Asperger’s syndrome (AS) is a neurobiological condition described as an autism spectrum disorder. An autism spectrum disorder is an autistic condition that does not meet diagnostic criteria for any other pervasive developmental disorder. Diagnostic manuals distinguish between AS and high-functioning autism (HFA) in two areas: HFA is associated with language delay, AS is not; and AS is associated with poorer motor function. Some experts on AS, like Tony Atwood, argue that AS and HFA are the same and these distinctions are artificial.
Ten years ago, few people in the United States had heard of AS Syndrome. Now, its presence is ubiquitous in media headlines and popular culture. Although the syndrome was first identified by Hans Asperger in 1944, it would be half a century before AS was added as a legitimate diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in the United States. Other countries had been researching AS for decades, though the term "Asperger’s syndrome" did not enter the English lexicon until 1981, following a published study by researcher Lorna Wing.
As awareness of AS has grown, the number of children and adults getting an AS diagnosis in the US has climbed. Critics harshly charge psychologists/neurologists of handing out the diagnosis like candy on Halloween, dispensing it to every "freak" that comes knocking as an excuse for children once considered "quirky."
A Few Facts About AS
It is said to be more common in males than females, though this might be partially because females with AS have a different social education from males, leading to differences in how it manifests. As people with AS age, its more obvious characteristics become less apparent, and many adults are misdiagnosed or never diagnosed. You can find full diagnostic criteria online, but to summarize, here are a few characteristics:
*Poor use of nonverbal behaviors (eye contact, facial expressions, communicative gestures)
*Difficulty making friends with peers
*Lack of social/emotional reciprocity
*Obsessive interests, inflexibility, rituals.
Controversy has erupted in AS communities as to whether it is a disability or a difference. Diagnostic criteria require that it "causes clinically significant impairment in social, occupational, or other important areas of functioning." One could argue it is therefore, by definition, a disability because if it were not disabling, it would not technically meet the criteria for an AS diagnosis.
I have my own views and can see both sides, but because the label has no bearing on how the condition affects someone (though not classifying it as a disability could hamper funding for research and treatment), I will not address this complicated argument.
AS cannot be diagnosed via blood test or brain scan, though MRI brain scans have often shown differences between those with AS and those described as "neurotypical." In children, diagnosis usually results from observation. Parents are interviewed on the child’s developmental behavior and the children take various tests (IQ tests, personality tests) and talk with the examiner. There are a few tests for adults, including the AQ test, found online, but nobody knows how accurate such tests are. Simon Baron Cohen (Borat’s cousin!) is a leading researcher on AS in the United Kingdom, and he is working with colleagues on an Adult Autism Assessment test.
Tony Atwood noted that AS is a spectrum disorder, meaning it is on a scale. For example, if there are 100 criteria of AS and 25 required for a diagnosis, two people with AS can be quite different from one another. In addition, someone might meet 25 criteria whereas someone else might meet 75.
Baron Cohen has described AS as an "excessively male brain." There is much speculation about what causes AS, but it appears to have a genetic component and recurs in families. In my family, I have AS, my estranged husband has AS, and at least two of my children have AS. The oldest was never formally evaluated but is believed to be "on the spectrum." My husband believes his mother may have had AS.
AS parents are a mixed bag. Some do well, particularly with AS children, and others do quite badly. While I have a fairly close relationship with my children (though not typical of relationships I’ve seen between other parents and children), my husband struggles with parenting. Learning about AS has helped him become a little better, and it gets better as the kids get older. People with AS often have trouble appreciating age distinctions, so parents with AS can have trouble accepting that children are not miniature adults and tampering expectations accordingly.
Sometimes people with AS have "comorbid" conditions, like sensory processing disorder, OCD, Tourette’s, or ADHD (although the US DSM-IV precludes a diagnosis of ADHD with AS). Bipolar disorder has also been associated with AS. Teenagers with AS are more likely to experience depression.
Articles on AS often describe "restricted interests" as eccentric ones, like an obsession with train schedules (something Alfred Hitchock had) or with vacuum cleaner parts. Recent studies on AS suggest the range of interests has shifted and includes things like Pokemon, Anime, or certain electronic games.
Many positive qualities are associated with AS. Some people tend to be gifted in a specialized area—commonly mathematics and sciences. Some have other strengths, such as music or art. People with AS often do well in careers associated with one of their special interests. They tend to have strong memories, an ability to see details that others overlook, and unique problem-solving abilities—an ability to "think outside the box." Kids with AS, however, frequently have trouble meeting homework expectations and this can hinder academic progress.
People with AS can have a strong (perhaps rigid) sense of right and wrong and are unlikely to be dishonest or disloyal as partners, friends, and employees. If you get a bad haircut, and want an honest opinion, someone with AS will offer one.
Sometimes I have trouble discussing AS with those unfamiliar with it. They seem dismissive and try to reassure me that my kids seem "fine." If I talk to a friend about something one does that has me concerned, she feels she is comforting me in saying "All kids do that" or suggesting the behavior is probably not AS. Perhaps I am oversensitive, but I get the sense some people are skeptical that so many people in one family could have AS or do not believe it’s a "real" condition.
I think people expect it to be like "Rainman-type" autism, and when it is not, they become dismissive. With my children, it may take days before you realize something is atypical, particularly if you do not know what to look for or see them in their comfort zone.
If you are concerned something is not "right" with your child's development, do not let anyone persuade you to "wait and see" or hope the behavior is outgrown. In looking back on my experiences with my children, I saw many indications things were not typical, but neither I, nor doctors, nor teachers knew enough about AS to piece it together. If I knew then what I knew now, it would have been obvious.