What is Asperger's Syndrome?

(Asperger's: pronounced ass'-per-ger's with the accent on the first syllable and a hard 'g' sound. It is pronounced much like hamburger but with a ‘p’ instead of a ‘b’)

You, no doubt, know a person with Asperger's syndrome (ASP) but you may not have known that there was an official name for what you were observing. ASP is affectionately referred to as the "geek syndrome" because people with ASP are often the technologically or scientifically oriented individuals in your school or work place. They are the people you might go to when you have a technological problem or if you need an information resource person. They are probably not the ones you would seek out for emotional support, however.

Asperger's syndrome can be thought of as a neurosocial condition because the brain and nervous system are wired in such a way as to affect social behavior. The story doesn't end there, however. The condition also affects perception, sensation, cognition, physical coordination, organization, and moods. At the present time, ASP is thought to be an "autistic spectrum disorder". That means that the wo disorders of autism and ASP share characteristics, origins, and traits. Attention deficit disorder is also considered to be a close relative of the autism spectrum of disorders and in all 3 diagnoses, the area of the brain that is responsible for planning, organization, and impulse control is different than it is in neurotypicals.

The line between autism and ASP is somewhat of a mystery and is, in some cases, a very fine line. Intelligence, use of language, and the desire for social contact seem to be the traits that separate them more than any other. Autistic individuals do not like socializing and are not interested in other people, for the most part. They develop language skills much later than other children and in more severe cases, they may not learn to speak at all. Autistic individuals have an IQ in the mentally retarded range. There are autistic individuals who have language delays and all of the other traits associated with autism but have an average or higher IQ. They are called high-functioning autistics.

Distinct from people with autism, people with Asperger's syndrome, with their shyness and social phobia, often wish to socialize but have a difficult time knowing how to connect with others. ASP is accompanied by an IQ range of average to very superior.

Although ASP was first brought to the medical community's attention in 1944 by Hans Asperger, it was not entered into the psychiatric diagnostic manual of mental disorders until 1994. Since that recent inclusion, there has been more scientific research and interest in ASP than ever before. Theories about the causes and symptoms of the syndrome are rapidly changing as new brain imaging and neurological research studies increase our knowledge.

Most people with ASP have a special topic of interest that interest them to the exclusion of almost everything else. Common topics include trains, gadgets, electronics, history, music, or languages. Out of a burning desire to talk about his or her interest, he or she will bring every conversation to the special interest, no matter how the conversation began. Reciprocal, or back-and-forth conversation, is not in the skill set of a person with ASP. They will talk "at you" incessantly about a topic long after you have gone into a blank stare. It is this type of conversational style that makes them appear socially inept and it is why they are so often rejected.

Because of social awkwardness, people with ASP are usually on the outskirts of any social structure in which they find themselves, be it at work, school, church, or the community. You probably won't find them standing at the water cooler at work gossiping or engaging in small talk, for instance. Parties and gatherings are rarely attended by them, except when it is with their own family. They tend not to belong to groups, clubs, or organizations because their hypersensitivity to lights, crowds, noise, and motion can negatively impact their moods. Living and working alone is often much preferred, and because the syndrome can be accompanied by a superior intelligence, they can excel when left to create and design independently without the distractions of the social environment.

Having ASP has it's advantages. The syndrome endows the individual with a larger than average brain size that gives them savant-like abilities. People with ASP can focus intently on one topic and have a tenacity that is matchless. They can store huge amounts of information, learn languages easily, and are talented scientists, musicians, technicians, and historians. If there is something you want to know, ask a person with ASP. You will have a detailed and accurate response that will surprise you by it's volume and breadth.

People with ASP love and, in fact, crave information almost as you might crave chocolate. They are in good company. Amadeus Mozart, Albert Einstein, Alexander Graham Bell, Thomas Edison, and Sir Issac Newton, just to name a few, are posthumously thought to have had ASP. More recently, Dan Aykroyd announced that he had been diagnoses with ASP and many people believe that Bill Gates has Asperger-like traits, although this has not been confirmed publicly.

Because of an intuitive understanding of how mechanical or electronic machinery function, a person with ASP can usually fix just about any gadget. They tend to like working with machines more than working with people because machines are more predictable. Unlike machines, people lie, deceive, manipulate, or connive. These social tricks are foreign and confusing to the person with ASP.

Polite niceties seem phony and dishonest to the person with ASP. Social convention confuses them. The term "brutal honesty" has often been applied to their list of characteristics, and although their tactlessness may appear to be rude to most people, it is not meant to offend. Rather, it is meant to harmlessly and straightforwardly inform. They might point out to you, for instance, that your breath is bad, when your relationship does not warrant such intimate or sensitive discussions.

Don't be too surprised if you ask a person with ASP how he or she is feeling and get an explanation of what she or he is studying or working on instead. They are usually unaware of their feelings and may be accused of not having them at all. Significant others complain of feeling emotionally neglected by them. They do have deeply felt emotions, but may not know that they have them, let alone know how to express their feelings in words. Because the expected smile in the eyes, the voice, and on the mouth, is missing when you greet them, you might make the mistake of thinking that they don't like you. Don't be misled. They may like you very well but can't show it in the way that is recognizable to you.

You may have noticed a strange posture or gait when you met a person with ASP. They might walk stiffly with arms held tensely at their sides. Their shoulders may be carried high, or the opposite may be true. Because of low muscle tone and hyperflexibility they might slump in the chair or "slouch" when they walk. They generally have poor motor coordination and as a result, they almost always report that they were the last student to be chosen for a place on the team in school sports. They can excel, however, at solitary sports such as swimming, bicycling, jogging, or pool.

Their hand writing is usually pretty unreadable so they often adapt by printing or word processing. Hand flapping at the wrists, rocking back and forth in the chair, finger tapping, or knee bouncing soothes them but these behaviors are off-putting to others. You might observe a tense or pained facial expression when they are speaking to other people. They might have stiff lips and a sideways glance because they are so uncomfortable with social conversation. The effort to conform, when they don't understand social rules and conventions, makes them feel confused and anxious. They might avoid making eye-to-eye contact out of shyness and an aversion to sensory input, or they may stare at you too intensely.

Recognizing faces can be difficult for people with ASP. They report that they have to know you very well before they could recognize you in a crowd. They often have trouble reading and understanding body language, facial expressions, voice tones, analogies, or speech idioms. It is as if they were from an alien culture and were never taught the meaning of subtle gestures and nuances of conversation. As an example, if you were from Japan and were invited to an American home for dinner, you would take your shoes off at the door and while eating, you would keep both hands and arms on the table. Your American hosts would think you rude if they did not know the Japanese customs. People with ASP usually feel out of step with their peers in much the same way as that Japanese guest. In fact, people with ASP report that they feel much more accepted when around people of another culture because they are not expected to understand cultural traditions.

These technologically oriented people are concrete thinkers and therefore the meaning of a joke may escape them. They might understand the joke but can't figure out why it is thought to be funny. It just seems absurd to them. Tell them the one about a priest and a rabbi who go to heaven's gate together, etc... The person with ASP may tell you that it is silly to think that those two people would go anywhere together, in the first place. Despite the concreteness in their thinking, or perhaps because of it, a person with ASP can be very funny and entertaining. They see the absurdity of the social culture from the point of view of an outsider and can make us laugh at ourselves.

Add to the above list of characteristics a long list of symptoms such as anxiety, depression, obsessive- compulsive disorder, attention deficit/hyperactivity disorder, bi-polar disorder, tic disorders, sleep disorders, and learning disabilities, and you are getting closer to what it is to be a person with ASP. They struggle with sleep, eating, digestive, and sensory issues, all of which make melding into the social environment difficult.

In addition, many, if not most, people with ASP had been bullied in school and in the work place and suffer from trauma-related disorders, as a result. Most often they have been rejected, or worse, made fun of in social settings and it hurts them terribly. Loneliness and isolation is their constant companion.

ASP is a complicated combination of characteristics, extraordinary talents, and traits. It has a wide variety of symptoms that differ from one individual to the next. It can range in severity from very mild and hardly noticeable, as in the case of the eccentric college professor, to the very deeply affected individual who will never have a job or a family of his own. There are about 4 males to every one female diagnosed with ASP and there are approximately one in every 150 individuals who are diagnosed with autism spectrum disorders (including autism, ASP, high-functioning autism). The numbers of individuals diagnosed with ASP are increasing with time probably because we are diagnosing it earlier in development, diagnosing the milder forms, and are generally better at recognizing it. We don't know if it is increasing in prevalence at this time.

The cause of the syndrome is not fully understood but it appears to be the result of neurological changes in the brain of the developing fetus. The possible causes of ASP being investigated include exposure to neutotoxins, an over exposure to testosterone during gestation, nutrition, food sensitivities, genetics, exposure to mercury in vaccines, and a lack of oxytocin (the bonding hormone in mother's milk) in infancy. According to John Oritiz, Ph.D., a psychologist specializing in ASP, one in ten individuals born in a town in New Jersey have been diagnosed with ASP. This town was built on a toxic dump site.

There are a number of disorders that people with ASP may be incorrectly diagnosed with before they are finally diagnosed with ASP such as fetal alcohol syndrome, nonverbal learning disorder, tourettes, attention deficit/hyperactivity disorder, schizophrenia, obsessive-compulsive disorder, and/or traumatic brain injury. A thorough assessment by a trained psychologist or neurologist who specializes in the treatment and diagnosis of autism spectrum disorders is needed for a definitive diagnosis.

The syndrome cannot be eliminated or "cured" but treatment for disturbing symptoms such as anxiety, depression, or phobias that some individuals with ASP experience is available and effective. Many people with Asperger's never need psychological or psychiatric treatment. They are happy, satisfied, and self assured. But, for those who are not, the problem for seekers of treatment is that not many mental health practitioners are familiar enough with the syndrome to treat it effectively. A mental health professional treating ASP must be equipped with a comprehensive knowledge of the syndrome and have an appreciation for the syndrome as a whole, versus as a collection of disparate symptoms.

ASP treatment specialists find that social skills training, anger management skills training, trauma recovery methodologies, mindfulness techniques, and cognitive/behavioral therapies are all helpful. Self-esteem and assertiveness building, and stress management techniques are all useful for bringing about a feeling of well being and confidence. Medicine for the symptoms that can sometimes trouble people with Asperger's such as sleep deprivation, ADHD, depression, obsessive-compulsive traits, and anxiety can be effective. But, above all else, the person with Asperger's syndrome must begin the journey of accepting himself completely and embracing the syndrome that brings them valuable talents and traits. Self acceptance brings with it a comfort in social situations and it chases away depression and anxiety.

Although there is no known cure for ASP, in either medicine or psychology, the brain is a very "plastic" and flexible organ. It can adapt and make new pathways as the person with ASP learns new behaviors and emotional responses. It is important to point out here that many people with ASP will tell you that, if they were magically given the opportunity to be "normal" and no longer have Asperger's syndrome, they would choose to stay as they are with their amazing characteristics and talents. Once they have learned that they are not inferior, but rather exquisitely different, they begin to appreciate themselves and their abilities.

Many people with ASP think of themselves, and the ASP population as a whole, as paradigm shifters, inventors, and innovators without whom the world would be much worse off. Where would we be now if it were not for Albert Einstein or Mozart? They were socially inept geniuses that changed the world with their creations.

The culture, at large, has yet to fully understand and accept the population of individuals in the autism spectrum. Therefore, finding a niche where they are appreciated and respected, and where their talents and abilities are valued, is vital to their success in life. Those who are lucky enough to find their unique place in society can excel and contribute significantly. It is the mission of the Adults Asperger's Association to open the door, through public education, to acceptance, both in society and within each individual with ASP. It is our hope that people with ASP will, in the near future, be supported and encouraged in their creative and "out of the box" way of thinking and problem solving---Barbara J Nichols, Ph.D., clinical psychologist