Asperger’s syndrome: a little known developmental disorder
MCR Cognitive Development Unit
3 Taviton Street London WCIH OBT
[Edited by MAAP Services, May 2007]
You may be involved with a rather baffling child or adult. You may have wondered if he or she has autism. The name “Asperger’s syndrome” may have been mentioned. We aim to tell you, in a few paragraphs, something about how this term is used, and what it implies.
What is Asperger’s Syndrome?
Asperger’s syndrome is named after an Austrian pediatrician, Hans Asperger (1906-1980). He identified a group of children and adults who had characteristic problems in the areas of social interaction and communication. He called them autistic, and emphasized their narrow special interests, good language and idiosyncratic learning styles: like a “little professor” or “a child just landed on earth”.
The term Asperger’s syndrome has been adopted recently to cover those individuals who, although may have many of the same difficulties as other people with autism, are different in certain ways which make professionals unwilling to use the term “autistic”. In particular, the person may have great interest in others, and wish to be sociable, although finding such interaction very baffling. Contrary to the stereotype of the silent and withdrawn autistic child, the person with Asperger’s syndrome may have very fluent language – may in fact tend to talk on and on regardless of the hearer’s interest. Despite superficially good language, they still have problems with communication. They may be over-precise, over-literal and socially insensitive in their communication. Particularly noticeable is an odd quality to the voice or speech melody, which can be monotone, silted or singsong. Body language, posture and gait may also be strikingly odd. A good vocabulary and excellent rote memory often leads people to over-estimate the real level of understanding and intelligence. Sometimes a child with rather poor general understanding is thought to be a prodigy because of unusual memory skills (e.g. being able to hum Mozart arias at the age of two).
Diagnosis of Asperger’s syndrome
Criteria of Asperger’s syndrome overlap greatly with that of autism: impairments in social interaction, in communication and imagination, presence of repetitive behavior, and imposition of routines. In addition, special interests (train timetables, astronomy, dates, collecting objects as well as facts) and clumsiness are considered particular features of Asperger’s syndrome. Individuals can be highly intelligent, while lacking in common sense. Their intellect may allow them to compensate for their handicaps, and obscure the real nature of their difficulties. The incidence of Asperger’s syndrome is as yet unknown, but is estimated by some to be one in every 150 live births. Asperger’s syndrome is much more common in males than in females.
What causes Asperger’s syndrome?
Asperger’s syndrome, like autism, has a biological basis in the brain. There may be a genetic component, and a genetic link to autism; autism and Asperger’s syndrome occur in the same family more often than by chance alone. The area of the brain affected is not yet known.
Not simply eccentric
Not everyone who has social difficulties, communication impairment, or a special interest has Asperger’s syndrome. People with Asperger’s syndrome are different from normal eccentrics in that they have not chosen to be different. For instance, Asperger’s syndrome individuals have almost insurmountable difficulties in understanding humor, and the intentions and attitudes of others. The difficulties a person with Asperger’s syndrome experiences will usually impair the quality of their lives, in many different areas. The most notable, and painful, is the lack of friends, and difficulty in integrating in job or school, despite the desire to “fit in”. These problems are all of a different quality and magnitude from those experienced by people who are sensitive loners who may retreat into a rich inner world of fantasy.
Should you start to worry?
It would be quite wrong if, having read so far, you began to wonder whether every shy child or adult has Asperger’s syndrome. The aim of this article is not to raise worries, but to give those readers who are already worried about their child’s long-standing social impairments a point of reference, and a source of further information. Most families affected by Asperger’s syndrome have suspected something seriously amiss with their child from the earliest years.
What can be done?
Recognition and diagnosis is a vital step. This allows the people with Asperger’s syndrome as well as the family, to stop blaming themselves. The social and communication problems must be recognized as real handicaps, and not as simply a lack of manners, willingness, or intelligence. Support and understanding are needed from those around. This is especially true during adolescence and adulthood, when the person with Asperger’s syndrome may have some dawning awareness of his/her handicap, and become depressed. People with Asperger’s syndrome do not out-grow their social naiveté and striking lack of “common sense”. Therefore, they are very vulnerable and liable to panic in apparently ordinary situations of change. People with Asperger’s syndrome lack empathy, which creates its own problems for caregivers. It is useful to remember that the person with Asperger’s syndrome may be self-centered, but is not deliberately selfish. This distinction may be hard to make, and those around may instinctively feel that the Asperger’s syndrome sufferer is being callous, unkind, or even cruel and calculating. In fact the root cause of such problem behavior is probably a fundamental lack of social understanding and insight.
Choice of educational provision is a major concern. Many such children are in mainstream schools, where degree of success depends on considerable support. The needs and personality of the individual child and their family need to be considered, and is not fruitful to make general recommendations. A social skill curriculum is a necessary addition to the child’s education.
A collection of chapters by professionals and parents can be found in U. Frith (ed): Autism and Asperger Syndrome. Cambridge: Cambridge University Press, 1991.