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Aspergers and Lack of Empathy

Aspergers is an autism spectrum disorder (ASD), and is now referred to as "high-functioning autism" in the U.S. It is distinguished by a pattern of symptoms rather than a single symptom, and is characterized by (a) qualitative impairment in social interaction, (b) stereotyped and restricted patterns of behavior, activities and interests, and (c) no clinically significant delay in cognitive development or general delay in language. Intense preoccupation with a narrow subject, one-sided verbosity, restricted prosody, and physical clumsiness are typical of the condition, but are not required for diagnosis.

The lack of demonstrated empathy is possibly the most dysfunctional aspect of Aspergers. People with Aspergers experience difficulties in basic elements of social interaction, which may include a failure to develop friendships or to seek shared enjoyments or achievements with others, a lack of social or emotional reciprocity, and impaired nonverbal behaviors in areas such as eye contact, facial expression, posture, and gesture.

A mother of an Aspergers child tells her story of a son who seemed to lack empathy:

“The realization that my child was lacking the feeling of empathy gradually came to me when he was between the ages of 2 and 4. I had a vague idea someplace in the back of my mind that a part of my child's difficulties with coping in the world around him had something to do with the reality that he did not seem to really feel his emotions apart from experiencing anger and sadness. Even if I said that he was happy, he could not agree with me proclaiming that just because he was poking fun at something did not mean that he was happy. 

As a young child, he totally couldn't cope with his 8 month old sibling crying whenever he fell down, bumped his head or pinched a finger. My child asked the most perplexing questions like "why is that baby shouting?" …"why is he doing that?" …and, my personal favorite …"can't we take that loud baby back to the store and get a new one?" I patiently spelled out many times that after an infant injures himself, he or she whines until the discomfort stops but my child continued to be convinced that this infant made that racket simply to irritate him.

When my child was 4, it started to be clear to me that he was not able to empathize. I had come down with an especially awful flu virus and passed out on the family room floor in the center of a game that I was playing with the children. When I came to, my younger child was patting my cheek and saying "Mommy, what's wrong?", while my older child had a meltdown because I had stopped playing! Actually, after my hubby raced me to the hospital, children in tow, my Aspergers child continued to be upset with me for interrupting "his" game. 

Soon after that, I had a summary of feelings stuck on the refrigerator in big letters and spent part of everyday hoping to get him to comprehend his emotions and the emotions of other people. He came to hate the "face game" when I put a collection of catalogues in front of him and asked him to cut out all of the faces that matched up the list of feelings. Since I did not know back then that he had Aspergers, I'm not completely sure I approached this issue in the best way. 

As he grew older and began school, we experimented with numerous discussions around the issue of emotions, how they may control us, or we can control them. We talked about how to be warm and friendly to other children, how they would feel if he treated them all like insects, and how to recognize his own emotions. Honestly, I don't know that we really succeeded in this area. I believe he has learned not to say what he truly believes in certain circumstances due to parental disapproval. It is really an issue that we will most likely focus on for a long time.”

Aspergers individuals have difficult reading body language (i.e., non-verbal communication). This reduced ability to read body language means less displays of empathy; however, in this case, "empathy" is used in the sense of mimicry of emotions.

There is a natural tendency of people to mimic others in their behavior. So if one person laughs, it is more likely that other people within earshot will laugh too. The same occurs with sadness. Empathy comes to play because sadness is not just tears but an entire set of circumstances.

So what happens is that the Aspergers individual is seen as responding inappropriately to other’s emotions. That's because he/she is not connecting through body language. So in a very real sense, the person with Aspergers is less empathetic. One would not expect an Aspie to respond to body language just as you would not expect a deaf person to respond to your voice.

Does this mean that people with Aspergers have no feelings? No. In the commonly understood sense, Aspies have feelings like anyone else. If you don't know about an event, you have no feelings about it. So to use a rather strange example here, you would have no worries about running over an invisible man. There are people and events we know about only by reading about them or by hearing the stories. Just like people without Aspergers, Aspies have empathy with people they read about.

Many people with Aspergers have the ability to feel empathy (some more so than others, some maybe not so much). Aspergers is not the same for each and every person who has it. However, the blanket statement that people with Aspergers lack empathy is not all that accurate. It is a statement without explanation –a statement, black-and-white as it is, that doesn’t take into account each person’s individuality, and the reality that others can feel more than you can know. This is especially true when much that can be felt by those with Aspergers is not met with the same need for expression as it is for those without Aspergers.

A groundbreaking study suggests people with Aspergers do not lack empathy – rather, they feel other’s emotions too intensely to cope. Thus, the “lack of empathy issue” may have more to do with “sensitivity to stimuli” than an inability to put oneself in someone else’s shoes.


More resources for parents of children and teens with Asperger's and High-Functioning Autism:

Aspergers: Inaccurate Stereotyping

"Is it fair to say that some people unfairly stereotype children and teenagers who have an autism spectrum disorder? It seems to me that society views this population as "trouble-makers" or mentally handicapped - and even dangerous (e.g., they get blamed for some school shootings), which is just plain ignorant in my opinion. What's your opinion please?"

Click here for my response...

Helping Aspergers and HFA Children with Homework

Aspergers and High-Functioning Autistic (HFA) children may have a hard time staying focused on their assignments long enough to complete them.

They are highly intelligent and very creative individuals; however, they may have coexisting conditions such as ADHD or NVLD (Non-Verbal Learning Disability) that affect their ability to process information. As a result, moms and dads may need to assist with homework tasks to ensure they are completed on time.

Here are some tips for parents who want to help their child with homework:

1. As he advances through school, the homework will become more complex with projects that cannot be finished in one night. Help him break these projects into steps and write out a schedule for completion. Post the schedule where he can read it and check off each step as it is completed.

2. Create a space free from the distractions of television, toys and siblings.

3. Enforce a regular schedule for finishing homework to create a sense of structure.

4. Help him organize his schoolwork by using colored folders and notebooks. Encourage him to choose a color he associates with a specific subject, such as green for science or red for reading.

5. If homework involves assignments from more than one subject, consider taking a short break in between each subject. Use a timer with a loud ringer to indicate when the break is finished.

6. Maintain a presence in the area when he is working in order to be available to answer questions or gently remind him to stay on task.

7. Make sure all of the items needed for assignments are available in one spot. When supplies are centralized and organized, he will not need to get up to look for things.

8. Provide a planner to record assignments each day. Communicate with his teacher to ensure that assignments are recorded accurately in the planner and work is being turned in.

9. Teach him to pack his backpack the night before so everything is ready before the morning rush to school and no homework is left at home.

Preventing Homework-related Meltdowns—

There are some basic strategies that moms and dads can employ to help prevent those dreaded evening meltdowns. The first step is to observe the youngster and see what hinders him from completing his work. This is paramount to planning homework sessions. During these observations, jot down answers to the following about your son/daughter:

1. Does he fatigue quickly?
2. Is he easily distracted by noise or activity?
3. What frustrates or upsets him?
4. What is his best time of day?

• Break Down Large Assignments— Some homework assignments can be overwhelming for children on the autism spectrum. Moms and dads will sometimes need to work closely with their child to help him get started. Providing one or two examples may be all that is required in some instances. For more complicated work, parents may want to demonstrate how to break it down into smaller steps. This added attention may be needed for each unfamiliar assignment.

• Eliminate Vagueness— Sometimes assignments may be unclear, even to moms and dads. If this happens often, it would be best for parents to communicate with the teacher about their kid’s needs. Receiving more detailed instructions for upcoming assignments will go a long way to ensuring that homework gets done correctly and without tantrums. The key is to get the information ahead of time so that the youngster can be prepared, not surprised with an unknown.

• Establish Consistent Time and Place— After observing the youngster for a few days, establish a consistent time for homework, preferably when he is well fed and at his best. The amount of time he spends on homework nightly will vary by grade level. When homework length begins to increase, he may stay more focused with short breaks. Incorporate these into the schedule and make sure he has enough time to complete assignments without rushing. It is beneficial to have a special homework location away from the TV, radio, or other distractions. Aspergers and HFA kids can also be frustrated by clutter, so make sure that the workspace is organized and that all necessary materials for homework are available and easy to find.

• Incorporate Interests— A unique quality of kids on the spectrum is that they can develop abnormally intense interests in one or two subjects. Common ones may include weather, sports statistics, or computers. Using a little ingenuity, moms and dads can persuade the youngster to do seemingly unrelated work by integrating his interests. Kids fascinated by computers may be encouraged to complete writing assignments using an online dictionary, for instance. Kids who have nightly reading requirements could be allowed to choose books that are related to weather, dinosaurs, or other science topics of interest. If the youngster seems to dislike math, create word problems for practicing addition, subtraction, and multiplication using subjects such as baseball or cars.

Homework can be much easier for "special needs" children when they are offered structured and daily routines. Moms and dads can also work with teachers to clarify new or complex assignments.

Aspergers and HFA kids possess unique skills and can grow to be highly productive, thriving members of society. But, like everyone, they face their own set of challenges along the way. Homework may be one of those challenges. With careful planning however, moms and dads can make this necessary and important chore less worrisome and help to pave their youngster’s way to success.

==> How to Prevent Meltdowns and Home and School

Is there a connection between Aspergers and homosexuality?

Currently, there is no known link between Aspergers and homosexuality that research has been able to determine. However, there is a growing body of subjective evidence that Aspergers adults are more likely than those without Aspergers to self-identify with sexualities other than heterosexuality (e.g., asexuality, pansexuality, polysexuality, bisexuality).

Some research suggests that male homosexuality is inherited and caused by a lack of testosterone in the mother's blood during pregnancy (or an excess of it if the baby is female). Since it is easier for a woman to lack testosterone (the male hormone only found in low levels in females), this could explain the higher incidence of homosexuality among men than women.

Aspergers has many possible causes, and similar to homosexuality, there is a hereditary factor with the influence of testosterone on the fetus possibly being the most important factor. The incidence of Aspergers is also much greater among males, but unlike male homosexuality, it is allegedly not caused by a lack of testosterone – but an excess of it.

Researchers have discovered a link between high levels of testosterone in babies still in the womb and Aspergers traits in children. Babies exposed to high levels of testosterone in the womb appear to be at greater risk for autistic characteristics. While researchers are careful to note that although they cannot prove testosterone exposure in the womb causes Aspergers, they strongly believe it may one day be implicated as one of the main factors related to this disorder. Children with Aspergers do seem to have an exaggeration of the typical male profile because they have a very strong interest in systems, like numbers, but have difficulties with empathy.

In could be said that, whereas a male homosexual's brain is too feminine due to a lack of testosterone during its formation, an autistic's brain is too masculine – even for a man. Thus, if there is a link between Aspergers and sexuality-preference, the link would most likely NOT be homosexual.

Most people with Aspergers are heterosexual, but many do not get married. Similarly, a gay male with Aspergers is likely never to have a long standing domestic partnership (let alone a “marriage”). 

The Aspergers Comprehensive Handbook
 
COMMENTS:

•    Anonymous said… Although I consider myself heterosexual I see people as people not necessarily genders so I wouldn't rule out a homosexual relationship if the person made me happy, I was attracted and it felt right. I'm now living with my long term partner and hope this lasts but I do think it's possible that people on the spectrum like myself just see people as people x
•    Anonymous said… Complete non sense
•    Anonymous said… I agree with you guys...my child told me many times that gender isn't an issue. I'm at a stage that as long as my child is happy, I'm also happy.
•    Anonymous said… I have more of an interest in aspie children who are gender questioning because there appears to be a high percentage. I woulder f this is because
•    Anonymous said… I heard there's a connection between Aspies and twins
•    Anonymous said… I think it's the confusion in social situations that may cause people with aspergers to choose a same sex partner...getting put off, not understanding, awkwardness towards opposite sex
•    Anonymous said… If anything my son is too interested in the opposite sex for his age...
•    Anonymous said… Interesting. One of our observations as parents has been the blindness to society's taboo subjects - so open (often intense) curiosity about subjects many people never question themselves about.
•    Anonymous said… Is because of the black and white way our children see things and so feel that whatever way they feel they should just be accepted.
•    Anonymous said… Mine has always been interested in girls.....I mean always!!! He finds them all attractive. I don't know what's more worrying lol x
•    Anonymous said… Mine is in the early teen years and says he can tell when someone is attractive. He also says he is not interested in either gender. I've read this is also common in Aspies . He recognizes himself as an Asexual
•    Anonymous said… My son says all girls are beautiful but still makes sexual remarks about boys, I just see it as "it is what it is"
•    Anonymous said… My son sees no difference in gender. I think as he gets older it will be completely individual who he falls in love with. I don't believe he will look for a girlfriend in particular.
•    Anonymous said… My undergraduate thesis was related to this topic and I presented at IMFAR on it in 2012. Email me at llgilmou@ualberta.ca for a copy of the article by Gilmour, Schalomon, and Smith (2012).
•    Anonymous said… No, not really!
•    Anonymous said… Only so far as Aspies get called 'gay' at school.
•    Anonymous said… PS, I'm 70 and still suffer from it.
•    Anonymous said… So the way I live my life is seriously uncommon and not expexted? Gay marriage, almost 10 yrs relationship, with Asperger... Well tell me something new smile emoticon
•    Anonymous said… There's a definite link between Aspergers and loving people for who they are, rather than their genitalia.
•    Anonymous said… Well I'm Gay and have Aspergers and did all my life. I think it's tougher on Gays since we have much less support especially when I was growing up.
•    Anonymous said… YES, there definitely is!! These are two things which happen to human beings! Connection identified, next subject please.

Post your comment below…

Evaluating Clients for Aspergers: Advice for Therapists

Question

I am a family therapist for the Anderson Center of Saint John’s. A client of mine recently reported a childhood history of difficulty learning social rules, learning problems, and rocking behaviors, which he learned to stop. He also reports social difficulties as a young adult. What is the easiest method to evaluate him to rule out Aspergers?

Answer

Aspergers (AS) can be quite difficult to diagnose. Individuals with this condition can function relatively well in daily life; however, they are generally socially immature and may be perceived as strange or eccentric.

While the more overt symptoms of Aspergers are typically more apparent in early childhood, symptoms may only become apparent with the increasing functional and social demands of adolescence. In the teenager with Aspergers, the stress of unrecognized disability, limited achievement, and a sense of failure are often revealed by increasing contrast with siblings and peers. Family and peers may become exasperated by the individual's self-centered insensitivity, obsessiveness, and rigid inflexibility, further distorting personal relationships. Each one of these variables can add secondary disability and lead to dependency that is disproportionate to the individual's mental ability.

Grown-ups with Aspergers present with subtle and specific difficulties, particularly in communication, social interactions, and interests. However, not all individuals are affected as extremely as noted below:

• Social relationships: Relationships are one-sided, distant, or absent. An unempathic objectivity leads to difficulties ranging from understanding friendship (how friends differ from acquaintances) to developing sexual relationships (grasping rules that distinguish seduction from date rape). People with Aspergers misunderstand relationships and are either too intense or too detached.

• Interests: At the most extreme, an individual with Aspergers has an eccentric life with rigid routines and a systematic, narrow focus on activities such as stamp collecting, baseball statistics, or railway timetables. Interests remain circumscribed and, rather than being an avenue for social interaction, they are enjoyed in solitude.

• Communication: Conversation is often one-sided, long-winded, circumstantial, lecture-like, and delivered in a robotic fashion. Less obvious abnormalities include unrecognized, underlying discrepancies between verbal and nonverbal language and between comprehension and expression. Individuals may lack eye contact, have few facial expressions and awkward body movements, and they may eventually develop social anxiety and nervous tics.

Grown-ups with Aspergers may also have problems with future planning and organization. Some compensate for this by being extremely meticulous in their planning and keeping extensive written or mental checklists. Other possible symptoms include hypersensitivity to sensory stimuli, violent outbursts, self-injurious behavior, rituals, odd posturing, and hand flapping.

When evaluating an individual for possible Aspergers, therapists can adhere to these guidelines…

Setting:

• Waiting causes increased stress levels. Whenever possible, schedule clients for Aspergers assessment as the first or last appointment of the day. If this is not possible, allow them to wait in a small side room or in their car, or allow them to go home and come back at a later agreed time.

• Prevent other sensory overload by minimizing loud noises and high-pitched sounds.

• Be aware that hand flapping, rocking, or ear covering may be their calming mechanism, so do not stop the behavior unless absolutely necessary.

• Avoid bright lighting. Some individuals with Aspergers are very light sensitive and can even detect the flashing of fluorescent lights.

Interview:

• Allow the individual extra time to process what you say to them.

• Ask for the information that you need, because an individual with Aspergers may not volunteer vital information without being asked directly, and because they may expect you to know what they are thinking.

• Avoid using facial expressions, body language, or gestures without verbal instructions, as these may be misunderstood.

• Explain what you are going to do before you do it, and use pictures when possible.

• Individuals with Aspergers do not understand personal space. Thus, they require more personal space than the average individual, or they may invade your space.

• Individuals with Aspergers take everything literally, so be concrete and avoid the use of idioms, irony, metaphors, and words with double meanings.

• Realize that the individual may not make eye contact during the interview, and do not assume that a nonverbal individual does not understand what you are saying.

• Use clear, simple language and speak in short sentences.

Physical Assessment:

• If performing something intrusive, such as phlebotomy, realize that individuals with Aspergers may have high or low pain tolerance or an unusual response to pain, such as laughter, humming, singing, or clothing removal. Use local anesthetics whenever possible.

• Give direct requests. Say, "Open your mouth." Don't say, "Can you open your mouth?" With the latter question, they may not understand that you are actually asking them to do something.

• Exams may prove very stressful, so warn the individual before touching him/her.

Therapists may choose to utilize an assessment tool to identify Aspergers. One that is easily available is the Adult Asperger Assessment (AAA), developed at the Aspergers Research Center (ARC), situated within the School of Clinical Medicine in the Department of Psychiatry, Section of Developmental Psychiatry, at the University of Cambridge, United Kingdom. Other diagnostic rating scales can be found at Online Asperger Syndrome Information & Support (OASIS).

Because individuals with Aspergers may misperceive their situation, it really is helpful to complete the assessment with data from others, such as spouses, buddies, teachers, and employers. Additionally it is advisable to give the individual with Aspergers an itemized report of the assessment to avoid misunderstandings that may arise from spoken communication.

Differential Diagnoses:

The the signs of Aspergers imitate other disorders; therefore, therapists must become familiar with the most probable differential diagnoses:

• ADHD is characterized by impaired functioning in multiple settings, including home and school, and in relationships with peers. Symptoms include impulsiveness, hyperactivity, and inattention.

• Antisocial PD is characterized by a pattern of disregard for other individual's rights, often crossing the line and violating those rights.

• Catatonic schizophrenia is characterized by prominent psychomotor disturbances that may alternate between extremes such as hyperkinesis and stupor.

• Generalized anxiety disorder is characterized by constant, exaggerated worrisome thoughts and tension about everyday routine life events and activities for a period of at least 6 months.

• Obsessive-compulsive PD is characterized by a preoccupation with orderliness, perfectionism, and control at the expense of flexibility, openness, and efficiency.

• Panic disorder is characterized by repeated episodes of intense fear that strike often and without warning. Physical symptoms include chest pain, heart palpitations, shortness of breath, dizziness, abdominal distress, feelings of unreality, and fear of dying.

• Paranoid schizophrenia is characterized by relatively stable and often paranoid delusions, usually accompanied by auditory hallucinations.

• Personality disorders (PD): Avoidant PD is characterized by a persistent and complex pattern of feelings of inadequacy, extreme sensitivity to what other individuals think about them, and social inhibition.

• Schizoid PD is characterized by a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings.

• Selective mutism is characterized by the persistent lack of speech in at least 1 social situation, despite the ability to speak in other situations.

• Simple schizophrenia (especially treatment-resistant) is characterized by an insidious but progressive development of oddities of conduct, inability to meet the demands of society, and a decline in total performance.

• Social phobia is characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations.

Aspergers is tough to diagnose, and the diagnosis ought to be confirmed by a mental health professional well versed in the diagnosis and treatment of Aspergers. However, a definitive diagnosis can be quite a relief because it allows individuals to learn about their condition, understand where and why they have difficulties, and obtain suitable support.

The Aspergers Comprehensive Handbook

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