Asperger's syndrome (AS), is a pervasive developmental disorder commonly referred to as a form of "high-functioning" autism. The term "Asperger's syndrome" was coined by Lorna Wing in a 1981 medical paper; she named it after Hans Asperger, an Austrian psychiatrist and pediatrician whose work was not internationally recognized until the 1990s.

Contents

1 Characteristics 2 Social interaction and cognitive patterns 3 DSM definition 4 Relationship to autism 5 Possible causes and origins 6 Effect on relationships 7 A gift and a curse 8 Criticisms 9 Affectionate terms 10 Careers and free trade effects 11 References 12 See also 13 External links 13.1 Community forum sites 13.2 Support groups 13.3 Informational 13.4 Medical community 13.5 Humor 14 Literature

Characteristics

Like other conditions currently classified as an autism spectrum disorder, Asperger's Syndrome is strongly sex-linked, with males currently comprising approximately 75 percent of diagnoses. However, this figure may not be completely accurate, as girls are arguably more exposed to social situations and thus have more of a chance to learn to imitate the non-autistics and behave "normally".

Non-autistics — called neurotypicals, or NTs, by people on the autistic spectrum who reject the word "normal" — possess a comparatively sophisticated sense of other people's mental states. Most people are able to gather a whole host of information about other people's cognitive and emotional states based on clues gleaned from the environment and the other person's body language. Persons with autism are relatively deficient in this ability, and the individual with Asperger's can be every bit as "mind-blind" as the person with profound classical autism. For those who are severely affected by "mind-blindness", they may, at best, see a smile but not know what it means (is it an understanding, a condescending, or a malicious smile?) and at worst they will not even see the smile, frown, smirk, or any other nuance of interpersonal communication. They generally find it difficult or impossible to "read between the lines"; that is, figure out those things a person is implying but is not saying directly. It is worth noting, however, that since it is a spectrum disorder, a few with Asperger's are nearly normal in their ability to read facial expressions and intentions of others. Those with Asperger's often have difficulty with eye contact. Many make very little eye contact, finding it overwhelming, while others have unmodulated, staring eye contact that can be off-putting to others.

Asperger's syndrome can involve an intense and obsessive level of focus on things of interest and is often characterized by special (and possibly peculiar) gifts; one person might be obsessed with 1950s professional wrestling, another with national anthems of African dictatorships, another with building models out of matchsticks. Particularly common interests are means of transport (for example trains), computers, and dinosaurs. These interests are often coupled with an unusually high capacity to retain and recall encyclopedic amounts of information about the favored subject.

In general, orderly things have appeal to individuals with Asperger's. When these special interests coincide with a materially or socially useful task, the individual with Asperger's can often lead a profitable life. The child obsessed with naval architecture may grow up to be an accomplished shipwright, for instance. In pursuit of these interests, the individual with Asperger's often manifests extremely sophisticated reason, an almost obsessive focus, and eidetic memory. Hans Asperger called his young patients "little professors", based on the fact that his thirteen-year-old patients had as comprehensive and nuanced an understanding of their field of interest, as university professors. It is because of this that individuals with Asperger's are considered to have a higher intellectual capacity while suffering from a lower social capacity.

Individuals with Asperger's have emotional responses as strong as, or perhaps stronger than, most people, though what generates an emotional response might not always be the same. What they lack (or are markedly slower to develop) is the inborn ability to perceive the emotional states of others or to express their own emotional state via body language, facial expression and nuance in the way that most people do. Many people with Asperger's report a feeling of being unwillingly detached from the world around them; they lack the natural ability to see the subtexts of social interaction, and equally lack the ability to broadcast their own emotional state to the world accurately.

This leads to many troubles in childhood and adulthood. Asperger's children are often the target of bullying at school because of their idiosyncratic behaviour, language, and interests, and because of their lower or delayed ability to perceive and respond appropriately to non-verbal cues, particularly in situations of interpersonal conflict.

When a teacher asks a child with Asperger's, "Did the dog eat your homework?", the child with Asperger's will remain silent if they don't understand the expression, trying to figure out if they need to explain to the teacher that they don't have a dog and also that dogs don't generally like paper. The child doesn't understand what the teacher is asking, cannot deduce the teacher's meaning, or the fact that there is a non-literal meaning, from the tone of voice, posture or facial expression, and is faced with a question which makes as much sense to him as "Did the glacier in the library bounce today?". The teacher may walk away from the experience frustrated and thinking the child is arrogant, spiteful, and insubordinate. The child sits there mutely, feeling frustrated and wronged.

Those affected by Asperger's may also manifest a range of other sensory, developmental, and physiological anomalies. It is common for Asperger's children to evidence a marked delay in the development of fine motor skills. They may display a distinctive 'waddling' or 'mincing' gait when they walk and may walk with their arms held out in an unusual manner. Compulsive finger, hand, or arm movements, such as flapping, are also observed.

Some Asperger's children suffer from varying degrees of sensory overload , and may be pathologically sensitive to loud noises or strong smells and may dislike being touched — for example, certain Asperger's children exhibit a strong dislike of having their head touched or their hair disturbed. The "sensory overload" factor may exacerbate problems faced by Asperger's children at school, where levels of noise in the classroom can become almost intolerable for them.

Another noted behavioural characteristic that may be present is echolalia, which causes the subject to repeat words, or parts of words, when they speak, like an echo. Children with Asperger's often display advanced abilities for their age in language, reading, mathematics, spatial skills, or music, sometimes into the 'gifted' range, although as noted above, they may be counterbalanced by appreciable delays in other developmental areas.

Social interaction and cognitive patterns

Asperger's can also lead to problems with normal social interaction between peers. In childhood and teenage years, this can cause severe problems as a child or teen with Asperger's can have difficulty interpreting subtle social cues, and as such be ostracized by their peers, leading to social cruelty. A child or teen with Asperger's is frequently puzzled as to the source of this cruelty, unaware of what has been done "wrong". Recent efforts in the field of special education have concentrated on teaching children with Asperger's how to interact with their peers, achieving only moderate success, while the alternative of teaching their peers to cope with Asperger's children does not seem to have been seriously considered by many professionals. The social alienation of some people with Asperger's syndrome is so intense in childhood that some create imaginary friends for companionship.

Asperger's syndrome hardly guarantees a miserable life, however. Often the intense focus and tendency to work things out logically, characteristic of Asperger's, will grant them a high level of ability in their field of interest. Despite their difficulty with social interaction, many people with Asperger's possess a rare gift for humor (especially puns, wordplay, doggerel, satire), and writing. In fact, sometimes their fluency with language is such that a number of them also qualify as hyperlexic. While many people with Asperger's will probably not have lives that are considered a social success by common standards, and there are some (with varying degrees of this disability) who will remain alone their entire lives, it is possible for such people to find understanding people (sometimes also on the autistic spectrum, sometimes not) with whom they can have close relationships. While they face enormous obstacles, some overcome them and prosper in society. Many autistics have children, in which case their children may be neurotypical or may have an autism spectrum disorder. Many autists are unaware of their autism, because milder forms of autism are widely misunderstood and often undiagnosed or misdiagnosed by professionals.

DSM definition

Asperger's is defined in section 299.80 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as:

1. Qualitative impairment in social interaction, as manifested by at least two of the following:
   1. Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
   2. Failure to develop peer relationships appropriate to developmental level
   3. A lack of spontaneous seeking to share enjoyment, interest or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
   4. A lack of social or emotional reciprocity
2. Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
   1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
   2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
   3. Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
   4. Persistent preoccupation with parts of objects.
3. The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.
4. There is no clinically significant general delay in language (e.g., single words used by age two years, communicative phrases used by age three years)
5. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills or adaptive behavior (other than in social interaction) and curiosity about the environment in childhood
6. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.

Please read the DSM cautionary statement.

The Diagnostic and Statistical Manual's diagnostic criteria have been roundly criticized for being vague and subjective: what one psychologist calls a "significant impairment" another psychologist may call insignificant.

Relationship to autism

Experts today generally agree that there is no single mental condition called autism. Rather, there is a spectrum of autistic disorders, with different forms of autism taking different positions on this spectrum. But within certain circles of the autism/AS community, this concept of a "spectrum" is being severely questioned. If differences in development are purely a function of differential acquisition of skills, then attempting to distinguish between "degrees of severity" may be dangerously misleading. A person may be subjected to unrealistic expectations, or even denied life-saving services, solely on the basis of very superficial observations made by others in the community.

In the 1940s, Leo Kanner and Hans Asperger, working independently in the United States and Austria, identified essentially the same population, Asperger's group being perhaps more "socially functional" than Kanner's as a whole. Some of Kanner's originally identified autistic children, might today get an Asperger's syndrome diagnosis, and vice versa. It is a mistake to say that a "Kanner autistic" is a child who sits and rocks and does not communicate. Kanner's study subjects were all along the spectrum.

Researchers are grappling with the problem of how to divide up the spectrum. There is no easy way to do this. It would appear that one can divide the population of autistics in any particular way and define the group accordingly. Autistics who speak, those who don't. Autistics with seizures, those without. Autistics with more "stereotypical behaviors", those with less, and so forth. Some are trying to identify genes associated with these traits as a way to make logical groupings. Eventually, one may hear about autistics with or without the HOXA 1 gene, with or without changes to chromosome 15, etc. Traditionally, Kannerian autism is characterized by significant cognitive and communicative deficiencies, including delays in or lack of language. Often it will be clear that these people do not function normally. An individual with Asperger's on the other hand will not show delays in language. It is a more subtle disorder and affected individuals will often only appear to be odd. Kanner's syndrome is described in the article autism.

Some clinicians believe that communicative and/or cognitive deficiencies are so essential to the concept of autism that they prefer to consider Asperger's as a separate condition altogether from autism. This opinion is a minority one. Uta Frith (an early researcher of Kannerian autism) has written that people with Asperger's seem to have more than a touch of autism to them. Others, such as Lorna Wing and Tony Attwood, share in Frith's assessment. Dr. Sally Ozonoff, of the University of California at Davis's MIND institute, argues that there should be no dividing line between "high-functioning" autism and Asperger's, and that the fact that some don't start to produce speech until a later age is no reason to divide the two groups, as they are identical in the way they need to be treated.

Asperger's syndrome and other forms of autism are often grouped together in a Pervasive Developmental Disorder family.

Possible causes and origins

The causes and origins of autism and Asperger's syndrome are subjects of continuing conjecture and debate, and there is still considerable debate on these topics, alongside the broader debate about whether Asperger's and other conditions (such as ADHD) are part of the so-called autism spectrum or not.

Amongst several competing theories are the underconnectivity theory developed by cognitive scientists at Carnegie Mellon University and the University of Pittsburgh, the Neanderthal theory, the extreme male brain theory by Simon Baron-Cohen, the lack of theory of mind, and the Pre-operational autism theory, which states that autistic people are those who get neurologically stuck at the pre-operational stage of cognitive development, where much of information processing is at a holistic-visual level and is largely musical and non-verbal. This also addresses the issue of the theory of mind where children at the pre-operational stage of cognitive development have not attained decentralisation from egocentrism.

The Monotropism hypothesis argues that the central feature of Autism is attention-tunnelling, monotropism. The hypothesis is founded on the model Mind as a Dynamical System: Implications for Autism. In this model of mind, the fundamental and limited resource is mental attention. Mental events compete for and consume attention. In a polytropic mind, many interests are aroused to a moderate degree. In a monotropic mind, few interests are very highly aroused. When many interests are aroused, multiple, complex, behaviours emerge. When few interests are aroused then a few, intensely motivated, behaviours are engendered. From monotropism hypothesis, autism results from different strategies of distributing attention in the brain.

The underconnectivity theory indicates a deficiency in the coordination among brain areas. With the aid of functional magnetic resonance imaging (fMRI), it was seen that white matter, which connects various areas of the brain like cables, have abnormalities in people with autism [For those interested in brain studies see ].

The underconnectivity theory holds that autism is a system-wide brain disorder that limits the coordination and integration among brain areas. This theory is parsimonious, in that it explains why autistic people are matured on certain dimensions, such as visual information processing and logical analysis, and yet are socially — and sometimes neuro-physiologically — significantly younger than their chronological age. The underconnectivity theory can be regarded as monotropism in the brain.

Other theories address the rise of autism in recent times. They suggest that the rise of visual media and the increasingly central role of visual information processing in the breakdown of language contributes to the increase of autism. Other theories involve the effect of toxins and poisons on neural development. It has been suggested that high levels of heavy metals such as lead may be a causal factor, and lead poisoning has been strongly linked to some cases of severe autism.

One of the most controversial claims is that conditions such as autism and Asperger's are caused by adverse side-effects of immunisation — particularly the so-called triple antigen vaccine — and from the heavy-metal preservatives that in the past were used in their manufacture. Although this theory has a degree of popular currency and has been discussed in a number of documentaries on the subject, it fails to address the basic empirical observation that Asperger's and related disorders are overwhelmingly predominant in males, yet children of the two sexes are immunised in roughly equal numbers.

A lesser known theory is that Asperger's and related syndromes may, in part, perpetrate genetic traits which were once highly advantageous to survival. One of the most notable characteristics of many people with Asperger's is that even very young children display a prodigious and often eidetic (photographic) memory, with the ability to precisely recall very large amounts of music, dialogue and speech after even a single hearing.

Although being able to precisely memorize and recall vast amounts of detail, such as cricket scores, dinosaur facts or television-show dialogue, may seem little more than an unusual trait in our society, it is important to realize that such a skill would have had a high value in pre-literate society. The ability to accurately memorize and re-tell stories, myths, histories and other important oral traditions — such as directions to a remote food or water source — could have meant the difference between life and death before the invention of writing.

In September 2004, Marc-Antoine Alexandre Bourget has published his master thesis at UQAM showing that 29% of autistics have a mitochondrial DNA anomaly that allowed him to formulate his hypothesis of a mitochondrial neanderthal Eve that six genetic markers dated circa 27000 BC. While his hypothesis is considered controversial, it could explain the origin of autism by hybridation of neanderthal characteristics in homo sapiens lineage. That would explain the crossing over and inprinting in Prader-Willi Syndrome. However, the hypothesis that Neanderthals and Homo Sapiens interbred is itself controversial, with some researchers claiming that their recent DNA studies show that the two species never interbred.

Effect on relationships

The significant others of people with Asperger's are more prone to major depression than the general population because people with Asperger's often have trouble showing affection or have little desire to show affection, and can be very literal and hard to communicate with in an emotional way. It is helpful for those involved with someone with Asperger's to read as much as they can about Asperger's syndrome, obsessive-compulsive disorder, hyperlexia and other comorbid disorders. It also helps to visit support groups' websites on the Web and talk with others who are involved with people with Asperger's. A significant other will often be much less angry or depressed if he or she understands that the Asperger's symptoms are not intentionally directed, but are part of a neurodevelopmental disorder. That when someone does not spontaneously show affection, it does not necessarily mean that he or she does not feel it. Thus, the significant other will come to feel less rejected and be more understanding. Light will be shed on the nature of the misunderstandings. They may figure out ways to work around the problems; for example, by being more explicit about their needs. For instance, when describing emotions, it can be helpful to be direct and to avoid vague terms like "upset" when the emotion being described is "anger". Another suggestion could be to lay out in clear language what the problem is and to ask the partner with Asperger's to describe what emotions are being felt or ask why a certain emotion was being felt.

A gift and a curse

Recently, some researchers have speculated that many well-known people including Andy Warhol, Andy Kaufman, Craig Nicholls, Glenn Gould, Gary Numan, Mozart, Erik Satie, Nikola Tesla, Albert Einstein, Isaac Newton, and Bill Gates have or had AS, as they showed some Asperger's related tendencies, such as intense interest in one subject and social problems. Such diagnoses remain controversial, however (cf. BBC News, Einstein and Newton "had autism", 30 April 2003), and some more so than others, as most scholars seem to agree that Satie suffered at least from some form of autism.

The obvious social contributions of such individuals has led to a shift in the perception of Asperger's and autism away from the simple view of a disease needing to be cured towards a more complex view of a syndrome with advantages and disadvantages. There is a semi-jocular theory within science fiction fandom, for example, which argues that many of the distinctive traits of that subculture may be explained by the speculation that a significant portion thereof is composed of people with Asperger's. A Wired Magazine article called The Geek Syndrome suggested that Asperger's syndrome is more common in the Silicon Valley, a haven for computer scientists and mathematicians. It created an enduring myth popularized in the media and self-help books that "Geek Syndrome" equals Asperger's syndrome, and precipitated a rash of self-diagnoses. Though these conditions do share traits, there is a consensus that most geeks are arguably "variant normal" and do not exhibit autistic-spectrum behaviors. "Geeks" may exhibit an extreme professional or casual interest in computers, science, engineering and related fields, and may be introverted; however, they do not suffer from impairements per se. This does not imply that there is no overlap between "geeks" and Asperger's patients, but it should be noted that self-diagnosis is a dangerous practice, and one prone to error.

Criticisms

Some people, including some people diagnosed with Asperger's syndrome, argue that Asperger's syndrome is a social construct. Professor Simon Baron-Cohen of the Autism Research Centre has written a book arguing that Asperger's syndrome is an extreme version of the way in which men's brains differ from women's. He says that, in general, men are better at systematizing than women, and that women are better at empathizing than men. Hans Asperger himself is quoted as saying that his patients have 'an extreme version of the male form of intelligence'.

One objection which has been put forward to this view is that, although AS is more common among males than females, females with AS do not necessarily come across as particularly masculine personalities, and some of them can show an exceptional interest in "feminine" activities e.g. dancing.

Affectionate terms

"Aspie" is an affectionate term used by some with Asperger's syndrome to describe themselves. Others prefer "Aspergian," or no name at all.

Careers and free trade effects

Free trade may have a strong impact on available careers for those with the syndrome in "high wage" countries. Those with the syndrome generally gravitate toward technical and scientific jobs which either do not require a lot of social interaction, or in which poor social skills can be "forgiven" because of other skills.

However, globalization and Internet technology has made it possible to hire experts for as much as 1/10th the wage level found in the high-wage countries. This diminishes the value of non-social skills and can put those with the syndrome at a disadvantage. For example, unemployed computer programmers are encouraged to strive for more "face time" with customers and managers in order to find a job feature that remote (global) workers cannot directly compete with. The problem is that formal education in social skills is hard to find and probably not very effective.

As technical jobs shrink or stagnate due to globalization, economists often suggest a liaison job, such as project manager or systems analyst for displaced computer programmers, for example. ("software engineer" is sometimes included in this category, depending on the company.) Unlike direct programming, these liaison jobs continue to expand in the high-wage country. However, often companies prefer more socially-inclined employees for such positions, even if their technical abilities are not as strong as those with Asperger traits. Thus, even though such jobs have some technical aspect to them, Asperger candidates may still be bypassed. More formal education is not necessarily a solution because social and office politics skills are the bottleneck to many liaison positions, not technical ability.

References

• [1] Mayes SD, Calhoun SL, Crites DL: Does DSM-IV Asperger's disorder exist?, Journal of Abnormal Child Psychology 2001 June; 29(3), pages 263–271, online version
• The ADHD-Autism Connection: A Step toward more accurate diagnosis and effective treatment, by Diane M. Kennedy, ISBN 1578564980 (The aim of this book is to explore the similarities that attention deficit hyperactivity disorder (ADHD) shares with a spectrum of disorders currently known as pervasive developmental disorders.)
• Asperger's Syndrome — A Guide for Parents and Professionals by Tony Atwood. This book is considered to be the Bible as far as general AS books go.
• Martian in the Playground by Claire Sainsbury. This book is all about the schoolchild with Asperger's Syndrome.
• Freaks, Geeks and Asperger's Syndrome (ISBN 1843100983) by Luke Jackson. This book won the National Association of Special Educational Needs Children's book award. Luke Jackson and his family starred in the British TV program, My Family and Autism. Luke is about 14 and has Asperger's syndrome. He has a brother with dyslexia, a brother with ADHD and a brother with profound autism. He also has three neurotypical sisters.
• Men, Women and the Extreme Male Brain by Simon Baron-Cohen. The author proposes the theory that autism and Asperger Syndrome can be explained as extreme examples of the male type of mind.

See also

• Autism rights movement
• Conditions comorbid to autism spectrum disorders
• Autism
  • List of persons with autism spectrum disorders
  • List of fictional characters on the autistic spectrum
• Picture thinking

External links

Community forum sites

• WrongPlanet.net Asperger's Syndrome Support online resource and community for those with AS
• Aspergia Promoting the development of an Aspergian cultural identity.
• Aspies for Freedom Site that has a positive approach to autism and focuses on civil rights advocacy.
• AutismForum.net offers a discussion forum, articles, and a chat room for the Autism community.
• Aspergers Community Board offers a discussion forum for parents of AS children and teenagers, as well as for adults with Asperger's. Also offers pre-set searches for common queries.
• Aspergian PrideContains articles, web links, and forums that present positive views of autistic identity as a unique, meaningful culture and as a way of being.
• SpectrumHaven.com Site for kids and teens with Asperger's Syndrome
• AspieTALK (United Kingdom & Ireland) Discussion Forums & Chat Room for Adults & Teens in the UK & Republic of Ireland with Asperger Syndrome - includes regional forums (e.g Central England, Scotland etc.)

Support groups

• ASPEN Asperger Syndrome Education Network
• Autism Society of America
• National Autistic Society, UK
• Autistics.org, resources by and for persons on the autistic spectrum

Informational

• Autism Assembly Coalition of people on the autism spectrum, websites and groups, part of the global autism rights movement.
• Autistic Pride Day Official information site for Autistic Pride Day, June 18th each year.
• Autism Awareness Campaign UK
• Oops wrong planet syndrome, This is a brilliant page with a unique way of explaining AS.
• Online Asperger Syndrome Information and Support
• Dallas Asperger Network for Information, Support and Help
• Online (informal) test for signs of Asperger's
• Autism In Mind, autism support website.
• Neurodiversity.com, Autistic spectrum resources
• AS-IF (aspergerinformation.net) Great resources about Asperger
• Autism and Computing, Autistic spectrum resources
• A survival guide for people with Asperger syndrome, by Marc Segar
• Mind as a Dynamical System: Implications for Autism, They argue that the central feature of Autism is attention-tunnelling, monotropism.
• Aspies.co.uk, Personal site detailing interventions taken to help a child with Asperger's Syndrome.
• The Neanderthal theory of autism, A non-dysfunction theory of autism and many other related conditions.
• An aspie quiz, A test aimed at the behavioral differences between NTs and aspie.
• Head-tilt test could reveal Asperger’s, New research suggests that early diagnosis of Asperger's syndrome, from as early as six months of age, could be achieved by a simple and non-invasive test.
• Mental Health Matters: Asperger's Syndrome
• Quackwatch.org: Misconceptions about autism: Vaccines cause autism
• Autistic Advocacy
• Online Asperger Syndrome Information & Support
• AskAnAspie.com Offers information (written by a group of students at the University of Chicago who have Asperger's Syndrome and High Functioning Autism) that is specifically designed for parents.

Medical community

• Cure Autism Now Foundation

Humor

• Institute for the Study of the Neurologically Typical (a parody by autistic and Asperger's people)

Literature

• The Curious Incident of the Dog in the Night-time: A Novel by Mark Haddon ISBN 0385509456
• The Adhd-Autism Connection : A Step Toward More Accurate Diagnoses and Effective Treatments by Diane Kennedy, Rebecca Banks, Temple Grandin; ISBN 1578564980
• Shadow Syndromes: The Mild Forms of Major Mental Disorders That Sabotage Us by John J. MD Ratey; ISBN 0553379593
• Understanding and Working With the Spectrum of Autism: An Insider's View by Wendy Lawson; ISBN 1853029718