Aspergers symptoms in adults

Signs & Symptoms of Asperger’s Syndrome

Causes and risk factors for Asperger’s syndrome

There is no one single cause for the development of autism spectrum disorders, including Asperger’s syndrome. However, when considering the complexity of the disorder and the fact that symptom severity varies, there are likely many different causes. Some current theories include:

Genetic: Research has determined that several genes appear to be involved in autism spectrum disorder. In some children, the presence of Asperger’s syndrome can be associated with genetic disorders, such as Rett syndrome or Fragile X syndrome. Additionally, genetic changes may make a child more susceptible to autism spectrum disorder or create the possibility for environmental risks. Furthermore, other genes may affect brain development or the way in which brain cells communicate, or will determine the severity of symptoms.

Physical: Brain imaging studies have shown that there are structural and functional differences in specific areas of the brain of those who have Asperger’s versus those who do not. These differences may be caused by abnormal migration of the embryonic cells during fetal development, which then affects the way in which the brain is wired and further goes on to affect the neural circuits that control thought and behavior.

Environmental: Researchers are also exploring the impact that environmental factors, such as viral infections, prenatal complications, and air pollutants, may play in the development of autism spectrum disorders, like Asperger’s syndrome.

Risk Factors:

  • Being male
  • Presence of a co-occurring mental health disorder, such as depression or anxiety
  • Family history of autism spectrum disorders or other mental health conditions
  • Being born 10+ weeks premature
  • Having another medical condition, such as Fragile X syndrome, tuberous sclerosis, epilepsy, and Tourette syndrome
  • Being born to older parents

Signs, Symptoms, & Causes of Asperger’s Syndrome

Learn about Asperger’s syndrome

Asperger’s syndrome (AS) is a neurobiological disorder that is included on the autism spectrum disorders (ASDs), which encompass a number of developmental disabilities. These complex neurodevelopmental disorders are characterized by communication difficulties, social impairment, and restrictive, repetitive patterns of behaviors. ASDs occur along a continuum of severity and the symptoms of the disorder can appear in a number of different combinations in each child or teen with the disorder. Two children with the same diagnosis may share certain behavioral patterns, but may display a different range of abilities and skills. Some people who have ASDs are severely disabled and require substantial support for activities of daily living. Asperger’s syndrome, however, is considered to be the mildest form ASD and those who have it are considered to be “high functioning.”

While early diagnosis using standardized screening by the age of two is the goal, the nonspecific pattern of symptoms associated with Asperger’s syndrome may delay proper diagnosis and treatment. After a diagnosis of Asperger’s syndrome is given, a treatment plan that coordinates multiple therapeutic modalities (such as speech therapy to reinforce proper communication techniques, physical therapy to overcome fine and gross motor delays, and occupational therapy to reduce overstimulation from sensory stimuli) should begin as early as possible. A treatment plan for AS should build upon the child’s interests, follow a predictable schedule, and actively engage the child’s attention in structured activities, while providing regular reinforcement of positive behaviors. Some children with AS benefit from social skills training to teach appropriate peer interactions, cognitive behavioral therapy to teach emotional regulation, and medication on an as-needed basis to ease symptoms of comorbid, co-occurring disorders. With effective, prompt treatment and support, most children with Asperger’s syndrome are able to overcome the many challenges associated with the disorder.

Is My Child with ADHD on the Autism Spectrum?

Some parents wonder whether their child with attention deficit disorder (ADHD or ADD) may have some form of autism as well. And they wonder for good reason: Most families of children with the condition previously known as Asperger’s syndrome (AS), an autism spectrum disorder, receive an ADHD diagnosis — or misdiagnosis — before a pediatrician concludes that it’s autism and ADHD together.

Is ADHD on the Autism Spectrum?

The symptoms of autism spectrum disorders and ADHD overlap. Most children on the autism spectrum have symptoms of ADHD — difficulty settling down, social awkwardness, the ability to focus only on things that interest them, and impulsivity. ADHD itself, however, is not part of the autism spectrum.

A mother I recently met with summed up her confusion and eventual enlightenment: “John is smart, and quick to learn something new, if he is interested,” she says. “But he has a terrible time focusing on things he isn’t interested in. When this happens, he starts rocking or pacing around the room. For years, we thought it was ADHD, but, at his last evaluation, his teachers suggested that he might have a form of autism. After seeing a pediatrician, he received a diagnosis of Asperger’s. Knowing he has it — and working to relieve the symptoms — is a relief.”

Asperger’s Syndrome Causes

Researchers don’t understand what causes Asperger’s syndrome (now simply autism spectrum disorder), although there seems to be a strong genetic component. Although AS is on the autism spectrum, the symptoms are often milder than the symptoms of classic autism in younger children. Children with AS, like all individuals on the spectrum, have difficulties in three areas: communication, social interaction, and restricted interests.

Signs Your Child May Have Asperger’s Syndrome

More severe forms of autism are often diagnosed in the first two years of a child’s life, but AS is usually diagnosed at a later age. A major reason for that is that children with AS develop language skills more or less on time. While they may have moderate delays in the development of speech, the majority of such children communicate by age three.

Asperger’s Syndrome Symptoms Checklist

A child with AS might have some or all of the symptoms listed below. Symptoms are often less severe than in a child with autism.

Impaired communication – verbal and nonverbal

  • Speech development may be normal or somewhat delayed, but difficulties arise in the functional and social use of language for communication
  • Impaired use of nonverbal behaviors, including eye contact, body language, and social expressions

Restricted repertoire of activities and interests

  • Narrow interests that are abnormal in intensity and focus (a single TV show, say, or an unusual object, like a vacuum cleaner)
  • Rigid adherence to nonfunctional routines and rituals (following a strict protocol when leaving the house to go to school)
  • Stereotyped repetitive motor mannerisms (pacing)

Poor Social Interaction

    • Failure to develop age-appropriate peer relationships (inability to understand the social give-and-take of friendships)
    • Failure to seek out others to share enjoyment, interest, and achievements (not sharing a good grade on a test or a just-finished painting with a family member)
    • Lack of social and emotional reciprocity (not enjoying being with others just for the sake of being together)

Why Parents Miss Signs of Asperger’s Syndrome

Parents may be slow to pick up on AS in their child. Its subtle combination of symptoms leaves parents wondering if anything is wrong or if the symptoms are part of their child’s personality. A child with an unusual special interest, like the Titanic, may seem delightful to an adult, but odd to another 7-year-old. When a child goes to preschool, social difficulties become more evident. Typically, kids with AS are unable to make friends. They have a hard time reading other people or understanding humor.

Most children with AS want to make friends, but they don’t know how. Their poor conversation skills and difficulty reading social cues can lead to loneliness or a mood disorder as they go through middle school.

Asperger’s Diagnosis and Treatment

Getting Evaluated for Asperger’s Syndrome: Parents who suspect that their child has Asperger’s syndrome should consult with a developmental and behavioral pediatrician, a child psychiatrist, or a psychologist with expertise in the autism spectrum. The evaluation will likely involve observing your child and talking to you about his development. You may be asked about your child’s social interaction and communication skills. Your child may undergo several tests to determine her level of intellect and academic abilities, and to assess her abilities in the areas of speech, language, and visual-motor problem-solving.

Parents can assist the doctor’s evaluation. Write down any symptoms you have noticed, key personal information (any major stress or recent life changes), a list of medications, vitamins, and supplements your child takes, and questions you want to ask the doctor.

Treatment Plan for Children with Asperger’s Syndrome: Most children benefit from early, specialized interventions that focus on behavior management and social-skills training: learning how to interpret gestures, eye contact, tone of voice, humor, and sarcasm, for example. Cognitive behavior therapy may help them manage obsessive behavior and anxiety.

About half of children with AS will be treated with medication. While stimulant medications, like Ritalin, are among those most commonly prescribed, caution is advised. Stimulants are less likely to be effective than in children diagnosed with ADHD alone, and more likely to cause side effects.

Accommodations for Asperger’s at School

Schools are getting better at providing services for children with Asperger’s syndrome. Many schools offer pragmatic language therapy, which helps a child learn the basics of social interaction. Look for “friendship groups,” or a “lunch bunch.” Parents should make sure that social skills accommodations are part of their child’s individualized education program (IEP).

Because children with AS have a greater capacity to lead an independent life than children with more severe forms of autism, parents and their professionals who work together can help kids with Asperger’s learn to advocate for themselves as they approach adulthood.

Eileen Costello, M. D., is a member of the ADDitude ADHD Medical Review Panel.


Updated on December 16, 2019

Is an adult with Asperger syndrome sitting in your waiting room?

In 1944, Hans Asperger described a subset of children who exhibited “a lack of empathy, little ability to form friendships, one-sided conversation, intense absorption in a special interest, and clumsy movements.”1

In recent years, Asperger syndrome has become increasingly recognized in the medical community and by the general public. It has been popularized in the media in John Elder Robison’s bestselling book, Look Me in the Eye; with the television character Sheldon Cooper in The Big Bang Theory; and in the 2009 film, Adam, a romantic comedy with the title character accurately portraying a young man with Asperger syndrome.

See related editorial

In this article, we discuss the causes and characteristics of Asperger syndrome, with special focus on adults: how it presents, how to treat it, and how to enhance the delivery of care.


One in 88 children is diagnosed with an autism spectrum disorder, and the rates of Asperger syndrome and other autism spectrum disorders appear to be increasing.2 Whether this increase is the result of more thorough assessment and identification or of environmental changes is hotly debated.3 The rise began before the proposed changes to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) to combine autism, Asperger syndrome, and pervasive developmental disorder not otherwise specified to simplify diagnosis.4 Asperger syndrome affects males three to four times more often than females.5 For most patients, the effects persist throughout life.


Poor social skills are a hallmark

People with Asperger syndrome struggle with social interaction and face challenges in forming and maintaining relationships. They tend to have less eye contact (often the first indicator), smiling, animated speech, and physical communication such as hand gestures. They tend not to solicit another’s attention to something they themselves find interesting. They often lack social and emotional reciprocity and have difficulty understanding another person’s thoughts or feelings,6 and they have marked difficulty reading social cues. Some adults may appear rigid, selfish, or narrow-minded.

Sometimes behavior is in the normal range but is out of context for a particular situation.7 For example, a preprofessional student with Asperger syndrome might walk into a psychiatric evaluation to assess fitness for duty and take a seat cross-legged on the floor and have a snack. Poor grooming inappropriate for the occasion may also be observed, such as showing up for a formal photo with unkempt hair and in a stained shirt that is half tucked in.

Many adults with autism spectrum disorders are oblivious to their social reputation.8 They are often unaware that their behavior is out of place and only learn that it is not normal when they are told. Others recognize that they have trouble empathizing with or understanding the perspectives of others, but they are at a loss as to how to improve. The syndrome has a tremendous impact on broader aspects of life, such as employment, functional independence, relationships, and social networks.

Other odd behaviors are common

Repetitive behaviors. Many patients with Asperger syndrome have repetitive behaviors, which can manifest as repeating phrases or expressions, attempting to imitate others, and rocking. They tend to follow routines, do not enjoy spontaneity, and are more inflexible and uncomfortable when their planned regimen is altered.

Gait or balance issues may be observed on physical examination.9 Uncoordinated motion and clumsiness are common,10 and some patients may have a bouncy, stilted gait or may walk on their toes, although the latter is more common in children than adults. Many patients have illegible handwriting.11

Fixations. Many Asperger patients have unusual and intense obsessions with subjects like numbers, dates, or aerodynamics of planes. Children with such fascinations are described as “little professors” or as having “geek syndrome.”12 Certain obsessions often continue into adulthood, although one area of interest may fade and another may take over. Such “expertise” in adults may gain them respect, even though they may seem very odd in other ways.

Lack of boundaries. Patients with Asperger syndrome tend to have poor spatial awareness and to be unaware of physical boundaries, standing too close for others’ comfort or unusually far away. Lack of boundaries may extend beyond the physical, as patients may inappropriately help themselves to food or use an item belonging to another without invitation, being unaware that the behavior may be intrusive or inappropriate.

How To Identify Asperger Syndrome In Adults

By Tiffany Bailey

Updated June 28, 2019

Though originally considered a separate disorder of its own, Asperger Syndrome is now considered part of the autism spectrum of disorders. This condition is generally detected in younger children that fail to meet certain milestones, particularly social ones, but sometimes may remain undetected until adulthood.

Source: .com

What Is Asperger Syndrome?

Asperger Syndrome is a psychological condition on the autism spectrum that affects social skills, emotional expression (though not the capability), language and communication, and general behavior. Though there is no confirmed cause of Asperger’s, it is believed to primarily be a genetic condition, as well as speculation that it may be a result of complications during pregnancy and birth or even exposure to certain toxic elements during development, though this is as of yet unconfirmed. These two latter assumptions are thought to simply aggravate the pre-existing genetic potential for an individual to be born with an autistic spectrum disorder. It is also speculated that some experiences in childhood may also even be a contributing factor to this condition, though this potential cause is highly disputed.

Many conditions on the autism spectrum, including Asperger Syndrome, are still being analyzed and studied.

What Does Asperger’s Look Like In Children?

In children, Asperger Syndrome is generally detected when a child is failing to meet the criteria for certain “milestones.” Many children on the autism spectrum and with Asperger’s show extreme difficulties functioning in social situations. They may fail to interact with others appropriately or even whatsoever. They struggle to read body language and respond to social cues. Many tend to avoid eye contact, even with those close to them, such as family members. They sometimes lack the enthusiasm and outgoing qualities of most children their age and primarily keep to themselves. There may also be complications about motor skill development, with the child showing problems with coordination and clumsiness.

Due to the lack of proper social and emotional development, many children with Asperger’s display a lack of emotional expression (or “flatness”), but can also exhibit traits and behaviors on the complete opposite side of the spectrum and burst into tantrums, suffer with severe anxiety, or be “overly emotional” in nature.

When diagnosed early, these children stand a significant chance at increased and improved emotional development, as well as learning the appropriate coping skills to help them navigate their years up to adulthood and beyond.

How Does Asperger Syndrome Present Itself In Adulthood?

In adults, the diagnosis of Asperger Syndrome may not be as clear-cut and as simple in a small child. Many adults have lived years without a formal diagnosis and have learned self-taught coping skills to help them get through their lives with minimal negative impact. Some have even learned and devised coping strategies so successful that licensed professionals have struggled to find a proper diagnosis for them when they’ve sought therapy and treatment for their social and psychological concerns.

Whereas the symptoms of Asperger’s are rather basic in young children, there are more complex factors at play in adulthood that transform those traits into more developed and intricate ones.

The severity of these symptoms in adults with Asperger’s may vary, but often these individuals are high-functioning in nature and able to carry on with their daily lives despite internally struggling with these difficulties. The inability to properly understand some of the factors of “normal” life around them and how to process those factors appropriately can be masked to others by learned skills and having created a mental “how-to” manual of how to behave and navigate the outside world. While they’re able to function and successfully manage certain aspects of their lives, they may struggle with other aspects. Sometimes they may even present no outside signs of having this disorder and appear to be perfectly functioning adults.

Source: .com

Lack Of Empathy And Social Impairment

The most common identifying symptom in adults with Asperger’s is a lack of empathy. It’s not exactly a lack of emotion, because those with this condition can still experience emotion and often rather intensely, but rather the inability to express or process it properly. As with the children diagnosed with Asperger’s, the adult with this disorder still struggles with social cues, reading body language, and responding appropriately. Their voices and tones may fluctuate in a manner not suitable for the situation or conversation. They may be unable to grasp the use of sarcasm, irony, or vagueness. They may react improperly or not at all, and the behavior of not making eye contact can also still be a problem for some, as well as improper facial expressions in response to social stimuli. This behavior is often received negatively by others that may not know the individual lacks this capability to engage in standard social interactions appropriately, and therefore the person with Asperger’s may come off as lacking the right emotional response to most situations.

Part of the trouble lies in their ability to process situations better factually than emotionally.

Numerous individuals with Asperger’s struggle with social interaction and therefore may avoid populated and overwhelming social events or even interpersonal relationships due to the difficulties of understanding and maintaining them, finding it easier to engage in solitary activities and avoid the problem entirely.

Repetitive Motions And Behaviors

Commonly misdiagnosed as Obsessive-Compulsive Disorder (OCD), there are some physical symptoms besides just the behavioral and emotional symptoms of Asperger Syndrome. The individuals afflicted with Asperger’s may display repetitive behaviors, similar in some ways to those with OCD, such as repeated motions involving objects, repeated hand gestures such as “hand-flapping” or clapping, and more commonly rocking themselves back and forth. This repetitive compulsion can also extend to daily activities, such as consistently doing things in a certain order, repeating the same activities, or insisting on a strict and specific schedule for their everyday life. In this case, the repetitive behaviors provide a reliable pattern to reduce anxiety and allow the individual to know exactly what to expect daily.

Source: .com

Sensory Sensitivity

Some individuals with Asperger’s experience sensory sensitivity, such as being overstimulated by certain sounds, visuals (primarily bright lights), smells, or even physical sensations. It would not be unusual for one to be particular about clothing or household items they regularly come into contact with due to certain fabrics provoking unwelcome and overwhelming sensations via skin contact.

Intense Singular Focus

Another trait bordering on obsessive behavior is a person with Asperger Syndrome’s ability to hone in on one specific subject or interest. This often ends up being a lifelong and heavily pursued hobby or career choice. The interest can range from creative interests to educational subjects to something as simple as pets, animals, cars, games, books, or a specific collection. It goes beyond the intensity of the average person’s level of interest in the topic and plays a significant role in some way in the individual’s life. Whether that be by working towards the goals of learning as much as possible, acquiring as much as possible, or choosing and pursuing a career relevant to the interest to involve themselves with it as much as possible. These are often neutral or positive interests, though some people struggling with this intense fascination with a subject may resort to hoarding or other unhealthy mechanisms and require assistance in finding a healthy alternative for their expression and involvement with the ideal subject of choice.

Impaired Motor Skills

Another lingering trait from childhood is the impairment of fine motor skills in the individual. Those with this particular trait may struggle with tasks that require coordination or accuracy, as well as having difficulties with things such as legible handwriting (which is something much more noticeable in adults by comparison to children).

Depression and Anxiety

With all of the above factors wreaking havoc on a person’s relationships, daily life, and interactions with the world, it’s no wonder that depression and anxiety would be a resulting symptom of an adult trying to cope with these concerns. Usually due to the difficulties of navigating their highly specific routines, being unable to focus properly on their obsession-fueled subject of choice, and the lack of desirable and pleasant social interaction, an individual is extremely susceptible to the loneliness and hopelessness of depression as well as the frantic and unsettled feelings of anxiety.

Treatment Of Asperger Syndrome In Adults

Many adults diagnosed later in life with Asperger Syndrome are relieved to finally have a label to attach to their difficulties and therefore a set of criteria to focus on for bettering their everyday lives and gaining significantly more understanding of their condition and the effects it may have.

There is no cure for Asperger Syndrome.

However, there are many alternatives for learning positive coping mechanisms and strategies to overcome the various problem areas of the disorder and regain some semblance of a balanced, productive, and healthy life.

Adult Asperger Assessment

It is extremely uncommon for an adult with Asperger Syndrome to exhibit all of the traits of the disorder simultaneously. Many experiences just a few and in any combination. This can often lead to initial misdiagnoses and a longer treatment period until the correct diagnosis of Asperger’s has been confirmed.

A diagnosis is often determined based upon the individual’s observable behaviors and personal disclosure of symptoms, behaviors, and experiences. Other conditions will need to be ruled out in the process to ensure proper treatment. This is now simplified and clarified using the Adult Asperger Assessment (AAA).

The Adult Asperger Assessment is done electronically and is designed to reduce false positives regarding the diagnosis of Asperger Syndrome. It examines the criteria of the condition and allows an individual to receive a computer-scored result, for accuracy purposes, based upon their numeric responses to the information presented in the assessment.

Copies and variations of this assessment are available on the Autism Research Center website and can be completed at home for those curious about their potential scoring, but taking the assessment on your own is not a replacement for the proper testing and confirmation of results under the supervision of a licensed professional.

Source: .com

Therapy And Treatment

Children that have Asperger Syndrome detected early on in their lives have been shown to have great potential in overcoming the limitations imposed by the disorder and stand a greater chance at the improved quality of life later on thanks to the early recognition of symptoms and significant effort placed into learning the appropriate social and functioning skills for adulthood.

Adults diagnosed with Asperger’s may have struggled for many years trying to understand their condition without professional help, but the guidance of a mental health expert can easily be recruited to ensure they learn the new skills and techniques to better their present life and their future.

Treatment for Asperger’s may sometimes include medication to calm overly disruptive behaviors, such as hyperactivity or the inability to focus, but primarily focuses on behavior modification and reducing symptoms by other means. The treatment will vary greatly depending upon the factors present in the individual.

The main goal of treatment for Asperger Syndrome focuses on:

  • Learning the appropriate skills necessary for social interactions
  • Gaining a thorough understanding of language and its varied uses to understand social interactions with others better
  • Reducing sensory overstimulation
  • Understanding the individual’s strengths and weaknesses and how to best apply those to daily life
  • Finding measures to reduce anxiety and increase the individual’s awareness of relevant situations, therefore providing them with structure and expectations for when they may be presented with such events

Other areas of interest may also be taken into account and addressed accordingly based on the varying symptoms and their impacts specific to each.

Seeking Help

If you or someone else you know may have Asperger Syndrome or suspect that may be the cause of difficulties in your social and daily life happenings, don’t hesitate to reach out to a licensed professional in your area for guidance and a proper diagnosis, or contact the BetterHelp online therapy professionals to seek further care.

5 Characteristics of a Person with Asperger’s Syndrome

Asperger’s Characteristics

  • Intellectual or Artistic Interest
  • Speech Problems
  • Delayed Motor Development
  • Poor Social Skills
  • The Development of Harmful Psychological Problems

Asperger’s Syndrome is one of the disorders that is generally considered high functioning on the Autism spectrum. Individuals with Asperger’s Syndrome, known as Aspergians, suffer from a number of impairments, namely social, but also can have challenges with motor skills. For example, Aspergians have difficulty with communication in a variety of ways. They may have self-imposed rules or patterns that are usually very restrictive.

Intellectual or Artistic Interest

Many of the diagnosed Aspergians will have at least one particular field of intellectual or artistic interest and talent. Asperigans show a great skill in their area of interest at an early age and proceed to effectively excel at it later in life. Wolfgang A. Mozart is a great example of a historical figure with Asperger’s-like characteristics. Mozart was extremely skilled at composing music; he was known to compose as a young child and continued doing so late into life. Aspergians may thrive in fields such as photography, webpage design, accounting, engineering or data entry.

Speech Differences

Speaking differences such as lack of verbal rhythm, monotone pitch and a peculiar inflection on certain words impact most Aspergian children. Adult Aspergians have the same characteristics since many do not outgrow it. They are often unable to control their voice’s volume according to their surroundings. It is not uncommon to hear Asperigans speak loudly in quiet places such as a place of worship or a library.

Delayed Motor Development

Some children with Asperger’s Syndrome have delayed development with fine and gross motor skills. Children with delayed fine motor skills may struggle to hold a pencil correctly or when grasping objects with their fingers. Delayed gross motor skills may include inability to throw a ball overhand or swing on monkey bars even after repeated demonstration. This characteristic varies widely and can been seen in both the mild and more severe cases.

Poor Social Skills

Because of their limited fields of interest and a low emotional ability, Asperigans feel isolated through most of their childhood and into adulthood. Aspergians do try to make friends, but they are often either temporarily successful or completely unsuccessful due to their lack of social skills. In the end, they sometimes display a lack of interest or even curiosity for the discussions, thoughts and opinions of the people they temporarily befriend.

The Development of Harmful Psychological Problems

The potential for development of harmful psychological disorders typically occurs during puberty or immediately thereafter. The most common disorders are anxiety and depression. Unfortunately, young Aspergians have a high rate of suicide that may be directly related to anxiety and depression. The only other demographics with a higher suicide rate for teenagers is transgender and homosexual individuals.

Related: 15 Best Applied Behavior Analysis Online Programs

The characteristics above are traits children and adults with Asperger’s are challenged by through their entire lifespan.

Living with an Asperger Profile for Adults

For more than two decades, AANE staff have learned about the talents and struggles of adults with Asperger profiles. Working closely and talking extensively with adults with Asperger’s, ranging in age from 18 to 83, along with their parents, relatives, and spouses, we have together explored successful strategies for addressing the challenges of Autism Spectrum differences. We have developed a comprehensive array of services and programs to meet the needs of adults and their families, including—but not limited to—telephone and face-to-face supports for adults and their families, social activities in multiple locations, discussion/support groups for adults, in-person and online support groups for parents of adults, book readings, and internships in the AANE office. Below is a review of some of the recurrent themes that have arisen out of our collective years of experience.

A Range of Successes and Struggles

Many adults with Asperger profiles appear to have very high levels of functioning—but what does that actually mean? It can mean that one functions very well in some arenas and not well in others. Maybe someone does quite well at work because s/he is extremely bright and well-suited to the job. For example, an employee on the Autism Spectrum may be successful because the work environment does not overload the person’s senses or require multi-tasking, or because the social contact on the job is minimal or highly structured, with clear expectations, or because the people at work are supportive, accommodating, or have similar/compatible personalities. This same person may not have or know how to create or maintain a satisfying life outside of work. Success for adults in our society usually means success at work; success in that arena could mask the fact that an adult also struggles in some fundamental ways that could be explained by an Autism Spectrum difference. There may be others who cannot function in a work environment, but can maintain one or a few friendships or acquaintances, be successful public speakers, and live independently. Maybe someone can neither maintain employment nor sustain friendships, but can produce beautiful art (visual, written, musical). There are infinite combinations, and all could be considered Asperger Syndrome, depending on the lens through which you look. At AANE, we suggest that the lens be broad enough to accommodate adults with AS who may not “look the part.”

It’s Hard Work Fitting In!

How is it that some adults can present so well? Older adults with Asperger Syndrome grew up before the diagnosis existed in the United States; it first appeared in the DSM-IV in 1994. The diagnosis may not have existed, but the adults did—and they needed to find ways to survive. The adults that we meet at AANE are survivors. Without the neurology that supported an intuitive understanding of social behavior, many adults with Asperger profiles learned to spend their time observing their environments and the people around them. They tried to make sense of the confounding behavior of their peers and tried to understand why people were always telling them, “You’re so smart, why can’t you just…(fill in the blank): go to a family function and behave (sensory, social, anxiety), complete this work assignment (executive functioning, processing speed), do what’s asked of you (illogical, theory of mind), tell a therapist how you’re feeling (reliance on thinking more than feeling). Through observation and trial and error (after error), they managed to survive into adulthood. Some adults with Asperger profiles develop an understanding of the world around them, a framework of how and where they do or don’t fit in; they learn and apply skills and strategies to use in particular situations, anticipate and manage upsetting sensory input. Imagine how absolutely exhausting it would be to do all of those things relying on cognition, not intuition. Nevertheless, after years of applying these skills and strategies, an adult with an Asperger profile can look pretty good, maybe even “passing”—or almost passing—for NT (neurotypical).

Anxiety and Depression are Common

So after years of practice and trying to fit in or find a comfortable place in the world, some adults with Asperger profiles have put together a life, and many live with the worry that it could all come apart because of how precariously it is crafted. Working so hard to fit in, to understand or hide your neurology comes with a very high price tag. In addition to the exhaustion, mentioned before, there is often a huge overlay of depression and anxiety on top of the basic neurological condition. It is depressing when there is no obvious place in the world where you belong; when everyone else seems to know the rules by heart and you were never given the manual. The repeated trials and failures to make friends, work, live independently, manage your own affairs and even succeed in therapy are constant reminders of being “less than”; it should come as no surprise that these experiences so often lead to depression. And why not be anxious when “the world outside door is scary”? It is unknown, unpredictable, full of people walking down the same sidewalk you are, crowded MBTA trains, store clerks who may want to talk to you, sensory assaults and a myriad of things that are not within your control. When you lack the intuitive ability to generalize, every time you go out the front door is a new challenge. More or less neurotypical people do not have to be thinking constantly just to function somewhat comfortably in the world. Many adults with Asperger profiles operate from a baseline of anxiety. Faced with the additional anxieties that come from living in an unpredictable world, an adult with this profile can look pretty good in one setting and fall apart in another.

Misdiagnoses are Prevalent

And yet with all of these challenges, many adults have learned to approximate neurotypical behavior. Many adults have learned independently what today is being explicitly taught to our children with AS. Adults who have learned how to compensate, learned tricks and strategies, crafted some sort of life for themselves, may be denied the diagnosis because they do not quite fit the criteria. They may look too good, or, because of the overlays on the Asperger neurology, they may look like something else is going on. AANE board member Gyasi Burks-Abbott refers to the “Asperger’s pedigree,” i.e., the number of diagnoses someone has received before stumbling upon Asperger Syndrome/Autism Spectrum difference. These incorrect or incomplete diagnoses may include: ADHD, Bipolar Disorder, Schizophrenia, Borderline Personality Disorder, Obsessive Compulsive Disorder, Intermittent Explosive Disorder, Major Depression, Generalized Anxiety Disorder, Social Phobia, Narcissistic Personality Disorder, Oppositional Defiant Disorder, Sensory Integration Dysfunction, or Autism: Residual State. There can be genuine co-morbidity (dual or multiple diagnoses simultaneously), but many symptoms can be explained by AS. For many, with the discovery of an Autism Spectrum difference, the myriad diagnoses fall away, frequently leaving behind the depression and anxiety.

Diagnostic Criteria are Imperfect

When people begin to learn what’s expected in the NT world, develop new skills, and gain increased understandings of themselves, they can actually change their behaviors, becoming more outwardly focused, aware of and interested in other people. Does that change their underlying neurology? Should a high functioning adult lose or never receive the diagnosis that could prove to be so helpful?

Considering the diagnostic criteria for ASD, many of the adults that we meet at AANE would not necessarily fit the diagnosis. Most adults maintain pretty good eye contact. Virtually all of them have a sense of humor—and quite a sophisticated one, at that! Some have had successful careers, even careers that demand multitasking—although the ability to juggle multiple tasks may not carry over to their home lives. (Successful multitasking at work may be driven by an intense interest and a clear road map—a highly structured work environment.) Many adults can take part in the give-and-take of conversation, taking turns speaking and listening. They demonstrate theory of mind in a number of ways (the ability to put oneself in someone else’s shoes and even empathize). Some have had intense interpersonal relationships (positive and lasting or not). Some have good gross motor skills. Not all are good at math and computers! Some are capable of lying (though generally because it is the “logical” thing to do in the situation). Some avoid certain loud noises but gravitate to others. It is especially difficult to diagnose based on presentation in a therapist’s office, since that is a setting that would be comfortable for many adults with an Asperger profile: one-on-one, talking about oneself, with little environmental stimulation. With anxiety in check, AS traits may not be evident.

The Benefits of Identifying with an Asperger Profile

It seems that no one is looking to be in this “club,” but many people seek answers to explain the outsider status that has defined their lives. When they welcome it, it is usually because it fits where other diagnoses have not and because they have endured a lifetime of not understanding why their lives don’t seem like others, why they feel they are “from another planet.” So when someone receives the diagnosis of Asperger Syndrome or ASD as an adult, s/he can begin to look back on his or her life and understand it in a new light. It may explain some of the successes as well as the many challenges. It often, but not always, comes as a relief. The self-blame (“How can I be so smart and so stupid at the same time?”) can subside; adults can often forgive themselves for some things that went wrong. They can sometimes forgive their caregivers, parents and teachers, who were also operating without full information. Going forward, they can apply their new knowledge to help avoid previous pitfalls. People don’t embrace the diagnosis because they want to belong—they embrace it because it fits. The difference it makes in someone’s life to have this understanding is profound. It provides a community, a place where Asperger neurology is typical and being NT is in the minority.

The Future of Asperger Syndrome

Where will we be in our understanding of AS in the next 10-20 years? It is likely this diagnostic area will be further refined; maybe there will be Asperger subtypes, since the challenges that account for the Autism Spectrum diagnosis show up to different degrees in different people. Let us be open to learning from the adults who’ve lived undiagnosed or misdiagnosed, from their stories of survival. Let us encourage adults with Asperger profiles to understand themselves to the best of their abilities so that they can self-advocate, asking for what they need and offering solutions that may alleviate their challenges and leverage their many strengths. AANE will be here as a resource, a support, and a community along the way.

Aspergers in Adults: Signs, Symptoms, and Treatment Options

What an individual does an Asperger’s diagnosis will obviously vary from one person to the next.

Some individuals may choose not to explore treatment options at all.

However, many studies show that those who choose to focus on recognizing the underlying reasons for certain behavioral traits and work to understand the effects of their behaviors have seen incredibly beneficial and life-changing results.

Working with an Aspergers psychologist has shown to:

  • Improve communication skills
  • Aid in developing lasting relationships
  • Alleviate the challenges and anxiety associated with the fear of not being able to relate to others

Furthermore, the FDA has not approved any drugs to specifically treat Aspergers or autism spectrum disorders. However, a doctor may prescribe certain medications in order to alleviate symptoms of anxiety or depression in patients. These medications include:

  • Antipsychotic medications
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Stimulant drugs

Aspergers in Adults: Bottom Line

To reiterate, while many people still use the term, Aspergers is technically no longer an existing diagnosis. The appropriate, current term for the diagnosis is autism spectrum disorder.

Autism spectrum disorder is often greatly misunderstood. In more ways than one, the lack of knowledge that the general public has about ASD is troublesome. Think about it. Every day, whether you realize it or not, you probably have some form of interaction with someone with ASD. Yet, as a society, we know little about ASD other than the stereotypes associated with the condition.

Just imagine how many judgments we could avoid if there was a better understanding of the disorder.

If you believe you may have Aspergers, it makes sense to seek treatment from a mental health expert. Most adults with Aspergers have significant strengths in areas of their lives. Working with someone who can recognize these strengths and help develop the areas lacking can prove to make a remarkable difference for an individual with ASD.


What Are the Main Characteristics of Asperger’s Syndrome in Adults?

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