As
soon as we meet a person we make judgements about them. From their
facial expression, tone of voice and body language we can usually tell
whether they are happy, angry or sad and respond accordingly.
People with Asperger syndrome can find it harder to read the
signals that most of us take for granted. This means they find it more
difficult to communicate and interact with others which can lead to high levels of anxiety and confusion.
About Asperger syndrome
Asperger syndrome is a form of autism,
which is a lifelong disability that affects how a person makes sense of
the world, processes information and relates to other people. Autism is
often described as a 'spectrum disorder' because the condition affects
people in many different ways and to varying degrees.
Asperger syndrome is mostly a 'hidden disability'. This means
that you can't tell that someone has the condition from their outward
appearance. People with the condition have difficulties in three main
areas. They are:
- social communication
- social interaction
- social imagination.
They are often referred to as 'the triad of impairments' and are explained in more detail on page 3.
While there are similarities with autism, people with Asperger
syndrome have fewer problems with speaking and are often of average, or
above average, intelligence. They do not usually have the accompanying learning disabilities associated with autism, but they may have specific learning difficulties. These may include dyslexia and dyspraxia or other conditions such as attention deficit hyperactivity disorder (ADHD) and epilepsy.
With the right support and encouragement, people with Asperger syndrome can lead full and independent lives.
Three main areas of difficulty
The characteristics of Asperger syndrome vary from one person to another but are generally divided into three main groups.
Difficulty with social communication
If you have Asperger syndrome, understanding conversation is like trying to understand a foreign language.
People with Asperger syndrome sometimes find it difficult to express themselves emotionally and socially. For example, they may:
- have difficulty understanding gestures, facial expressions or tone of voice
- have difficulty knowing when to start or end a conversation and choosing topics to talk about
- use complex words and phrases but may not fully understand what they mean
- be very literal in what they say and can have difficulty
understanding jokes, metaphor and sarcasm. For example, a person with
Asperger syndrome may be confused by the phrase 'That's cool' when
people use it to say something is good.
In order to help a person with Asperger syndrome understand you, keep your sentences short - be clear and concise.
Difficulty with social interaction
I have difficulty picking up social cues, and difficulty in knowing what to do when I get things wrong.
Many people with Asperger syndrome want to be sociable but have
difficulty with initiating and sustaining social relationships, which
can make them very anxious. People with the condition may:
- struggle to make and maintain friendships
- not understand the unwritten 'social rules' that most of us
pick up without thinking. For example, they may stand too close to
another person, or start an inappropriate topic of conversation
- find other people unpredictable and confusing
- become withdrawn and seem uninterested in other people, appearing almost aloof
- behave in what may seem an inappropriate manner.
Difficulty with social imagination
We have trouble working out what other people know. We have more difficulty guessing what other people are thinking.
People with Asperger syndrome can be imaginative in the
conventional use of the word. For example, many are accomplished
writers, artists and musicians. But people with Asperger syndrome can
have difficulty with social imagination. This can include:
- imagining alternative outcomes to situations and finding it hard to predict what will happen next
- understanding or interpreting other people's thoughts,
feelings or actions. The subtle messages that are put across by facial
expression and body language are often missed
- having a limited range of imaginative activities,
which can be pursued rigidly and repetitively, eg lining up toys or
collecting and organising things related to his or her interest.
Some children with Asperger syndrome may find it difficult to
play 'let's pretend' games or prefer subjects rooted in logic and
systems, such as mathematics.
Characteristics of Asperger syndrome
The characteristics of Asperger syndrome vary from one person to another but as well as the
three main areas of difficulty, people with the condition may have:
- love of routines
- special interests
- sensory difficulties.
Love of routines
If I get anxious I get in a tizz. I have a timetable; it helps me to see what I have to do next, otherwise I get confused.
To try and make the world less confusing, people with Asperger syndrome may have rules and rituals
(ways of doing things) which they insist upon. Young children, for
example, may insist on always walking the same way to school. In class,
they may get upset if there is a sudden change to the timetable. People
with Asperger syndrome often prefer to order their day to a set pattern.
For example, if they work set hours, an unexpected delay to their
journey to or from work can make them anxious or upset.
Special interests
I remember Samuel reciting the distances of all the planets
from the sun to a baffled classmate in the playground when he was five.
Since then he has had many obsessions, which he loves to talk about at
length!
People with Asperger syndrome may develop an intense, sometimes obsessive, interest
in a hobby or collecting. Sometimes these interests are lifelong; in
other cases, one interest is replaced by an unconnected interest. For
example, a person with Asperger syndrome may focus on learning all there
is to know about trains or computers. Some are exceptionally
knowledgeable in their chosen field of interest. With encouragement,
interests and skills can be developed so that people with Asperger
syndrome can study or work in their favourite subjects.
Sensory difficulties
Robert only has problems with touch when he doesn't know what's
coming - like jostling in queues and people accidentally brushing into
him. Light touch seems to be worse for him than a firm touch.
People with Asperger syndrome may have sensory difficulties.
These can occur in one or all of the senses (sight, sound, smell,
touch, or taste). The degree of difficulty varies from one individual to
another. Most commonly, an individual's senses are either intensified
(over-sensitive) or underdeveloped (under-sensitive). For example,
bright lights, loud noises, overpowering smells, particular food
textures and the feeling of certain materials can be a cause of anxiety
and pain for people with Asperger syndrome.
People with sensory sensitivity may also find it harder to use
their body awareness system. This system tells us where our bodies are,
so for those with reduced body awareness, it can be harder to navigate
rooms avoiding obstructions, stand at an appropriate distance from other
people and carry out 'fine motor' tasks such as tying shoelaces. Some
people with Asperger syndrome may rock or spin to help with balance and
posture or to help them deal with stress.
Who is affected by Asperger syndrome?
There are over half a million people in the UK with an autism spectrum disorder
- that's around 1 in 100. People with Asperger syndrome come from all
nationalities, cultures, social backgrounds and religions. However, the
condition appears to be more common in males than females; the reason for this is unknown.
Causes and cures
What causes Asperger syndrome?
The exact cause
of Asperger syndrome is still being investigated. However, research
suggests that a combination of factors - genetic and environmental - may
account for changes in brain development.
Asperger syndrome is not caused by a person's upbringing, their
social circumstances and is not the fault of the individual with the
condition.
Is there a cure?
There is currently no 'cure'
and no specific treatment for Asperger syndrome. Children with Asperger
syndrome become adults with Asperger syndrome. However, as our
understanding of the condition improves and services continue to
develop, people with Asperger syndrome have more opportunity than ever
of reaching their full potential.
There are many approaches, therapies and interventions, which can
improve an individual's quality of life. These may include
communication-based interventions, behavioural therapy and dietary
changes.
Diagnosis
Because Asperger syndrome varies widely from person to person, making a diagnosis
can be difficult. It is often diagnosed later in children than autism
and sometimes difficulties may not be recognised and diagnosed until
adulthood.
The typical route for getting a diagnosis is to visit a GP. He or she can refer an individual to other health professionals
who can make a formal diagnosis. Most frequently they will be
psychiatrists or clinical psychologists and, in the case of children,
paediatricians.
Some people see a formal diagnosis as an unhelpful label; however, for many a diagnosis:
- helps the individual, families, friends, partners, carers,
professionals and colleagues to better understand and manage their needs
and behaviour
- is the key needed to open the door to specialised support, eg supported living or finding suitable employment.
There are diagnostic differences between conditions on the
autism spectrum. Sometimes people may receive a diagnosis of autism or
autistic spectrum disorder (ASD), high-functioning autism (HFA) or
atypical autism instead of Asperger syndrome. Alternatively, they may be
given a diagnosis of pervasive developmental disorder - not otherwise
specified (PDD-NOS) or semantic pragmatic disorder. However, people who
have been given these diagnoses will have similar difficulties and
similar support needs to those who have Asperger syndrome.
You can find more information about diagnosis and how to get one
If you would like to read more about the different types of
autism (including Asperger syndrome) and the diagnoses that people get,
see:
-
High-functioning autism and Asperger syndrome: what's the difference?
-
The use and misuse of diagnostic labels.
