Adults with Asperger's - The Eyes Have It

Researchers in 1997 (Baren-Cohen) found that adults with Asperger’s have difficulty reading mental states by looking at a person’s eyes – not only the expressions of the eyes, but the location of their gaze. These findings were expanded upon in 2002 (Rutherford), when researchers found that adults with AS have difficulty extrapolating people’s mental states from their vocalizations.

Take just a minute to imagine some of the implications.

• You might miss the message of a potential friend who uses vocal inflection to communicate her irritation with your long story; her social rejection results

• You might not see that the person gazing past you is no longer interested in your words; when he abruptly walks away, you’re left confused and mid-sentence

• You might not notice the heavy-lidded, far-away gaze of your partner, which implies her deep thought; when you interrupt her, her anger seems “out of the blue”

• You might not see the knowing glance between party goers when you introduce a boring topic; when you proceed to elaborate, group members leave

• You might miss the sarcasm of a coworker when he shares that a secret is “common knowledge”; when you mention it to a coworker the next day, you’ve unwittingly committed a serious social blunder

We constantly use our flexible and dynamic ability to read and react to myriad social cues to avoid social disasters. Adults with AS who may not have this luxury are left trying to navigate the social landscape with no real map. The negative reactions, indifference and subtle (or not-so-subtle) rejection they deal with can lead to social anxiety, confusion, avoidance, isolation, even depression.

You can cut some slack for those who struggle to keep up with an ever-changing social context by resisting the urge to expel them from the group. You can resist the urge to mock or embarrass. If you have social gifts, you can share them. Remember, adults with AS are often developing the computer programs you work with and performing the neurosurgery you may benefit from.

The Hidden Social Curriculum

In a very interesting book published in 2004, authors Myles, Trautman and Schelvan propose that some individuals may lack social intuition. The Hidden Curriculum is a brief survey of commonly missed "rules" that can help inform people who struggle to understand social norms.

The authors explain that social intuition, the skill of automatically understanding social rules, "is the lifeline that saves most of us on a daily basis from an array of potentially disastrous social situations."

It seems that neurotypical people, in contrast to those with AS, constantly, instantly and seamlessly survey the unwritten rules in social environments to make decisions about how to proceed successfully within a given context.

Great. For them.

As most readers know, socializing is not so simple for most people with Asperger's. While many people with AS can accomplish this constant surveying, assessing and decision making, it might use up nearly all his or her energy. With no assurance of success! After an exhausting evening of trying to keep up with conversations, mimic others' behavior, and stay off topics like Star Trek, it's no wonder many people with AS end up avoiding the social settings they crave.

According to the authors, and according to most clinicians, social skills are just that - skills. They can be taught, learned, practiced and mastered. Where to start? Let's start with the category of friendship.

Here is some loose paraphrasing of some of the "rules" the authors list. Some of them may sound amusingly obvious; others give the reader pause. See what you think:

• Friendship takes a lot of time to develop. Just because someone has been nice to you once does not mean he or she wants to be your friend.
• You should not have to pay someone to be your friend.
• If someone asks you to hang out, it's probably not a good idea to ask him or her to hang out every day.
• When someone does not want to hang out, don't pressure him or her to hang out - accept the answer and move on.
• Just because someone is very popular, it does not mean that he/she is nice or a good person.
• When you're first getting to know someone, consider doing a structured activity together first, like going to the movies or playing miniature golf. This way, there's a starting and stopping point, and you don't have a lot of time to talk.
• Friends say nice things to each other, not nasty comments like "You are such a loser."
• It's ok to feel mad at your friend sometimes. You can work out your differences and tell your friend why you felt mad.
• Friends forgive each other for mistakes they accidentally make.
• When you have a friend over, follow these steps:

1. Greet him and lead them inside.
2. Offer him a drink.
3. Ask him what he feels like doing. Have two activities in mind
(like video games or a movie)

• Consider following your hobbies to find friends - many adults find friends in book clubs, chess clubs, athletic groups, etc. These groups may be independent of work or school.
• If you're at a friend's house to eat and don't like what's being served, say "Just a little bit, please. I'm not very hungry' instead of "I don't want any - I don't like it
• When hugging a relative of the opposite sex, keep yourself a little separate, and don't hug for too long.
• Spend some time talking about what your friend is interested in. This way, you won't dominate the conversation with your own interests, and your friend will feel included.

If you find yourself faltering, please know you're not alone. And remember that you can master these skills so that people want to be around you. Don't lose hope.

Asperger's and Pinnochio - Wooden Conversations

Did you know that approximately 93% of our communication is nonverbal?

How incredible!

And what bad news for those of us who make little use of paralinguistics - the gesturing, facial expressions, tone modulations and postures which help communicate our message's meaning.

Signs that you may not be infusing your communications with the oopmh! that keeps people interested: when you're speaking people may act bored, look distracted, talk over you, ignore you, or cut the conversation short so they can move on to other, more engaging conversation.

If you notice people reacting to you in these ways, take heart. You can modify how you communicate in ways that change how others perceive you. You can also become aware of signals you give out that can confuse others and cause them to disengage. So start troubleshooting now to avoid conversation that is stiff and wooden. After all, the only one who can get away with wooden conversation is Pinnochio.

How Gestures are Used

Gestures are generally used to either supplement language or to replace language. For instance, if I put my fingers to my lips because I want silence while I finish my phone call, I'm replacing language ("please be quiet") with a gesture. However, if I tell my teammate, "Great game!", and then slap my open, up-facing palm with his (also known as a "high-five"), I've used a gesture to add oomph! to my verbal message.

People use countless gestures to add meaning to their verbal messages in all kinds of settings. Think of the boss who asks where that report is, but pairs the question with a definitive frown: she's just let you know that she's not happy about something - and it probably has to do with the report.

Understanding how gestures play into communication takes practice. If you're speaking to a coworker, who begins tapping his feet and looking around, you'd be wise to understand that he's feeling impatient. Depending on the context, you may want to wrap it up, ask if another time to talk would work better, or remember that he may want a turn in the conversation. This "conversational multitasking" takes cognitive flexibility - and just like stiff muscles, flexibility increases with time and practice.

Posture is an important feature of communication. Many adults with AS struggle with core strength - feeling like Pinnochio with no strings can make it awfully difficult to sit or stand erect. However, slouching can communicate fatigue, boredom and disinterest....often the last messages one wants to send.

Eye contact is another form of communication which falls by the wayside for many with AS. Yet lack of eye contact can communicate disinterest, even disrespect! If you'd like your conversation partner to get the message that you value him or her, are listening and care, the importance of sporadic eye contact cannot be overstated.

Did you know that hygiene also can be considered a form of communication? We actually communicate a great deal to others via our daily cleaning and grooming habits. Ineffective or inconsistent hygiene says much to others about your self-esteem, confidence and intelligence. Hygiene can be considered the foundation for good communication - if it's not there, it's unlikely that the best repertoire of jokes and gestures will get you anywhere.

Avoiding the Wooden Conversation with Improved Paralinguistics

How can one go about increasing the effectiveness of his or her paralinguistics?

Start with the basics. The first thing others notice about us is usually our grooming. Daily showering and teeth brushing, deodorant use and clean, wrinkle-free clothing can do wonders for the impression we send to others. Of course this sounds pretty basic, but it's not for many adults with AS. Why? Often it comes down to sensory overload: the sensitive system can be overloaded by the cold blast of shower water or the pungent taste of peppermint toothpaste. There are so many products on the market to help the individual with sensory issues manage daily tasks which can produce overload: from soft, tagless washcloths to mild, bland toothpastes - why not invest in making hygiene as comfortable as possible? This is the time for action, not shame.

As discussed above, posture says a lot. Remember that posture often communicates mood, intent or attitude. Taking the time to practice and perfect this small aspect of communication is well worth the effort and time. You may catch yourself sagging against walls or shifting and slouching down in your seat. When you do, straighten up. Exercises designed to increase core strength can help immensely. For examples, see the Mayo Clinic's site:http://www.mayoclinic.com/health/core-strength/SM00047

If you struggle making eye contact, try looking at the small space between the eyes of the person you're speaking with. Intersperse this with real eye contact - it will lessen the burden on you while preserving the message that you want to send - that you are actively engaged in the conversation and want to connect with the person you are speaking with. Constant eye contact is not necessary...but intermittent eye contact really is. As with most things, practice helps the behavior become more natural, comfortable and automatic.

Lastly, the smile. So many adults with AS have a standing face that feels neutral to them - but looks angry or bored to others! Don't fall into the habit of the wooden, expressionless face. Smiling briefly takes practice but lets others know you're not just a puppet. People generally respond very well to being smiled at, and smiling can communicate friendliness and openness, which fosters connection.

You can change the way you communicate without changing what you say. Adults with AS often have vastly impressive stores of knowledge and incredibly unique perspectives to share. Don't let a Pinnochio-like presentation prevent friends and coworkers from benefiting from all the richness of what you have to say.
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Asperger's: Are You Thinking What I'm Thinking??

"It just doesn't FEEL like you GET how I'm feeling..."

Have you ever heard this from a loved one?

Adults with Asperger's in relationships often hear similar complaints from their partners. Yet highly intelligent Aspies often find ways around this effect in work and other settings. What is it about intimate relationships which magnifies this effect, and what can Aspies do about it?

Adults with Asperger Syndrome are well known to have challenges with social interaction. Often, even long after the obvious signs of these challenges are gone, the adult Aspie often continues to "feel different". But they may be missing their own successes by focusing on the differences, rather than the similarities, between theirs and the social interaction outcomes of NTs.

It's often thought that these typical "social deficit symptoms" stem from so-called "mind-blindness" -- an inability to express a "theory of mind", or to grasp what other people may be thinking, feeling and intending. Yet did you know that adults with Asperger's, who are often highly intelligent, routinely pass tests designed to evaluate theory of mind?

In 2009 a team led by Uta Frith, of University College, London, and Atsushi Senju, of Birkbeck College, London, tracked the eyes of people with Asperger's while they took part in a standard test of theory of mind. The results were surprising.

The test, known as the Sally-Anne False Belief Task, works like this:

One character, Sally, places a marble in a basket and leaves the room. In her absence, another character, Anne, moves the marble to a box. When Sally returns, children are asked where she will look for her marble. If children understand that Sally's actions will be based on what she believes to be true, rather than the actual state of affairs, they should answer that she will look in the basket, rather than the box. This correct answer requires the child to predict Sally's behavior based on her now false belief.

Neurotypical children aged 4, and children with Down's syndrome, pass this test, while children and adults with autism spectrum disorders generally do not. Adults with Asperger's pass it -- but Professor Frith's study shows that their success may be due to a very different mechanism.

The team asked adults with Asperger's, and neurotypical (NT) adults, to take the Sally-Anne task while their eye movements were tracked. Both groups got the task right when assessed verbally, but their eye movements told a different story.

The NTadults generally took their first glance towards the correct place -- the basket where Sally thinks her marble is -- in anticipation that that is where she will look. However, members of the Asperger's group looked equally often at both the box and the basket before making their choice. They did not seem to have a spontaneous understanding of the right answer -- the direction of their first glance was a matter of chance.

The implications of this are fascinating. It may be that people with Asperger's do have difficulties with theory of mind: unlike those with NT brains, they lack the ability to jump straight to the right decision, almost as a matter of instinct. What they seem to do instead is to work out other people's beliefs and intentions by means of logical reasoning.

The finding is also encouraging news for therapy. Theory of mind in itself, it seems, can be learned. That is, the same results can be attained via "intuition" AND logic.

Adults with Asperger's may arrive at social conclusions via logic, but feel exhausted after their success. It may be true that social interactions never do take on the intuitive, fluid quality many adults enjoy when communicating.

Perhaps when it comes to the social interactions of adults with Asperger's the most important part may not be the means, it may be the end itself. If you have Asperger's, you may benefit from focusing less on how you operate differently, and more on the results you achieve or want to achieve.

Chances are you're not coming across as poorly as you think.

Mobile Electronics: Do they Help or Hinder the Aspie?

When I ride the bus I am struck with just how different the riders look from how they might have looked just ten years ago.

Of course I am not the first to notice that people are largely in their own bubbles - ears occupied by headphones, eyes occupied by screen. The chit chat, the shared human experience of bus-riding - that awareness of being part of a group of human beings engaging in the activity of travel via public transportation - has changed.

Critics call this dependence on electronics dangerous. Electronics usage, largely a solitary activity (at least in the physical sense), prevents people from connecting with others, and increases isolation, which can be damaging for people who already struggle with socializing. Penelope Trunk writes in the March 19, 2006, Boston Globe,“The human moment is a quality of interaction you don’t get from computers, or even the phone.”

But defenders of technology assert that the people who use technology while in group settings are often the very individuals who would have avoided socializing anyway. Technology, they propose, just gives them a comfortable way to avoid it.

But is it too comfortable?

The issue may not be black and white, however, at least for Aspies. Exposure Therapy, a form of cognitive-behavioral therapy, is a well-researched avenue for facing and overcoming sources of anxiety, such as simple phobias. The therapy involves the creation of a program of steadily escalating steps or challenges, which work towards a final goal of reduced or eliminated anxiety responses. Reducing interactions with others to near zero may prevent Aspies from receiving the very therapy that might reduce discomfort in social situations: real-time interactions with others, with their messy outcomes and unpredictable paths.

Yes Aspies themselves often report reduced anxiety in groups when able to rely, at least partially, on technology. "My iPod had become a security blanket," says one client with Asperger's, "without it I found the bus intolerable, and wouldn't even board before the headphones were in." Yet this very client benefited greatly from a self-imposed regiment of practiced, brief "chit-chat sessions" with riders. They key to his success may have been selective use of his electronic gadget in social settings, such that its function was not total escape, but a support gadget of sorts. After adopting a more balanced understanding of how to use his gadget for anxiety modulation, rather than total prevention, he was able to increase social interactions, lower their associated anxiety and gain a sense of mastery over a previously fear-laden situation: group transportation.

For Aspies, technology may work best as an adjunct to socializing, rather than a substitute. Awareness and self-monitoring are key to the success of the Aspie who aims to lower social anxiety and reduce reliance on mobile electronics. Aspies, like all, largely require both solitary and group connection. After asking teens about this very issue, Neal Starkman of The Journal writes in his March 1, 2007 article on communication and technology, "From their responses, it seems that young people want technology because it secures two basic needs that, seemingly contradictory, are crucial to their well-being: to be left alone, and to connect with others."

If you have Asperger's and and iPod, you may want to push yourself to interact when you can....for some, it may be the only way to ride the bus comfortably. For information on cognitive behavioral techniques and Asperger's visit www.terratherapy.org or http://www.nacbt.org/whatiscbt.htm

Aspies are Robots: Stereotypes that Hurt

Back in 2006, researcher teams in the USA and Germany teamed up to assess empathy in adults with Asperger's. Their findings were published in the Journal of Autism and Developmental Disorders. The results were deemed surprising by many in the field at the time. Why? Because they contradicted many widely held beliefs about people on the spectrum, who are often described as "robotic" and "incapable of empathy". "They just can't read between the lines!" is a common complaint regarding Aspie adults.

Consider, however, the abstract below:

Who Cares? Revisiting Empathy in Asperger Syndrome

A deficit in empathy has consistently been cited as a central characteristic of Asperger syndrome (AS), but previous research on adults has predominantly focused on cognitive empathy, effectively ignoring the role of affective empathy. We administered the Interpersonal Reactivity Index (IRI), a multi-dimensional measure of empathy, and the Strange Stories test to 21 adults with AS and 21 matched controls. Our data show that while the AS group scored lower on the measures of cognitive empathy and theory of mind, they were no different from controls on one affective empathy scale of the IRI (empathic concern), and scored higher than controls on the other (personal distress). Therefore, we propose that the issue of empathy in AS should be revisited.

Authors:
(1) Millhauser Laboratories (MHL-400), Center for Brain Health, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA
(2) Institute of Experimental Psychology, University of Dusseldorf, Dusseldorf, Germany
(3) Nathan Kline Institute, Orangeburg, NY, USA

This research is contrary to most stereotypical versions of the Aspie as cold-hearted and uninterested in the feelings of others. So why does the common stereotype persist? Perhaps it is easy to miss empathy which is heartfelt, but not explicitly expressed. Perhaps, in this case, the burden is on the typical partner, friend or loved one to do the reading between the lines.