A High-Functioning Asperger Child?
We find ourselves in the new age of neurobiology. Understanding the brain and the enormity of neurodivesity has confronted us with the reality (as with most aspects of the biological world) of a continuum perspective and the existence of a variety of manifestations of “classic disorders”. These variations in severity and type represent real and valid distinctions. Rather than cultural inventions, I would suggest that "milder" forms of conditions such as depression, represent meaningful variations which our ever increasing advances in diagnosis and recognition have allowed us to discern.
Autism presents as a textbook example of this continuing differentiation and subsequent recognition of neurodiversity. From the initial documentation of profound “classic” autism by Leo Kanner in 1944, the field of autism has grown to recognize several legitimate and clinically relevant subgroups of this disorder. Asperger syndrome is one such development and it would appear that we may indeed find other variations within the autistic spectrum.
In my work, I have come to recognize several examples of emerging subgroups of Asperger syndrome. One such subset of children represents the socially able or more competent end of this syndrome. They typically can present as charming and pleasing to adults, yet display the typical symptoms of rigidity and preference for sameness. They thrive on adult company and intially seem well emotionally integrated. Yet closer analysis reveals a dependency on adult relationships. Maintaining an almost compensatory “small adult” status forms a central part of their access to the social world. In the peer world however, they are far from integrated and often simply tolerate peer time, waiting for more comfortable situations. These children social deficits typically elude standardized measures of social maturity and represent the high end of the Asperger continuum. Unlike classic AS they possess social strengths that make their social appearance less overtly odd or inappropriate. At the core of this difficulty is a pervasive struggle in understanding social cues and resilient empathic responses.
Characteristics of the High Functioning Asperger Child
Mildly socially odd presentation
Prolific and intense language use
Usually competent and pleasing in adult interactions
General good school abilities (Poss. LD issues, poor reading comprehension)
Intense Interests, especially factual information
Empathic with adults
Evidence of sensory integration problems
Often well-behaved, amiable children
Tendency towards anxious symptoms
Poor peer relational integration, may have one or two similar (interest-based) friends
Within the peer relational context the social disability of these children becomes apparent. Peer interactions are conflicted and sparse irrespective of the efforts of adults. The child typically appears at a loss in social participation. Thus, the diagnosis of this particular subgroup must involve close assessment of the classroom and other social environments where the child’s peer relational competence can be adequately assessed. As previously mentioned, the high functioning aspergian child may elude recognition until later childhood, with social processing deficits seriously impairing transition into mature peer relations and independence.
As with all diagnostic formulations, this scheme is limited to identifying particular aspects of a child’s functioning that may require attention towards facilitating developmental growth.