Ants, bees, non-human primates, and a few other animals live in societies. Clearly, from an evolutionary viewpoint, social competence must have a neurobiological basis. We are all neurobiologically scripted for intuitive social interaction and are inherently social creatures. But, as expected, social competence, like any other neurocognitive function, must be a variable falling along a continuum. There are bound to be outliers.
NEUROTYPICAL SYNDROME
Neurotypical is a label for nonautistic people. Neurotypical syndrome (NT) is a neurobiological disorder characterized by a preoccupation with social concerns, delusions of superiority, and obsession with conformity. By autistic standards, the “normal” brain is easily distractible, is obsessively social, and suffers from a deficit of attention to detail and routine. Thus people on the spectrum experience the neurotypical world as relentlessly unpredictable and chaotic, perpetually turned up too loud, and full of people who have little respect for personal space. Autistics find most neurotypical people annoying and illogical.
There is no known cure.
Members of the Autistic Networks International (ANI) began appearing at conferences and set up booths that were little oases of autistic space where people could take a break from the probing stares, the swirl of perfumes, the press of flesh, the unpredictable outbreaks of applause, and the constant reminder that their existence was a tragic puzzle.
People struggling in social situations for most of their lives didn’t know why. Having only a small group of close friends was thought odd but they never knew how to correct it. The general public and the hiring companies must understand this group of people. Many fall through the cracks due to their “odd” behaviours despite having so much to contribute if given the chance.
Baron-Cohen looks upon the milder variants of autism and Asperger’s as differences in cognitive styles. Normal people are good at “folk psychology” (social interactions), and people with Asperger’s are interested in “folk physics” (how things work).
Neurotypical is only one kind of brain wiring, and, when it comes to hi-tech, it is likely an inferior one.
NEURODIVERSITY can be every bit as crucial for the human race as diversity is for life itself. Who can say what form of wiring will prove best at any given moment?
It is not that more autistics were becoming visible in the world, but the world itself was becoming more autistic – and this was a good thing. The revenge of the nerds was taking shape as a society in which anyone with access to a computer and a modem could feel less disabled by the limitations of space and time. Social status as a dork was the inevitable side effect of being highly gifted. They think differently.
Autism has come a long way since the days of Kanner when he had seen only 150 true cases. It was Asperger’s world now. American psychiatry seems unable to conceive of healthy eccentricity or complex individuality. Instead, psychiatrists have evolved an elaborate coding system, which gives them undue control over families. A diagnosis of Asperger’s may, for example, keep a talented child out of the gifted program at school.
The goal is to alleviate those with Asperger’s from the pressure to conform. It is best to learn how to use your uniqueness to your advantage and find your place in the world.
ASPERGER’S SYNDROME (AS)
Autism, from the Greek word meaning “self”, was coined in 1911 by Swiss psychiatrist Eugen Bleuler, who used it to describe withdrawal into one’s inner world. Autistic children appear to be in a world of their own, isolated and alone, with senses that can overload easily.
In 1943, psychiatrist Leo Kanner studied the case histories of 11 highly intelligent children who shared a common set of symptoms consistent with autism: the need for solitude, the need for sameness, to be alone in a world that never varied. Kanner assumed that these children came into the world without innate, biologically provided ways of emotionally connecting with other people.
In 1944, Viennese medical professor Hans Asperger described “a particularly interesting and highly recognizable type of child” who has an autistic personality that is an “extreme variant of male intelligence”. Asperger described four boys who had severe difficulties of social integration that were compensated for by a high level of thought and experience that can lead to exceptional achievements in later life. He chose the label autism for this condition as referring to an inherent fundamental disturbance of contact, the shutting off of relations between self and the outside world. Asperger remarked that for these boys, social adaptation has to proceed via the intellect, and in fact, they have to learn everything via the intellect. He considered the autistic syndrome to be a stable personality trait that is genetically transmitted in families.
Both scientists used the term ‘autistic’ in their reports. While Kanner’s syndrome was published in 1943, Asperger’s report was written in German and remained undiscovered until 1991 when it reappeared in Uta Frith’s textbook, Autism and AS.
In 1962, psychiatrist Gerhard Bosch compared infantile autism to Asperger’s autistic syndrome and considered them to be two variants of the same condition. In one family, one young lad has classic autism disorder, and his younger brother has Asperger syndrome, thus confirming that both variations are indeed the same genetic condition.
In 1979, psychiatrist Lorna Wing introduced the term Asperger syndrome to describe the abnormal autistic personality. She was a British psychiatrist who embarked on a quest to discover the kinds of assistance and services that would be most useful to families like her autistic daughter. Her first child had autism, and with other parents, they founded what was to become the National Autistic Society in 1961. The logo adopted by the society – a puzzle piece – eventually became the universal symbol of autism parents’ organizations worldwide.
As students became teenagers, she turned her attention to autistic adults, as she realized they were not “cured” and would require a living environment suited to their needs for the rest of their lives. “Children need praise and encouragement, but most of all they need the opportunity to continue their education and training so that they can maintain and extend abilities. . . and acquire occupational skills.” In 1972, the society launched Somerset House, the first residential facility and school in Europe for autistic adults.
These achievements put Lorna and her colleagues light years ahead of their American peers in understanding of autism. They knew that autism might manifest itself in varying degrees of severity. She thought Kanner’s theories of refrigerator mothers were bloody stupid.
Michael Ritter conducted the first twin study of autism, providing proof of the genetic basis for the first time. He also untangled autism from schizophrenia, showing that they were separate conditions that only rarely occur together.
Using restrictive criteria, an attempt to determine the prevalence of autism came up with an estimate of 4.5 per 10,000, a very low number. This was replicated by other researchers and became the oft-quoted baseline against which all future autism prevalence estimates would be compared in the coming decades.
Lorna realized that the study left out most children likely to fall on the Asperger side of the line. She also had Asperger’s paper translated from German to English and realized that Asperger had seen the same thing in his Vienna clinic that she was seeing. They were kids that nobody knew what to do with. They didn’t fit into Kanner’s narrow box, were also highly intelligent but couldn’t pick up subtle social signals from the people they were talking to.
There was no diagnostic label on the books that would enable them to access psychiatric services. There were many shades and hues along the autistic continuum, and all autistic people seemed to benefit from the same highly structured and supportive educational approaches, just as Asperger had predicted. Some children remained profoundly disabled, while others blossomed in unexpected ways when given an accommodating environment and special consideration by their teachers.
Lorna then introduced a new diagnostic label – Asperger’s syndrome – as autism had so many negative connotations. She then wrote a case series in 1981 and changed the continuum to the autism spectrum, indicating that the continuum shades imperceptibly into garden-variety eccentricity – all the features that characterize Asperger’s syndrome can be found in varying degrees in the normal population.
Research and publications on Asperger’s syndrome reached their peak during 2000-2012. Different research groups proposed a set of criteria for AS diagnosis. While several of these criteria overlap, WHO’s International Classification of Diseases and Disorders set the following key characteristics that can be diagnostic for Asperger’s Syndrome: Qualitative social impairment involving dysfunctional social adaptivity, impaired non-verbal communication for interaction, and lack of social reciprocity, the restrictive pattern of interest, motor clumsiness, repetitive behaviour, and extreme obsessiveness to specific rituals.
Autism impacts the normal development of the brain in the areas of social interaction and communication skills. The disorder makes it hard to communicate with others and relate to the social world. In some cases, aggressive and/or self-injurious behaviour may be present; however, internal behaviours such as withdrawal, depression, anxiety, eating disorders, and social isolation may be just as prevalent. Persons with autism may exhibit repeated body movements (hand flapping, rocking called stimming), unusual responses to people or attachments to objects, and resistance to changes in routines.
Developmental disorders that lie on the autistic spectrum are genetically related neurological conditions. All have stereotyped and obsessional behaviours and abnormalities in socio‐emotional and communicative behaviour.
Asperger’s syndrome (AS) as part of the autism spectrum disorder (ASD) was first described in America in the 1994 edition of the Diagnostic and Statistical Manual of Mental Disorders.
As there was not sufficient evidence of distinguishable characteristics for AS that can class the syndrome as ‘one biologically and clinically diagnosed entity’, the DSM-5 in 2013 revised and categorized Asperger’s Syndrome as another variant of autism spectrum disorder (ASD). This decision was criticized by the scientific community, and many clinicians have reservations about the DSM. Many people with Asperger’s prefer their separate diagnosis.
Due to the substantial number of overlapping similarities between Asperger’s Syndrome and Autism, it is very easy to confuse one with the other. Classical autism has delayed language development, and most have mental retardation (learning disability). Asperger’s syndrome is a mild form of autism and generally manifests without extreme mental disabilities – their IQs are typically in the normal to the very superior range. They are usually educated in the mainstream, but many require special education services.
There is no history of language delay but still shows characteristic impairments in reciprocal social interaction – there is a dissociation between cognitive and social skills.
AS subjects display age-specific or earlier verbal development, meticulous speech ability, higher desire for social reciprocation, may learn to read at an early age, and supreme imagination compared to ASD patients. On a cognitive level, AS subjects are more perceptive, and they possess superior verbal performance and visual-spatial ability compared to ASD patients.
AS patients often demonstrate high verbal IQ and strong grammatical skills and they often outperform others in fluid reasoning although they are reported to show a delayed reaction time with poor performance IQ, specifically in symbol coding and processing speed. What will differ greatly will be the person’s area of talent, visual or nonvisual modes of thinking, and severity of anxiety and oversensitivity to sensory input.
AS is more common than classical autism. Epidemiological surveys report that about 4 out of every 10,000 children are autistic whereas about 68 out of 10,000 children are diagnosed with AS.
Asperger’s children may not be identified as such until they start having social problems at age eight or nine. They are the children who are “little professors” at four and five, but later become lonely, with few friends. Adults with Asperger’s run the gamut from brilliant scientists to unhappy loners on the fringes of society.
With adolescence, the social and academic worlds become more complex and there is the expectation that the child should be more independent and self-reliant. Previously, social play was more action than conversation, friendships being transitory and social games relatively simple. In adolescence, friendships are based on more complex interpersonal needs rather than practical needs, someone to confide in rather than play ball with.
Instead of one teacher for the whole year where they develop a working relationship, different teachers may have different methods of assessment. Knowledge of history is no longer remembering dates and facts but organizing a coherent essay. English requires abilities with characterization and to ‘read between the lines’. Group projects may be difficult as the AS pupil may not assimilate into a working group of students
The symptoms and signs of AS are more conspicuous at times of stress and change and teen years have major changes in expectations and circumstances.
Brain studies demonstrate that the social deficits in autism and Asperger’s are highly correlated with measurable biological differences. But the question remains: When does a difference in the size of a certain brain region become an abnormality, instead of just a normal variation? If one selected 100 people at random from a large corporation or at an airport and scanned their brains, one would find a range of differences in the size and activation level of their amygdala (the most affected part of the brain in autism). Brain scan results from this normal cross-section of the public could likely be closely correlated with tests that evaluate sociability and social skills. Conducting this experiment on the general public would show that normal brain variation could be measured.
Furthermore, people tend to choose careers that they are good at, and it is predicted that there would be a high correlation between a person’s job and the characteristics of the amygdala. Out of the 100 hypothetical people from a large corporation whose brains were scanned, the technical people in the computer department would probably show less activation in their amygdalas compared to the highly social salesman in the marketing department.
Many accomplished families in Silicon Valley have children with autism. This mysterious rise in diagnosis was not restricted to Silicon Valley – it was happening all over the world.
Asperger’s syndrome is on a continuum with the normal. Traits associated with severe involvement are observed in mild forms in many so-called neurotypical people. One often sees Asperger-like traits in family members of people with autism: a father who is a computer programmer with poor social skills, an eccentric uncle, and other family members with depression or anxiety. Often, these “shadow syndromes” acquire no specific label or diagnosis.
Temple Grandin noticed how many parents at autistic conferences were gifted in technical fields. “I started to think of autistic traits as being on a continuum. The more traits you had on both sides, the more you concentrated the genetics. Having a little bit of the traits gave you an advantage, but if you had too much, you ended up with very severe autism.” She warned that efforts to eradicate autism from the gene pool could put humankind’s future at risk by purging the same qualities that had advanced culture, science, and technological innovation for millennia.
The whole definition of the term “neurological disorder” implies that something is going wrong in the brain. However, there is a growing recognition of the fact that when it comes to the processes in our brain, “going wrong” does not necessarily mean “going bad”. Our brain is too complicated a mechanism to be interpreted in simplistic terms. Some neurological disorders produce a peculiar state of mind often associated with high artistic and scientific achievements.
Some of the listed mental disorders in the DSM are the names of personality traits. At what point, after all, does a variation in personality become a true neurological disorder such as severe depression, bipolar disorder, schizophrenia, anxiety, or obsessive-compulsive disorder? When does moody become manic depressive? When does feeling blue become depressed? When does being fussy about cleanliness slip over into obsessive-compulsive disorder? When does autism turn into Asperger’s, and when is Asperger’s mild enough to be called something like “computer nerd”?
What, after all, is normality? Given that there is an enormous range of social behaviour with many degrees of adaptation and success or failure in the normal population, where does normality end and abnormality begin? Should one instead talk about normal and abnormal shading into each other? To put it another way, should one look at Asperger’s syndrome as a normal personality variant?
The difficulty in understanding and acknowledging autism, primarily high-functioning autism or Asperger’s Syndrome, by the medical, psychological, and psychiatric community, can lead to misdiagnosis and even failure to provide the services needed for students.
