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Asperger’s Syndrome or High-Functioning Autism

Posted by Marie.Bloomfield on April 25, 2015

 

  • Do you find it difficult to communicate and to socialise?
  • Do you experience intense emotions that are difficult to manage?
  • Do you have a particular intense interest?
  • Do you find it hard to empathise with other people?
  • Are you overly sensitive and intolerant of specific sound, touch, smell, taste, sensations, texture and so on?
  • Do you have stereotyped or repetitive behaviours?
  • Do you have low planning, organisational and self-help skills?
  • Are you clumsy, awkward and uncoordinated?

If you have many of those characteristics it is possible that you have Asperger’s Syndrome or an Autistic Spectrum Disorder.

Asperger’s Syndrome and Autism are one of the many neuro-divergent conditions that are part of the natural, normal human diversity which allow for a variety of functioning, self-expression, lifestyle and ways of being. Neuro-divergent conditions are a different way of relating to the world which at times has some benefits as well as disadvantages.  Many individuals gain by acknowledging their condition, being able to understand and accept themselves better.

What Is Asperger’s Syndrome(AS)?

The diagnosis of Asperger Syndrome(AS)  has been  revised in the  DSM-V(2013) to represents a new, more accurate medically and scientifically useful way of diagnosing individuals with autism-related disorders. Asperger’s Syndrome has been re-classified in the Autism Spectrum Disorder, more specifically on the “high functioning” end of the spectrum, however, the term Asperger’s Syndrome is still widely used. Individual with Asperger’s Syndrome or as they called themselves “Aspies”,  typically, have social difficulties, poor communication skills, restrictive, repetitive, and stereotyped patterns of behaviour and a narrow field of interest. 

Asperger’s Syndrome is a neurodevelopmental disorder which is present from early childhood.  Studies of children with Asperger’s Syndrome suggest that their problems with socialization and communication continue into adulthood.  Also they are prone to develop additional mental health conditions in adolescence and adulthood such as attention deficit, anxiety, depression, obsessive-compulsive  and bipolar disorders. They often feel isolated because of their poor social skills and narrow interests. Although now with the age of internet and social media they have found new ways to connect with one another.

The Asperger's Syndrome may vary and can range from mild to severe. The following characteristics are rarely all present in one person or may vary in degree:

  • Difficulties interacting with others especially their peers;

            -awkward and anxious in social situations.

            -do not make friends easily  

            -difficulties in initiating and maintaining a conversation that is not about their special interests or themselves,

            -conversation is often one-sided.

            -very literal and concrete

            -difficulties understanding non-verbal messages or abstract concepts.

            -difficulties negotiating with the perspective of others and to be empathic

            -inappropriate social interactions. 

            -may be misjudged by others as rude, disrespectful or pedantic.

  • Difficulties in managing emotions; have melt downs and experience emotions intensely and have difficulties in calming themselves or expressing emotions in socially acceptable ways. 
  • Repetitive behaviours; which may look odd (hand wringing and finger twisting) or having unusual mannerisms
  • Unusual preoccupations, interests or rituals; have set and rigid ways of thinking or behaving. They show a narrow range of interests, being intense, sometime obsessive.
  • Delayed motor development; clumsiness or uncoordinated motor movements.
  • Difficulties communicating; may not make eye contact when speaking to someone. They may have trouble using facial expression, for instance, not smiling and have flat tone of voice with few gestures. They may repeat questions or statements.
  • Average to above intelligence and verbal skills; many are talented in a special area, such as in the field of computing, music or mathematics.
  • Sensory overload; overly sensitive, intolerant and hyper-vigilant of specific sounds, touch, light, taste, smell or texture.  They can under or over-react to pain and discomfort.

Some children and adults may have many characteristics of Asperger’s Syndrome or High functioning Autism and still be able to function quite well at home, at school and at work. For a comprehensive assessment, there is a need to look at the strengths of each individuals as well as the areas of their difficulties and the support needed and available. 

Causes of Asperger's Syndrome or Autism

The cause of Asperger's syndrome is not known. We know that it tends to run in families which suggests that it may be inherited (passed on from parent to child). Research has found structural and functional differences in specific regions of the brains affecting neural circuits that control thoughts and behaviors causing different ways of relating to themselves, others and the world.

Frequency of  Asperger's Syndrome

Asperger's Syndrome has only recently been recognized in the 1990’s and therefore, it is difficult to know it’s prevalence. It is believe that it is more common than autism and the estimate range from 1 in every 100 to 250 or higher. It is four times more likely to be reported in males than in females.

 Asperger's Syndrome and Autism Spectrum Disorder Diagnosis

When diagnosing Asperger’s Syndrome there is a need for assessment of the Autism Spectrum Disorder (ASD).  Professionals like paediatricians, psychiatrists and psychologists will use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to make the diagnosis. The DSM lists the signs and symptoms of ASD and states how many of these symptoms must be present to confirm a diagnosis of ASD.

The DSM-5(May 2013) changes the way Autism Spectrum Disorder (ASD) is diagnosed. The changes reflect the current understanding of ASD, based on research. The ASD diagnosis also come with a severity ranking of 1, 2 or 3 depending on how much support the person needs. The diagnosis is based on two areas of difficulties: social communication(interaction and communication skills) and repetitive and restricted behaviour and interests (fixated interests, repetitive behaviour and sensory sensitivities)

In a child, when a number of symptoms are present the assessment can begin with a complete medical history. For instance, a toddler may have had low muscle tone or dyspraxia.  Psychologists can do further testings using developmental, behaviour, cognitive and social measures to establish a diagnosis.  Reports from parents and teachers are most important and will be taken into account to confirm the diagnosis. There is no single test available to diagnose Autism Spectrum Disorder (ASD). Instead, diagnosis is based on watching how a child plays and interacts with others (current development), interviewing parents, and reviewing the child’s developmental history (past development). By using a combination of tools, professionals can diagnose a child with ASD, and determine where on the spectrum the child falls.

High functioning Autism or Asperger’s Syndrome may remain undiagnosed until a child or adult begins to have serious difficulties in school, in the workplace or in their personal lives. A diagnosis can be investigated when it becomes clear that  the child’s abilities is less than the social demands being put on him or her.   Indeed, many adults with Asperger Syndrome are never diagnosed or only diagnosed when seeking help for related issues such as anxiety, depression, relationship break down or when their own children are diagnosed.

New diagnosis of Social Communication Disorder (SCD)

Individuals who were previously diagnosed as Asperger’s Syndrome may be re-classified as being affected more simply by a new condition called Social Communication Disorder (SCD) which is similar to ASD. But according to the DSM-5, the main difference between SCD and ASD is the absence of repetitive behaviour and sensory sensitivity.

For most people the process of the diagnosis can be very confronting. Typically the report will list deficiencies but it also point to the areas where there is a needs intervention. If your child receive a diagnosis for ASD, she/he may be eligible for financial support from the government and access to early intervention.

The typical professionals who can diagnose Autism Spectrum Disorder are Paediatrician, Psychiatrist and Psychologists and you may need a referral from your GP to access those professionals.

Treatment for Asperger's Syndrome or Autism Spectrum Disorder

Asperger’s Syndrome or Autism is a different way of thinking and being. There is not a cure as such but there are interventions that will help to improve functioning and well-being. A treatment plan will ideally coordinate therapies that meet specific needs and goals. In children, early interventions are always an advantage.

Effective treatment programs will usually involve:

  • Psychologist:  to provide cognitive behavioral therapy  and  mindfulness to manage anxiety, anger or obsession  as well to  promote social skills.
  • Medication: if necessary to manage depression, anxiety, obsessive-compulsive or bipolar disorders
  • Occupational or physical therapist: for children for sensory integration skill or to improve motor coordination
  • Speech therapist: to develop a more reciprocal normal communication
  • Parent training and support: to help to understand the special needs of the child and to be able to carry out programs at home

The future of children with Asperger’s Syndrome or High Functioning Autism

Many “Aspies” have normal and successful lives despite their struggles. However, they are prone to experience intense difficult emotions such as anxiety and depression.  

Because Asperger’s Syndrome or High-Functioning Autism has only been diagnosed recently there is a lack of long term research.  Many adults with Asperger’s Syndrome report that their difficulties eased over time and that they have learned to behave in ways that are socially acceptable. However, for most, social interactions remain a source of anxiety and difficulties. In addition, Adults with Asperger’s Syndrome often continue to struggle with self-care, planning, organisation as well as social and romantic relationships. Despite their high cognitive abilities, many find it difficult to get a job and often remain in the family home. Some adults with Asperger’s Syndrome, who are more intellectually gifted do learn to relate socially and are able to marry and obtain mainstream employment.

Some adults with Asperger’s Syndrome or on the Autism Spectrum excel in their jobs; especially if there is a low requirement for social interactions. For instance, architectural or engineering drafting, computer programming, language translator, special educator, librarian and scientist. Many adults with Asperger syndrome have been known to make great intellectual contributions in music, in sciences,  computer sciences, mathematics, and physics.  Many of them have special talents which lead them to make contributions in their field of interest and even to win Nobel prizes for their work. There are many great people that are suspected to have had Asperger’s Syndrome or be on the Autism Spectrum such as Bill Gates, Albert Einstein, Marie Curie, and Wolfgang Mozart. Many Asperger’s have shined and amazed the world with their achievements.

Screening test
Here is a pdf file of a screening test by Psychologist Simon Baron-Cohen and his colleagues at Cambridge's Autism Research Centre, who have created the Autism-Spectrum Quotient, or AQ, as a measure of the extent of autistic traits in adults. AQtest.pdf

The test is not a way of making a diagnosis for high functioning individuals on the autistic spectrum or Asperger’s.  Remember that you can’t diagnose autism or Asperger by taking a quiz on the internet.  The screening test is only an indication. There may be other factors contributing such as social anxiety or depression.
It is possible also that the individual has a lot of the traits but this may not be causing a problem in their day to day living.  A diagnosis and treatments are offered only if the person is struggling or is suffering in some ways.

If you are interested to know more, the following links offer standardised screening test online which gives an indication of AS but are not diagnostic.

For children:   https://psychology-tools.com/cast/

For teens and for adults: