In-Depth: Asperger’s Disorder
Impairments in Social Interactions with Others
Although the social criteria for Asperger’s Disorder (also known as Asperger’s Syndrome, or AS) and autism are identical, the former condition usually involves fewer symptoms and has a generally different presentation than does the latter. Individuals with Asperger’s Disorder are often socially isolated but are not unaware of the presence of others, even though their approaches may be inappropriate and peculiar.
For example, they may engage another person — usually an adult — in one-sided conversation characterized by long-winded, pedantic speech, about a favorite and often unusual and narrow topic. Also, although individuals with Asperger’s are often self-described “loners”, they often express a great interest in making friendships and meeting people. These wishes are invariably thwarted by their awkward approaches and insensitivity to other person’s feelings, intentions, and nonliteral and implied communications (e.g., signs of boredom, haste to leave, and need for privacy). Chronically frustrated by their repeated failures to engage others and make friendships, some of these individuals develop symptoms of depression that may require treatment, including medication.
In regard to the emotional aspects of social transactions, individuals with Asperger’s Syndrome may react inappropriately to, or fail to interpret the valence of, the context of the affective interaction, often conveying a sense of insensitivity, formality, or disregard to the other person’s emotional expressions. That notwithstanding, they may be able to describe correctly, in a cognitive and formal manner, other people’s emotions, expected intentions and social conventions. But they are unable to act upon this knowledge in an intuitive and spontaneous fashion, thus losing the tempo of the interaction.
Such poor intuition and lack of spontaneous adaptation are accompanied by marked reliance on formalistic rules of behavior and rigid social conventions. This presentation is largely responsible for the impression of social naivete and behavioral rigidity that is so forcefully conveyed by these individuals.
As with the majority of the behavioral aspects used to describe AS, at least some of these characteristics are also exhibited by individuals with higher-functioning autism, though, again, probably to a lesser extent. More typically, autistic persons are withdrawn and may seem to be unaware of, and disinterested in, other persons. Individuals with AS, on the other hand, are often keen, sometimes painfully so, to relate to others, but lack the skills to successfully engage them.
Impairments in Communication with Others
In contrast to autism, there are no symptoms in this area of functioning In the definition of Asperger’s Disorder. Although significant abnormalities of speech are not typical of Asperger’s Syndrome, there are at least three aspects of these individuals’ communication skills which are of clinical interest.
First, though inflection and intonation may not be as rigid and monotonic as in autism, speech may be marked by poor prosody. For example, there may a constricted range of intonation patterns that is used with little regard to the communicative functioning of the utterance (assertions of fact, humorous remarks, etc.).
Second, speech may often be tangential and circumstantial, conveying a sense of looseness of associations and incoherence. Even though in some cases this symptom may be an indicator of a possible thought disorder, it is often the case that the lack of coherence and reciprocity in speech is a result of the one-sided, egocentric conversational style (e.g., unrelenting monologues about the names, codes, and attributes of innumerable TV stations in the country), failure to provide the background for comments and to clearly demarcate changes in topic, and failure to suppress the Vocal output accompanying internal thoughts.