In 1944, the Austrian pediatrician Hans Asperger encountered the case of four children whose behavior showed difficulties in integrating socially.
They were small children with a level of intelligence that was within statistical normality, but who presented important deficits in certain abilities of a more specific nature, such as the ability to put themselves in the shoes of others, the ability to use the resources of non-verbal communication, or the ability to coordinate various precise movements in a more or less orderly fashion. This made them clumsy both in certain activities that required movement, and in interpersonal relationships .
The “autistic psychopathy”
Initially, Dr. Hans coined the term “autistic psychopathy” to refer to this as yet unexplored phenomenon and described it as a disorder, emphasizing its implications for the social life of those who developed this disorder: they tended to isolate themselves and deal little with others , perhaps because of the frustrating situations caused by misunderstandings and communicative incompatibilities in general with the rest of the children.
A few years passed before this clinical entity was named Asperger’s syndrome ; Dr. Lorna Wing did so in 1981 after having studied the case of another group of children who presented the symptoms described by the previous researcher under the name of autistic psychopathy.
Then, in 1992, Asperger syndrome was added to the tenth edition of the International Classification of Diseases Manual (ICD-10) and two years later, to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV). Since then, this term has become popular and is known at the grass-roots level.
What is Asperger’s syndrome?
Asperger syndrome is a neurobiological disorder that forms part of the autism spectrum disorders (ASD) , a concept that groups together a set of psychological disorders of a chronic nature whose causes are unknown, although they share similar symptoms.
As far as it has been possible to observe through several neuroscience investigations, the brain of a person with Asperger’s Syndrome works differently from that of most people, especially with regard to communication and social interactions in general, as well as in the performance of typical daily tasks in those who have an autonomous life. and in the adequate adaptation to daily demands. Thought patterns are rigid, based on clear rules , and stop working well if something in the environment starts to change a lot or introduces an element of chaos.
On the other hand, these symptoms begin to become evident at a very early age, around the second or third year of life. Normally, the first warning signs appear when parents observe an abnormal clumsiness and a low level of psychomotor control in their son or daughter. Unlike what happens with cases of autism that do not fall into the category of Asperger’s syndrome , language is not affected, although the use of language is affected, taking into account the context , as we shall see.
On the other hand, experts in the field estimate that approximately two out of 10,000 children have developed Asperger’s syndrome, and much more has been seen to emerge in males than females.
The specific symptoms of Asperger’s syndrome are as follows, although please note that they do not necessarily all occur, and this condition can only be diagnosed by a certified mental health specialist .
- Repetitive Rituals
- Peculiarities in language (formal speech, monotone…)
- Difficulty with non-verbal communication (limited expression, rigidity…)
- Poor and uncoordinated motor skills
- Inappropriate social-emotional behavior
Young people with Asperger’s syndrome tend to take a literal approach to language : sentences mean what the set of technical definitions of the words explicitly used shows.
That’s why people with Asperger’s syndrome symptoms have a harder time taking a hint, finding moments when a friend or family member needs emotional support, recognizing what’s a joke and what’s not, etc.
How is it diagnosed?
In most cases the diagnosis is made around the age of 7 , although as we have seen the symptoms appear much earlier. Furthermore, there is the added difficulty that the diagnostic criteria for Asperger syndrome are mainly related to children, so it is not so well known how it affects adults or older people.
In the diagnostic manuals used by psychiatrists and psychologists, Asperger syndrome is placed among developmental disorders in general and on the autism spectrum in particular . This syndrome was officially recognized in the fourth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-IV) and it is in the fifth edition of this manual (DSM-V) where the diagnostic category of Asperger’s syndrome disappears, referring now to autism spectrum disorders (ASD). It will be the level of impairment and the aids required that will determine the severity of the disorder (level 1, level 2 or level 3).
The ICD-10 describes Asperger’s syndrome by showing its repercussions on the reciprocal social interaction typical of ASDs, and also associates it with a phenomenon of another type: people with Asperger’s syndrome tend to develop very specific and defined areas of interest , and it is not common for them to have a level of intelligence well below the average, leading to intellectual disability.
Psychotherapeutic contributions in Asperger’s
It is crucial to know how to make a diagnosis that fits properly with reality and that allows for psychological assistance to the person with Asperger’s syndrome, taking into account their special needs. Furthermore, psychological intervention should be carried out as soon as possible, bearing in mind that the degree of psychological vulnerability of children is greater than that of adults .
On the other hand, psychological intervention designed to enable the person to better manage their problems must be designed and executed by accredited specialists. In addition, if possible, an attempt is made to involve family members in this process, given that collaborative work in therapy and in the domestic setting is more effective (both contexts work towards the same result: having a positive impact on the patient).
In this way, many people can contribute to the improvement process by informing themselves about the way of thinking, expectations, stressful or uncomfortable situations and the needs of that particular person who has developed Asperger’s syndrome. This is where friends, teachers, doctors, monitors, etc. come in.
As Asperger syndrome affects several areas of life, it does not consist of a single method and strategy , but several adapted to each specific objective. Basically, the following forms of psychological intervention are used.
1. Basic social skills training
These sessions help the person to become familiar with language codes that do not respond to formal speech, and help them to know what to do when they cannot interpret what others are saying.
In psychotherapy, a context is created in which the patient questions his/her dysfunctional beliefs and habits that generate discomfort , especially if this discomfort has to do with the disorder with which the person has been diagnosed.
In the case of Asperger’s syndrome, it is especially important to learn how to manage anxiety, as this is something that affects this type of patient very much.
3. Occupational or physical therapy
This intervention makes a lot of sense if the person has problems living autonomously by making coordinated movements that are part of everyday life: getting dressed, using a computer, etc.
What progress can be made in therapy?
According to Isabel Sánchez Montero, expert psychologist in contextual therapies and part of the Málaga PsicoAbreu team of psychologists, one of the most important steps in knowing the diagnosis and during the treatment time is the “acceptance” by the family. A child with Asperger’s Syndrome needs, like another, guidance and help to be able to develop in the world , and our work involves changing the perspective and our interpretation of what we have experienced, rather than forcing its times and developments into our own.
Paying attention to small advances, however small, and ignoring those things that are not very important; using language and rules in a flexible and moderate way, teaching them to listen through our patience and repetition, using adequate information in a clear and concise way, all this will be very useful so that the day-to-day life of these families is not full of impotence, complaints and frustration. Sometimes, the biggest challenge is to change the eyes with which we see the world.
Although people with Asperger’s may need support and care throughout their life cycle, the truth is that these people can learn to deal with social situations and personal relationships successfully . Proof of this are those adults who carry out their professional and family work effectively.