Asperger Syndrome |
Asperger Syndrome is named for a Viennese physician, Hans Asperger. He observed four children in
his practice who had difficulty integrating socially. Their intelligence appeared normal but they
lacked nonverbal communication skills ("body language"), failed to demonstrate empathy with their
peers, and were physically clumsy. Their speech was either disjointed or overly formal. An
all-absorbing interest in a single topic dominated their conversations.
Dr. Asperger described the condition as primarily marked by social isolation. He also stated,
"exceptional human beings must be given exceptional educational treatment, treatment which takes
into account their special difficulties. Further, we can show that despite abnormality, human
beings can fulfill their social role within the community, especially if they find understanding,
love and guidance".
Asperger's observations were not widely known until 1981, when English doctor Lorna Wing
published a series of case studies of children showing similar symptoms, which she called
"Asperger's" syndrome. In 1994, the Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV) included AS, making it a distinct diagnosis recognized by professionals.
Asperger's Syndrome has a variety of characteristics and can range from mild to severe. Persons
with AS show marked deficiencies in social skills, have difficulties with transitions
or changes and prefer sameness. They often have obsessive routines and may be preoccupied
with a particular subject of interest.
They have a great deal of difficulty reading nonverbal cues (body language) and very often
the individual with AS has difficulty determining proper body space. Often overly
sensitive to sounds, tastes, smells, and sights, the person with AS may prefer soft clothing,
certain foods, and be bothered by sounds or lights no one else seems to hear or see. It's
important to remember that the person with AS perceives the world very differently.
Therefore, many behaviors that seem odd or unusual are due to those neurological differences and
not the result of intentional rudeness, bad behavior, or "improper parenting".
Persons with AS can be extremely literal and have difficulty using language in a social
context. A child may have a wonderful vocabulary and even demonstrate hyperlexia but not
truly understand the nuances of language and have difficulty with language pragmatics. Social
pragmatics also tend be weak, leading the person to appear to be walking to the beat of a
Motor dyspraxia (inhibited coordination) can be reflected in a tendency to be clumsy. In
social interaction, many people with Asperger's syndrome demonstrate gaze avoidance and
may actually turn away at the same moment as greeting another. The children I have known do
desire interaction with others but have trouble knowing how to make it work. They are,
however, able to learn social skills much like you or I would learn to play the piano.
Many of the weaknesses can be remediated with therapy aimed at teaching social and pragmatic
skills. Anxiety leading to significant rigidity can be also treated medically. Although it is
harder, adults with Asperger's can have relationships, families, happy and productive lives.
There is growing evidence that Asperger Syndrome may be caused by a variety of factors that
affect brain development and sensory perception. It is not uncommon for a child who was initially
diagnosed with ADD or ADHD be re-diagnosed with AS.
An example of the "literal" type of communication used by someone with Asperger's: He referred to
a hole in his sock as "a temporary loss of knitting".
- Excellent rote memory
- Generally anxious and unable to cope with any form of criticism or imperfection
- Can be the victims of teasing in a school environment, which may cause them to withdraw into
- Often appear clumsy and may have an unusual gait or stance
- Often have a good vocabulary but have dificulty in non-literal social communication.
- Fluorescent lighting causes severe problems for many autistic people, because they can see a sixty cycle flicker. Household electricity turns on and off sixty times each second, and some
autistic people see this. Problems with flickering can range from excessive eyestrain to seeing a
room pulsate on and off.
- People with autism require much more time than others to shift their attention between
auditory and visual stimuli, and they find it more difficult to follow rapidly changing, complex
social interactions. "If I relate to people too much, I become nervous and uncomfortable."
Using videotapes to observe people's emotional & social reactions helps develop this area.
- greater need for sensory stimulation
- disinclined to extemporaneous speaking
- resists change to working procedures
- disinclined to "office politics" (doesn't recognize hierarchical routing, seeks direct
communication with the person having information)
- trouble recognizing or generating customary business/social "lies"
- disinclined to use of metaphors
- difficulty in recognizing questions as "rhetorical"
Social Skills Training: This is one of the most important facets of treatment for all age groups
of people with Asperger's. The individual needs to learn body language the way an adult learns a
foreign language. People with Asperger's must learn concrete rules for eye contact, social
distance and the use of slang. Global empathy is difficult, but they can learn to look for
specific signs that indicate another individual's emotional state. Social skills are often best
practiced in a small group setting. Such groups serve more than one function. They give people a
chance to learn and practice concrete rules of interpersonal engagement. They may also be a way
for the participant to meet others like himself. Individuals with Asperger's do best in groups
with similar individuals. If the group consists of street-wise, antisocial peers, the Asperger's
individual may retreat into himself or be dominated by the other members.
People with AS lack the natural ability to see the subtexts of social interaction. They have
trouble communicating their own emotional state, (resulting in well-meaning remarks that may
offend), or finding it hard to know what is "acceptable". The unwritten rules
of social behavior that mystify so many with AS have been termed the "hidden curriculum". People with AS must learn these social skills intellectually rather than intuitively.
Non-autistics intuitively gather information about other people's cognitive and emotional states
from clues in the environment and other people's facial expressions and body language, but, in
this respect, people with AS are impaired; this is sometimes called mind-blindness.
A person with AS can have trouble understanding the emotions of other people: the "messages" from
facial expression, eye contact and body language are often missed. This caused problems in their
showing empathy with other people. They are usually shocked, upset and remorseful when told that
their actions are hurtful or inappropriate. It is clear that people with AS do not lack emotions.
Emotions are not usually shown in a conventional way. Sometimes, the opposite problem occurs: the
person with AS is unusually affectionate to a significant other and misses or misinterprets
signals from the other partner, causing the partner stress.
People with AS typically have a highly pedantic way of speaking, using a far more formal register
of language than appropriate for a context. A child with this condition may regularly speak in
language that could easily have come from a university textbook, especially if it's their special
area of interest. Individuals with AS may use words idiosyncratically, including new coinages and
unusual juxtapositions. This can develop into a rare gift for humor (especially puns, wordplay,
doggerel and satire).
In written language skills, no significant differences were found between standardized scores of
AS & non-AS children; however, in hand-writing skills, the AS participants produced significantly
fewer legible letters and words than the neurotypical group.
Narrow, intense interests
Asperger Syndrome can involve an intense and obsessive level of focus on things of interest. For
example, one person might be obsessed with 1950s professional wrestling, another with computers,
and another with building models out of matchsticks. Many of these are normal interests; the
difference in people with AS is the unusual intensity of their interest. Repetitive interests in
people with autism are more often in the domain of "how things work" and less often in the
domain of "how people work", suggesting that the obsessions are not arbitrary, but reflect
the AS focus on objects over people.
Sometimes these interests are lifelong; in other cases, they change at unpredictable intervals.
In either case, there are normally one or two interests at any given time. In pursuit of these
interests, people with AS often manifest extremely sophisticated reasoning, an almost obsessive
focus, and a remarkably good memory for trivial facts. Hans Asperger called his young patients
"little professors" because he thought they had as comprehensive and nuanced an understanding of
their field of interest as university professors.
In school, they may be perceived as highly intelligent underachievers or overachievers, clearly
capable of outperforming their peers in their field of interest, yet persistently unmotivated to
do regular homework assignments. This proclivity toward 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.
In general, orderly things appeal to people with AS. 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 AS experience varying degrees of sensory overload. Some may even be
pathologically sensitive to loud noises.
Speaking to an Apergan
Be selective with what you say. Aspergans take what you tell them literally. So, it can be a problem if you use figures of speech since they will hear these literally. You'll likely be surprised at how well he knows a specific area that you may not know yourself.
If this is a business or professional setting (or just someone with whom you haven't spoken before), it is usually more productive to speak in direct terms rather than in colloquial, circumspect "social" language.
You may notice one or more of these characteristics in an Aspergan's speech & behavior (more noticable if they're young):
- Assumes that you are interested in what he is talking about.
- Assumes you want to participate in the things he wants to do, and appears upset if you donít.
- Gets upset over requests or instructions unrelated to the subject being discussed.
- Asks detailed questions to in respose to casual comments.
- Will respond to a criticism as if he were defending a thesis, but struggle at answering basic open-ended questions about the same topic.
- Have a few, fixed routines. A suggestion of adding to, or altering them produces great irritation.
Hate At First Sight
SOCIAL REFLEXES. People assess one another in social contexts intuitionally rather than analytically. By this process, the Asperger Gait can engender a "hate at first-sight" response. You will see people greeting each other politely, then suddenly turn to you with a glaring, hateful countenance. There's some kind of Aspie body language that's odd to them.
It's also seen in the animal kingdom: a flock of birds ignoring an awkwardly-moving bird who appears otherwise normal and healthy. People will frequently look a stranger in the eye with disgust, even loathing, based on nothing but this "there's something about him" reflex.
Be aware that simple-minded reflexes can be easily "fooled" by using simple gestures that are familiar to the simpleton. The "Alpha" stance: eye-contact, chest out, walking assertively, cause man and beast to respond favorably to one's "aura."
Establishing sexual relationships requires a knowledge of a wide array of nonverbal
communication. People in the autistic spectrum aren't "wired" for that. Some may learn enough to
be able to have relationships, though that learning process may mean a decade-long delay in
starting a real relationship.
People on the high functioning end, i.e., Asperger Syndrome, have sexual desires as strong as a
neurotypical person. But consider how hard it is for NT adolescents to deal with their awakening
sexuality, approaching people of the opposite sex, etc. Then consider the innate social
impairments of someone in the autistic spectrum. It doesn't take much for the poor kid to
conclude that "normal" sexual relationships are no more attainable than "normal" friendships had
been up to that point. Yet those sexual desires still demand an outlet.
Duscussions on sexual forums often reveal that many fetishists of all stripes (not just AS) talk
of having experienced an unusual attraction to the fetish object long before puberty.
So the big question for a fetishist on the spectrum is which came first: Did the fetish develop
out of the person's frustration over believing they cannot have normal relationships? Or was the
fetish there all along as part-and-parcel of the autistic condition?
But one problem is clear: Fetishes can be realized alone. That's a "perfect" trap for someone
whose wiring keeps them on the fringes of social interaction. Learning the communication idioms
necessary to "break through" into the world of normal relationships is the inconvenient necessity
for the AS individual.
Google: autism, Sexual Development
Do You Have Asperger's?
Though a casual questionnaire with tongue slightly in cheek, 17 or more items may indicate a
gifted adult with Aspinger's Syndrome. More on these
stats from source site.
Asperger - Getting a Diagnosis |
What the Indicators Are
• To: What doctors look for
• To: DSM-IV Diagnostic Criteria
The "Triad of Impairments:"
* "Lack of imagination" refers to difficulty imagining alternative outcomes and finding
it hard to predict what people will do next. It doesn't refer to
- Impairment of social relationships
- Impairment of social communication, and
- Impairment of imagination*
The way that each individual is affected by the triad is along a continuum:
one person may have more deficits in the area of imagination than in social
relationships or social communication.
Hans Asperger defined the indicators as:
- Social impairment - extreme egocentricity
- Speech and language peculiarities
- Repetitive routines
- Motor clumsiness
- Narrow interests
- Non-verbal communication problems
"Social" Triad of Impairments:
- Aloof - over-formal or stilted in social contact, to
schizoid and isolative behavior, including becoming electively mute and complete withdrawal from
interpersonal interactions. In extreme circumstances individuals may neglect all aspects of
personal care and hygiene, some decompensate into a psychotic state.
- Active but odd - own needs seen as priority. Little or no
concept of consensus or compromise. Little or no understanding of social rules and societal
norms. These difficulties are compounded by deficits in interpreting non-verbal behaviors,
abstract concepts and complex social language.
- Passive - accepts social approaches with indifference,
will often comply with all requests, therefore making them
vulnerable to exploitation. May show some pleasure in social contact, but make
no spontaneous approaches. Has difficulties dealing with stress
and changes in routines.
Getting A Diagnosis
Because Asperger syndrome has only really been recognised within the last 25 years, and barely
heard about at all until during the last 15 years, many adults are still
only just getting diagnosed after a lifetime of being different and not knowing why.
There are many different routes to getting a diagnosis, but one of the first places you could try
is your family doctor.
Step 1 - Be Prepared
Read the diagnostic criteria and make notes of some
examples relevant to yourself.
If you are an adult seeking a diagnosis for yourself, be ready to give examples of AS traits from
your childhood. Recall reactions from parents, teachers, and other kids, to these traits.
You won't need to give the GP a life story. They just need to know that you have valid reasons
for suspecting you meet the diagnostic criteria and that it has been life-long, not just a stage
you are going through.
Practice talking about the issues you want to raise. If you haven't got someone to talk to, then
just practice saying them out loud to yourself or writing them down. Take
some notes along with you to refer to.
Step 2 - See Your GP
Make an appointment to see your GP specifically about Asperger Syndrome. (Don't try and
tag it on to the end of a consultation about something else.)
Your GP will not diagnose you himself. What you are asking for is a referral to a specialist. The
doctor won't do this unless he feels there is good cause to do so. They will want to know:
Some doctors might be suspicious of your motives and be reluctant to refer you, so it is important to be persistent and quite clear about how important it is to you. He may actually be willing to refer you but not be sure who to refer you to.
- how you found out about Asperger syndrome
- some examples you can give meeting the diagnostic criteria
- why you want a diagnosis
Step 3 - The Referral Appointment
The term "diagnosis" is misleading, as it is more like a professional opinion that you are
obtaining. The value of the opinion depends on the experience of the professional who gives it. A
diagnosis certainly isn't is a pass or fail test.
A number of different doctors and health professionals may be involved in the actual diagnosis.
You may have more than one appointment and see more than one specialist. It could take a long
time until you get anything confirmed. It is important to ensure that
whoever and whatever the consultant and/or diagnostic team is that they have some experience of
diagnosing Asperger Syndrome.
Referral appointments can vary:
It can be a difficult experience. But if it really matters to you, then commit to pursuing the
matter until you get the results you're seeking.
- Sometimes they will just interview you
- Sometimes they will want to speak to family
- They might do some simple psychological tests
This is from the "Australian Scale for Asperger Syndrome". Though it is directed toward
diagnosing children, the symptoms are similarly relevant to adults with AS. As there is more
interest in treating children, it is a bit more work for an adult to pursue a serious and
accurate diagnosis. But take note of the criteria described here and apply it to pertinent
examples from your life both in childhood and as an adult.
[A version of the original can be found on:
A: SOCIAL AND EMOTIONAL ABILITIES
1. Does the individual lack an understanding of how to play with other children? For example,
unaware of the unwritten rules of social play
2. When free to play with other children, such as school lunchtime, does the individual avoid
social contact with them? For example, finds a secluded place or goes to the library.
3. Does the individual appear unaware of social conventions or codes of conduct and make
inappropriate actions and comments? For example, making a personal comment to someone but the
individual seems unaware how the comment could offend.
4. Does the individual lack empathy, i.e., the intuitive understanding of another person's
feelings? For example, not realizing an apology would help the other person feel better.
5. Does the individual seem to expect other people to know their thoughts, experiences and
opinions? For example, not realizing you could not know about something because you were not with
the child at the time.
6. Does the individual need an excessive amount of reassurance, especially in changing situations
or when thing go wrong?
7. Does the individual lack subtlety in their expression of emotion? For example, the individual
shows distress or affection out of proportion to the situation.
8. Does the individual lack precision in their expression of emotion? For example, not
understanding the levels of emotional expression appropriate for different people.
9. Is the individual uninterested in playing competitive sports or activities with other
10. Is the individual indifferent to peer pressure? For example, does not follow the latest craze
in toys or clothes.
B. COMMUNICATION SKILLS
11.Does the individual take a literal interpretation of comments? For example, is confused by
phrases such as, "get your act together," "looks can kill," or "pull yourself up by your
12. Does the individual speak using unusual intonations? For example, the individual seems to
have a "foreign" accent or monotone that lacks emphasis on key syllables.
13. When talking to the individual, does he appear uninterested in your side of the conversation?
For example, not asking about or commenting on your thoughts or opinions on the topic.
14. When in a conversation, does the individual tend to use less eye contact than you would
15. Is the individual's speech over-precise or pedantic? For example, talks in a formal way or
like a walking dictionary.
16. Does the individual have problems repairing a conversation? For example, when confused by the
speaker's choice of words, he does not ask for clarification but either switches to a familiar
topic, or takes ages to think of a reply.
C. COGNITIVE SKILLS
17. Does the individual read books primarily for information not seeming to be interested in
fictional works? For example, being an avid reader of encyclopedias and science books but not
keen on adventure stories.
18. Does the individual have an exceptional long-term memory for events and facts? For example,
remembering the neighbor's car license plate from several years ago, or clearly recalling events
that happened many years ago.
19. Does the individual lack social imaginative play? For example, other children are not
included in the child's imaginary games, or the child is confused by the pretend games of other
20. Is the child fascinated by a particular topic and avidly collects information or statistics
on that interest? For example, the child becomes a walking encyclopedia of knowledge on vehicles,
maps, or league tables.
21> Does the individual become unduly upset by changes in routine or expectation? For example, is
distressed by going to school by a different route.
22. Does the individual develop elaborate routines or rituals that must be completed? For
example, lining up the toys before going to bed.
E. MOVEMENT SKILLS
23. Does the individual have poor motor coordination? For example, is not skilled at catching a
24. Does the child have an odd gait when running?
F. OTHER CHARACTERISTICS
Does the person display any of the following characteristics: (Check all that apply)
a. Unusual fear or distress due to:
b. A tendency to rock backward and forward when excited or distressed
- ordinary sounds, e.g., electrical appliances
- light touch on the skin or scalp
- wearing particualr items of clothing
- unexpected noises
- seeing certain objects
- noisy, crowded places, e.g., supermarkets
c. A lack of sensitivity to low levels of pain
d. Late in acquiring speech [more associated with basic Autism than with Asperger Syndrome]
e. Unusual facial grimaces or tics.
Diagnosed as an Adult - National Autistic Society (UK)
299.80 Asperger's Disorder |
[ As it appears in the "DSM-IV-TR", p80-84 ]
(To: Summary of Diagnostic Criteria)
The essential features of Asperger's Disorder are severe and
sustained impairment in social interaction (Criterion A) and the development of restricted,
repetitive patterns of behavior,
interests, and activities (Criterion B). The disturbance must cause clinically significant
impairment in social, occupational, or other important areas of functioning (Criterion C).
In contrast to Autistic Disorder, there are no clinically significant delays or deviances in
language acquisition (e.g.,single non-echoed words are used communicatively by age 2 years, and
phrases are used by age 3 years)(Criterion D), although more subtle aspects of social
communication (e.g.,typical give and take in conversation) may be affected. In addition,
during the first 3 years of life,
there are no clinically significant delays in cognitive development as manifested by expressing
normal curiosity about the environment or in the acquisition of age-appropriate learning skills
and adaptive behaviors (other
than in social interaction)(Criterion E). Finally, the criteria are not met for another
specific Pervasive Developmental Disorder or for Schizophrenia (Criterion F). This
is also termed Asperger's Syndrome.
The impairment in reciprocal social interaction is gross and
sustained. There may be marked impairment in the use of multiple nonverbal behaviors
(e.g.,eye-to-eye gaze, facial expression, body postures and gestures) to regulate
social interaction and communication (Criterion A1). There may be failure to develop peer
relationships appropriate to developmental level (Criterion A2) that may take different forms at
different ages. Younger individuals
may have little or no interest in establishing friendships. Older individuals may have an
interest in friendship but lack of understanding the conventions of social interaction.
There may be a lack of spontaneous seeking
to share enjoyment, interests, or achievements with other people (e.g.,not showing, bringing, or
pointing out objects they find interesting) (Criterion A3). Lack of social or emotional
reciprocity may be present (e.g.,not actively participating
in simple social play or games, preferring solitary activities, or involving others in activities
only as tools or "mechanical" aids)(Criterion A4). Although the social deficit in
Asperger's Disorder is severe and is defined in the same way as in
Autistic Disorder, the lack of social reciprocity is more typically manifest by an eccentric and
one-sided social approach to others (e.g.,pursuing a conversational topic regardless of other'
reactions) rather than social and emotional indifference.
As in Autistic Disorder, restricted, repetitive patterns of
behavior, interests, and activities are present (Criterion B). Often these are primarily
manifest in the development of encompassing preoccupations about a circumscribed topic or
about which the individual can amass a great deal of facts and information (Criterion B1).
These interests and activities are pursued with great intensity often to the exclusion of other
must cause clinically significant impairment in social adaptation , which in turn may have a
significant impact on self-suffiency or on occupational or other important areas of functioning
(Criterion C). The social deficits and
restricted patterns of interests, activities, and behavior are the source of considerable
In contrast to Autistic Disorder, there are no clinically
significant delays in early language (e.g.,single words are used by age 2, communicative phrases
are used by age 3)(Criterion D). Subsequent language may be unusual in terms of the
individual's preoccupation with certain topics and his or her verbosity. Difficulties in
communication may result from social dysfunction and the failure to appreciate and utilize
conventional rules of conversation, failure to appreciate
nonverbal cues, and limited capacities for self-monitoring.
Individuals with Asperger's Disorder do not have clinically
significant delays in cognitive development or in age-appropriate self-help skills, adaptive
behavior (other than in social interaction), and curiosity about the environment in childhood
(Criterion E). Because early language and cognitive skills are within normal limits in the
first 3 years of life, parents or caregivers are not usually concerned about the child's
development during that time, although upon detailed interviewing
they may recall unusual behaviors. The child may be described as talking before walking,
and indeed parents may believe the child to be precocious (e.g.,with a rich or "adult"
vocabulary). Although subtle social problems may exist,
parents or caregivers often are not concerned until the child begins to attend a preschool or is
exposed to same-age peers may become apparent.
By definition the diagnosis is not given if the criteria are
met for any other specific Pervasive Developmental Disorder or for Schizophrenia (although the
diagnosis of Asperger's Disorder and Schizophrenia may coexist if the onset of the Asperger's
Disorder clearly preceded the onset of Schizophrenia)(Criterion F).Associated Features and Disorders
In contrast to Autistic Disorder, Mental Retardation is not
usually observed in Asperger's Disorder, although occasional cases in which Mild Mental
Retardation is present have been noted (e.g.,when the Mental Retardation becomes apparent only in
the school years, with
no apparent cognitive or language delay in the first years of life). Variability of
cognitive functioning may be observed, often with strengths in areas of verbal ability
(e.g.,vocabulary, rote auditory memory) and weaknesses in non-verbal areas (e.g.,visual-motor and
visual-spatial skills). Motor clumsiness
and awkwardness may be present but usually are relatively mild, although motor difficulties may
contribute to peer rejection and social isolation (e.g.,inability to participate in group
sports). Symptoms of overactivity and inattention are frequent in Asperger's Disorder, and
many individuals with this condition receive a diagnosis of Attention Deficit/Hyperactivity
Disorder prior to the diagnosis of Asperger's Disorder. Asperger's Disorder has been
reported to be associated with a number of other mental disorders, including Depressive
Specific Age and Gender Features
The clinical picture may present differently at different ages.
Often the social disability of individuals with the disorder becomes more striking over
time. By adolescence some individuals with the disorder may learn to use areas of strength
(e.g.,rote verbal abilities) to
compensate for areas of weakness. Individuals with Asperger's Disorder may experience
victimization by others; this, and feelings of social isolation and an increasing capacity for
self-awareness, may contribute to the development of depression and anxiety in adolescence and
adulthood. The disorder is diagnosed much more frequently (at least five times) in males
than in females.
Definitive data regarding the prevalence of Asperger's Disorder
Asperger's Disorder is a continuous and lifelong disorder.
In school-age children, good verbal abilities may, to some extent, mask the severity of the
child's social dysfunction and may also mislead caregivers and teachers - that is, caregivers and
teachers may focus on the child's good verbal skills but be
insufficiently aware of problems in other areas (particularly social adjustment). The
child's relatively good verbal skills may also lead teachers and caregivers to erroneously
attribute behavioral difficulties to willfulness or stubbornness in the child. Interest in
forming social relationships may increase in adolescence
as the individuals learn some ways of responding more adaptively to their difficulties - for
example, the individual may learn to apply explicit verbal rules or routines in certain stressful
situations. Older individuals may have an interest in friendship but lack understanding of
the conventions of social interaction and may more likely
make relationships with individuals much older or younger than themselves. The prognosis
appears significantly better than in Autistic Disorder, as follow-up studies suggest that, as
adults, many individuals are capable of gainful employment and personal self-sufficiency.
Although the available data are limited, there appears to be an
increased frequency of Asperger's Disorder among family members of individuals who have the
disorder. There may also be an increased risk for Autistic Disorder as well as more
general social difficulties.
Asperger's Disorder must be distinguished from the other
Pervasive Developmental Disorder, all of which are characterized by problems in social
interaction. It differs from Autistic Disorder in several ways. In Autistic
Disorder there are,
by definition, significant abnormalities in the areas of social interaction, language, and play,
whereas in Asperger's Disorder early cognitive and language skills are not delayed significantly.
Furthermore, in Autistic Disorder, restricted, repetitive, and
stereotyped interests and activities are often characterized by the presence of motor mannerisms,
preoccupation with parts of objects, rituals, and marked distress in change, whereas in
Asperger's Disorder these are primarily observed in the all-encompassing
pursuit of a circumscribed interest involving a topic to which the individual devotes inordinate
amounts of time amassing information and facts. Differentiation of the two conditions can
be problematic in some cases. In Autistic Disorder, typical
social interaction patterns are marked by self-isolation or markedly rigid social approaches,
whereas in Asperger's Disorder there may appear to be motivation for approaching others even
though this is then done in a highly eccentric, one-sided, verbose, and
Asperger's Disorder must also be differentiated from Pervasive
Developmental Disorders other than Autistic Disorder. Rett's Disorder differs from
Asperger's Disorder in its characteristic sex ratio and pattern of deficits. Rett's
Disorder has been diagnosed
only in females, whereas Asperger's Disorder occurs much more frequently in males. In
Rett's Disorder, there is a characteristic pattern of head growth deceleration, loss of
previously acquired purposeful hand skills, and the appearance of poorly coordinated
gait or trunk movements. Rett's Disorder is also associated with marked degrees of Mental
Retardation and gross impairments in language and communication.
Asperger's Disorder differs from Childhood Disintegrative
Disorder, which has a distinctive pattern of developmental regression following at least 2
years of normal development. Children with Childhood Disintegrative Disorder also display
marked degrees of Mental
Retardation and language impairment. In contrast, in Asperger's Disorder there is no
pattern of developmental regression and, by definition, no significant cognitive or language
Schizophrenia of childhood onset usually develops after
years of normal, or near normal, development, and characteristic features of the disorder,
including hallucinations, delusions, and disorganized speech, are present. In Selective
Mutism, the child usually exhibits
appropriate communication skills in certain contexts and does not have the severe impairment in
social interaction and the restricted patterns of behavior associated with Asperger's Disorder.
Conversely, individuals with Asperger's Disorder are typically verbose. In
Language Disorder and Mixed Receptive-Expressive Language Disorder, there is language
impairment but no associated qualitative impairment in social interaction and restricted,
repetitive, and stereotyped patterns of behavior. Some individuals iwth Asperger's
may exhibit behavioral patterns suggesting Obsessive-Compulsive Disorder, although special
clinical attention should be given to the differentiation between preoccupations and activities
in Asperger's Disorder and obsessions and compulsions in Obsessive-Compulsive Disorder.
In Asperger's Disorder these interests are the source of some apparent pleasure or comfort,
whereas in Obsessive-Compulsive Disorder they are the source of anxiety. Furthermore,
Obsessive-Compulsive Disorder is typically not associated with the level of impairment in social
interaction and social communication
seen in Asperger's Disorder.
The relationship between Asperger's Disorder and Schizoid
Personality Disorder is unclear. In general, the social difficulties in Asperger's
Disorder are more severe and of earlier onset. Although some individuals with Asperger's
Disorder may experience heightened and debilitating anxiety in social settings
as in Social Phobia or other Anxiety Disorders, the latter conditions are not
characterized by pervasive impairments in social development or by the circumscribed interests
typical of Asperger's Disorder. Asperger's Disorder must be distinguished from normal
social awkwardness and normal age-appropriate interests
and hobbies. In Asperger's Disorder, the social deficits are quite severe and the
preoccupations are all-encompassing and interfere with the acquisition of basic skills.
Diagnostic Criteria For 299.80 Asperger's
[Conclusion to above, p84, DSM-IV-TR]
A. Qualitative impairment in social
interaction, as manifested by at least two of the following:
B. Restricted repetitive and stereotyped
patterns of behavior, interests, and activities, as manifested by at least
one of the following:
marked impairments in the use
of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression,
body postures, and gestures to regulate social interaction
failure to develop peer relationships
appropriate to developmental level
a lack of spontaneous seeking
to share enjoyment, interests, or achievements with other people (e.g.
by a lack of showing, bringing, or pointing out objects of interest to
lack of social or emotional reciprocity
C. The disturbance causes clinically
significant impairment in social, occupational, or other important areas
encompassing preoccupation with
one or more stereotyped and restricted patterns of interest that is abnormal
either in intensity or focus
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
persistent preoccupation with
parts of objects
D. There is no clinically significant
general delay in language (e.g., single words used by age 2 years, communicative
phrases used by age 3 years)
E. There is no clinically significant
delay in cognitive development or in the development of age-appropriate
self-help skills, adaptive behavior (other than social interaction), and
curiosity about the environment in childhood
F. Criteria are not met for
another specific Pervasive Developmental Disorder or Schizophrenia
...Normal people seem to put a great deal of emphasis on independence, despite the fact that they
are much more socially dependent than I am. I have lived independently now for most of the last 7
years. I really don't think total independence is all it's made out to be.... people have called
Asperger Syndrome "nerd disorder" because it is a higher-functioning form of autism...I have a
very good "guest mode" where I can appear quite normal; however, being forced to sustain guest
mode for an extended period can, and has, lead to a serious breakdown. My ability to behave near
normally at times has led others to believe that I can do it all the time and if I don't then I
am lazy, unmotivated, manipulative, and deliberately annoying. No one expects a tightrope walker
to do it all the time...
... If I was placed in a slight stress situation, words would sometimes overcome the barrier and
come out.... a person with autism is: "I am what I think rather than what I feel" ...
When a "normal" person thinks about something, the facts and the emotions are combined into a
seamless whole. (I now understood why so many people allow emotions to distort the facts.) As an
autist, my mind always separates the two. Even when upset, I scan my mind for "What's the
customary response for this type of event/conversation/behavior?"
I keep reviewing the facts until I can come to a logical conclusion. For me, social
relationships have been learned solely by intellect and use of my visualization skills. All my
thoughts are in pictures, like videotapes. When I encounter a new social situation I scan my data
banks for a similar situation that I can use as a model to guide me. My data banks also contain
an archive of previous experiences, even news articles about diplomatic relationships between
different countries. I use these scenarios to guide me in different situations. I then run
videotapes in my imagination of all the possible ways to predict how the other person might act.
Other people appear ridiculous to me, unpredictable, emotional unguided missles who's trajectory I have to somehow "predict." I have great difficulty with new social situations if I cannot recall a similar situation to use as a guide. Over time, I have built up a tremendous library of memories of my past experiences, TV, movies, and newspapers to spare me the social embarrassments caused by my autism.
Dr. Asperger noted that autistic children observe themselves constantly. They see themselves as an object of interest. For most people social interactions and emotions are the most important thing in their life. I have emotions but they are more like child emotions and only when I was working on my book, Thinking in Pictures, I realized I'm missing emotional complexity in my life, but I have replaced it with intellectual complexity. I obtain great satisfaction out of using my intellect. I like to figure things out and solve problems. This really turns me on. When I observe emotional complexity in others, it is sort of a rhythm that goes on between a boyfriend and a girlfriend. I often observe this on airplanes. Sometimes I get to sit next to them. It is similar to observing beings from another planet. The relationship is what motivates them; but for me, it is figuring out how to design something.
Self-stimulation, obsessions, rituals etc. are common behaviors in autistic persons.
Self-stimulation releases tension and regulates sensory input. It compensates for the lack of
interpersonal stimulation autistic people experience. There's often a direct correlation between
increases in self-stimulation and decreases in self-injury. When it's necessary to blend-in,
self-stimulation needs to be modified, of course. But obsessions are an inherent part of autism,
providing the "sense of reality" necessary to maintain one's sanity.
Playground teasing for autistic children is routine due to the way they appear to non-autists.
Some people believe they should allow children to be bullied because it will "toughen them up",
they need to learn to act normal, they brought it on themselves (by acting weird), or, simply,
"kids will be kids". Teasing may not affect the more oblivious autistics. Some autists have very
little awareness of other people as kids, let alone whether those people are teasing them.
But as they grow older, the teasing, beating, and social ostracism can lead to depresion,
self-injury, and suicidality. Teasing and bullying can have very serious consequences. Training
the kid in self-defense is essential. Don't impart the lie that the world is inherently fair.
It's WAR, and any parent who doesn't enable their offspring to fight their enemies is leaving
their kids' survival in the hands of every mal-adjusted idiot they will encounter.
CAREER & AUTISM
[Book - "Thinking In Pictures: and Other Reports from My Life with Autism" -
Temple Grandin ]
This brings up the importance of getting autistic people in high school and junior high school
interested in something they can turn into a career. They need to build on their talents, such as
art work and computer programming. Autistics also need mentors to explain the ways of the world and to help in selling themselves to get a job. In fact, getting and maintaining a job is one of the most difficult steps in the life of a person with autism; often during interviews, people are turned off by our direct manner, odd speech patterns and funny mannerisms.
While I was working at Corral Industries, I learned that being technically right was not always
socially right. I criticized some sloppy welding in a very tactless way, and the workers got
angry. The plant engineer gave me some good advice: "You must apologize to the workers before a
small problem turns into a big one". He made me go to the cafeteria and apologize, and he helped
me learn to criticize more tactfully. I quit the job at Corral Industries and continued to write
for the Arizona Farmer Ranchman while I started my design business on a free-lance basis.
Free-lancing enabled me to avoid many of the social problems
that can occur at a regular job. It meant I could go in, design a project, and leave before I got
into social difficulties. I still don't easily recognize subtle social cues
for trouble, though I can tell a mile away if an animal is in trouble. However, I
would never stress enough how important it is that High Functioning and Asperger people develop
their talents. There should be places for these guys to work, making shoes or painting for
example: they need to be developed, they need to go to University. It is important to allow these
people to get a job and, if there are difficulties at a regular job, you can avoid sensory
problems being a free lance and working at home. But, I think also it's important to let all
children with autism develop their talents from the beginning.
• "...Most people go into a new job and will be able to sum up the social hierarchy pretty
quickly. They watch others to see how they are expected to behave. But a person with Asperger
syndrome will probably have all their attention devoted to making sense of their environment and
the work they are going to be asked to do."
• Social communication can be a big obstacle at work. You've got: Social bonding rituals
like sarcastic banter and teasing; networking and developing rapport with colleagues; the
pressure to perform well and impress at after-work social activities; handling bullies and
exploiters; and projecting an image of competence and intelligence. Trying to do work and cope
with all that at the same time is like doing the same job as the person next to you while
Asperger's & Success
Some of the world's most famous people showed signs of autism or Asperger's syndrome, according
to Jo Douglas, of The Spectrum Diagnostic, Assessment and Therapy Centre in Belfast.
"People with autism have an ability to see the world differently and have moved society on," she
"People with Asperger's have went on to become mathematical geniuses.
"They also can brilliant actors, as they've a better ability to read a script and adapt the
"Asperger's Syndrome provides a plus - it makes people more creative,"said Professor Michael
Fitzgerald, a leading expert at Dublin's Trinity College.
Historial Irish writer WB Yeats may have had an autism disorder, the professor believes.
He has just published a new book, about autism and creativity: Is there a Link Between Autism in
Men and Exceptional Ability?
Professor Fitzgerald said that Yeats' parents were told he would never amount to much after he
failed to get into Trinity College.
Even though he had problems with reading and writing and a poor academic record at school, he
went on to write poetic works of art and win the Nobel Prize for Literature, in 1923.
Famous people who, according to experts, have displayed signs of Autistic Spectrum Disorders
- Jane Austen (1775 - 1817), English novelist and author of Pride and Prejudice.
- Ludwig van Beethoven (1770-1827), composer of classical music during 18th - 19th century.
- Alexander Graham Bell (1847 - 1922), inventor of the telephone.
- Albert Einstein (1879 - 1955), scientist who developed the theory of relativity.
- Vincent Van Gogh (1853 - 1951), Dutch painter.
- Woody Allen (1935 - ), US comedian, director and actor.
Testosterone and Aspergers
- There are about nine males with Asperger syndrome for every one female with the disorder.
•Google: Asperger, testosterone, women
Asperger Syndrome has been described as an "extreme male brain". This theory holds that AS simply
matches an extreme of the male profile:
The "tomboy" theory: women with Aspergers display more male behaviors than NT women.
- with a particularly intense drive to systemize
- and an unusually low drive to empathize.
The amount of prenatal testosterone - produced by the fetus and measurable in the amniotic fluid
in the womb - predicts how sociable a child will be. The higher the level of testosterone, the
less eye contact the child will make as a toddler, and the slower the child will develop
The "Neanderthal Theory" attempts to link autistic, Asperger, and ADHD traits to the presence of
Neanderthal genes. The theory does not enjoy support from the scientific community.
Some of the points of this theory:
The main difference between Neanderthals and modern humans that can be observed in the
archaeologic record is raw material movement. Modern humans moved raw materials much longer
distances than Neanderthals did. This indicates that modern humans had much larger social
networks than Neanderthals had. The sudden explosive development during the Upper Paleolithic,
when Neanderthals and modern humans met, needs an explanation.
Neither modern humans nor Neanderthals had a comparable rate of technology development before
this. Since modern humans would contribute with larger social networks, and therefore the spread
of new technology, the role of Neanderthals in this must have been as inventors. It would then
follow that Neanderthals were much more inventive, but that they kept their inventions within
their groups. For several reasons explained in the theory, it then follows that a probable group
structure of Neanderthals were matriarchal and with no exchange between groups other than of
mates upon maturity. This postulate predicts:
More on this at:Wikipedia - Neanderthal Theory
- Autistics will often lack social adaptations for dealing with unknown people.
- Autistics will often be very efficient with conflict resolution in close-knit groups.
- Autistics will often feel they were born with the wrong gender when participating in
- Autistics will often be involved in BDSM, fetishes, exhibitionism, and other sexual
Stims & Traits
STIMS: "self-stimulation", behaviors believed to stimulate one's own senses. Examples
People with autism report that some 'self stims' serve a regulatory function for them, such as
calming them, improving concentration, or shutting out overwhelming sounds.
- rocking one's body
- echolalia (the repetition of vocalizations made by another person).
The vestibular system provides the brain with feedback regarding body motion and position. This
is commonly dysfunctional in Autism, and may be responsible for toe walking. Research studies
at the Center for Visual Management in Tarrytown, New York, four children who were toe walkers
had their toe walking eliminated within seconds after wearing prism lenses.
"Another intervention used to stop toe walking involves wearing a cast to stretch out the tendon.
The cast is applied every two weeks for a total of 6 to 8 weeks. Another treatment involves
surgery. Long-leg casts are then worn for six weeks and followed by night splinting for several
• Some try the phone book reverse stretch. Stand on a medium thick book and try to touch
your heels to the floor. Hurts at first so get into it slowly.
• It is assumed that toe walking has to do with sensory overload when the whole foot
contacts the ground or sole of the shoe.
WHY WOULD ASPERGER'S/AUTISM CAUSE TOE-WALKING? Some find that it improves balance, coordination
and motor-control. One seems to become more unsteady with normal heel-toe walking. Those who
experience this exhibit it more frequently indoors. This may be due to the narower pathways one
must maneuver within to negotiate furniture, walls, etc., while one has a much wider field to
operate within outdoors (It is believed that coordination difficulties are associated with AS &
SHOULD IT BE PREVENTED? Probably yes, since its odd appearance will cause problems fitting-in
socially. In an ideal world, it would probably be better to let people practice their natural
walking inclinations freely, but such hypothetical fantasies are useless for everyday living
As I further examined this trait, I wondered: Why is one inclined to do this while sitting, where
balance is not an issue? Is the calf-muscle conditioned to this raised position from general
toe-walking? After decades of normal walking, the calf muscle must certainly be used to flexing
normally by now. So the cause must be neurological rather than physical. But what would be the
neurological reason for doing this while seated?
When I assume a flat-footed position while seated, my upper body tends to lean forward as if to
compensate. I then arch my back sufficiently to assume normal upright seating. Perhaps the
toe-walking habit has conditioned the back to assume a partially-stooped position, and the seated
"toe-walking" is done to balance the forward-leaning back (and the resultant shift in one's
center of gravity). I think I'm onto something here...
POSSIBLE CORRECTIONS: braces for the foot to hold it flat while the back is held erect with a
posture-trainer or back-brace. (Such apparatus may have to be improvised from removable casts and
ordinary back-braces). A bit odd for wearing at the office, but while on one's home computer this
would draw fewer comments.
•Google Search: www.wrongplanet.net "stim" stimming
• "How do you stim?" - WrongPlanet Thread
AS Messageboard -
WrongPlanet.net - Multiple threads
GRASP - "Global, Regional AS Partnership" -
Pro-AS; Multiple info & history articles
Asperger & Career (on this site)
Asperger's & Employment -
Sensory overload, Selling yourself, - "...I became overloaded and couldn't even speak. My
boss thought I was drunk. The store: blasting music, flashing lights, people shouting for
attention... They all thought I was trying to get out of doing the work."
•STIM, Google Search: www.wrongplanet.net STIMMING:
• "How do you stim?" - WrongPlanet Thread
HUMOR: "Diagnosis for NT" - http://isnt.autistics.org
"INDIGO & CRYSTAL" - The idea that asperger/autism/ADD behaviors indicate a "scrambled energy pattern" which is more sensitive to negative energy emanating from envrionment and people. Solutions include becoming more gounded, physical contact with the earth (electromagnetic harmonization, discharging negative energies from the artificial environment), and becoming aware of their different order of perceptions.
• Google: "Indigo & Crystal"