Aspergers Without Social Problems??

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My 15-year-old son was recently diagnosed with Asperger's Syndrome. The psychologist who diagnosed him said that he doesn't look like a typical Aspie because he doesn't have many of the social issues that are a hallmark feature of Asperger's. She thought that his IQ has helped him to learn coping mechanisms to deal with some of the symptoms. He is able to look you in the eye and carry on a "normal" conversation.

But he still is very shy and anxious, doesn't fit in with his peers. He also has rigid thinking, although he doesn't have daily routines that he has to perform. But if he was planning on mowing the grass at 8:00 and you change it to 10:00, he can't seem to switch gears. He also has always had a narrow focus on whatever was his interest at the moment. Typical things, like Legos or Star Wars, but to an intense level. I remember when he was 8 or 9 and he could talk for 2 hours without a breath to his friends about Bionicles. They liked Bionicles, but not to that extent!! He still has that obsessional trait, but he tries to cover it up. This summer he watched Iron Man 3 probably 100 times, plays the music over and over, etc.

Not surprisingly, although most teenage boys love videogames, his interest went over the top and he became completely addicted. Last year in school he would stay up until 3-4:00 am playing. When we took away his computer this summer, he went into a deep depression and threatened suicide, leading to hospitalization and a 2-week treatment program. This year we had more computer issues after a bout with anxiety. He had gotten behind in some of his classes while he was taking Driver's Ed in the evenings, but couldn't get past his anxiety to talk to teachers about making up assignments. He turned to the computer again, and ended up completely shutting down. He is currently not in school.

Our new psychiatrist said that he does not have Asperger's Syndrome because he doesn't have the severe social issues. Is it possible to have it without severe social impairment?

I thought symptoms could be mild moderate or severe. I think my social issue are mild but they were bad when I was a kid. I always though they were mild because I did have friends growing up and I knew another boy who seemed to have severe social issues and no way was I bad as he was when I was at that age so I was shocked when I read mine were very poor and that was from fifth and sixth grade.

There is another aspie here who doesn't have many social issues as many aspies do but she was still diagnosed.

Did he have social problems as a young child? Particularly between the ages of 5 and 9.

Your new Psychiatrist is a moron.

It's not at all uncommon to develop such sophisticated coping mechanisms that most of the people around you cannot tell you're having problems. That's the very reason AS is more difficult to diagnose in adults and in females - the external cues are less obvious. Many of us learn to fake eye contact well enough to get by, and carrying on a normal conversation isn't necessarily a problem at all, though initiating a conversation with a stranger (or under pressure) can be difficult or next to impossible.

Mental Health Professionals with little real world experience with High Functioning Autism, especially with teens and adults with autism, often succumb to the popular myth that all High Functioning Autism looks like Rainman. That couldn't be further from the truth. It's not unusual for people with AS to have careers and marriages and raise children of their own. Often we just pass for 'odd' or 'quirky' and people around us are none the wiser. There are Hollywood celebrities and Nobel Prize Laureates with Asperger Syndrome.

The behaviors you describe are all very clearly indicative of AS/HFA, so I see no reason to question the original diagnosis. Other than the gaming addiction, which didn't exist when I was that age, he sounds exactly like me at 15.

I think it may be a little difficult at 15 to be positive either way if he does not demonstrate deficiencies in social functioning. Usually a diagnosis is preferred by about 8, toward the end of a child's primary development. By 15 it's possible for adaptation to play some part, either way.

ASD, and to a degree it's sub-types, is an umbrella diagnosis with the only consistent criteria of deficiencies in social and communicative functioning, which in itself is vague. Under it there are a whole host of “optional extras” that may or may not effect any individual, and to varying degrees.

At 15, the specific difficulties that he is having are probably more significant that the umbrella condition. There is no treatment for “Asperger's Syndrome” exactly, but there are for many of the “optional extras” an individual might have, such as depression/anxiety, social anxiety, hyper-focus, OCDs, etc. By this point, the possibility of it is probably something to keep in the back of your mind while dealing with him, but focus more directly on the specific issues.

As far as IQ compensating, I suppose it could. But I know of an ASD person who has an IQ well above average, and while it did provide some compensatory adaptation, it wasn't until a later age. At 15 he was socially fairly inept. As a child he was very noticeably different.

Social abilities among ASD people fall along a range of basic capability and (as stated in preceding posts) an ASD-affected individual may be able to (consciously or unconsciously) adapt their personal behaviour into a personal 'style' that enhances their interpersonal skills to a greater or lesser degree, perhaps even such that they are perceived as 'normal' by most casual observers. Nevertheless, those social issues characteristic to ASDs are still there, although masked.

Your new psychiatrist may say that your son does not have AS.

However, this is irrelevant, unless he is proposing to rediagnose your son (which is unlikely, but which you should strongly resist if suggested).

This perception of your psychiatrist should also not result in treatment that is inappropriate to your son's diagnosis, or which fails to take into account any relevant personal characteristics relating to that diagnosis. If it does, it should result in a formal complaint by you to the relevant body or bodies.

Hopefully, the psychiatrist's remarks were purely personal (and somewhat ignorant) observations, and will be corrected as he becomes professionally-acquainted with your son.

I've learned something on these posts: Listen to Willard. He knows of what he speaks. Your son is an Aspie who simply learned coping mechanisms. His behavior has changed but not his person.

BTW, in my very, very experienced opinion -- having had my brain analyzed to death by psychotherapists -- most of them are full of s**t.

I'd like to echo Willard's sentiment.

I can interact socially rather well in certain situations as I've learned the social skills appropriate to those situations and I can look people in the eye if need be.
I'm told I'm a great conversationalist, and people really seem to enjoy having long conversations with me, at least until we disagree.
I was still diagnosed with asperger's, despite all of that being the case at the time of my diagnosis.
There are aspies, like myself and likely your son, who are highly verbal and talkative, and who enjoy and engage in social interactions when it suits us because we have learned, over time, the particular sets of skills necessary for those interactions in some contexts.

One thing that I think you should consider is that although the DSM & other diagnostic manuals define autism/ASD/AS in terms of them being primarily social disorders in terms of their diagnostic criteria, research into the neuropathology of autism/ASD/AS as well as the reported experiences of autists and aspies suggest that it is, in fact, primarily a sensory processing disorder and should be looked at as well as diagnosed from that perspective.
You can look up something called the 'Intense World Theory' which does a decent job of explaining it (and which many of us came up with on our own based on our own experiences long before ever hearing about it elsewhere), and if you're interested in learning more about it from a scientific perspective I would reccommend the works of Olga Bogdashina.

I'd also like to point out that forcibly separating an autist/aspie from a special interest, i.e. when you took away your son's computer, is exactly the wrong way to get us to engage with the rest of the world and do things outside those interests, and as you've seen will only lead to meltdowns and other severe reactions.
Please don't do that to your son again if at all possible.
The most effective treatment for that sort of thing for people like us tends to be cognitive behavioral therapy (a positive reinforcement based style of therapy) which I would strongly reccommend you look into for your son to help him become more functional.

I sincerely wish both you and your son the best of luck in persevering.
Welcome to Wrong Planet!

I'm going to deviate from the Willard worship, and say that your psychiatrist probably is hesitant for the same reason mine was at the age of 15, and he specialized in Asperger's. When I was 15, my official diagnosis was switched from Asperger's to PDD-NOS because I no longer exhibited many of the classic symptoms, which is probably what's happened with your son. I was told over and over that my social skills were fine, but I didn't believe anyone because I was and still am a perfectionist. So if your son is able to adapt well, good for him. Giving a diagnosis of any kind is very tough. He sounds close enough to Aspergers to be Aspergers.

I'm both gifted & Autistic. I started using Pavlovian triggers to aid social issues starting in the 5th or 6th grade. While I used it primarily for calming (having to write on the board in front of the class, test anxiety, etc.), I was also using it to aid disassociation during physical bullying. I was not cognizant that it was disassociation that I was doing, of course. That realization came in college. All I knew was that I could press one of my trigger points and feel the calm of my hiding spot. My spot was just a water closet next to the bathroom lit only with indirect light where I'd go to be alone.

At one point I heard from a friend in grade school that people hated me because I wouldn't look at them. So I worked to change that, regardless of how annoying/distracting it was to me. I didn't learn the bridge-of-the-nose trick; I really wish that had occurred to me! That was maybe some time in the 6th-7th grade. Well before high school.

The first elective I signed-up for in High School was Psychology in my Junior year. I'd been looking forward to it for two years. I was excited because the Pavlovian stuff had proven so useful that I wanted to see if there was more I could use, and to see if I could figure out why I did stupid things. It was in that class where I learned of Skinner and his work, and started using that to help me sculpt & script a low-rejection social personae. That was a long process. In fact that work is perpetual. I still say stupid and hurtful (blunt) things without thinking sometimes.

For further consideration, I had a core group of friends from the time I was very young, 4 or 5. We all lived within a block of each other. I went to both grade school and high school with most of them. Even they ostracized me from ages 12-16, after which we reconnected. I didn't make new friends during this period, choosing instead to immerse myself in my auto-didactic computer programming. I did not socialize on any level other than casually with anyone outside of my core, neighborhood group of friends. They were the least mean.

All I knew is that people didn't like me, and I was trying to figure out what I was doing wrong and fix it, because it was clearly me who was broken.

Taken all together, it may have looked to the adults around me like I was socially normal. I was not, and I'm still not. At 46 I don't hide in a closet anymore, but the image & calm of the water closet in my childhood home is still my go-to image for "calm/relax."

You have to show most of the traits not all. In my support groups there are usually one or two extraverts

As others have pointed out, the social impairments can vary in intensity. I haven't been diagnosed officially, but I find it difficult to engage others in conversation (especially if I don't know them), I don't make eye contact readily, and I don't always express myself "appropriately." However, I can understand tone of voice and facial expressions and such--things that many with Asperger's have trouble with--and I've learned through observation how I'm supposed to act in certain situations (even though it doesn't always come naturally). It's a wide spectrum, and no two people on it are affected in the same way.

If they're so worthless, how do you know who is and who isn't on the spectrum?

If the person is a short distance away, especially if it's someone giving a lecture, I've learned to look at their shoulder or if they're wearing a tie, at the knot.

A few minutes of looking at their face and eyes is all I can handle.

Thanks for all the help. Despite being able to communicate fairly well, I really do think that he has Asperger's. The anxiety and rigidity in his life are so overwhelming. We can work some on the anxiety with medication, but the rigidity is hard to deal with.

Bodyles, you said that taking away the object of interest is the wrong way to go about things. But what do you do if the child refuses to work under parameters? We have tried for four years, but every year he becomes increasingly more obsessed with it. Last year when he was staying up until 3-4:00 am, there was no way to deal with him. He refused any time limits, refused to let us put parental monitoring software on, etc. As soon as school was done, we took it away from him, which led to depression and a suicide threat.

This fall, we gave it to him again (required by school), but with limitations. Smart kid--broke through all our parental blocks, charged over $600 in one month on videogames. He ended up not going to school, which is where we are now. He has been out for 6 weeks and refuses to go do an online school unless we give him a laptop. He won't work at a desktop at home so that we can monitor him and says that he would rather go to juvenile detention (which he really would do rather than give it up). So how do we deal with him?

And not just the computer, but everything at home. Everything has to go his way or he shuts down. Doesn't throw tantrums, but goes to his room and sleeps, which eventually leads to the severe depression we had this summer.

I am desperate.

I'd call his bluff. Send him to juvenile detention. The experience will be either (a) Boring beyond the power of man to express or (b) Confusing at best and Terrifying at worst, due to some of the other behaviour he may encounter.

And either way, the experience might provide him with an opportunity for a little rethink of how this specific strategy played out for him