Psychological Conditions

Asperger’s Syndrome (AS)

Asperger’s Syndrome (AS) is classified as being on the Autistic Spectrum. Unlike Autistic Disorder, however, there are no significant developmental delays in general adaptive behavior, overall intellectual level, or basic language ability. AS is more common, by far, in boys and its exact cause is still being researched.

The core issues in AS are in the realms of social behaviors, motor functioning, and the nature and range of interests. Typical manifestations include problems in non-verbal social behaviors such as poor eye contact and facial expressions that are mismatched with situations and expected feelings. Understanding the specific mind-set and emotions of the people with whom they interact is hard for those with AS, thus they characteristically lack social reciprocity. Being too literal and having difficulties following nuances of social communication is common, as is an atypical speech pattern. Often, AS individuals sound monotone or speak with a peculiar rhythm. As children, they tend to relate better to older and younger people as opposed to those of a similar age. Consequently, making and sustaining friendships is quite problematic.

Having AS is very frustrating. For the person with AS, experiencing life is akin to watching a movie that is missing scenes or has dialog that is randomly muffled or accentuated. This is one of the reasons that AS is associated with periodic outbursts of temper or, conversely, feelings of alienation and social withdrawal. For family members, the lack of being able to comprehend or feel connected to one’s own child can be overwhelming and lead to a whole gamut of difficult feelings.

Also common in AS are atypical or restricted interests. For example, someone with AS may only want to learn about maps, historical dates, animals or a particular game. Additionally, people with AS often seem physically awkward and are often found to have sensory issues like over-reacting to noises or needing to smell certain objects. They are often very selective about food. This can lead to problems in getting adequate nutrition. In addition to various kinds of worries and anxieties, stereotyped movements or tics are also a common aspect of AS.

Impulsivities, compulsivities, or both can accompany AS. Therefore, it is not surprising that Attention-Deficit Disorder and Obsessive-Compulsive Disorder can be co-occurring conditions. Compulsive Behaviors that may serve, in part, as compensations for the basic physiological sensitivities and lack of control that are experienced are often found. Needing to travel certain routes or sitting in particular chairs, and repetitiveness are prime examples of these types of problems.

Although AS starts in childhood, many are not accurately diagnosed until teenage years or as adults. High intelligence, special talents or strengths, and achievements can mask AS and make diagnosis or acceptance of this condition by parents or educators more difficult. Although AS is not necessarily a barrier to educational, career success per se, high achievers with AS who have had insufficient intervention or lack insight tend to have inadequate or problematic social lives, even if they have been able to attain a relationship. Actually, it is often not AS itself but heightened levels of anxiety, depression, or a relationship issue that lead to first clinical consultation for high achievers with AS.

Although AS was first described in 1944, only fairly recently did the prevalence of AS and the need for better diagnostic methods and more effective interventions become evident. AS benefits from a comprehensive approach involving knowledgeable professionals including physicians, psychologists, educators, speech therapists, occupational and physical therapists, and behaviorists. The psychological and behavioral focus is on improving social understanding and social skills (pragmatics), parent education, stress management, and addressing the negative emotions and behaviors that interfere with functioning. A particular concern is the reduction of sensitivities and compulsive behaviors.

Although early intervention is key, it is really never to late to get help. In fact, there is increasing evidence that many of the characteristic symptoms and problems associated with AS can be modified over time. AS is a complex and challenging condition but the good news is that improvements can be made.