An Overview Of Asperger Syndrome

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Some current issues in Asperger syndrome: a presentation originally given to the most recent (2009) Brookdale care conference

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An Overview Of Asperger Syndrome

  1. 1. Overview Autism spectrum disorder: a lifespan perspective To be published, Jessica Kingsley, 2010 Can the world afford autistic spectrum disorder? Published Jessica Kingsley, 2009 www. dilemmas.org Digby Tantam, Universities of Cambridge and Sheffield Dilemma Consultancy
  2. 2. Theme analysis of 5 websites of people with AS/ HFA •  sense of alienation •  sense of frustration •  depression as a central emotion •  a pervasive sense of fear or apprehension
  3. 3. Green et al compared 20 adolescent men with AS with 20 with conduct problems •  AS group •  Severely impaired practical social functioning •  Anxiety •  Obsessional disorders •  Both groups had •  Depression •  Suicidal ideation •  Tempers and defiance
  4. 4. Outstanding areas for concern: Sheffield survey •  Reduction of available support in adulthood •  Lack of paid work (36%, 6% of whom supported) •  Lack of independence •  60% living with parents •  21% living independently •  56% thought they could be more independent with support •  Victimization 90% said they had been bullied Brookdale care conference, London
  5. 5. Emotional problems in adolescents and adults with Asperger syndrome (findings from Sheffield survey) •  Self-harm: thoughts 50%, actual 11% •  Violence: threats 83%, actual 34% •  Bullied 90%, 30% currently (includes adults) •  Majority have anxiety-related disorder
  6. 6. Themes in adulthood Ryan, S, Räisänen, U "It's like you are just a spectator in this thing": Experiencing social life the [`]aspie' way. Emotion, Space and Society 2008; 1: 135-43. •  feeling different •  trying to fit in •  safe spaces •  uncommon sense
  7. 7. Contributors •  Sheffield survey •  Myles Balfe •  Ting Chen 24 November 2009 •  Mike Campbell •  Bullying project •  submitted to Autism •  Paul Naylor •  Jenny Wainscot Parents, teachers, and people •  Jenna Williams with Asperger syndrome •  15 medical students Sheffield Asperger Parents •  International Journal of Action Group Psychology Brookdale care conference, London
  8. 8. An artefact of ascertainment? CHANGING PREVALENCE OF ASD
  9. 9. From Bandolier
  10. 10. Data from the US National Survey of Children’s Health (from www.leftbrainrightbrain.co.uk)
  11. 11. Rising prevalence •  Kaye,J.A., del Mar,M., & Jick,H. (2001) Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. BMJ, 322, 460-463. •  Prevalence rate in children probably 1 in 150 2009 November 24 Brookdale care conference, London
  12. 12. Brookdale care conference, London
  13. 13. MMR vaccination has not caused ASD— in fact there is no known cause for most causes, although genes must play a part •  The risk of autism was similar in vaccinated and unvaccinated children •  Onset did not occur soon after vaccination •  There is no sub-type of ASD that could be attributed to MMR vaccination •  Madsen, KM, Hviid, A, Vestergaard, M, Schendel, D, Wohlfahrt, J, Thorsen, P, Olsen, J, Melbye, M A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism. N Engl J Med 2002; 347: 1477-82.
  14. 14. Being disconnected from the interbrain FEELING DIFFERENT
  15. 15. Hunyuan hanging temple, Mt. Hengshan, Shanxi
  16. 16. The interbrain   Extended cognition   Automatic processing Jerry Ryan, 7 of 9 StarTrek   Reflexive vs. reflective processing   ‘The borg’ Neurotypical Aspie Brookdale care conference, London
  17. 17. Is it better not to connected to the interbrain? •  Fewer informational viruses •  Understand machines in their own right not as defective people •  Fairness is not prejudiced by sympathy •  Not in chains
  18. 18. “l’homme est né libre, et partout il est dans les fers. J.-J. Rousseau 2009 November 24 Brookdale care conference, London
  19. 19. Many other educational obstacles, plus emotional difficulties TRYING TO FIT IN Brookdale care conference, London
  20. 20. •  Dysexecutive syndrome Associated (planning) developmental disorders •  Dyslexia (writing and spelling) Predominantly •  Dyspraxia (coordination) with fronto-striatal or typical AS fronto-cerebellar •  Attention deficit/ hyperactivity disorder (impulsivity, executive functions, task persistence) •  Also links with •  Tourette syndrome •  Expressive dysphasia (may lead to elective mutism) •  Dysgraphia •  Dyscalculia •  Topographical disorientation Brookdale care conference, London
  21. 21. Atypical Asperger syndrome •  Primary abnormality is lack of empathy, partly due to failure of non-verbal interpretation (‘face blindness’) •  Ability to make relationships but not to keep them •  Lack of empathy may lead to antisocial behaviour, but greater problem is lack of persuasiveness and ‘social influencing power’ 2009 November 24 Picture on left from Pelphrey et al, 2002 and on right from the film, “Ripley’s game” starring Matt Damon as Ripley Brookdale care conference, London
  22. 22. Knowing about the world using non-verbal cues Who is being shot? Terrorists or partisans? 2009 November 24 Brookdale care conference, London
  23. 23. Associated psychiatric disorders (213 adults with HFA/ AS in personal clinic series) Schizophrenia 0.5% Cycloid psychoses Depression 17.8% Mania 1.4% Anxiety 43.2% OCD 7.8% Substance abuse 6.6% Brookdale care conference, London
  24. 24. Timing of psychological disorders associated with AS (many of these disorders probably greater in more able group) •  Aet 11-13 Surge of anxiety-related problems including OCD, dysmorphophobia, panic disorder •  Aet 16-18 Secondary depression, social phobia •  Aet >16 •  Progressive social withdrawal often attributed to schizophrenia •  Late adolescence bipolar disorder •  Brief ‘cycloid’ psychoses •  Non-psychotic hallucinoses •  Aet >18 ‘Catatonia’ •  Aet >25 Paranoid states •  Aet >35 Social withdrawal, isolation, relationship disrepair 24 November 2009 Brookdale care conference, London
  25. 25. Bullying and exclusion at and from school begin a process of narrowing the number of safe spaces SAFE SPACES
  26. 26. Consequences of bullying •  Passive failure to be included •  Reduced use of community resources (social exclusion) •  Experience of being unwanted/marginalized •  Active rejection , blaming, scapegoating Painted Bird by Edward •  Stigma as a means of Gafford, inspired by the keeping threatening novel ‘Painted Bird’ by Jerzy Kosińsk , itself Other at a distance based on what has been •  Bullying claimed is a fictive war- time experience of the author in Poland
  27. 27. Who bullies and why? Evidence is limited, but •  On behalf of a social group •  Bullies are highly regarded, but not popular •  Bullies’ in-group status may be tenuous •  Victims are different •  Victims may be more aggressive than non-victims, and are perceived, perhaps as more threatening Brookdale care conference, London
  28. 28. •  A particularly wide ranging tool kit •  Readiness to consider the most intense emotional issues and in the next moment, the most practical and cognitive ones •  Having a clear grasp of the The limitless potential of social control by shaming individual in front of you, not just in life experience, or temperament, but in cognitive abilities •  Be aware of shame and shaming Brookdale care conference, London
  29. 29. Does social exclusion lead to functional movement impairment Is there a difference in the amount of physical activity of pupils with AS compared to others? •  Mean number of steps per hour: AS group = 902, control group = 1312 (t = -2.645, p = .027) Brookdale care conference, London
  30. 30. Table 2 How many people in your class do you: speak to, not like, and think not like you? (AS/HFA n = 25; /HFA n = 22) How many people do you speak to in your class? Everyone Most People Few People None AS/HFA 2 6 15 2 No AS/HFA 6 12 4 0 How many people do you not like in your class? Everyone Most People Few People None AS/HFA 0 6 13 6 No AS/HFA 0 3 12 7 Do you think there are any people in your class who do not like you? Everyone Most People Few People None AS/HFA 1 5 16 1 No AS/HFA 0 2 11 9 24 November 2009 Brookdale care conference, London
  31. 31. 24 November 2009 Brookdale care conference, London
  32. 32. Where were people with AS in Sheffield? •  Most living at home, even above 30. •  Most had difficulties coping with changes in everyday environments •  Difficulties moving between places (for example using public transport) •  Most common places frequented were libraries and cinemas Brookdale care conference, London
  33. 33. Is the person with AS king of the cyber world? UNCOMMON SENSE
  34. 34. Is Asperger syndrome the future? Owen Thor Walker apointed to TelstraClear, who previously wrote code enabling a hacker group to steal £13.9M from bank accounts Bram Cohen, founder BitTorrent, and self diagnosed Aspie
  35. 35. •  THE END

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