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Straight talk about Asperger syndrome

 

© 2006-2012 Paul Cooijmans

Introduction

 

Asperger syndrome, officially called Asperger's disorder in the diagnostic manual, has become a more or less popular diagnosis in the late twentieth century. As result there has been much writing and talk about it, and a relatively wide audience is now aware of the condition and some facts and notions related to it. Not all of these notions are true, while some known facts remain unmentioned; publicity around Asperger syndrome suffers to some extent from the phenomenon of believing what one likes to believe and ignoring what one does not like to know. I will try to set a few things straight. It is assumed in this article that the reader already knows what Asperger syndrome is.

 

 

 

Is it autism?

 

Asperger is listed as a Pervasive Developmental Disorder. This is a group of serious inborn life-long disorders which include autism (Autistic Disorder) as well as Asperger and a few other disorders. So in the diagnostic manual, Asperger is not autism but is explicitly mentioned in its own right.

 

There are however researchers and psychiatrists who believe Asperger is really the same as autism and should not be a separate diagnosis. There is controversy, with to my knowledge a majority in favour of the viewpoint that autism and Asperger are the same. I have written a review in Netherlandic of a book dealing with this.

 

In the current diagnostic criteria (D.S.M. IV), the main difference between the diagnoses is that autism requires a delay in language (speech) development in the first years of life, while Asperger requires the absence of such a delay. In practice, the Asperger diagnosis is by convention only given to persons who are not mentally handicapped.

 

Personally I think Asperger and autism should not be treated as the same disorder and do deserve separate diagnoses. I have heard that some psychiatrists, who believe Asperger and autism are the same, more or less boycott the current diagnostic criteria and simply give everyone "autism". This is bad because it makes research into the possible differences a priori impossible. It would be better to revise the Asperger criteria and make them more different from those for Autistic Disorder, for instance by including the less popular negative features that are missing from the current image of Asperger, but have been observed by Hans Asperger in his original study and are known from forensic psychiatry. These include motor clumsiness, insensitivity to another's feelings, destructiveness, aggression, endlessly bottled-up anger, violent outbursts, and grim sadism. Some of these set Asperger apart from classical autism, and failing to include them in the criteria makes it appear as if Asperger and autism are really the same.

 

In addition and on the positive side, children with Asperger tend to have an unusual and rich fantasy life, while autistic children on the other hand are observed to be lacking in imagination.

 

Finally, Asperger may have to be moved, as also suggested by Sula Wolff, from the category Pervasive Developmental Disorders to the category Personality Disorders, "Cluster A" (Schizoid, Schizotypal, Paranoid), wherewith it may be closely related to begin with. This will also make it more explicit that Asperger, although likely having a genetic link with autism, is also related to a form of Schizophrenia (probably the paranoid variant), and in some cases the premorbid stage thereof, and that therefore there exists a risk of developing psychosis in Aspergoid persons, more so than in autistic persons. Several percent of those with Asperger become schizophrenic later on, and this percentage may even rise to around five percent after removal of those who really are cases of autism but incorrectly received an Asperger diagnosis as a result of the current insufficient criteria.

 

In actuality, however, one now appears to be planning the opposite: to abolish the separate Asperger diagnosis with the next revision of the diagnostic manual (D.S.M. V), and include these individuals with autistics in a kind of general autism spectrum diagnosis.

 

Are they highly intelligent?

 

There is a notion that Asperger syndrome is related to high intelligence. A few things must be said about this:

 

Because of the convention to give this diagnosis only to who are not mentally handicapped, the average I.Q. of people with Asperger is artificially elevated compared to that of the rest of the population, which does include the mentally handicapped. But this means not that persons with Asperger are highly intelligent per se; just that their I.Q.'s are mostly over 70.

 

Asperger is thought to be related to genius, and this makes people think of high intelligence. However, the relation with genius — which is real according to me — does not lie in the supposed high intelligence of those with Asperger, but in their conscientiousness and associative horizon, both of which are important components of genius next to intelligence.

 

Actually, within the group of individuals with Asperger, those with high intelligence are a minority (just as they are in the general population) and in the group of highly intelligent persons, those with Asperger are a minority (just as they are in the general population).

 

My own work with high-range intelligence tests has shown even more; that in the high range of intelligence there is a negative correlation between I.Q. and Asperger. In other words, those with Asperger are less intelligent. More recently I have also begun to suspect this may be different for females; in females, Asperger may not have this limiting (reducing) effect on intelligence, and it may even be that females with Asperger are more intelligent than other females. But that is still a hypothesis. In any case, the matter with females does not change the overall picture much, as females are a minority both among individuals with Asperger and among the highly intelligent.

 

Are they geniuses?

 

Genius, according to me, requires a wide associative horizon and large amounts of conscientiousness and intelligence. The first two thereof are typical of Asperger syndrome, be it not necessarily in all cases where conscientiousness is concerned. This means that the minority of persons with Asperger who in addition have high intelligence are likely to become geniuses, or at least creative.

 

In studying the history of genius and the lives of geniuses it quickly becomes obvious that most if not all geniuses are Aspergoid, although a formal diagnosis is as good as never available (which is logical as Asperger was only in the 1990s added to the diagnostic manuals).

 

In fact the real challenge is to come up with examples of non-Aspergoid genius. If such exists, it is most likely to be found in the performing arts (singing, dancing, acting) and in the non-exact or "alpha" sciences. Possible candidates are the composer W. A. Mozart and the psychiatrist S. Freud (not that I personally consider them geniuses; I just mention them because they are generally considered that).

 

 

 

Are they savants?

 

A savant excels in one or two very narrow fields while lacking the general intelligence to do anything useful with that ability. Savants are really always mentally handicapped. As by convention the Asperger diagnosis is not given to mentally handicapped persons, those with Asperger are inherently never savants. Sometimes they are said to possess "savant-like" skills though, but that is a manner of speech not to be taken too literally.

 

What can be said about the risk of developing psychosis or Schizophrenia?

 

Several percent of those with Asperger's disorder become psychotic or schizophrenic later on, and with more refined diagnostic criteria this percentage may turn out to be somewhat higher. Although rare, a psychotic development is therewith several times more likely in these persons than in the general population. A general observation in psychiatry is that lower intelligence significantly increases the risk of actually becoming schizophrenic in people thus disposed; higher intelligence appears to have a protective effect.

 

It is tempting to speculate as to which other factors in life may contribute to a psychotic development. I believe that both high levels of stress and the use of certain recreational drugs may cause psychosis in Aspergoid persons. In particular it concerns stress in relation to dealing with people (especially groups), and drugs of the hallucinogenic kind, including marihuana and hashish (the latter two are nowadays also called "cannabis").

 

Also, those Aspergoid persons who have marked schizotypal features may be considered chronically psychotic to begin with. Schizotypal personality is, of the "Cluster A" Personality Disorders, that which is closest to Schizophrenia, and some consider it an actual form thereof and suggest it be moved the to category with Schizophrenias.

 

Is it a "light" or "mild" form of autism?

 

The question whether Asperger is autism has been dealt with already under "Is it autism?". That it is a light or mild form is another popular notion. Because of their normal or higher intelligence — I.Q. 70+ — persons with Asperger appear to function more easily in society than persons who have autism in combination with mental retardation. This may lead one to think it is only a mild handicap.

 

In reality, Asperger syndrome is a severe handicap which makes life very much harder than it would be for a person of the same intelligence without the condition. It is always hard to express the severity of a handicap, but a safe guess is that Asperger is on par with for instance missing both legs (not just one) or with being completely blind (not just having very bad eyesight). In any case, the severity of the handicap is underestimated in popular publications about Asperger syndrome. The professional success of some Aspergoid individuals in adult life is deceptive in that it hides the inner suffering of the persons, which is nevertheless revealed by the high incidence of depression and suicide among them.

 

A thing that complicates this question is that the current diagnostic criteria for Asperger are almost the same as those for Autistic Disorder, so that as a result of this unfortunate circumstance the Asperger diagnosis is sometimes incorrectly given to who really have a light or high-functioning form of autism.

 

Do they take things literally?

 

It is natural for a person with Asperger to communicate literally and verbally; that is, to not use and not interpret non-literal language (manners of speech, imagery et cetera) and non-verbal communication. This has partly to do with being attached to truth, to what is real, to being unable to pretend and lie. For another part it is caused by having a wide associative horizon and therefore seeing several possible interpretations to a given non-literal expression and not knowing which is intended, while a normal person with a narrow associative horizon only sees one interpretation to that expression (regardless if this is the intended) and is thus unaware of the interpretation problem. And while the one interpretation assumed by the normal person may well be different from what the speaker intended, normal people are generally so loose and unconscientious in their communication that they don't even notice the other person has misunderstood them, so that there appears to be no problem.

 

However, in practice there are not few people with Asperger who purposely try (but fail) to leave this inclination toward the literal and verbal behind, probably because of the profound problems it causes in everyday life. They desperately try to "read between the lines", interpret facial expression and intonation, and so on, to "fit in" with normal people. They desperately try to use intonation, facial expression and non-literal speech themselves for the same reason. But because of their innate inability for non-literal and non-verbal communication, this desperate pretending only results in more misunderstanding, which they often fail to recognize because of the same innate inability. They want to "fit in" so badly that they betray their own nature, but fail even in that betrayal, and subsequently fail to recognize that failure as well. They try to be normal, but they can not.

 

The deeper background of this failure is probably that the communication style of normal people is essentially inconsistent, unreal, and untenable. The Aspergoid communication style is superior, but is so rare that one is constantly being heavily penalized for it.

 

One might wonder why some with Asperger want so much to "fit in". It is so that a person with Asperger is seen by most normal people as "different", even though many of those normal people will violently deny this when confronted ("There's nothing wrong with you!"). And some normal people naturally follow the line, "This person is different from what I am used to/This person therefore annoys me/Therefore I have to make this person suffer/As hard as I can/As long as I can/And I get away with it easily as this person can not defend oneself/Otherwise I would not dare bully this person as I am an extreme coward and cry for my female parent while defecating in my trousers whenever someone so much as points a finger at me in response to my bullying". As a result, persons with Asperger tend to be the target of extreme continuous torture in almost every social environment they are or become part of. They are the natural focus of the inferior's hatred. Yes, it says "torture", and not "abuse" or even "teasing", as one sometimes sees, as those disgusting euphemisms do not even begin to describe reality. It is in the light of this life-long suffering that one must see the attempts of some misguided Aspergers to "fit in". They think the torture will end if they learn to act normal. But it will not and they can not.

 

Are they ahead of evolution?

 

It is said by some that Asperger syndrome is a new stage in human evolution. If this is true then only partially, as there are certainly aspects of the syndrome that are not desirable and should better not be passed on to future generations; that are not improvements at all. These are things like motor clumsiness, impaired spatial ability, impaired general intelligence, hypersensitivity, rigidity (inflexibility), being math-impaired, and being inclined to obsessions and compulsions.

 

Other Aspergoid aspects though are indeed superior and should be striven for in posterity. This need not take long; evolution is a much faster process than commonly thought, and through careful selective procreation significant improvement is achieved in a mere one or two generations, as we have known for millennia from animal breeding. Care must be taken to tune down the undesirable, disabling aspects at the same time. Examples of superior aspects are honesty (inability to lie and pretend), sense of justice, conscientiousness (including ability to focus on a subject, and the other aspects mentioned in my article on conscientiousness), and a wide associative horizon (including not being restricted in one's thinking by the conventions of the herd, the dull mass).

 

It must also be noted that some of the undesirable aspects are really the high end or exaggerated form of desirable aspects, so that one has to find an optimum there and not go further. For instance, rigidity (inflexibility) is the high end of ability to focus, to concentrate, on a subject. With too much focus it becomes difficult to switch to another subject, which is what rigidity is. And obsessions and compulsions are the high end of conscientiousness.

 

Furthermore it can be said that the profound social problems of people with Asperger largely result from the difference in communication style with the normal people, and from their honesty not being tolerated, and do not primarily originate inside themselves. So those problems will disappear as more are born who naturally use the Aspergoid (literal and verbal) style and are honest. Therefore, these aspects — the social problems — need and can not be outbred in their own right. The same goes for things like violent outbursts and grim sadism; such does not have its cause inside the person with Asperger, but is a response to the bullying, harassment, and torture by one's environment for years or decades at a stretch. One may understand it in the context of what is nowadays called "post-traumatic stress disorder".

 

An observation relevant in this respect is that Asperger sometimes seems to be a side-effect of processes that genetically enhance positive traits like mental ability and conscientiousness; this is mentioned under "Which hereditary or genetic factors appear to cause it?". Apparently, an evolutionary development toward higher mental ability, abstract thinking powers, verbal communication, carefulness, and ethics, produces more Aspergoid individuals.

 

Can they not lie?

 

It is said people with Asperger syndrome can not lie. This is true for some but not all; there are also people with Asperger who are pathological liars, either by themselves or out of a desperate attempt to "fit in" in a world where lying is standard behaviour. Also, it is not so much an inability as a virtue; it is the being attached to truth. The inborn full and unconditional dedication to truth, which is the basis for all true science, for scientific curiosity, and for justice and law.

 

It is nowhere more clear than in the person with Asperger who can not lie, that ethical values come from within and are not learnt from educators or influenced by social environment.

 

Are they incapable of prejudice?

 

Persons with Asperger syndrome often tend to be naive, to assume their own ethical level in others, which makes them sitting ducks. Ancient tribal instincts from the mammalian brain like prejudice and xenophobia toward those outside the own tribe are impaired in some Aspergoid persons, possibly because they are located in the same regions of the brain where the also impaired aspects of non-verbal communication are housed. Lacking the social heuristics of prejudice and xenophobia, they may not recognize evildoers in time and end up in wrong company and being taken advantage of.

 

Are they lacking in reciprocity?

 

Civilized societies are based on the principle of reciprocity; of returning favours, often mistaken for altruism. People give with the expectation to receive something in return, and when given something, they feel obliged to return the favour. One gives to oblige. Without this principle, societies beyond the size of a tribe could not exist.

 

In some with Asperger syndrome, this mechanism is clearly absent. When given something, they feel no obligation. When they give, on the other hand, they give freely, without expecting anything in return. They do not give to oblige, but are truly altruistic. This applies not only to material giving, but also to communication, and is related to the long intervals in contact with others, the discontinuity, the apparent silence or having forgotten about the other.

 

Are they clumsy?

 

Some but not all with Asperger syndrome are clumsy, which is a combination of poor motor coordination and impaired spatial insight. This is not always recognized in highly intelligent individuals, as their spatial insight and motoric ability may still be far above average while being significantly impaired. For instance, someone may have a verbal and numerical ability level at I.Q. 160 but a spatial ability level at 130. An ignorant person, even a professional, may see the 130 and not realize it reflects an impairment, because it is so far above the average. But a gap of 30 points is severe and indicates a disability, even if the absolute height of the lowest number is in the normal or "gifted" range.

 

My hypothesis about spatial impairment is that it occurs mainly in some but not all males with Asperger syndrome, and not in females, and that it may even be so that females with Asperger have higher spatial ability than normal females. As a result, females with Asperger may sometimes be good at practical technical work (technical work done with one's hands), whereas males with Asperger tend to be impaired in practical technical work (but not in theoretical technical work). A possible explanation for this difference is hypothesized by me in the article Spatial ability and autism.

 

Is it inherited?

 

It is said that if one of the parents has a disorder from the autistic spectrum, there is a chance of over 80 % that their child will have such a disorder too. When both parents have one this chance will be even greater. Also, even the family members who do not have the disorder tend to have features thereof. So it appears Asperger syndrome has a large genetic component, be it that it is on a continuum with other psychiatric disorders. The precise combination of genes you end up with is unpredictable and determines where on the continuum you are.

 

As there are one-egged twins of whom only one has the disorder, it can not be wholly genetic. Medical circumstances during pregnancy and around birth, and perhaps in the first months of life, may also play a role, probably in the sense that they cause certain genes to be expressed that would otherwise have remained passive.

 

A general fact about genetic traits is that they become stronger as one grows older. "You become ever more like your father" is a popular expression that reflects this. For Asperger, this means that the negative aspects, such as rigidity, too will become ever more of a burden throughout life. It also means that one must be very critical with regard to possible therapies or "cures" for Asperger, as applied to some children. The effect thereof can not be judged on short term. One has to follow such a person into old age, because of the fact that genetic traits become ever more expressed as one gets older. A possible effect of therapy in childhood may be deceptive; one's true genetic nature will come out eventually, in adulthood.

 

This very strong genetic factor means that purposely striving to increase Aspergoid features in a gene pool, as mentioned under "Are they ahead of evolution?", would indeed have fast and dramatic results. In fact it has already been observed that in areas where many Aspergoid people cluster together, like in Silicon Valley in the U.S.A. and around Eindhoven in the Netherlands, the incidence of autistic spectrum disorders has greatly increased. However, this has happened unintendedly and without attention to exactly which aspects one is increasing, so that relatively many children with disabling forms of autism are born. The trick is to analyze what goes on there, and determine which parental combinations — in terms of personality and intelligence — are the most likely to produce children with mainly the desirable aspects, so that one learns to avoid the disabling aspects of the disorder.

 

It is also said that Asperger is heritable to an even higher degree than is classical autism, which would suggest that autism in some cases, more than Asperger, has non-genetic causes in addition to the obvious genetic factor. One might even imagine that a particular genetic disposition would lead to an Aspergoid condition in one person, but to low-functioning autism in another who, for instance, happened to suffer early brain damage in some way.

 

Which hereditary or genetic factors appear to cause it?

 

While the hereditary or genetic nature of the Aspergoid condition is not fully proven and universally agreed upon, if one reads and looks around one may find the following situations to play a role, in reverse order of speculativeness and likelihood:

 

One or both of the parents have an autism spectrum disorder, or features thereof; this is straightforward, it "runs in the family";

One or both of the parents have a technical, technological, or intellectual profession; this has been observed by Hans Asperger in the 1940s, and is nowadays being studied seriously;

One or both of the parents are of Jewish descent; the notion that Asperger has a high incidence in Jews exists in some circles, where it is even claimed that the Hollywood film industry has been created largely by Aspergoid Jewish film directors. In this respect it should be noted that Jews have the highest average I.Q. of any ethnic group, and a highly plausible theory explaining the eugenic effects responsible for that is given by Henry Harpending and others in their article "The Natural History of Ashkenazi Intelligence". It seems reasonable to hypothesize that Asperger in Jews may be a side-effect of their thus genetically raised intelligence and conscientiousness;

The two parents have a large genetic distance to one another, that is, share little common ancestors; in practice this means they belong to different ethnic groups or different races. In such cases of "outbreeding" one may see what is called "heterosis". That is, positive traits are raised as a result of the greater number of heterozygous gene pairs, allowing the expression of dominant alleles therein that enhance the traits; also, there is a correspondingly smaller amount of disadvantageous double-recessive gene pairs. It is imaginable, and may be observed in practice, that Asperger sometimes emerges as a side-effect of outbreeding; this idea (insofar it concerns Asperger or autism being a result of outbreeding) was provided by Barry Beanland.

From the above one gets the impression that Asperger is a side-effect of genetic processes, or ways of breeding or mate selection, that enhance positive traits like intelligence.

 

Are they good programmers?

 

It is said many programmers have Asperger syndrome, and that the syndrome may be an asset for such work. Indeed, the conscientiousness, attention to detail, systemizing and so on that are typical of Asperger are important in programming. But programming has been changing, and especially since the 1990s ever more anti-Aspergoid elements have crept into the profession and are becoming more prominent as time goes on. Things like cooperation in a team, graphical environments, and e-commerce are not Asperger-friendly. The real low-level coding that suits the Aspergoid programmer best is slowly disappearing as software is more and more produced by "developers" using large integrated "environments" that produce the actual code automatically "under the hood".

 

So it remains to be seen if the software industry is really the refuge for Aspergoids some say it is.

 

[More articles and materials related to Asperger syndrome]