Question of the Week

February 19, 2007


Whether they have made a great discovery, or just an observation about daily life, there are times when people want to communicate.

"If so, your brain translates the idea into a sequence of words. The words are translated into vibrations that depart from your mouth, sail long distances through the air, and land on my eardrum. These vibrations are turned back into words, and then into meaningful sentences and ideas. My brain also picks up other non-verbal language, such as your facial expression and tone of voice. Meanwhile, I figure out any 'hidden agenda' or 'subtext' when you said those words. All these elements mix together to come up with an accurate understanding of what your 'self' meant to communicate to my 'self.' It's amazing that this process works at all. It is not really amazing that some people have trouble with some aspect of it. Those people whose primary difficulty is understanding the literal meaning of words are considered to have 'traditional' speech and language disabilities. Those people who have difficulty in the non-verbal parts of communication (including their desire and ability to use language in a social context) may be considered to have an Autistic Spectrum Disorder (ASD)."

Some people don't understand the words: how to say them, how to use them, or how to understand them. Others don't understand the levels of communication that go beyond the words. Still others struggle with both.

"'Autism' means a developmental disability significantly affecting verbal and non-verbal communication and social interaction, generally evident before age three, that adversely affects educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences."

There may be students in your school with autism. Depending on the severity of the disability, they may or may not have classes with you.

Not only can those with autism have a difficult time understanding the communication styles of others, it can also be difficult for others to understand the way in which a person with autism communicates and/ or interacts.

"Because their brains process information differently, teens with autism may not act like other people you know (or each other, because the severity of symptoms of autism varies from person to person). They can have trouble talking and sometimes communicate with gestures instead of words. Some spend a lot of time alone, don't make friends easily (and may not act like they want to), and don't react to social cues like someone smiling or scowling at them. They often do not make eye contact when you are talking to them. ... Some teens with autism are passive and withdrawn, whereas others are overactive and may have tantrums or act aggressively when they are frustrated ... Because they don't have the ability to express emotions like anger and frustration in more acceptable ways, teens with autism may express themselves in ways that seem inappropriate. ... One common misconception is that people with autism don't feel or show emotion. Although they can feel affection, they often don't express it the same way others do. To an outsider, this can come across as being cold or unemotional.

While those with Autism often have difficulties with both non-verbal and verbal communication, those with Asperger's syndrome are more likely to struggle with the non-verbal. "Asperger´┐Żs syndrome [AS] is a developmental disorder in which people have severe difficulties understanding how to interact socially. People with Asperger's syndrome have some traits of autism, especially weak social skills and a preference for sameness and routine. But unlike those with autism, children with Asperger's syndrome usually start to talk around 2 years of age (the age at which speech normally develops). They have normal to above-normal intelligence. Both conditions belong to the group of disorders called pervasive developmental disorders."

While most people have heard about autism, many may not have heard about Asperger's syndrome.

"Asperger Syndrome or (Asperger's Disorder) is a neurobiological disorder named for a Viennese physician, Hans Asperger, who in 1944 published a paper which described a pattern of behaviors in several young boys who had normal intelligence and language development, but who also exhibited autistic-like behaviors and marked deficiencies in social and communication skills. In spite of the publication of his paper in the 1940's, it wasn't until 1994 that Asperger Syndrome was added to the DSM IV [Diagnostic and Statistical Manual of Mental Disorders (DSM) is the standard classification of mental disorders used by mental health professionals in the United States] and only in the past few years has AS been recognized by professionals and parents."

Since it was not until recently that AS began to get more attention from medical professionals and parents, many people have gone through life undiagnosed. There may be those with AS in your school who have struggled for years and never understood why.

"Individuals with AS can exhibit a variety of characteristics and the disorder can range from mild to severe. Persons with AS show marked deficiencies in social skills, have difficulties with transitions or changes and prefer sameness. They often have obsessive routines and may be preoccupied with a particular subject of interest. They have a great deal of difficulty reading nonverbal cues (body language) and very often the individual with AS has difficulty determining proper body space. Often overly sensitive to sounds, tastes, smells, and sights, the person with AS may prefer soft clothing, certain foods, and be bothered by sounds or lights no one else seems to hear or see. It's important to remember that the person with AS perceives the world very differently. Therefore, many behaviors that seem odd or unusual are due to those neurological differences and not the result of intentional rudeness or bad behavior...."

As more people become aware of AS, more and more children (and adults) are being diagnosed. Those previously misdiagnosed, or undiagnosed, are beginning to get a more accurate assessment of their symptoms. That said, there are still a lot of questions.

"At this time there is a great deal of debate as to exactly where AS fits. It is presently described as an autism spectrum disorder and Uta Frith, in her book Autism and Asperger's Syndrome, described AS individuals as "having a dash of Autism". Some professionals feel that AS is the same as High Functioning Autism [HFA], while others feel that it is better described as a Nonverbal Learning Disability [NLD]. AS shares many of the characteristics of PDD-NOS (Pervasive Developmental Disorder; Not otherwise specified), HFA, and NLD and because it was virtually unknown until a few years ago, many individuals either received an incorrect diagnosis or remained undiagnosed. For example, it is not at all uncommon for a child who was initially diagnosed with ADD or ADHD be re-diagnosed with AS. In addition, some individuals who were originally diagnosed with HFA or PDD-NOS are now being given the AS diagnosis and many individuals have a dual diagnosis of Asperger Syndrome and High Functioning Autism."

There may be people you know, or students in your classes, with an AS diagnosis. In many cases, you may never know unless the person chooses to tell you. While younger children may not understand -- or be aware of -- what the eventual diagnosis really means, teens and tweens (and adults) are often faced with different challenges once it has been determined that they have AS.

"Asperger syndrome is quite a tricky thing to explain. Your friends and even your teacher may never have heard of it. This may mean that you and your family will have to inform the people you meet of your condition, and help them to understand any problems (and talents) you may have. Unlike something like measles which is very easy to recognise, another person cannot tell whether you have Asperger syndrome just by looking at you. People who pass you in the street will not be able to guess. This means that you can choose which friends you want to tell. Asperger syndrome does not mean you are not clever. On the contrary, people with the condition usually have an average or above average intelligence level. Therefore, any one who calls you names, simply doesn't know as much about Asperger syndrome as you do."

Questions of the Week:
Why is it important for you (and others in your school) to know about autism and Asperger's syndrome (even if you don't think that you know anyone who has been diagnosed with either one)? How can knowing about these disorders help you better communicate with (and understand the communication of) all people? If you (or someone you know) were to receive a diagnosis of AS, how would you decide who to tell?

Please email me with any ideas or suggestions. Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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