Sarah wrote us, “My nephew was recently diagnosed with Asperger’s Syndrome. I am nervous of reacting in the wrong way and would like to know more about it so that I can be helpful and not just afraid of putting my foot in my mouth.”

Minda Miller of Alchemilla answers for us:

In 1944, an Austrian pediatrician named Hans Asperger recorded his observations of a number of children who, though they were of normal intelligence, shared some definite abnormal qualities: they moved awkwardly, had difficulty socially, difficulty with verbal communication, and seemed to lack empathy. Each also seemed to be over-focused on a single topic of interest and were, most particularly, marked by social isolation. He labeled this condition “autistic psychopathy.” In the 1980′s the English Dr. Lorna Wing translated his works and borrowed his grouping, calling this personality disorder “Asperger’s.” In 1994 the American Psychiatric Association recognized Asperger’s officially as a brain development disorder and used this pattern of behaviors as the distinguishing feature. According to the APA, Asperger’s Syndrome, one of five brain development disorders that make up a group called Autism Spectrum Disorders (ASD), is basically, autism with language skills and IQ.

It is typically characterized by:

• average to above average intelligence
• excellent memory
• need for rules and routine and a tendency toward repetitive behavior
• over sensitivity to touch, tastes, textures, movements, loud sounds and/or lights over focus on limited topics, so that their range of interest in the world is drastically smaller than the average person
• communication issues:
• difficulty establishing or maintaining eye contact
• pedantic or one-sided speech
• difficulty navigating what most people would consider “normal” social interactions

Asperger’s is a life-long condition, noticeable in toddlerhood. The severity of Asperger’s varies, as does the individual’s ability to compensate and manage in the world around them.
Though most research indicates that Asperger’s is one of the rarer forms of ASD, affecting 3 per 10000 people, there are some advocates who claim that it is a very common syndrome, affecting 1 in every 154 people.

Treatments for Asperger’s

No one knows what causes Asperger’s, though there is evidence to support heredity. Therapies such as physical and behavioral therapies can help symptoms of the condition, so that clumsiness or awkward social behaviors can decrease over time. Some of the more successful therapies include:

• social skill training for more effective interpersonal interactions and more normal conversations
• cognitive behavioral therapy to reduce stress and obsessive interests and repetitive routines
• medication for depression or anxiety that maybe be caused by the challenges of Asperger’s
• occupational or physical therapy to improve motor skills
• education of people surrounding the Asperger’s patient so that they can support and work with them

Life With Asperger’s

As Tim Page writes in “Parallel Play,” his personal history about living with Asperger’s:
“We are informally referred to as “Aspies,” and if we are not very, very good at something we tend to do it very poorly. Little in life comes naturally—except for our random, inexplicable, and often uncontrollable gifts—and, even more than most children, we assemble our personalities unevenly, piece by piece, almost robotically, from models we admire. …
“So preoccupied are we with our inner imperatives that the outer world may overwhelm and confuse. What anguished pity I used to feel for piñatas at birthday parties, those papier-mâché donkeys with their amiable smiles about to be shattered by little brutes with bats. On at least one occasion, I begged for a stay of execution and eventually had to be taken home, weeping, convinced that I had just witnessed the braining of a new and sympathetic acquaintance.

“Caring for inanimate objects came easily. Learning to make genuine connections with people—much as I desperately wanted them—was a bewildering process. I felt like an alien, always about to be exposed. Or, to adapt another hoary but useful analogy, not only did I not see the forest for the trees; I was so intensely distracted that I missed the trees for the species of lichen on their bark.”

That said, many people with Asperger’s, including Tim Page, a Pulitzer Prize-winning critic and author, lead successful lives, managing careers, marriage and children. Temple Grandin is a famous example, whose intimate understanding and passion for animals has led to wholesale changes in the slaughterhouse industry to make the slaughter of cattle kinder to the animals, and who has said that, if given the option, she would never give back her autism; it has made it who she is today, it is part of her. Heather Kuzmich just put Asperger’s Syndrome in the spotlight when she made it through to the final week of America’s Top Model, and was chosen as the favorite model eight weeks in a row. Advocates of Asperger’s Syndrome have posthumously claimed Abraham Lincoln, Mark Twain and Albert Einstein, to name a few, to their ranks.

Bibliography

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. APA, 1994.
National Autistic Society. “Asperger’s Syndrome: What is it?” [Internet]. http://www.nas.org.uk/asperger (January 18, 2009).
National Institute of Health, January 2005. “Asperger Syndrome Fact Sheet” [Internet] http://www.ninds.nih.gov/disorders/asperger/detail_asperger.htm (January 18, 2009).
Page, Tim. “Personal History: Parallel Play.” The New Yorker, August 20, 2007; 56-62.
Parker-Pope, Tara. “Asperger’s Syndrome Gets a Very Public Face.” The New York Times, December 4, 2007.
Rapin, Isabelle. “The Autistic Spectrum Disorders.” New England Journal of Medicine, 347:302, August 1, 2002.
Sacks, Oliver. “An Neurologist’s Notebook: An Anthropologist on Mars.” The New Yorker, December 27, 1993; 110-125.