Q&A with William Shryer, MSW, LCSW
What is Asperger’s syndrome and how is it different from ADHD?
Asperger’s Syndrome is a variant of autism. While it is possible to have both ADHD and Asperger’s, Asperger’s is often misdiagnosed as ADHD.
A central difference between Asperger’s and ADHD is that the person with ADHD has a neurobiological difficulty in focusing and paying attention. A person with Asperger’s will have difficulty deciding on what to pay attention to, or will not be able to shift attention from what they want to think about to what someone else wants them to think about.
The higher functioning the person with Asperger’s may be, the more likely they are to be misdiagnosed by the uninformed.
When misdiagnosed as ADHD, the person with Asperger’s will often be prescribed medications to treat ADHD, which can make their internal anxiety state go to into high gear. If they have stuck thoughts, the stimulant medications can increase their stuckness so now they have what I call “attention surplus disorder.”
Does Asperger’s affect more boys than girls?
Asperger’s was thought to affect more boys than girls by a wide margin. However, we’ve learned that girls present differently and therefore are frequently missed or misdiagnosed.
It appears that girls with Asperger’s are better at watching and copying the behavior of other girls in order to fit in. And girls are more likely to help and support an “Aspie” peer, while boys are more likely to bully and make fun of peers with Asperger’s.
What are the typical behavioral manifestations?
This varies depending on the individual. However, here are some typical tendencies of people with Asperger’s:
- literal in their thinking
- difficulty or great discomfort making direct eye contact
- intense interest in specific topics
- difficulty with social nuances and the unwritten rules of social discourse
- difficulty with organization
- trouble understanding jokes (see: literal thinking)
- difficulty knowing what they’re feeling or with expressing emotions
- repetitive behaviors, such as hand flapping or rocking when experiencing stress
- hypersensitivity to light and noises
- difficulty with daily habits such as teeth brushing and hair combing
People with Asperger’s are often highly intelligent. Since they have a very concrete way of perceiving the world, they may do poorly at algebra but excel at calculus or trigonometry. They may have great skills with computers; they may also love computer games as they are not played with others directly.
Most people with Asperger’s focused on their particular fascination — be it vacuum cleaners, algae, dinosaurs, or medieval history — show little to no anxiety about it. The anxiety that these folks feel stems from not fully understanding how to navigate the social landscape.
How do people with Asperger’s manage long-term relationships?
I have known several Aspie men married to a non-Aspie women. Often, the non-Aspie person needs to learn reasonable expectations of their Aspie spouse. The partner with Asperger’s will have to be taught to remember birthdays and to say kind things; these things do not come naturally to them.
In the movie “Adam” — a wonderful movie about Asperger’s and relationships — a woman asks Adam, “Can I have a hug?” Adam responds, “Yes” — and then does nothing. The woman realizes that Adam was being concrete. So she follows up: “Can I have a hug now?” and he hugs her. This is a great example of how Aspie’s interpret language.
Can therapy help people with Asperger’s?
Typical therapy really doesn’t help people with Asperger’s. The abstract question, “How does that make you feel?” means nothing to them.
People with Asperger’s can benefit greatly from direction and coaching. A type of therapy that’s highly directed, very structured and involves the entire family, the school and other groups can be most helpful.
Assisting the schools to provide the support students with Asperger’s is also key. Often, schools and parents are overwhelmed and frustrated with the often behavior that people with Asperger’s can demonstrate.
This is one diagnostic category where the saying, “It takes a village” was never more true.
William Shryer received his MSW from the University of California at Berkeley specializing in children and families. He has been in private practice since 1981 specializing in autistic spectrum disorders, mood disorders, and the anxiety spectrum in children, adults and their families. He has lectured frequently to college classes and professionals in the areas of ADD and autistic spectrum disorders and their implications in the educational setting.
