NATURE OF ASPERGERS

The nature of Asperger's syndrome

Asperger’s is part of the Autistic Spectrum Disorder, a range of different disorders relating to communication, imagination, creativity and social interaction.

It affects people in different ways, and to varying degrees. There are three main areas of difficulties for those with Asperger’s:

• social communication
• social integration
• social imagination.

Asperger’s is similar to autism, but those with Asperger’s have fewer problems with speech. Unlike autism, those with Asperger’s have an average of above average intelligence, and do not normally have the learning difficulties associated with autism. However, they may have specific learning difficulties, such as dyslexia, or other conditions such as ADHD or epilepsy.

Most symptoms of Asperger’s improve over time, but difficulties with communication, social adjustment and independent living can continue into adulthood.

Symptoms of Asperger's syndrome

The symptoms of the three main areas of Asperger’s syndrome are:

Difficulty with social communication

• difficulty understanding gestures, facial expressions, tone of voice
• difficulty with the start and end of conversations, and picking appropriate topics of conversation
• using complex words and phrases, but not understanding them
• very literal use of words, difficulty with sarcasm, jokes, metaphors.

Difficulty with social interaction

• struggling to make and maintain friendships
• not understanding unwritten social rules, such as personal space, what is and isn’t appropriate to say in front of others
• finding others unpredictable and confusing
• seem uninterested in other people
• behaving inappropriately
• unlike those with autism, those with Asperger’s do not become withdrawn, and are happy to approach people, albeit somewhat awkwardly
• happy to discuss at great length a hobby or interest, but not recognising or understanding the listener’s responses or reactions.

Difficulty with social imagination

Those with Asperger’s can often be highly creative and imaginative. However, their imagination may be restricted in other ways.

• may find it hard to see alternative outcomes to situations
• dislike changing plans, uncertainty
• struggle to understand other people’s thoughts, feelings or actions
• a limited range of imaginative activities – children with Asperger’s may often play by lining up toys in a certain order, collecting things
• difficulty playing ‘let’s pretend’ games
• very narrow or specific interests, e.g. remembered camera model numbers but not having an interest in photography.

Other symptoms of Asperger’s include

• a love of routines
• special and specific interests, sometimes to the point of obsession
• sensory difficulties – the senses may either be intensified or under-developed, bright lights and loud noises can cause anxiety and pain
• difficulty with body awareness – knowing where they are and how to navigate around a room, problems with fine motor skills, making activities like tying shoelaces difficult
• needing order, structure, wanting to work from timetables
• may develop an intense or obsessive interest in a hobby.

When is the right time to seek help?

Diagnosis of Asperger’s can be difficult. It is often diagnosed later in life than Autism, and sometimes a diagnosis may not be made until adulthood.

Possible signs of autism in the first few years of life can include the child not being able to make eye contact, a lack of interest in other children and people, making repetitive movements, a sensitivity to light, touch, smell and taste.

In older children signs of autism may include having few close friends, a lack of communication skills, difficulties with conversation and not enjoying social situations.

If parents suspect their child is displaying any of these symptoms, the first point of contact is a GP.

Causes of Asperger's syndrome

It is thought that the cause of Asperger’s is a combination of factors – both genetic and environmental. It can also run in families.

Treatment for Asperger's

There is no specific course of treatment, but there are different approaches that can be used to help manage Asperger’s. The focus of the treatment is on management and behavioural therapy, to address specific issues of Asperger’s.

Therapies

• training of social skills
• medication for coexisting problems, e.g. depression or anxiety
• occupational/physical therapy for motor coordination
• social communication implementation.

Counselling

It has been found that a cognitive and behavioural approach is most useful when it comes to counselling those with Asperger’s. This approach tries to change the way the individual thinks about themselves and other people, and how thoughts and feelings alter mood.

Music therapy

Music therapy helps with communication, as well as self-awareness and reciprocal play.

Speech and language therapy

A child with Asperger’s may not see any reason to communicate with others, and therefore their speech skills do not develop as quickly as others. This then in turn limits their opportunities for many different forms of communication.

Speech therapy maximises communication, not just through speech but through play, symbols, social skills and listening.

Statistics

• half a million people in the UK have Asperger’s – 1 in 100 people
• it is more common in males than females
• 1 in 5 children with autism have been excluded from school
• only 15% of adults in the UK with autism are in full-time paid employment.

What should I be looking for in a counsellor or psychotherapist?

There are currently no laws in place stipulating what training and qualifications a counsellor must have in order to treat Asperger's syndrome. However, the National Institute for Health and Care Excellence (NICE) have developed a set of guidelines that provide advice about the recommended treatments.

In terms of psychological treatments, NICE recommend cognitive behavioural therapy (CBT) and/or behavioural therapy. To help treat symptoms such as anxiety and/or repetitive thoughts, medication may also be offered. The guidelines also list various therapies and treatments that should not be offered, including chelation therapy.

Counsellors treating people with autism or Asperger's syndrome may have to adjust the way they work, for example including more written or visual information. Therefore, it is advised that you seek a professional who has specific training and experience in working with people within the autistic spectrum.