to the experience of pain and discomfort, and the sense of balance, movement perception and body orientation can be unusual.
- The child with sensory sensitivity becomes hypervigilant, tense and distractible in sensory stimulating environments such as the classroom, unsure when the next painful sensory experience will occur.
- We know that the signs are more conspicuous in early childhood and gradually diminish during adolescence, but can remain a lifelong characteristic for some adults with Asperger’s syndrome.
From my clinical experience I consider that children and adults with Aspergers Syndrome have a different, not defective, way of thinking.
The person usually has a strong desire to seek knowledge, truth and perfection with a different set of priorities than would be expected with other people. There is also a different perception of situations and sensory experiences. The overriding priority may be to solve a problem rather than satisfy the social or emotional needs of others.
The person values being creative rather than co-operative.
The person with Aspergers syndrome may perceive errors that are not apparent to others, giving considerable attention to detail, rather than noticing the “big picture”.
The person is usually renowned for being direct, speaking their mind and being honest and determined and having a strong sense of social justice.
The person may actively seek and enjoy solitude, be a loyal friend and have a distinct sense of humour.
However, the person with Aspergers Syndrome can have difficulty with the management and expression of emotions.
Children and adults with Aspergers syndrome may have levels of anxiety, sadness or anger that indicate a secondary mood disorder. There may also be problems expressing the degree of love and affection expected by others. Fortunately, we now have successful psychological treatment programs to help manage and express emotions.