Reading "The Complete Guide to Asperger's Syndrome" (Tony Attwood)- by S. C. Sullivan, December 2017
Reading this heading, you might be wondering how Asperger's Syndrome, more commonly referred to as High-Functioning Autism in the more recent DSM-V diagnostic manual, has anything to do with LinkedIn and the workplace. On the contrary, there are millions of teenagers and young adults in the workforce today, and having personal experience (as well as friends and former classmates) with HFA has compelled me to learn more about some of the pros, cons, "hallmarks", and inconsistent conditions surrounding these individuals. Still others can and will be successful in work and life if we just take a little time to get to know them and their often-impressive skill sets. The other night, I was really excited about the arrival of my brother to the family home for Christmas. I was so glad he'd be on his way that I couldn't sleep very well, and I'd wanted to read the Attwood book for a long time. Around midnight, earlier this December, I decided to take advantage of the extra energy I had by trying to (not only) read and study the book mentioned. I brought the book out again the day after Christmas, and have written down some discoveries and summaries of Tony Attwood's ideas. Rather than using a lot of medical and evaluative jargon, I have simply written down all of the notes I took; however, these only cover chapters 2 and 3. I will plan to update this article as I have time to venture further through the book.
The first several ideas in the section of the book I've been reading say that, rather than using a child's "past history of language and speech use" to determine whether or not they have HFA (High-Functioning Autism), the clinician looking for signs of it should closely examine how that child uses them now. For me, that alone shows that a parent or physician should not just assume who another person is as soon as they are born, or even before that point. One other way in which Attwood shows us not to put the cart before the horse is in chapter 3, where he shows us that any kind of developmental delay or challenge a person faces while of school age does not remotely guarantee that they have any kind of disability or setback, whatsoever. In other words, the person searching for possible diagnoses should look at what the person being tested "does now," rather than at what they used to do earlier in life. I find that interesting.
Another critical thing to be gained from reading this book, and perhaps others like it, is to realize that DSM-V (and DSM-IV before it) can't even come close to finding a diagnosis of AS/HFA in a person unless "80 or more" traits used to describe someone with AS/HFA exist. Attwood goes on to assert that a person can have perhaps "20 or more" traits of a person on the spectrum without having any kind of disability, challenge, or difference. That person at work who just goes on and on about a few things from time to time is not necessarily a person with Asperger's/High-Functioning Autism at all, and may not even be on the spectrum, or be facing any difficulties or differences. If the DSM (Diagnostic and Statistical Manual) can't guarantee that anyone is remotely on the autism spectrum, than how reliable is it? Attwood follows this up by stating that any diagnosis or diagnostic attempt to prove or assert that anyone has Asperger's/HFA is, ultimately, subjective. Should science and medicine be subjective? That is not normally considered "good enough", but sometimes it manages to scrape by.
For those who don't know what Asperger's Syndrome (also called High-Functioning Autism) is, there is no clear answer or defining words for it. It was discovered by Hans Asperger, a Viennese pediatrician who operated a clinic before, during, and after the second World War. Dr. Asperger noted that many of the children at his clinic had a distinct way of conducting themselves, and studied them for decades, even after his clinic was bombed. One thing Tony Attwood discusses in the second chapter of the book is that another Austrian researcher of the same time-period, Leo Kanner, saw Autism much differently (and as a much more severe issue or set of difficulties), in comparison to Dr. Asperger, whereas Dr. Asperger saw obvious (and even enhanced) skills in many of his patients that these individuals could use later in life. They could, perhaps if not likely, be quite successful in the future. In contrast, Dr. Kanner, another early discoverer of autism, saw those with this "physiological difference" (as we would say today) as severely impaired, and perhaps even exhibiting mental retardation. I know we do not want to use that word, but I've used it here only to make a case for how far we've come in the field, and how far still to go.
One of the biggest hurdles to positive perceptions of young people and adults on the spectrum today come not from Dr. Asperger's work, but from the other perceptions. That is a massive problem in the workforce. I read an old post on Reddit last week in which an adult on the spectrum's younger brother asked the American public whether or not his brother could be a teacher. The post dates to around 2010, and unfortunately, the majority of those who replied stated very directly that teaching was not an option for this adult on the autism spectrum. It was mentioned that he just had high-functioning autism, but others remained steadfast in their comments and perceptions. These hundreds of people who never even met this aspiring teacher decided that they knew what was and was not best for him, and that's appalling. Luckily, other British and American clinicians of more recent times have made a stronger push toward honoring directly the work of Dr. Asperger, and his distinguished perceptions and experiences of his patients.
Here are some notes from Chapters 2 and 3 that sum up what I've written:
(1) The DSM manuals don't spell out what those with Asperger's/HFA actually do that marks them as having it.
(2) It is not made obvious how AS/HFA actually impacts the day-to-day actions and skills or difficulties of those with it.
(3) The DSM manuals prefer a diagnosis of Autism instead of AS/HFA; luckily, many researchers and practitioners reject that stance.
(4) People can have some abilities within the (ret*d) range without having that condition.
(5) Not all doctors take the DSM manuals seriously when seeking a diagnosis, leading to a situation (chapter 3) in which a diagnosis of Asperger's Syndrome/HFA becomes subjective (I may have mentioned this above).
(6) The more you get away from Dr. Asperger's research, the harder it is to track AS/HFA in an authentic and just way. In other words, if your beliefs and perceptions follow those of Dr. Kanner, rather than researchers who followed Dr. Asperger's work more closely, you might very well be doing an injustice to, say, your patients, if you're a doctor, clinician, special educator, or consultant.
(7) Girls and women are affected by AS/HFA in ways that often differ from the way that boys and men experience it. They may also be better at "hiding" this condition or trait.
(8) Diagnosing adults with AS/HFA may be far more difficult, for similar reasons it may be difficult to diagnose girls as having it.
(9) Those who know adults found to be on the spectrum can be helpful in fostering or supporting the process of seeking a diagnosis, and/or resources to assist those on it, regardless of the degree to which their AS/HFA may or may not impact them.
(10) Girls and women with AS/HFA may see their symptoms or AS-related traits more when it comes to emotion and relationships, while boys and men with AS/HFA (who aren't yet aware of it, same with the girls and women) might see troubles in employment and relationship circumstances and allocations.
In sum, this article covers only the first three chapters of Tony Attwood's book. I hope to enlighten the workplace and social spheres, not by merely repeating what actual doctors might have said (I'm not a doctor; I'm a musician and future teacher), but by helping all of us to take a closer and more compassionate look at those we know, those we've spent time with, and those we'll never meet, with Asperger's Syndrome/High-Functioning Autism. Many of these individuals have been, are, and will become some of the world's greatest living resources, even if they don't look like Einstein or Beethoven, and even if the things that challenge or motivate them aren't deemed immediately apparent or applicable to the solutions and insights we look for as a society and world. Thank you for taking the time to read it, and I'd like to wish you a Merry Christmas, Happy Holidays, and a Joyful New Year in 2018.
12 Jan 2018, 4:17 pm
