Along with her movement for climate change, Greta Thurnberg also talked about a mental health concern that needed much attention. On September 1, 2019, the 16-year-old took to Twitter, to talk about her experience of having Asperger’s Syndrome- what she called a superpower! Statistics revealed that her media appearance escalated searches as well as awareness among the masses regarding this syndrome (Hartwell et. al. 2021). Such awareness is a key step in improving the quality of life of people with Asperger’s or Autism Spectrum Disorder (ASD) and possibly preventing comorbidities such as depression and anxiety for them.
The ICD- 10 classifies Asperger Syndrome as a pervasive developmental disorder characterized by abnormalities in reciprocal social interaction as typically seen in Autism Spectrum Disorders along with a restricted and stereotypical pool of interests and activities. However, marked delays in language or cognitive development are not observed.
Hans Asperger, in 1944, was the first one to describe these symptoms as ‘Autistic Psychopathy.’ Wing (1981) went on to use the term ‘Asperger’s Syndrome’ in scientific medicine for the first time. The DSM IV also classified it as a pervasive developmental disorder however in the recent edition (DSM-V, 2013) it has been subsumed under the category of Autism Spectrum Disorders.
The origin of Asperger’s syndrome is multifactorial; especially deficits in the theory of mind, central coherence, and executive functions are noted. Theory of mind involves the ability to attribute mental states to oneself and others (Cowan et al., 2019). Children with Asperger’s disorder present with clinically significant disruptive behaviors, anxiety, and depression (Gillott et al., 2001). Furthermore, they have difficulty understanding their own inner emotional states and the emotional states of others (Baron-Cohen et al.,1985). In addition, these children may not be able to identify or describe feeling states and may not understand their own bodily sensations of emotional arousal (Hill et al., 2004)
Another model which attempts to understand Asperger’s is the Weak Central Coherence Theory. Firth (1989) was one of the first people to study this theory. Central coherence refers to the ability to extract meaning from a collection of details. Weak central coherence is observed in ASD as the tendency to attend to and remember details rather than global form or meaning (Happe, 2021). This could result in a common feature of lack of context in conversation coexisting with reduced social communication.
Therefore, a current theoretical disease model is based on the assumption that in Asperger’s syndrome the abilities reflected by the three concepts- “theory of mind,” “central coherence,” and “executive functions”, are deficient (Kamp-Becker et.al., 2010).
The prevalence of Asperger’s syndrome in childhood is estimated at 0.02% to 0.03% (Roy et al., 2009). Asperger’s is far more common in boys than in girls, with a sex ratio of 8:1 (Kamp-Becker et.al., 2010). Representative studies of the prevalence in adults are currently lacking. However, since the core symptoms of Asperger’s syndrome persist throughout patients’ lifetimes (Tantam, 2000), we can assume that Asperger’s syndrome is probably not much less common in adults. Delays in executive functioning can lead to problems regulating emotions. An approach is suggested by Klin and Volkmar (2000) recommending the following therapeutic principles for patients with Asperger’s syndrome:
- Practicing and discussing social perceptions
- Stepwise and structured training/coaching in problem-solving skills and life skills
- Practicing behaviors in unfamiliar situations
- Practicing the transfer of certain insights to other situations
- Promoting a concrete development of identity that is based on everyday behaviors
- Analyzing situations that trigger frustrations and analyzing how patients may affect others
- Facilitating further helpful measures, such as ergotherapy or physiotherapy.
Additionally, research in recent times is also looking at the potential benefits of Social Skills Training (SST) for children with Asperger’s syndrome. Diverse theoretical perspectives on SST are being employed by researchers to design different intervention programs. The clinical use is currently widespread but minimally evidenced, hence breeding grounds for intensive exploration.
References
Baron-Cohen, S., Leslie, A. M., & Frith, U. (1985). In Does the autistic child have a “theory of mind”? (1st ed., Vol. 21, pp. 37–46). essay.
Cowan, T., Le, T., & Cohen, A. (2019). Chapter Three - Social cognition and schizotypy. In Social Cognition in Psychosis (pp. 71–88). essay, Academic Press.
Gillott, Alinda & Furniss, Frederick & Walter, Ann. (2001). Anxiety in High-Functioning Children with Autism. Autism : the international journal of research and practice. 5. 277-86. 10.1177/1362361301005003005.
Happé, F. (2021). Weak Central Coherence. In: Volkmar, F.R. (eds) Encyclopedia of Autism Spectrum Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-91280-6_1744
Hartwell, Micah & Keener, Ashley & Coffey, Sara & Chesher, Tessa & Torgerson, Trevor & Vassar, Matt. (2020). Brief Report: Public Awareness of Asperger Syndrome Following Greta Thunberg Appearances. Journal of Autism and Developmental Disorders. 51. 10.1007/s10803-020-04651-9.
Hill, N. E., & Taylor, L. C. (2004). Parental school involvement and children’s academic achievement: Pragmatics and issues. Current Directions in Psychological Science, 13, 161–164.
Kamp-Becker I, Schröder J, Remschmidt H, Bachmann CJ. Health-related quality of life in adolescents and young adults with high functioning autism-spectrum disorder. Psychosoc Med. 2010 Aug 31;7:Doc03. doi: 10.3205/psm000065. PMID: 20930927; PMCID: PMC2940215.
Mesibov, G. B., Shea, V., & Adams, L. W. (2001). Understanding asperger syndrome and high functioning autism. https://doi.org/10.1007/b107746
Roy, M., Dillo, W., Emrich, H. M., & Ohlmeier, M. D. (2009). Asperger´s syndrome in adulthood. Deutsches Ärzteblatt International. https://doi.org/10.3238/arztebl.2009.0059
Tantam, D. (2000). Psychological disorder in adolescents and adults with Asperger syndrome. Autism, 4(1), 47–62. https://doi.org/10.1177/1362361300004001004
Volkmar, F. R., & Klin, A. (2000). Diagnostic issues in Asperger syndrome. In A. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome (pp. 25–71). The Guilford Press