You know this type of person: geeky, tech-savvy, otaku (おたく) or someone who’s die-hard fan of anime, LOVES discussing astronomy (versus astrology) or anything too intellectual, yet is awkward when it comes to social relationships (usually a virgin or with less than 2 partners). You usually call him a “professor” but actually he’s not. He has average to above-average or gifted intelligence, normal cognitive (learning) and language development but is socially blind. These are the characteristics of someone with Asperger Syndrome.
What is Asperger Syndrome?
Asperger syndrome (AS) also spelled Asperger’s Syndrome, Asperger Disorder, Asperger’s is an autism spectrum disorder (ASD) that is characterized by significant difficulties in social interaction and nonverbal communication, alongside restricted and repetitive patterns of behavior and interests. It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development. Although not required for diagnosis, physical clumsiness and atypical (peculiar or odd) use of language are frequently reported. This means normal language and intelligence, but clueless in socialization; “robot-like” or android-like” behavior. Asperger syndrome was named from the Austrian pediatrician Hans Asperger who, in 1944, studied and described children in his practice who lacked nonverbal communication skills, demonstrated limited empathy with their peers, and were physically clumsy. The modern conception of Asperger syndrome came into existence in 1981 and became an official diagnosis in 1994. The diagnosis of Asperger’s was eliminated in the 2013 fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and replaced by a diagnosis of autism spectrum disorder on a severity scale. Though the DSM-5 doesn’t recognize AS anymore, the ICD-10 still recognizes Asperger syndrome as part of the more general pervasive developmental disorders.
What causes Asperger syndrome?
The exact cause of Asperger’s is unknown. Although research suggests the likelihood of a genetic basis, there is no known genetic cause and brain imaging techniques have not identified a clear common pathology.
What are the symptoms of AS?
The main symptoms of AS include poor communication skills, obsessive or repetitive routines, and physical clumsiness.. Most children improve as they mature to adulthood, but social and communication difficulties may persist.
- Problems with social skills: Children with Asperger’s syndrome generally have difficulty interacting with others and often are awkward in social situations. They generally do not make friends easily. They have difficulty initiating and maintaining conversation.
- Eccentric or repetitive behaviors: Children with this condition may develop odd, repetitive movements, such as hand wringing or finger twisting.
- Unusual preoccupations or rituals: A child with Asperger’s syndrome may develop rituals that he or she refuses to alter, such as getting dressed in a specific order.
- Communication difficulties: People with Asperger’s syndrome may not make eye contact when speaking with someone. They may have trouble using facial expressions and gestures, and understanding body language. They also tend to have problems understanding language in context and are very literal in their use of language.
- Limited range of interests: A child with Asperger’s syndrome may develop an intense, almost obsessive, interest in a few areas, such as sports schedules, weather, or maps.
- Coordination problems: The movements of children with Asperger’s syndrome may seem clumsy or awkward.
- Skilled or talented: Many children with Asperger’s syndrome are exceptionally talented or skilled in a particular area, such as music or math.
What distinguishes Asperger’s Disorder from classic autism are its less severe symptoms and the absence of language delays. Children with Asperger’s Disorder may be only mildly affected, and they frequently have good language and cognitive skills. To the untrained observer, a child with Asperger’s Disorder may just seem like a neurotypical child behaving differently. This belief may become a complication once a child with AS is not diagnosed and grows up confused in a “chaotic” neurotypical world.
More specific AS symptoms in children:
- Not pick up on social cues and may lack inborn social skills, such as being able to read others’ body language, start or maintain a conversation, and take turns talking.
- Dislike any changes in routines.
- Appear to lack empathy.
- Be unable to recognize subtle differences in speech tone, pitch, and accent that alter the meaning of others’ speech. So your child may not understand a joke or may take a sarcastic comment literally. And his or her speech may be flat and hard to understand because it lacks tone, pitch, and accent.
- Have a formal style of speaking that is advanced for his or her age. For example, the child may use the word “beckon” instead of “call” or the word “return” instead of “come back.”
- Talk a lot, usually about a favorite subject. One-sided conversations are common. Internal thoughts are often verbalized.
- Avoid eye contact or stare at others.
- Have unusual facial expressions or postures.
- Be preoccupied with only one or few interests, which he or she may be very knowledgeable about. Many children with Asperger’s syndrome are overly interested in parts of a whole or in unusual activities, such as designing houses, drawing highly detailed scenes, or studying astronomy. They may show an unusual interest in certain topics such as snakes, names of stars, or dinosaurs.
- Have delayed motor development. Your child may be late in learning to use a fork or spoon, ride a bike, or catch a ball. He or she may have an awkward walk. Handwriting is often poor.
- Have heightened sensitivity and become overstimulated by loud noises, lights, or strong tastes or textures. For more information about these symptoms, see sensory processing disorder
Symptoms of AS in teen years:
Most children with AS generally improve when reaching teenage years. However, problems with socialization are becoming more apparent as they are at high risk for social isolation, bullying, and depression due to their obvious differences in behavior and interests. Remember, teens love to conform to anything “cool” stuff (I’m totally related to this struggle though).
A description of AS symptoms in teens is quoted from WebMD:
Most symptoms persist through the teen years. And although teens with Asperger’s can begin to learn those social skills they lack, communication often remains difficult. They will probably continue to have difficulty “reading” others’ behavior. Your teen with Asperger’s syndrome (like other teens) will want friends but may feel shy or intimidated when approaching other teens. He or she may feel “different” from others. Although most teens place emphasis on being and looking “cool,” teens with Asperger’s may find it frustrating and emotionally draining to try to fit in. They may be immature for their age and be naive and too trusting, which can lead to teasing and bullying. All of these difficulties can cause teens with Asperger’s to become withdrawn and socially isolated and to have depression or anxiety. But some teens with Asperger’s syndrome are able to make and keep a few close friends through the school years. Some of the classic Asperger’s traits may also work to the benefit of your teen. Teens with Asperger’s are typically uninterested in following social norms, fads, or conventional thinking, allowing creative thinking and the pursuit of original interests and goals. Their preference for rules and honesty may lead them to excel in the classroom and as citizens.
Right. AS teens don’t like neurotypical interests like reality shows, showbiz, or pop music (but instead are huge fans of classical music, computers, and encyclopedias like I do). That’s why they are often shunned and bullied by peers, causing social isolation, anxiety, and depression just because they are different from the more common neurotypicals.
AS Symptoms in Adults:
AS adults still do improve a lot be being becoming more aware of their strengths and weaknesses. Here’s an excerpt from WebMD about AS symptoms in adults:
Symptoms in adulthood
Asperger’s syndrome is a lifelong condition, although it tends to stabilize over time, and improvements are often seen. Adults usually have a better understanding of their own strengths and weaknesses. They are able to learn social skills, including how to read others’ social cues. Many people with Asperger’s syndrome marry and have children. Some traits that are typical of Asperger’s syndrome, such as attention to detail and focused interests, can increase chances of university and career success. Many people with Asperger’s seem to be fascinated with technology, and a common career choice is engineering. But scientific careers are by no means the only areas where people with Asperger’s excel. Indeed, many respected historical figures have had symptoms of Asperger’s, including Wolfgang Amadeus Mozart, Albert Einstein, Marie Curie, and Thomas Jefferson.
Usually, AS adults are comparable to Big Bang Theory’s Sheldon Cooper, Dr. Gregory House from “House”, Adam Raki of “Adam” (not the Biblical Adam but the 2009 rom-com movie), and Sherlock Holmes. They are usually described as “intellectually” smart but poor socially (romantically awkward). However, unlike more severe ASD conditions (PDD-NOS, autistic disorder, CDD, Rett syndrome), they are more successful (although will struggle a lot) in finding career and forming relationships and family, if given proper and enough family support.
What happens if AS is not diagnosed or identified?
Much difficulty is faced by an AS individual if he or she is undiagnosed (or is not aware of his or her condition) particularly in career choices and relationships, which can have a drastic effect on his or her well-being. Growing up with undiagnosed Asperger’s Syndrome can be traumatic for many individuals. Adults with Asperger’s Syndrome have often developed negative perceptions of themselves and may regard themselves as “weird”, “crazy,” or “broken.”
Adults with AS are also susceptible to having various psychological difficulties. Often these challenges are a result of the individual’s difficulty coping with their AS, as well as the stress, anger, frustration, confusion, anxiety and fear that they feel.
These additional difficulties are often misinterpreted, misdiagnosed, misunderstood and mistreated, especially if the underlying AS is undiagnosed or is not adequately understood. 
Some of the most common additional difficulties include:
- Anger outbursts (physical or verbal aggression, verbally threatening behavior)
- Agitation and restlessness
- Increase in obsessional or repetitive activities, thoughts, or speech
- Low mood or depression
- Apathy and inactivity
- Onset of uncharacteristic, bizarre behavior or thoughts
It is also common for adults with AS to experience chronic struggles in major life activities such as family, friendships, finances, health, and the workplace. Examples of these struggles include:
- Difficulty maintaining serious or romantic relationships
- Partners or spouses complaining of lack of intimacy
- Children feeling distant from AS parents
- Friendships end due to lack of attention or invitations
- Not understanding why friends or partners become frustrated
- Lack of proactive attention to finances and health, resulting in dangerous neglect
- Chronically being “underemployed” or unemployed
- Frequent job changes due to “boredom”, lack of challenge, or interpersonal problems
That’s where psychologists and psychiatrists misdiagnose AS people with mental disorders (mood disorders, psychoses), or other neurological disorders (ADHD), and that’s usually incorrect diagnoses, making undiagnosed AS more complicated.
Common complications of undiagnosed AS:
- decreasing internal motivation
- rigid ways of thinking
- limited distractions from negative/obsessional thoughts
- limited insight into own difficulties or reasons
- poor coping strategies
- low threshold for tolerance of stress, frustration and anger
- poor self-identity, understanding and esteem
How is AS diagnosed?
A diagnosis of Asperger syndrome is usually made by a paediatrician who works with a team of specialists, such as a psychologist and speech pathologist, to conduct an in-depth assessment of the child’s skills and abilities.
There are several types of assessments, sets of criteria or rating scales that can be used to diagnose Asperger syndrome. The assessment will usually include questions about social and emotional abilities, communication skills, learning abilities, movement skills and special interests.
For adults with suspected AS, some first self-search about AS, others are identified by either their parents, spouse/partner, or friend/colleague. Then, diagnosis goes like this:
- Many individuals pursue neuropsychological testing with a neuropsychologist (PhD) or a psychiatrist (MD). As a result of this testing, it may be determined that the individual has Asperger Syndrome, something related to AS, or something different. This will give a fairly full picture of strengths and challenges and of how one’s brain processes information.
- In addition to those with an MD or PhD, any professional with the credentials and expertise to diagnose any other condition may also make a diagnosis of Asperger Syndrome. Such professionals may be social workers (MSW), master’s level psychologists (MA), or other mental health professionals.
- Neuropsychological testing is not required to get an “official diagnosis”. To apply for SSI there must be written documentation in the record from an M.D. or PhD. that there is some type of a psychological issue (not necessarily AS). There is no requirement of psych testing. The other issues regarding inability to work may be best described by other clinicians.
- Asperger Syndrome Diagnostic Scale (ASDS)
- Autism Spectrum Screening Questionnaire (ASSQ)
- Childhood Autism Spectrum Test (CAST) (previously called the Childhood Asperger Syndrome Test)
- Gilliam Asperger’s disorder scale (GADS)
- Krug Asperger’s Disorder Index (KADI)
- Autism-spectrum quotient (AQ; with versions for children, adolescents, and adults)
It is never too late for an individual to increase self-awareness in order to capitalize on strengths and work around areas of challenge. Knowing about Asperger Syndrome gives the individual an explanation, not an excuse, for why his or her life has taken the twists and turns that it has.
How is Asperger Syndrome managed?
There is no cure for Asperger syndrome. Therapies like occupational therapy, language therapy, and social skills training are done to improve AS symptoms.
- An applied behavior analysis (ABA) technique called social skills training for more effective interpersonal interactions;
- Cognitive behavioral therapy to improve stress management relating to anxiety or explosive emotions and to cut back on obsessive interests and repetitive routines;
- Medication, for coexisting conditions such as major depressive disorder and anxiety disorder;
- Occupational or physical therapy to assist with poor sensory processing and motor coordination;
- Social communication intervention, which is specialized speech therapy to help with the pragmatics of the give and take of normal conversation;
- An ABA procedure known as positive behavior support includes training and support of parents and school faculty in behavior management strategies to use in the home and school.
Vocational training is important to teach job interview etiquette and workplace behavior to older children and adults with AS, and organization software and personal data assistants can improve the work and life management of people with AS.
Medications can also be given for comorbid conditions like anxiety disorder, major depressive disorder, inattention and aggression. The atypical antipsychotic medications risperidone and olanzapine have been shown to reduce the associated symptoms of AS; risperidone can reduce repetitive and self-injurious behaviors, aggressive outbursts and impulsivity, and improve stereotypical patterns of behavior and social relatedness. The selective serotonin reuptake inhibitors (SSRIs) fluoxetine, fluvoxamine, and sertraline have been effective in treating restricted and repetitive interests and behaviors.
What is the prognosis for AS?
The prognosis is somewhat better than other ASDs, although comorbid mental problems appear alongside improvement. There is some evidence that children with AS may see a lessening of symptoms; up to 20% of children may no longer meet the diagnostic criteria as adults, although social and communication difficulties may persist. Individuals with AS appear to have normal life expectancy, but have an increased prevalence of comorbid psychiatric conditions, such as major depressive disorder and anxiety disorder that may significantly affect prognosis. Although social impairment may be lifelong, the outcome is generally more positive than with individuals with lower functioning autism spectrum disorders.
A quote from Wikipedia is stated below for more of AS prognosis:
Although many attend regular education classes, some children with AS may utilize special education services because of their social and behavioral difficulties. Adolescents with AS may exhibit ongoing difficulty with self care or organization, and disturbances in social and romantic relationships. Despite high cognitive potential, most young adults with AS remain at home, yet some do marry and work independently. The “different-ness” adolescents experience can be traumatic. Anxiety may stem from preoccupation over possible violations of routines and rituals, from being placed in a situation without a clear schedule or expectations, or from concern with failing in social encounters; the resulting stress may manifest as inattention, withdrawal, reliance on obsessions, hyperactivity, or aggressive or oppositional behavior. Depression is often the result of chronic frustration from repeated failure to engage others socially, and mood disorders requiring treatment may develop. Clinical experience suggests the rate of suicide may be higher among those with AS, but this has not been confirmed by systematic empirical studies.
With earlier assessment and intervention of AS, prognosis gets better, though adult assessment can be helpful too and enlightening. Prognosis may be improved by diagnosis at a younger age that allows for early interventions, while interventions in adulthood are valuable but less beneficial. There are legal implications for individuals with AS as they run the risk of exploitation by others and may be unable to comprehend the societal implications of their actions.
How common is AS?
Asperger syndrome range from 1 in every 250 children to 1 in every 10,000. It is four times more likely to occur in males than in females and usually is first diagnosed in children between ages 2 and 6, when communicative and language skills are emerging and settling. The male-female ratio for AS range from 1.6:1 to 4:1. AS is associated with epilepsy, nonverbal learning disorder, tics, Tourette syndrome, and bipolar disorder, and the repetitive behaviors of AS have many similarities with the symptoms of obsessive–compulsive disorder and obsessive–compulsive personality disorder.
Some people with AS are proud of their disorders and some don’t want to be cured. Does AS have an advantage?
AS is said to be the more common of the ASDs, although not as fully recognized in many parts of the world; most people still view AS as mere eccentricity or immaturity of a person affected with it. Nevertheless, AS has been suspected to a lot of historical figures who contributed to science, technology, and music; hence contributing to civilization as a whole. This is where some AS people advocate AS strengths (great attention to detail, analytical, knowledge-loving as opposed to neurotypical love of status and social superiority). AS, though has social difficulty, has an advantage too.
In fact, Australia-based English psychologist Tony Attwood presents an opinion about the advantage of children with AS:
From my clinical experience I consider that children and adults with Aspergers Syndrome have a different, not defective, way of thinking.
The person usually has a strong desire to seek knowledge, truth and perfection with a different set of priorities than would be expected with other people. There is also a different perception of situations and sensory experiences. The overriding priority may be to solve a problem rather than satisfy the social or emotional needs of others.
The person values being creative rather than co-operative.
The person with Aspergers syndrome may perceive errors that are not apparent to others, giving considerable attention to detail, rather than noticing the “big picture”.
The person is usually renowned for being direct, speaking their mind and being honest and determined and having a strong sense of social justice.
The person may actively seek and enjoy solitude, be a loyal friend and have a distinct sense of humour.
However, the person with Aspergers Syndrome can have difficulty with the management and expression of emotions.
Children and adults with Aspergers syndrome may have levels of anxiety, sadness or anger that indicate a secondary mood disorder. There may also be problems expressing the degree of love and affection expected by others. Fortunately, we now have successful psychological treatment programs to help manage and express emotions.
I agree with him though. Being obsessed with planets isn’t abnormality nor being a die-hard fan of classical music. What needs to be managed is the social difficulties. It’s not that AS people are antisocial; AS has intuitive analytical brain that it just can’t comprehend pragmatic “earthling” world. That’s why in Asperger forums like Wrong Planet, people with AS (also called Aspies) feel like “we are living on a different planet with different language.” In short, AS people/aspies are comparable to aliens that need formal education about
earthlings neurotypical or typically developing people in terms of socialization.
That’s why it is very important for all of us to be aware and accept people with Asperger syndrome. What they need is understanding and acceptance, not prejudice.
Famous people with AS. Plenty. And contributed a lot in our world. See the list in my autism article here.
Diane Kennedy, an author and advocate for Asperger Syndrome, writes, “They are our visionaries, scientists, diplomats, inventors, chefs, artists, writers and musicians. They are the original thinkers and a driving force in our culture.”
Hans Asperger, the German doctor who discovered the syndrome, would agree with Kennedy’s assessment. He believed that “for success in science or art, a dash of autism is essential. The essential ingredient may be an ability to turn away from the everyday world, from the simply practical and to rethink a subject with originality so as to create in new untrodden ways with all abilities channeled into the one specialty.”
Other famous people suspected to have Aspergers:
- Marie Curie
- Jane Austen
- Margaret Mead
- Pablo Picasso
- William Shakespeare
- Thomas Jefferson
- Benjamin Franklin
- Hans Christian Andersen
- Lewis Carroll
- James Joyce
- Nikola Tesla
Ow? But these people are geniuses…
There is an ongoing debate about overlapping neurodiversity and giftedness. Maybe I’ll discuss that issue later on.
This is a typical interest of an AS person. Clocks. Interesting topic though.
While neurotypicals are obsessed with…
sex… okay, that doesn’t mean aspies are asexual beings (though there are a lot claiming to be) or not interested to sex…
Although AS people are socially awkward, they can be a very loyal friend or lover. Too bad they are prejudiced by the “cool” but promiscuous neurotypicals who did nothing but collect lovers and discriminate AS folks by having them a label “nice guy/girl” who always last. But that’s because…
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AS Teen teaches bullies a life lesson: http://pix11.com/2015/07/06/teen-with-aspergers-syndrome-teaches-bullies-who-beat-him-up-a-life-lesson/
Susan Boyle has Aspergers: http://www.theguardian.com/fashion/2013/dec/08/susan-boyle-i-have-aspergers
Why people with Asperger syndrome has difficulty socializing? Here’s the list of reasons: http://ownshrink.com/aspergers/why-aspies-have-problems-socializing-tips/
Advantages of having Asperger syndrome: http://www.yourlittleprofessor.com/the-benefits-of-aspergers-syndrome/