What were some of the specific characteristics noted by Dr. Asperger and clarified by his successors? While AS is a multifaceted condition and far from being “one size fits all,” several traits are likely to be found in those with AS. They may not appear significant when considered individually; taken together, however, the effect is striking and an indication that Asperger’s Syndrome may well be present. The following characteristics are taken from the 1991 Gillberg Diagnostic Criteria, which were the first “official” criteria published and are still the guidelines of choice for a great many clinicians.1
- Social difficulties: This sense of isolation is perhaps the most common, prominent feature of AS. Much like the cage that enclosed the canary, there is some sort of barrier which stands between those with AS and their peers. Though nearly invisible, it is very real. Like the baseball player who reaches out to catch the ball but never quite manages to, Asperger individuals are reaching out to connect with people but are forever missing that connection. Much of this difficulty is a result of being unable to “read” people and to pick up on the subtle social cues which are such an important element of interpersonal relationships. The important thing to remember is that unlike individuals with “classic” autism, who are often socially indifferent, those with Asperger’s want to connect with others and experience significant frustration due to their inability to do so. In addition, a lack of understanding of appropriate social conduct combined with a tendency to impulsive behavior is a common source of conflict with non-AS people who do not understand these challenges.
- A limited range of interests with intense focus: An Asperger individual will often display what seems like an excessive fascination, bordering on obsession, with memorizing (and reciting) facts such as local bus schedules or the comings and goings of Halley’s Comet over the last five hundred years, to the exclusion of almost all else. The resulting paradox is that while the AS person is an object of wonder and admiration for this encyclopedic knowledge in the area of expertise, he or she is also considered “odd,” “eccentric,” and “unbalanced.” Associates frequently become bored with repeated airings of information which they find uninteresting and will avoid the AS individual, contributing to further isolation.
- Underdeveloped fine and gross motor skills: Many children are physically awkward, particularly as they approach adolescence. This is normal, but most outgrow it and find their bearings. On the other hand, people with AS frequently experience chronic difficulty with basic motor skills–such as catching a ball or walking in a straight line. This has significant social consequences for children, especially boys, who are often judged based on their physical prowess and may be labeled as “gay” or “sissy” if they show a lack of aptitude in sports and games.
- Cognitive challenges: While individuals with AS are frequently quite intelligent, as evidenced by their ability to memorize facts, there is often difficulty in applying their knowledge and seeing the “big picture.” Their verbal and grammatical skills often range from the normal to the superior, but again may be expressed without a larger context. Poor organizational skills may also be a factor. Adults and peers without a proper understanding of the condition may conclude that the AS person is either “stupid” or “lazy” and may even tell the person so. As a result, the affected party frequently comes to accept the labels and begins applying them to himself or herself.
- Poor sensory integration: One of the more enigmatic aspects of AS (along with autism, ADHD, and other neurological disorders) is difficulty with sensory integration. In brief, this means that the individual with the disorder experiences “overload” with regard to one or more of the senses. Some are overly sensitive to loud noises, others to textures, and still others to the sensation of being in a large group of people. This can also have an effect when one or more senses are combined. For example, some people with AS can either listen to somebody who is talking to them or look at them, but cannot do both at the same time; the combined effect is too overwhelming.2 This may be a key factor in the lack of eye contact which is notorious among people with Asperger’s Syndrome.
- Emotional problems: The continued sense of social isolation, coupled with teasing and bullying, often leads to feelings of depression and anxiety. Navigating the interpersonal dynamics of school, church, or even home can be a social and emotional minefield.The fear of saying or doing the wrong thing, and of the possible repercussions, is often so great that a full-blown anxiety disorder develops at a young age. As the anxiety continues and increases, the overtaxed brain is at risk of collapsing under the weight of the stress, resulting in depression.3
Because of the various “side issues” associated with Asperger’s Syndrome, it is frequently misdiagnosed as clinical depression, bipolar disorder, ADHD, and other conditions. While treatments for these may be of help, they do not address AS as a whole. Since there is no magic cure-no pill, no surgery, no therapy-it is essential for the AS person to find a counselor who is familiar with Asperger’s Syndrome as well as the other disorders and who is willing to take the time to sort through the symptoms so as to make an accurate diagnosis.
Notes
1. The more controversial and restrictive DSM-IV criteria of the American Psychiatric Association are currently under revision and are expected to match more closely the Gillberg criteria. The latter are believed to resemble more accurately the characteristics originally observed by Hans Asperger. The DSM-V is scheduled for publication in 2011, according to the timeline at http://www.dsm5.org/timeline.cfm. On the possibility of revising the criteria for DSM-V, see page 4 of “Asperger Syndrome Grows Up” at http://www.aspires-relationships.com/Asperger_Syndrome_Grows_Up.pdf.)
2. Juanita P.Lovett, Solutions for Adults with Aspeger’s Syndrome, p. 81
3. See Dr. W. Dean Belnap’s article “How the Brain/Body Reacts to Anxiety and Stress” at http://www.meridianmagazine.com/ideas/060127brain.html)
