Asperger Syndrome – Being an Adult with Asperger
Asperger syndrome (AS) is a pervasive developmental disorder characterized by altered social interactions, restricted interests and repetitive and stereotyped behavior as in autism but, contrary to the latter, should not show any significant delay in acquisition of language, psychomotor and cognitive skills. Although studies on Asperger Syndrome focus on childhood cases, the fact that it is a continuous and life-long disorder shows its prevalence in adulthood. Most studies on Asperger Syndrome concentrate on childhood while there is scarcity of reports about the clinical and neurobiological characteristics of these individuals in adulthood. Asperger Syndrome can lead to significant health and social difficulties for adults and unlike Asperger Syndrome in childhood, in Adulthood it can be as complicated as dealing with Autistic disorders.
Origin
Asperger’s syndrome also known as Asperger’s Disorder was first described in the 1940s by Viennese pediatrician Hans Asperger, who observed autism-like behaviors and difficulties with social and communication skills in boys who had normal intelligence and language development. Until 2013, Asperger’s syndrome was thought to be a form of autism yet distinct from it because of differences in the timing that each condition typically appears in life, how each condition progresses, and the impact each has on any one individual. During this same year the American Psychiatric Association recognized the predominance of similarities between Asperger’s syndrome and autism, merging them into a new classification called Autism Spectrum Disorder (ASD). This syndrome was essentially unknown in the English literature for many years. An influential review and series of case reports by Lorna Wing (1981) increased interest in the condition, and since then both the usage of the term in clinical practice and number of case reports and research studies have been steadily increasing. Despite some new research leads, knowledge on Asperger syndrome is still very limited. For example, we don’t really know how common it is, or the male/female ratio, or to what extent there may be genetic links increasing the likelihood of finding similar conditions in family members.
Diagnosis and Prognosis
Most people with Asperger Syndrome are diagnosed in their childhood. When Asperger’s and autism were considered separate disorders under the DSM-IV, the symptoms for Asperger’s Disorder were the same as those listed for autism; however, children with Asperger’s do not have delays in the area of communication and language. To be diagnosed with Asperger’s, a child must have normal language development as well as normal intelligence. The first step to diagnosis is an assessment, including a developmental history and observation. This should be done by medical professionals experienced with autism and other PDDs. Somato-organic findings to confirm Asperger’s syndrome are not known. The diagnosis is a clinical one and is made on the basis of psychopathological findings and a thorough medical and psychiatric history—including a childhood history. Early diagnosis is crucial so that children are able to receive treatment early one giving them an increased chance of being successful in school and eventually living independently.
There are also characteristics that are related to Asperger’s but are also shared by other conditions. An example of this is difficulty noticing whether people are bored or not listening in conversations. Lots of people don’t pay much attention to whether people are listening to them, but that doesn’t mean they have Asperger’s. On the other hand, in combination with other signs of Asperger’s, not noticing how people respond in conversations, could be a significant confirmation of an Asperger’s diagnosis. Being diagnosed does not mean that life will be easier for the individual, the social categorization of Asperger's Syndrome as a “disorder” or “disability” has psychosocial effects such as low self-esteem, stress, and social isolation. All these effects can lead to bigger problems, adults and teenagers with Asperger Syndrome often deal with bullying which leads to depression and suicidal thoughts.
Currently there are nine screening questionnaires that are used to identify adults who may have Asperger’s. Most require the respondent to indicate whether he or she agrees with a statement related to Asperger’s.
Asperger and Adulthood. Asperger Syndrome is usually associated with childhood and autism, but adults with Asperger are the ones dealing with the greater problems. During childhood, someone that is diagnosed with Asperger has the support and nurturing of their parents or caregivers, as an adult dealing with this syndrome become harder as different stages in life must be fulfilled. Little research has been done to learn about the social and mental development of adults and teenagers with the syndrome. But Research with clinical populations of people with Asperger syndrome suggests that this group often experiences significant health and social difficulties. It has been found that Asperger Syndrome can create high levels of social problems and social exclusion, and difficulties managing day to day tasks such as washing and cleaning.
Many adults with Asperger Syndrome are able to work successfully in mainstream jobs, although they may continue to need encouragement and moral support to maintain an independent life. Living an independently can be the hardest part for adults with Asperger. When you lack the intuitive ability to generalize, every time you go out the front door is a new challenge. More or less neurotypical people do not have to be thinking constantly just to function somewhat comfortably in the world. Many adults with Asperger profiles operate from a baseline of anxiety.
Asperger Syndrome can make the easier situations of adulthood very difficult, difficulties often arise especially in relationships. Because of their lack of empathy, persons with Asperger’s syndrome may have difficulties to make contact with potential partners in an appropriate way. This also includes the whole area of sexuality. Some people with Asperger’s have a very low need for physical closeness, others even have an aversion to it.
Treatment. Asperger’s syndrome in adulthood can be diagnosed by thorough anamnesis, heteroanamnesis—with emphasis on childhood—and painstaking clinical examination. The considerable psychosocial impairments affect the patients’ professional, social, and private lives. The precise etiology is still unknown, but a multifactorial origin with genetic, neurobiological, and psychosocial components appears probable. Early intervention seems to be the key to success when it comes to treating Asperger’s. This means that the earlier you start a therapy, the better. Every child and adult with Asperger’s is different. You might have to try several treatment approaches before you notice improvement.
The ideal treatment for AS coordinates therapies that address the three core symptoms of the disorder: poor communication skills, obsessive or repetitive routines, and physical clumsiness. There is no single best treatment package for all children with AS, but most professionals agree that the earlier the intervention, the better. There aren't any drugs approved by the FDA that specifically treat Asperger's or autism spectrum disorders. But certain drugs can help control secondary symptoms that often accompany the disorder, such as anxiety, hyperactivity, depression, or attention problems. Some people with Asperger’s take medications like antipsychotics, stimulants, or antidepressants.
Conclusion. Asperger’s syndrome should be included in the differential diagnosis of adults who display the corresponding symptoms. The etiopathogenesis and treatment of Asperger’s syndrome in adulthood should be further investigated. Adults with Asperger Syndrome need greater assistant when living an independent life. It is crucial for adults with Asperger to continue to receive treatment and therapy since their everyday life only gets more difficult as they go through different stages of adulthood. Although Asperger’s syndrome is one of the more common differential diagnoses in child and adolescent psychiatry, in adults the disorder has received particular attention only recently.
Smalls, 2018