Mondays with Maureen: What you need to know about adults with Aspergers

Adults With Aspergers: What Other Family Members Need To Know

By My Aspergers Child

Aspergers is typically first diagnosed in children. In contrast to those with autism, adults with Aspergers usually acquire language skills normally, develop appropriately in cognitive abilities and tend to have higher-than-average verbal skills. The most significant feature of Aspergers is the inability to interact appropriately on a social basis. If untreated, many difficulties continue into adulthood.

Eccentric people have always existed, but until recently, Aspergers wasn’t recognized as a possible cause of strange adult behavior. Aspergers, one of the neurological disorders on the autism spectrum, can be mild, causing only somewhat unusual behavior, or severe, causing almost complete inability to function in society without assistance. Adult Aspies, like kids with the syndrome, have trouble deciphering the normal rules of society, which impacts their home, work and social lives.

Grown-ups with Aspergers have high intellectual functioning – but diminished social abilities. An adult Aspie might:

• appear clumsy
• follow repetitive routines
• have limited or unusual interests
• lack social skills
• lack the ability to read non-verbal cues
• seem egocentric
• use peculiar speech and language

Typical adult symptoms include:

• “black and white” thinking
• a tendency to be “in their own world”
• appear overly concerned with their own agenda
• difficulty managing appropriate social conduct
• difficulty regulating emotions
• follow strict routines
• great musical ability
• highly focused in specific fields of interest often to the exclusion of other pursuits
• inability to empathize
• inability to understand other perspectives
• intense interest in one or two subjects
• outstanding memory

Let’s go into greater detail regarding Aspergers in adults:

1. Assessment—Aspergers is a clinical diagnosis versus medical. Neurological and organic causes remain unknown. Psychological interviewing that includes medical, psychiatric and childhood history contributes to an Aspergers diagnosis. Aspergers is considered a pervasive developmental disorder according the DSM-IV. The DSM-IV extension after Adult Asperger Assessment (AAA) includes a list of criteria for an Aspergers diagnosis. Aspergers may coexist with other mood and behavior disorders.

2. Behavior— Grown-ups with Aspergers usually prefer structured lives with well-defined routines and may become agitated or upset when these routines are broken. If, for example, your spouse normally eats breakfast at 9 a.m. and becomes stressed out when asked to eat at an earlier time, this may be indicative of Aspergers. Unlike adults with autism, however, an individual with Aspergers will probably be able to keep his frustration in check. Grown-ups with Aspergers may also be reluctant to initiate conversation and require prodding to talk to you at all, especially if that individual is already engaged in a favored activity when you try to initiate conversation. Eye contact may be rare. An individual with Aspergers may have obsessive tendencies that manifest in such ways as insisting all of his books be lined up in a certain order on the shelf or that the clothes in his closet are categorized by color, style or season. Reliance on routine, obsession with categories and patterns and limited conversation are all symptoms of Aspergers that may be observed at home.

3. Cognitive Symptoms— While grown-ups with Aspergers are often of above-average intelligence, they may process information more slowly than normal, making it difficult to participate in discussions or activities that require quick thinking. Grown-ups with Aspergers may have trouble with organization and seeing the “big picture,” often focusing on one aspect of a project or task. Most are rigid and inflexible, making transitions of any type difficult.

4. Common Careers— Adults on the autism/Asperger continuum have sophisticated skills in certain areas, such as those dealing with numbers or art. Most often, these skills do not exist together. Careers that do not rely on short-term memory are better suited for an individual on the spectrum. Appropriate careers include computer and video game design, drafting, commercial art, photography, mechanic, appliance repair, handcraft artisan, engineering and journalism.

5. Communication— Grown-ups with Aspergers may demonstrate unusual non-verbal communication, such as lack of eye contact, limited facial expressions or awkward body posturing. They may speak in a voice that is monotonous or flat. They may engage in one-sided conversations without regard to whether anyone is listening to them. Grown-ups with Aspergers are often of high intelligence and may specialize in one area or interest. This leads to a lack of interest in alternate topics and the unwillingness to listen when others are speaking. Such poor communication skills can lead to problems finding a job or interacting effectively in a workplace environment. Grown-ups with Aspergers often communicate poorly with others. Many talk incessantly, often about topics that others have no interest in. Their thought patterns may be scattered and difficult to follow and never come to a point. Speech patterns may have a strange cadence or lack the proper inflections. An individual with Aspergers may have difficulty understanding humor and may take what’s said too literally.

6. Diagnosis— Most grown-ups with Aspergers are able to live relatively normal lives. They are often regarded as shy, reserved or even snobbish by others. As these are not considered abnormal behaviors, a real diagnosis may come late in life, or not at all. You can get a more accurate picture of whether your partner/spouse has Aspergers by talking to the people who know him, such as co-workers, college professors, other relatives and friends (though an individual with Aspergers may have a very limited social circle). Ask whether your partner/spouse initiates conversation, if he seems awkward and unsure of himself during social interactions and whether he has any strange behaviors his peers may have noticed. If the answers you get make you suspect Aspergers, you can encourage your partner/spouse to seek medical attention to manage the condition better.

7. Emotional Symptoms— Unlike adults with autism, people with Aspergers want to fit in with others. Their social and work-related difficulties can cause anxiety, anger, low self-esteem, obsessive compulsive behaviors and depression. They may feel disconnected and distant from the rest of the world, a feeling called “wrong planet” syndrome.

8. Imagination— Grown-ups with Aspergers may be unable to think in abstract ways. They may be inflexible in their thinking, unable to imagine a different outcome to a given situation than the one they perceive. Such rigid thinking patterns may make predicting outcomes of situations difficult. Grown-ups with Aspergers may develop strict lifestyle routines and experience anxiety and distress if that routine is disrupted. To avoid such disruption, some adults may keep extensive written to-do lists or keep a mental checklist of their plans.

9. Physical Symptoms— Grown-ups with Aspergers are often physically awkward. Many have a peculiar walk, poor posture or general clumsiness or difficulty with physical tasks.

10. Preoccupations and Obsessions— One of the diagnostic criteria for Aspergers is an “encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.” A grown-up with the syndrome may obsessively latch on to a single hobby or area of interest, often memorizing facts to the smallest detail. Some individuals are successful in their work environment because of their attention to detail and ability to retain information. An inability to be flexible or to deal with changes in routine is also a trait. An adult with the syndrome may have difficulties in his home life, often demanding little or no change in routines or schedules.

11. Prognosis— Aspergers is a continuous and lifelong syndrome. Individuals with Aspergers should be able to function with the syndrome with proper coping skills in place. Adapting their environment to their syndrome is especially critical. Finding a work environment that de-emphasizes social interactions may be appropriate. In addition, having a regular work routine and schedule may be beneficial. Interventions, such as social skills training, education and/or psychotherapy, may be necessary to better manage symptoms.

12. Relationships— Because grown-ups with Aspergers struggle to understand emotions in others, they miss subtle cues such as facial expression, eye contact and body language. As a result, an adult Aspie appears aloof, selfish or uncaring. Neurologically, adults with Aspergers are unable to understand other people’s emotional states. They are usually surprised, upset and show remorse when informed of the hurtful or inappropriate effect of their actions. Affected adults show as much interest as others do in intimate relationships. However, most Aspergers adults lack the social or empathetic skills to effectively manage romantic relationships. An individual with Aspergers behaves at younger developmental age in relationships. The subtleties of courtship are unfamiliar and sometimes inappropriate physical contact results.

13. Social Interaction— Grown-ups with Aspergers may have difficulty interacting in social groups. For example, they may choose inappropriate topics to discuss in a group setting or find making small talk difficult or even annoying. As they tend to be literal thinkers, they may have trouble understanding social metaphors, teasing or irony. They may lack empathy or find it hard to relate to other people. Some adults with Aspergers have anger management problems and may lash out in a social setting without regard to another’s feelings. They may report feeling detached from the world and having trouble finding and maintaining relationships.

An individual with the syndrome lacks the ability to display appropriate non-verbal behaviors, such as eye contact, facial expressions, body postures and gestures. He may have difficulties in initiating and maintaining friendships because of inappropriate social behaviors. He may appear rude or obnoxious to others and at times is left out of social encounters. Unlike adults with autism, who withdraw from other people, adults with Aspergers often want to fit in but don’t know how. The inability to “read” other people’s social signals or to display empathy for other’s problems leads to awkward social encounters.

14. Speech Patterns— Another feature of Aspergers is impaired speech. The individual with this syndrome may speak in a monotone voice or may speak too loudly and out of place. He may interpret everyday phrases literally. The commonly used phrase “break a leg” will be taken literally to injure one’s self. Subtle humor or sarcasm may not be understood or may be misinterpreted. Some individuals display highly developed vocabulary, often sounding overly formal and stilted.

15. Stereotypical Behavior— Grown-ups with this syndrome often are preoccupied with something to the extreme level. For example, if an individual with Aspergers likes football that is all he will talk about–all the time and with everyone. These individuals are also often obsessed with parts of objects. On another note, grown-ups with Aspergers need routines to help them function. They do not like changes in routines, and find them difficult. Other stereotypical behavior in which they engage is body movements; they often flap their hands or fingers, or make complex body movements.

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