An Overview Of Asperger Syndrome

Overview

Autism spectrum disorder: a lifespan perspective To be published, Jessica Kingsley, 2010 Can the world afford autistic spectrum disorder? Published Jessica Kingsley, 2009 www. dilemmas.org

Digby Tantam, Universities of Cambridge and Sheffield Dilemma Consultancy

Theme analysis of 5 websites of people with AS/ HFA

•  sense of alienation •  sense of frustration •  depression as a central emotion •  a pervasive sense of fear or apprehension

Green et al compared 20 adolescent men with AS with 20 with conduct problems

•  AS group •  Severely impaired practical social functioning •  Anxiety •  Obsessional disorders

•  Both groups had •  Depression •  Suicidal ideation •  Tempers and defiance

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Outstanding areas for concern: Sheffield survey •  Reduction of available support in adulthood •  Lack of paid work (36%, 6% of whom

supported) •  Lack of independence

•  60% living with parents •  21% living independently •  56% thought they could be more independent with

support •  Victimization 90% said they had been bullied

Emotional problems in adolescents and adults with Asperger syndrome (findings from Sheffield survey)

•  Self-harm: thoughts 50%, actual 11% •  Violence: threats 83%, actual 34% •  Bullied 90%, 30% currently (includes adults) •  Majority have anxiety-related disorder

Themes in adulthood Ryan, S, Räisänen, U "It's like you are just a spectator in this thing": Experiencing social life the [`]aspie' way. Emotion, Space and Society 2008; 1: 135-43.

•  feeling different •  trying to fit in •  safe spaces •  uncommon sense

Contributors

Parents, teachers, and people with Asperger syndrome Sheffield Asperger Parents Action Group

•  Sheffield survey •  Myles Balfe •  Ting Chen •  Mike Campbell •  submitted to Autism

•  Bullying project •  Paul Naylor •  Jenny Wainscot •  Jenna Williams •  15 medical students •  International Journal of

Psychology

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CHANGING PREVALENCE OF ASD

An artefact of ascertainment?

From Bandolier

Data from the US National Survey of Children’s Health (from www.leftbrainrightbrain.co.uk)

Rising prevalence

•  Kaye,J.A., del Mar,M., & Jick,H. (2001) Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. BMJ, 322, 460-463.

•  Prevalence rate in children probably 1 in 150 24

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MMR vaccination has not caused ASD—in fact there is no known cause for most causes, although genes must play a part

•  The risk of autism was similar in vaccinated and unvaccinated children

•  Onset did not occur soon after vaccination •  There is no sub-type of ASD that could be

attributed to MMR vaccination •  Madsen, KM, Hviid, A, Vestergaard, M, Schendel, D, Wohlfahrt, J, Thorsen, P, Olsen, J, Melbye, M A

Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism. N Engl J Med 2002; 347: 1477-82.

FEELING DIFFERENT Being disconnected from the interbrain

Hunyuan hanging temple, Mt. Hengshan, Shanxi

The interbrain

  Extended cognition   Automatic processing  Reflexive vs. reflective

processing   ‘The borg’

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Jerry Ryan, 7 of 9 StarTrek

Neurotypical

Aspie

Is it better not to connected to the interbrain?

•  Fewer informational viruses

•  Understand machines in their own right not as defective people

•  Fairness is not prejudiced by sympathy

•  Not in chains

“l’homme est né libre, et partout il est dans les fers. J.-J. Rousseau

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TRYING TO FIT IN Many other educational obstacles, plus emotional difficulties

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Associated developmental disorders Predominantly fronto-striatal or fronto-cerebellar

•  Dysexecutive syndrome (planning)

•  Dyslexia (writing and spelling) •  Dyspraxia (coordination) with

typical AS •  Attention deficit/ hyperactivity

disorder (impulsivity, executive functions, task persistence)

•  Also links with •  Tourette syndrome •  Expressive dysphasia (may lead to

elective mutism) •  Dysgraphia •  Dyscalculia •  Topographical disorientation

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Atypical Asperger syndrome •  Primary abnormality is lack

of empathy, partly due to failure of non-verbal interpretation (‘face blindness’)

•  Ability to make relationships but not to keep them

•  Lack of empathy may lead to antisocial behaviour, but greater problem is lack of persuasiveness and ‘social influencing power’

Picture on left from Pelphrey et al, 2002 and on right from the film, “Ripley’s game” starring Matt Damon as Ripley

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Knowing about the world using non-verbal cues

Who is being shot?

Terrorists or partisans?

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Associated psychiatric disorders (213 adults with HFA/ AS in personal clinic series)

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Schizophrenia 0.5% Cycloid psychoses

Depression 17.8%

Mania 1.4%

Anxiety 43.2%

OCD 7.8%

Substance abuse 6.6%

Timing of psychological disorders associated with AS (many of these disorders probably greater in more able group)

•  Aet 11-13 Surge of anxiety-related problems including OCD, dysmorphophobia, panic disorder

•  Aet 16-18 Secondary depression, social phobia •  Aet >16

•  Progressive social withdrawal often attributed to schizophrenia •  Late adolescence bipolar disorder •  Brief ‘cycloid’ psychoses •  Non-psychotic hallucinoses

•  Aet >18 ‘Catatonia’ •  Aet >25 Paranoid states •  Aet >35 Social withdrawal, isolation, relationship disrepair

24 November 2009 Brookdale care conference, London

SAFE SPACES

Bullying and exclusion at and from school begin a process of narrowing the number of safe spaces

Consequences of bullying •  Passive failure to be

included •  Reduced use of

community resources (social exclusion)

•  Experience of being unwanted/marginalized

•  Active rejection , blaming, scapegoating •  Stigma as a means of

keeping threatening Other at a distance

•  Bullying

Painted Bird by Edward Gafford, inspired by the novel ‘Painted Bird’ by Jerzy Kosińsk , itself based on what has been claimed is a fictive war-time experience of the author in Poland

Who bullies and why? Evidence is limited, but

•  On behalf of a social group •  Bullies are highly regarded, but not popular •  Bullies’ in-group status may be tenuous •  Victims are different •  Victims may be more aggressive than non-victims, and are

perceived, perhaps as more threatening

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The limitless potential of social control by shaming

•  A particularly wide ranging tool kit

•  Readiness to consider the most intense emotional issues and in the next moment, the most practical and cognitive ones

•  Having a clear grasp of the individual in front of you, not just in life experience, or temperament, but in cognitive abilities

•  Be aware of shame and shaming

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Does social exclusion lead to functional movement impairment

Is there a difference in the amount of physical activity of pupils with AS compared to others? •  Mean number of steps per hour: AS group =

902, control group = 1312 (t = -2.645, p = .027)

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Table 2

How many people in your class do you: speak to, not like, and think not like you? (AS/HFA n = 25; /HFA n = 22)

How many people do you speak to in your class?

Everyone Most People Few People None

AS/HFA 2 6 15 2 No AS/HFA 6 12 4 0

How many people do you not like in your class?

Everyone Most People Few People None

AS/HFA 0 6 13 6 No AS/HFA 0 3 12 7

Do you think there are any people in your class who do not like you?

Everyone Most People Few People None

AS/HFA 1 5 16 1 No AS/HFA 0 2 11 9

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Where were people with AS in Sheffield?

•  Most living at home, even above 30. •  Most had difficulties coping with changes in

everyday environments •  Difficulties moving between places (for example

using public transport) •  Most common places frequented were libraries

and cinemas

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UNCOMMON SENSE Is the person with AS king of the cyber world?

Is Asperger syndrome the future?

Bram Cohen, founder BitTorrent, and self diagnosed Aspie

Owen Thor Walker apointed to TelstraClear, who previously wrote code enabling a hacker group to steal £13.9M from bank accounts

•  THE END