Asperger's Syndrome: Understanding the Mystery

Asperger’s syndrome has been appearing more frequently in the media lately. Several months ago, the disorder stirred up some controversy in an article about the "original" Craigslist killing (Michael Anderson, not Philip Markoff), when Anderson’s attorney introduced his client’s Asperger’s diagnosis as a possible mitigating factor in his client’s actions; he claimed that it was impossible for Anderson to show remorse, or any type of "appropriate" feeling, even though he may well have felt it.

Earlier this summer, a Macalester College graduate filed suit against the college over an incident that occurred at the school’s first home football game. After Macalester lineman Jacob Bond refused to remove his football helmet during the national anthem, head coach Glenn Caruso asked him to leave the football team. In his suit, Bond claimed that the college "harassed him for exercising free speech and neglected its duty to deal with his Asperger’s syndrome…" (Minneapolis Star Tribune, July 18, 2009).

And, in a sure sign of the importance and increased misunderstanding of a complicated issue, Hollywood is now jumping into the fray with the movie Adam, a romantic comedy in which the male love interest turns out to have Asperger’s syndrome.

In short, Asperger’s syndrome appears to be popping up everywhere lately. But even with the growing number of reports about this disorder in the media, for many people, there is still a fair amount of confusion about it. What exactly is Asperger’s syndrome?

According to the book Asperger’s…What Does It Mean to Me? by Catherine Faherty, Asperger’s is actually known by many different names. High-Functioning Autism, Asperger's Syndrome or Asperger’s, Pervasive Developmental Disorder (PDD), Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS), and Autism Spectrum Disorder (ASD) are all terms that have been used to refer to autism, but that usage is not necessarily accurate.

While many people today have probably heard the term "autism" before, use of the term "Asperger’s" is relatively new (it was only formally recognized by the Diagnostic and Statistical Manual of Mental Disorders in 1994), and has thus been creating some confusion between that and autism among those hearing about both disorders in recent news reports. While Asperger’s is considered by many to be a form of autism, it is important to understand the characteristics that make it unique from that disorder.

According to the book The Everything Parent’s Guide to Children with Asperger’s Syndrome by William Stillman, while autism and Asperger’s both fall under the heading of the broader diagnosis of PDD, children with Asperger’s differ from children with autism because they show no clinically significant delays in language, cognitive development, development of age-appropriate self-help skills, adaptive behavior (other than social interaction), or "curiosity about the environment in childhood". Asperger’s, unlike true autism, is primarily an impairment in social interaction.

Stillman writes that in order to receive a diagnosis of Asperger’s, children must show impairment in two or more of the following areas:

• The use of eye contact, facial expressions, gestures, and other nonverbal behaviors during social interaction
• A lack of development of peer relationships
• Failure to "seek to share enjoyment, interests, or achievements" with other people
• Failure to reciprocate emotions or social gestures

In addition to those areas of impairment, Stillman says, a child with Asperger’s will demonstrate "restrictive repetitive and stereotyped patterns of behaviors, interests, and activities." What does that look like? Stillman lists the following common characteristics:

• Unusually intense preoccupation with one or more stereotyped interests
• Obsessively following specific, nonfunctional routines or rituals
• Repeated motions, such as hand or finger flapping or twisting
• Unusual preoccupation with parts of objects.

Many parents of young children (and children nowadays may be diagnosed at as young as 3 years of age) may occasionally see their children exhibit some of these symptoms, but in order for those symptoms to be definitively classified as Asperger-symptomatic, they must be significant enough to cause challenges for the child at home, at school, and in other aspects or their daily lives. This is not the same as a child flapping his hands in excitement over an anticipated birthday gift - many children might flap their hands out of excitement, but for a child with Asperger’s, the behavior is non-situational (although it may worsen in given situations), persistent, and problematic.

Children with Asperger’s may also have some sensory issues, with extreme sensitivity to textures, tastes, or sounds or smells; some unusual speech patterns, often either speaking in a monotone or in a "sing-song" manner; and may display what are often referred to as "flat affect" facial expressions - expressions that are fixed or unnatural-looking.

Just how common is Asperger’s? According to neurologychannel.com,
"Because Asperger's syndrome has been diagnosed in the United States only recently, it is unclear how many people have the disorder. Some studies indicate that 2 out of every 10,000 children have AS in the United States. Other studies indicate that as many as 3-4 of every 1000 children have this condition. Asperger's syndrome affects boys more often than girls, and siblings of children with the disorder are at increased risk."

For parents seeking a diagnosis for what they may perceive to be their child’s quirky, oppositional, or antisocial behavior, it is important to seek out a referral to a clinician qualified to make such a diagnosis. Such clinicians are usually pediatric psychiatrists or psychologists. The process of making a diagnosis of Asperger’s is complex, and includes medical evaluations; interviews with parents and/or teachers; and behavioral observations carried out by qualified clinicians.

Asperger’s can be difficult to diagnose, and because of this, it is often misdiagnosed, resulting in children being diagnosed with learning disorders, ADD/ADHD, dyslexia, anxiety disorder, bipolar disorder, and more. As with any difficult-to-diagnose condition, many myths have arisen about Asperger’s: Asperger’s children (or Aspies as they are more commonly being called) never make eye contact, are geniuses, don’t talk, can’t show affection, can’t learn, are stupid, are the victims of poor parenting, lack imagination, cannot build relationships, are a danger to society - the list is lengthy, and taken as a whole, quite sad.

The reality is that children with Asperger’s are unique individuals, just as children without Asperger’s are unique, so it is difficult and unfair to apply blanket generalizations to them as a whole. The one thing they all share is some level of difficult with social interactions. With the proper diagnosis; early intervention by parents, schools, and qualified clinicians; and greater public awareness and understanding of the true nature of this poorly -understood disorder, many of those myths can be dispelled, and children with Asperger’s can go on to lead productive and happy lives.

Resources: Asperger’s…What Does It Mean To Me? by Catherine Faherty, 2000;
Siblings of Children with Autism: A Guide for Families, by Sandra L. Harris, Ph.D., and Beth A. Glasberg, Ph.D., 2003; The Everything Parent’s Guide To Children With Asperger’s Syndrome by William Stillman, 2005.