When we talk about Autism Spectrum Disorder, ASD, APA 2013, we often find some misconceptions. For example, “he can’t be autistic because he has emotions” or “he can’t be Asperger’s because he’s too empathetic.”
These types of beliefs reinforce a stigma that certainly does not help to fully understand the variability of the autism spectrum. Neurodevelopment varies in a complex way from person to person in terms of functionality, adaptation and intellectual disabilities, if any. The Asperger syndrome is just one of the autism spectrum disorders with some specific characteristics.
Symptoms of Asperger’s and Autism Spectrum Disorders
The diagnostic criteria listed in the Diagnostic Statistic Manual 5 (DSM 5, 2013) are:
- Persistent deficit in social communication and social interactionin different contexts, which cannot be explained by a general delay in development, and which manifests itself through:
- Difficulty in socio-emotional reciprocity: an abnormal social approach and difficulty in conversation and / or a reduced interest, emotions and affections and / or a lack of initiative in social interaction.
- Deficits in non-verbal communication behaviors used for social interaction, ranging from poor integration of verbal and non-verbal communication, or abnormality in eye contact and body language, or deficits in understanding and use of non-verbal communication. verbal, up to the total lack of facial expressiveness and gestures.
- Difficulty in developing and maintaining relationships appropriate to the developmental level (not including those with parents and caregivers): difficulty in regulating behavior with respect to different social contexts and / or difficulty in sharing imaginative play and in making friends and / or apparent lack of interest in people.
- Behavior and / or interests and / or restricted and repetitive activitiesas manifested by at least 2 of the following points:
- Language and / or motor movements and / or use of objects, stereotyped and / or repetitive: as simple motor stereotypies, echolalia, repetitive use of objects, idiosyncratic phrases.
- Excessive adherence to routines, reused verbal or non-verbal behaviors and / or excessive resistance to changes (motor rituals, insistence on going the same way or eating the same food every day, incessant questions or discussions, or extreme stress following small changes).
- Highly restricted interest fixation with abnormal intensity or attention: Strong attachment or concern for unusual objects, overly persistent or circumstantial interests.
- Hyper-reactivity and / or Hypo-reactivity to sensory stimuli or unusual interests with respect to certain aspects of the environment: apparent indifference to heat / cold / pain, adverse response to specific sounds or tissues, excessive smelling or touching objects, fascination with lights or moving objects.
- Symptoms must be present in early childhood(but may not become fully manifest until social demand exceeds the limit of capabilities).
- The combination of symptoms must compromise daily functioning.
- These alterations are not better explained by intellectual disability or global developmental delay. Intellectual disability and autism spectrum disorder often occur concurrently.
Characteristics and causes of autism and Asperger’s
In males , autism spectrum disorder , including asperger’s syndrome , appears to occur four times more than in females and clinically in the latter it seems to be more associated with intellectual disabilities.
There is currently no shared agreement on what the specific causes of autism are. Scholars agree in supporting the etiopathogenetic hypothesis in favor of multifactorial mechanisms. That is the interaction of genetic and environmental factors, as well as other biological variables.
Finally, although the vaccine-autism issue is rather controversial, the literature on the subject notes that Autism Spectrum Disorders are not more present in the population of children who have received the vaccine than in those who have not received it. Ultimately, there is no scientific evidence to support this relationship.
Autism Spectrum Disorders are represented within the DSM-5 as a single diagnostic category that includes Autistic Disorder , Asperger’s Syndrome and Childhood Disintegrative Disorder but with no more differentiation as in DSM IV.
What needs to be distinguished in this new perspective is the autism spectrum from a typically developing condition and other disorders not attributable to the spectrum. Despite the conceptualization of a single diagnostic category, there are different and heterogeneous clinical manifestations of the spectrum varying from person to person and with different degrees of severity. In some cases, there may be an intellectual or language disability.
The concept of Asperger’s syndrome
The Asperger syndrome , as defined in the DSM IV, is no longer present in the DSM 5. However, in the clinic can still serve to distinguish the forms of mild autism those features that have long been associated with this label and activate the necessary resources to intervene specifically.
The autism spectrum is therefore a set of conditions associated with atypical development. This spectrum can be diagnosed through an assessment of clinical manifestations at the behavioral level, but there is no specific neurological examination.
As demonstrated by various international studies, what characterizes Autism Spectrum Disorders is in dimensional terms the different levels of autism and ways of manifesting themselves according to the severity and, in terms of continuity, the positioning of the same along an axis of neurotypicity-neurodiversity in which the “autistic traits” can be considered uniformly distributed in the general population as well as the clinical one.
The autism spectrum
The term neurotypical refers to all those who have a typical neurological organization and do not fall within the autism spectrum. Using the term neurodiversity on the other hand, is to be attributed to autism, but it is not equivalent to disability because there are non-pathological autistic manifestations.
Framing autism and Asperger’s in neurotypical terms means, for example, considering the wide diversity at the sensory level present in the autism spectrum. Numerous studies, even the most recent, reveal higher sensory perceptual differences. For example, they may show a more pronounced sensitivity to specific sounds, to light, to some smells or tastes or to the texture of some foods, but there may also be a peculiar tactile sensitivity.
Generally, there are perceptual differences with respect to the intensity and attention directed towards certain stimuli, but also a specific sensitivity in the perception of one’s body and of the motor component.
Emotions, empathy and the autism spectrum
There are emotional differences in the understanding and expression of one’s emotions, in their modulation according to the context and in interpreting the emotions of others according to the expressiveness of the body.
However, that doesn’t mean they don’t feel emotions. Sometimes they may experience emotions in certain situations that differ from expectations and context, such as feeling fear of a surprise or agitation or anger at an affectionate gesture such as a kiss or a hug. This is due to a sensory hypersensitivity to touch that may be present in some, or to the difficulty in understanding its social significance.
They can express affection in ways that are sometimes inappropriate to context, and are able to experience empathy . Finally, there are differences on a cognitive level, especially in the flexibility of thought, in the cognitive style, in the memory and in the restricted and repetitive interests. Interests can be atypical or unusual and are pursued with perseverance and intensity.
The attention paid to certain interests can be all-encompassing and for this reason we speak of hyperfocus . The person is thus completely absorbed while focused on the specific interest and may show little flexibility. Interests are often a way to relax or otherwise a source of pleasure. Moreover, it can allow to acquire a high command of certain skills and in some cases be expendable in work.
Historical Excursus on Autism and Asperger’s Syndrome
Historically, two main conditions have been distinguished, the condition of classic autism or Kanner’s autism and Asperger’s Syndrome .
The ‘ classic autism is characterized by the presence of most of the symptoms of autism spectrum with a language delay (do not speak before 3 years of age). About 50% of people with autistic functioning have mental retardation of varying intensity and an increased presence of motor stereotypies and repetition of words with no apparent meaning (echolalia).
Although used with caution, in common parlance two forms of autism are described, low functioning if there is mental retardation and high functioning if there is none.
Symptoms of Asperger’s
The Asperger syndrome manifests itself in accordance with intelligence or higher. Its characteristics may sometimes be more difficult to recognize than in classic autism due to the presence of greater adaptation or greater functionality. However, there may still be difficulties in understanding the mind of others, in expressing one’s emotions in a contextualized and socially appropriate way.
There are often hyper-sensitivity to lights, noises, olfactory and tactile and sometimes peculiarities in the movements and in the use of space such as to appear clumsy. For example, there may be difficulties in motor coordination and in the use of certain objects or means. They can use language in a very pragmatic way and therefore have difficulty understanding jokes, for example, despite having good language skills.
Interests and activities
We track down particular and repetitive interests that can be carried out in the same way every day. In some of these interests or activities they may be particularly gifted and able to selectively focus on one thing. There may be an interest in sharing activities with others or otherwise participating, but not knowing how to do it or how to get it.
Affectivity
Sometimes I can tend to express their affection for others by doing things for them rather than communicating it in words or they may believe that it is enough to say it once without having to keep repeating or demonstrating it.
Social isolation
They may feel “alien” and this can worsen their mood by fueling anxiety or depression. A secondary depression is often related to levels of social isolation or the possibility of being bullied , poor quality of life from an emotional point of view and work and the relative lack of efficient local services.
Some may have above average intelligence, however this does not improve social difficulties, which for some studies even seem to worsen as intelligence levels increase.
Coping with Asperger’s and Autism Spectrum Disorders
Although we are talking about difficulties of various kinds or differences in filtering the information that comes from the surrounding context, it is good to consider autism and Asperger’s conditions of development. In this sense, it is advisable to try to understand this functioning and look at the world with their eyes in order to help them make sense of what surrounds them and give a name to their experience so as to learn to share the meaning they give to it with the others.
