Asperger Syndrome

Here those of you with diagnosed or suspected Asperger Syndrome (AS) can share with me and other posters your experiences and ideas.  We can all provide the benefit of our experience to each other on coping with the world.  The facts about AS and our theories help to explain our position in the scheme of things.

I will be presenting information and thoughts about why we are where we now are for discussion.

Aspergers Syndrome was originally described by Hans Asperger in Vienna in 1944, using the term “autistic psychopathy” to describe the social deficits he observed in a group of children.

His original description, in German, received little attention in English-language literature until Lorna Wing translated his work in 1981.  The condition was not included in the official manual for professional therapists (DSM) in the USA until 1994.

Official descriptions are based on observed characteristics such as the following:

Asperger syndrome (AS) is characterized by social isolation and eccentric behaviour in childhood. Impairments in social interaction, non-verbal communication and unusual responses to the environment, similar to those in autism, are observed. Cognitive and communicative developments are within the normal or near-normal range in the first years of life.

Although verbal skills may appear to be an area of strength, typically speech patterns are characterized by abnormal inflection, repetition and a pendantic style. Idiosyncratic interests are common and may take the form of an unusual and/or highly circumscribed interest (e.g., in train schedules, snakes, the weather, deep-fry cookers, or telegraph pole insulators). There is some suggestion of an increased incidence of this condition in family members which indicates a genetic predisposition. The condition has lately been merged with high-functioning autism in official manuals although the definition previously emphasized differences from autism, for example, in terms of better communication (particularly verbal) skills and earlier development of speech.

The observed characteristics are in most cases caused by delay in changing from one thought pattern to another, which has been confirmed in neurophysical examinations to be due to less cross-linking between brain regions than in the neurotypical (NT, the usual type) brain.  This results in some superior traits, such as the ability to maintain exclusive focus on the topic at hand and emphasis on logic and consistency in all thinking.  Rather than being classified as an affliction, asperger syndrome can be seen as a form of neurodiversity.  The condition does not change noticeably throughout life but behaviour can be modified through learning.  A large genetic influence has been found.

At this point, an explanation of the autistic spectrum is required.  Autism is a lifelong, neurodevelopmental disorder characterized by difficulty with socialization and communication skills. It can result in mild to severe difficulties in thinking and learning and is frequently marked by unusual interests and repetitive behaviors such as twirling, rocking, and flapping one’s hands. Autism can significantly impede an individual’s ability to lead a fulfilling life and mature to independence. It is believed to be a dysfunction in the central nervous system (the brain and spinal cord).  Symptoms typically occur by the time a child is three years old.

The Autism Spectrum

Autism is one specific condition within a larger group of conditions known as Autism Spectrum Disorders (ASD) or the Pervasive Developmental Disorders (PDD).  The terms autism, ASD and PDD may be used interchangeably.  The word “spectrum” is important in understanding autism because it refers to the wide range of behavioral signs, symptoms, and degrees of severity that affect individuals. Individuals on the autism spectrum include those with Autistic Disorder, Pervasive Developmental Disorder NOS and Asperger Syndrome. In addition, Rett Syndrome and Childhood Disintegrative Disorder – two very rare, but serious disorders – are also included under the Pervasive Developmental Disorders.  In noting these main types, however, it must be emphasised that each person on the autism spectrum is an individual with characteristics and needs specific to them alone.

Despite their individual differences, many people with an ASD share similar struggles. Individuals with an ASD often have difficulty understanding, initiating and/or maintaining conversations and interpreting what others are thinking, feeling or saying. In addition to difficulties in socializing and communicating, many have unusual ways of playing, paying attention, and reacting to different sensations and situations. This sensitivity to sensory stimulation can make life extremely challenging. Environmental conditions, such as certain sounds, smells or textures, that are acceptable to others can be intolerable to someone with an ASD. Some people with an ASD become overly focused on a very narrow interest such as a specific topic or object. They may be resistant to changes in routine and seek to adhere to rituals. Individuals with an ASD often have difficulty regulating their behavior and may engage in self-comforting or self-stimulating behaviors. As a result of these characteristics, everyday situations can become a challenge for individuals with an ASD and their families.

Pervasive Developmental Disorders  are defined as follows in the Diagnostic and Statistical Manual of Mental Disorders, edition Four, Text Revision, DSM-IV-TR (note that, in DSM5, AS is included with Autism as a single diagnosis).

1.  Autistic Disorder: Sometimes called “classical autism,” Autistic Disorder is the most common ASD. Onset occurs before the age of three and is characterized by significantly delayed or unusual verbal or nonverbal communication skills and social interactions, as well as unusual, repetitive behaviors, and/or severely limited activities and interests. Individuals with Autistic Disorder have difficulty making eye contact, reading other people’s faces, nonverbal cues and gestures, and interacting with others. They may engage in repetitive or unusual movements such as twirling, rocking, hand flapping or clapping, posturing, or self-abusive behavior such as head-banging, slapping or biting themselves. They tend to speak later in life, if at all, and may refer to themselves by name instead of using “I” or “me. Echolalia – the repeating of all or part of what is said to them by someone else – is another common speech pattern among individuals with Autistic Disorder.

2.  Asperger Syndrome: Individuals with Asperger Syndrome (AS) generally do not have language or cognitive delays but do have difficulties in social behavior and communication and display unusual behaviors and interests. They may have unique speech patterns, or speak in a monotone or rhythmic voice. They often have difficulty engaging in conversations, reading social cues, and developing social relationships. They may also find it difficult to express and classify their feelings or to connect with and understand others’ experiences. It is not uncommon for individuals with AS to develop an obsessive interest in one narrow, specific subject and to become ‘experts’ on that subject. They can also be sensitive to different stimuli, such as sounds or noise level, the texture of certain materials, or certain foods or types of food, and they often follow strict schedules to feel in control.

3.  Pervasive Developmental Disorder — Not Otherwise Specified (PDD-NOS): If a child has symptoms of autism, but does not meet the specific criteria for a diagnosis of Autistic Disorder or Asperger Syndrome, a diagnosis of PDD-NOS is given. As with Autistic Disorder, this condition is recognized by marked difficulties in communication, social interaction with peers, and/or stereotyped behavior patterns or interests. Children with PDD-NOS display a range of traits. They may lack interest in interacting with other children and seek to avoid them altogether. They may enjoy some interaction, but still be unsure of how to behave with others, or they may tend to become over stimulated easily. Some may experience unusual sensitivities to certain events or objects in their environment or have a strong need for sameness and routine and react poorly to change. Some children may engage in noticeable movement patterns such as hand-flapping or twisting, toe-walking, lunging, darting, pacing, jumping, body rocking, and head rolling or head-banging.

4.  Rett Syndrome: Rett Syndrome, also known as Rett’s Disorder, is a rare genetic disorder that almost always affects females. It occurs at a rate of about one in every 10,000-15,000 female births. It is included among the Pervasive Developmental Disorders because in its early stages it resembles autism. Like the other disorders, this condition ranges from mild to severe in its expression. Development is normal during the first six to 18 months of life. At some point during this time, however, parents may notice a change in their child’s behavior and the loss of muscle tone and related abilities such as walking and hand use. Changes in the rate of head and brain growth, development of speech and reasoning, and the repetition of meaningless gestures, such as hand-wringing or hand-washing gestures, also occur. Approximately eight in 10 girls with Rett’s Disorder are prone to seizures.

5.  Childhood Disintegrative Disorder (CDD): Also called Heller’s Syndrome, CDD affects boys more often than girls, and is diagnosed if the symptoms are preceded by at least two years of normal development before the age of 10. CDD is an extremely rare disorder that resembles Autistic Disorder wherein a period of normal development is followed by a period in which the child loses already-developed skills. Skills loss occurs in language, self-care, toilet training, motor coordination, interest in the social environment, and social interactions. Over a period of two to four years, these children develop behaviors that appear autistic. Children who have CDD are also at greater risk for seizures.

My Theory

Various theories have been formulated to explain the differences between AS and NT behaviour and neurophysiology but the existence of strong genetic influences suggests a racial background to the situation.

During the journeys of homo sapiens originally within Africa and then through Asia and Europe, other subspecies were encountered.  These subsequently disappeared due to, no doubt, inability to compete with the supremely competitive nature of homo sapiens.  Parallels can be seen in the results of the contact of western man with aboriginal races within the last few centuries.  While many were eliminated by conflict or disease, others were assimilated.  In the case of a different subspecies, assimilation would not always be as successful as when the different is only of race within the same subspecies.  This is called hybridisation, due to incomplete compatibility of the genomes, which usually has results varying from infertility to physical and neurophysiological dysfunction, whether mild or severe.  Depending on which genetic contribution is dominant, a functional individual can exhibit characterisitics of either subspecies.

This discussion leads us to the heart of the theory.  The neurodiversity shown in AS shows a fully functioning but different type of human being.  A society composed exclusively of such people in a primitive setting would be structured and operate differently from one composed of the majority type.  It would depend on solitary hunters, using their high intelligence and inventiveness rather than by team efforts.  The individuals would be more wary of dangers, being solely responsible for their own safety while seeking sources of food and other basic needs.  Child rearing would be a communal function more than by the isolated family unit or extended family.  These and other examples of functional differences put into perspective the differences in behaviour between the two types.

Hybridisation between  the subspecies of species homo would result in some individuals fully functional in the image of one or the other side (manifesting as AS or NT) and in others having double recessive combinations resulting in defects of one sort or another.  These would explain the more disabled parts of the autism spectrum.

Rather than disprove this theory, what has been ascertained about, for instance, Neanderthal man (homo Neanderthalensis) presents some parallels with AS.  More than one researcher has found evidence that the subspecies was very intelligent and used tools crafted with a high degree of skill.

Archaeological anthropologists have found, on the other hand, that, having developed a satisfactory technology, they did not change it over a long period of time.  This characteristic is similar to the AS resistance to change of routine and would have rendered them uncompetitive with the subsequent waves of settlement by homo sapiens with their more aggressive and uncompromising approach.

Coupling this evidence with the discovery of multiple Neanderthal genes in modern human beings lends more credibility to the theory.  Characteristic Neanderthal skull shapes, for instance, are found in the contemporary population.  All this makes h. Neanderthalensis a good candidate for the origin of AS genes.

Many other subspecies, however, would have been encountered by h. sapiens on their long migrations, even in Africa where all are deemed to have originated.  If h. Neanderthalensis was not the donor of the neurological difference, then some other may well have been.

What does this mean for the treatment of autistic individuals.  In many cases, it has been found that sympathetic coaching in communication and self-awareness has resulted in early a high degree of functionality after early signs suggested profound handicap (for example, the story of Professor Temple Grandin).  This suggests that, in the early subspecies, children may have been more helpless in early years than those of h. sapiens and required a specific style of rearing that introduced them to the realities of their physical environment and to the awareness of their own minds and bodies.  This style is not typical of h. sapiens, whose children have comparatively self-managed “milestones” which are defined by their common experience and which would not necessarily be applicable to nor take account of the different needs of a variant.  Of course, the problems of the autistic individual are an extreme case under this theory, due to the mismatch of DNA, but serves to illustrate the general idea of the incompatibility of lifestyles that would have been unsatisfactorily juxtaposed within the one resultant culture.

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