In this empowering lecture, Professor Tony Attwood discusses defining characteristics of ‘Aspies’ – people with Asperger’s Syndrome – how these change from early childhood to adulthood & vary by gender.

Lecture Transcript

[00:00:00] Prof Tony Atwood: We’re going to focus on Asperger’s syndrome. It’s a way a trendy term. And we now know that autism spectrum disorders and Asperger’s is a part of that affects one in 68 children. So if you’re at a school divide, the number of children registered there by 68, we’ll tell you how many aspies and that’s the term I’m going to use.

[00:00:33] It’s a very positive term Aspies actually originally coined by those with Asperger’s syndrome themselves. And if you’re not Aspie you’re called neurotypical. And neurotypicals have their own problems too. And to be honest, my main concern is not Asperger’s. It’s the attitude of neuro typicals to someone who’s different.

[00:00:58] That’s my concern. Now, [00:01:00] if we’re going to get changes in slides, that’s it. I’m going to go through, what are the characteristics we look for? There’s a textbook called DSM. Which goes through it in detail. I’m a great fan of Harry Potter. I would like a sorting hat. So you just put the hat on and instead of slither or no Griffin door, it says, add odd ASD trouble is there’s too many DS in life and you get a kid who’s got multiple diagnoses, usually done in a very negative way from the child’s perception.

[00:01:38] But if we look at the criteria. That’s it right? First of all, people with ASD have difficulty understanding other people and that’s their biggest challenge in life. Neuro typicals are born pre-wired to make friends read a face. [00:02:00] Socialize is what they go to school for not to learn. They’re there for their friends and to play and socialize with them.

[00:02:06] But there are some children. Who are not so good at socializing and some with Asperger’s can socialize incredibly well, but it’s exhausting and they do it by intellect or the analysis, not by intuition. And for many typical kids, socializing is energizing for these kids. It’s exhausting. Now the first thing we look for is devastating, social, emotional reciprocity, the balance, and there seems to be two groups.

[00:02:36] There’s one group that there’s a group of kids playing over there, and this kid says I don’t get it. I don’t understand it. I prefer Lego or Minecraft and become socially engaged. And for this group, my definition of ASD is someone who in life has found something more interesting than socializing. But [00:03:00] have to be with social zealots.

[00:03:02] So they are withdrawn, isolated, highly conspicuous, but then there’s a second group who see all the socializing and go. Right. Okay. And then sort of being introverted and withdrawn, they’re motivated and intrusive. Right. Okay. And they join in, you do this, you do that. No. I’ll tell the teacher, et cetera. On I described.

[00:03:24] As Italian drivers, because they don’t read the signals. As I’m looking at you, your face is a traffic lights. If you smile and nod green light, I keep talking. If you’ve got unbelief slow down, not speed up. If you burst into tears, red lights stop, but they don’t see the no tailgating signs or men at work signs and keep interrupting.

[00:03:48] And they’re highly motivated and intrusive and abrasive and annoying to others because they don’t read the signals and become very upset when it’s pointed out the mistakes they’ve made. [00:04:00] So for this group, they want to socialize, but they’re incredibly clumsy when they do now. The next one is deficits in nonverbal communication.

[00:04:09] That is the ability to read faces, body language, tone of voice, and express those accurately themselves. And especially the ability to express feelings, because often when you have a person with Asperger’s and say, what are you feeling now? Or what were you feeling when you throw a wobbly or whatever it was they say, I don’t know.

[00:04:33] Come on. You must know. You can tell me every dinosaur in the Jurassic period. What are you feeling now? I don’t know. I’ll now complete the sentence. I don’t know how to grow. The many thoughts and feelings in my mind, hold one, identify it and explain it to you in speech. So you’ll understand. So there’s a major difficulty converting thought and emotion to speech, but not in the arts, [00:05:00] in the ability to sing in perfect pitch, to create music, to take photographs.

[00:05:04] And so they can get their personality and inner world through drawing music and the arts more than. The next one is devastating, developing and understanding relationships from classic autism. Not really bonding with mom as much as you’d expect, but then this is the kid who’s desperate for friends and they say, how do I make friends?

[00:05:26] And how do I keep friends? And when I say the teenagers, it’s how can I get a girlfriend? Can I buy one? And I say, no, it’s illegal. Although I must admit I could make a fortune running a dating agency for. And, and their mothers would pay me a fortune for them to leave home and get married. And so that mom can have a life now.

[00:05:51] So it’s understanding relationships. It’s friendships, typical kids on a beach on a summer’s day, never met each other just very quickly. They make [00:06:00] friends playing together. It’s dumb. And the kid with Asperger’s said, how’d you do. What signals say, I can join in, what can I say? What can I do? So all those features are confusing, nothing to do with intellect.

[00:06:13] It’s social understanding. That’s it. Now the next wall is restrictive. Oh, I hate the terminology. This is academics for you. Say it in words that nobody can understand makes you seem. Okay. They like routines. They don’t like change. There are certain words that provoked quite severe agitation, no weight change and not fair, strong sense of social justice.

[00:06:42] And so for this individual, they don’t like change the unexpected and surprises. They like routine and consistent. And when there is a change, they hit the panic button, but it’s a life of predictability is the one that they seek. Now, another component is highly [00:07:00] restricted fixated interests now, yes. When they’re young Thomas, the tank engine, it’s not in the diagnostic criteria, but they become incredibly knowledgeable in the volcanoes Minecraft.

[00:07:13] I could’ve made a fortune if I’d have actually a lot of Minecraft Pokemon and the other games are actually designed by aspects. Yes they are because they speak the ASPE language and all the aspects are in transpired from Steve jobs to bill gates, to all that group. So there is an interest, it may last hours.

[00:07:35] It may last decades, they collect information. They have a phenomenal knowledge of it. They’re a walking encyclopedia. But at school they’re being taught lessons. And I have to explain it like I did this week, as one teenager said, why am I having to learn Pythagoras theorem? Which I think is the square on the hypotenuse is equal to the sum of the squares on the other two sides.[00:07:56] I can’t remember it. I was drilled it, but from the [00:08:00] moment I finished high school, I have never, ever used it. And many with Asperger’s say what you’re teaching me is a waste of time and it is. But they want to know about their special interest. The next area is sensitivity to sensory aspects of their environment.

[00:08:18] Now that can include auditory. And when I talk to the teenagers and I say, which teachers do you like or not? Like they say, I hate teachers who shout. And so sometimes they don’t want to go into the playground, not because of the social company. But the kids shouting to each other running fast and they might bump into you or not liking a birthday party.

[00:08:45] Cause those are balloons that could go pop. So not only are they confused and the social minefield of the day, they also have major problems of sensory sensitivity. It’s tactile. As I walked across from the hotel to here, [00:09:00] there are a lot of kids going off to prestigious high school. And I find it amazing that young men wear shorts because I come from England.

[00:09:08] I think it’s really quite weird. However, they’re wearing ties now for those with Asperger’s they can’t stand things around their neck. They don’t like labels. They have that tactile sensitivity. It’s visual. I hate missing. Y because she wears bright clothing and it just blinds me. Teenage asked the uniform is black or all gray, not emos, but why have colors?

[00:09:34] I don’t know how they go. I don’t know what to wear. I’ll just wear black. And I also paint Mrs. Smith, not because of what she wears. She makes me want to vomit. What do you mean? She makes you want to vomit? She smells of coffee or her perfume makes me red. It’s also position of the body and movement skills.

[00:09:53] They can be notoriously clumsy may not respond to pain as you would expect, and may have [00:10:00] a problem of a mind body division that sometimes may self-injure at a mild level just to get their brain in connection with their body. Now, the next criteria is symptoms must be present in the early developmental period.

[00:10:16] But may not become manifest until social demands, exceed capacities. In other words, for some of the kids in the early days of preschool primary school, they can hold it together. They can socialize, but when they get to high school, the wheels fall off because life is now much more complicated. They’re trying to relate to toxic teenagers, the most dangerous creature on this planet for Greg forget.

[00:10:40] Great white sharks trying to eat. So. The most dangerous creature is a pack of teenage boys. Neither use snot ornament. Now what it means is that it’s later on and often in classic autism diagnosed in the preschool [00:11:00] years. Asperger’s boys primary school girls, high school and beyond, but more on that. But in other words, the symptoms may become apparent later and must cause clinically significant impairment in everyday functioning.

[00:11:16] And that’s where we’ve got to make a decision. Does this aspect affect that person’s quality of life in childhood often? Very much. Now we do have what we call the Asperger personality type, and that is as the Americans would say, The apple doesn’t fall far from the tree. And in half the cases we see there is a parent with similar characteristics.

[00:11:45] Interestingly, the highest level of having kids with ASD. If we go through the professions, yes, engineers are more likely to have kids with ASD even more like. Are those in [00:12:00] information technology, even higher is accountancy, but the Supreme profession for having ASD kids is medicine. Wow. Interesting. But that’s another topic.

[00:12:14] So there are personality characteristics. It’s always been here. We’ve now got a label for it, but what I’m now finding that early diagnosis and early intervention means that sometimes. I’m actually removing the diagnosis. Interesting. I saw a child when he was seven years old, classic Asperger’s soaring for two years, helped him with the development of friendship.

[00:12:40] Then didn’t see him usually a good sign. And then at 19, his mom said, could you see him because I’ve got a problem. He’s always wanted to be a police. And he has a strong sense of social justice has done all the first aid courses. And he really is dead set on being a police officer and you make a [00:13:00] great one.

[00:13:00] However, he’s asked to be an honest, to a fault. And on the application form wrote down that he had to the police academy Asperger’s they immediately sent back a letter, basically saying, how on earth could you think that a person with Asperger’s could be a police? Which is interesting because you then have to dismiss about 15% of police officers from the dog squad to the scene of crime investigators.

[00:13:28] So she said he has no idea what to do. Could you see him? Cause he’s very depressed in the whole process. So in walked a very tall, 19 year old young man, and I was chatting with him and I thought where’s the Asperger’s. I can’t pick up any aspect because. I’m going to redo the diagnostic assessment and on a particular test, you need a score of 65 or more to have Asperger’s.

[00:13:51] And his score was 42. So I wrote a letter to the police department saying he had Asperger’s. He now [00:14:00] no longer has sufficient to be a clinical significance in his daily life. Please consider him like any other citizen. And he got in. I was so. But then I got a few months later an email from him saying, thanks for the letter Tony I got in, but I didn’t like it.

[00:14:19] And he said, so I’ve joined the Navy and I’m really enjoying it because I’m doing radar. But then I sort of a few months ago and he said, yeah, but I didn’t like the living on board ship in close proximity to so many people. So I’m now at university studying psychology. Yes, because he started observing and analyzing people since he was three years old, it was his only way to cope.[00:14:49] So longitudinal studies clinical experience suggest about 15% move out of autism spectrum disorder. Now there are certain language components it’s [00:15:00] the pragmatics, the art of conversation. It’s monologue. It’s not seeking repair of a conversation. The prosody is odd for a lot of the kids when they’re young.

[00:15:12] This is an interesting fact that the United States has fewer kids with Asperger’s than it should because it exports them to Australia because many of our kids speak with an American accent because they learn language, not from parents or peers, but television and Dora the Explorer. So they speak with an American accent and can be so pedantic and they give you so much detail and spotting errors.

[00:15:39] They are great at spotting errors. And if you make an error, they are the first person to point out your mistake and you should be grateful to them for your mistake being pointed out high school principals. Don’t like it when their grammar is pointed out to the whole school. But their allegiance is to the tooth and countries and correction to look at [00:16:00] patterns and look at inconsistencies.

[00:16:02] And that’s one of the reasons they can be so good at maths because the math is study of patterns and they are good at studying patterns. Motor clumsiness can include being clumsy, unusual gait handwriting skills, but in team sports, they can be the last to be chosen because they’re poor at balls catching skills and so on which.

[00:16:22] Often their preferred activities are solitary, sedentary activities, often looking at a screen and handwriting waste of time, 19th century skill, you know, just teach them to voice record. Now when I’m doing the diagnostic assessment, I’ll show pictures and I’ll ask, what do you see now, a kid with Asperger’s you’re looking at this photograph may say she’s got a hand in the.

[00:16:50] Her brother has his hand on her shoulder or look, and there’s some plants crawling down the wall and there’s some magazines. I wonder if there are any train magazines, whereas [00:17:00] typical kids would say, she’s trying to steal a biscuit or a cookie he’s done in God’s squeezes her arm. If anybody looks she’ll drop it, they won’t get into trouble.

[00:17:08] But if she gets one, he expects half cause he helped her out. You see, it’s not wrong. It’s looking at the world through different eyes and not really working out what may be going on. Kid with Asperger’s what’s happening. He’s giving her the ball, but a little girl have a look at her face. How she feeling?

[00:17:27] Happy. Why is she happy? Cause he’s giving her the ball. Whereas typical kids will say she can’t understand why her brother is giving her the ball, but she hasn’t seen the broken window soon as she holds the ball. She did it, not me. She’s got the ball or a kid with Asperger’s looked at that for about 10 seconds silently.

[00:17:46] And then he said no way. No way would a ball that size make a hole that small that is physically impossible. [00:18:00] We do little stories for kids under the age of six. We have a little kid wanting a birthday present. What would you like for a present? She says a puppy comes the morning of her birthday. She’s so excited that she’s going to get a puppy.

[00:18:15] She walks down into the kitchen there on the kitchen table next to her mum. And dad is her one birthday present. She thinks he’s my puppy. And she opens the box and inside she finds books, lots and lots of books, no puppy. She’s so sad. Her mum and dad say, did you like your birthday present? And she says, thank you.

[00:18:36] It was a lovely. Why would she say that? And the kids with Asperger’s go, of course the books are about puppies. That’s why she said thank you. And I thought, yeah. So why would you say thank you for personal? You don’t want, it’s understanding those sorts of components and conventions. Now there are associated features.

[00:18:58] I’m going to explore a bit [00:19:00] about those a little bit further on, but there’s one thing that those with Asperger’s are really good. Worrying, they have a high level of anxiety, routines and rituals are imposed to reduce anxiety. Also an unusual profile of. There are the hydroelectric or dyslexic they learn to read early on to read about their special interest in mathematics.

[00:19:24] They are supremely mathematics or they’re hopeless at mathematics in drawing. They draw in photographic realism, or they have major difficulties and they sing in perfect pitch. Ha like Susan Boyle. However, I had one. Who’s teacher said, oh, he’s lovely. And he loves music. So I sing to him, but he keeps hitting me.

[00:19:46] Why does he hit me when I’m being nice to him? I said, because you sing off cocaine and he spots areas. They make great conductors to spot errors and great [00:20:00] engineers in sound, recording in studios because they can spot all the errors. Yeah. One of the things we’re starting to become more aware of is the diagnosis in girls and women, the invisible end of the spectrum.

[00:20:16] And they tend to fly under the radar of diagnosis because girls are smarter and more creative than the boys in coping with difference. Remember I said, for reciprocity, ignore, turn away or intrude girls do the third option. And that is okay. I don’t get it, but I’m going to watch. I’m going to observe.

[00:20:38] Who’s popular. Rebecca, what does she wear? Pink. Right? I’ll get pink. Pink, pink, pink, pink. What do they talk about? Barbies? I’ll get a hundred Barbies. How does she talk? What does she do? And they observe, analyze and imitate. It’s a much more intelligent way. I don’t get socializing. So what I’m going to do is see what’s going on and copy it.

[00:20:59] So it’s [00:21:00] the observation analysis and image. And now when they do that imitation for a brief while cured of autism, but what she’s got is a surface sociability, but a lack of true social identity, the real self must be hidden. I can only be the person that people want me to be and who they want me to be is so successful.

[00:21:25] But I’m ashamed of the real news. It’s masquerading, it’s watching an imitating could to conceal social confusion and this causes anxiety and stress and a lack of self identity. But one of the other issues can be in the teenage years, she’s either a goody, two shoes, puritanical, none that the teachers want the whole class to be, or she says, right.

[00:21:52] I watched, I analyzed, I imitated, I walk the walk, I talk the walk, walk, talk, talk the talk and walk the [00:22:00] walk, but it didn’t work. So I’m going off the rails. And she goes through because it didn’t work well, promiscuity, at least I’ll be appreciated body piercing yet. I’ll give it a try. So one of the issues is going to be going off the rails because of nonacceptance and income speak years when they are the goodies.

[00:22:21] Can lead to suppression of many issues. They often read fiction because when you read Harry Potter, you can work out what people are thinking and feeling because Hermione the text is her thoughts and feelings on her mind. She is the quintessential Aspie girl at Hogwarts. She has no female. Many of the girls with Asperger’s when young are tomboys or they watch soap operas home in a way, your neighbors, because they haven’t got friends and can’t fit in watch TV as your documentary of socialization, but prefer to be with boys than girls.

[00:22:55] Girls are bitchy mean too faced and horrible boys are [00:23:00] fun, engaging. And I like to be with the boys because I get their jokes and we both like engineering Lego and mathematic. They decode social situations by doll play. So what she does is not Bobby getting married or Bobby doing retail therapy. This Barb is teacher.

[00:23:18] This Barb is her. These Barbies are the kids and she replays, decode and unpacks the events of the day by playing with Barbie or rehearsing, what to say or do tomorrow. She may also because she’s isolated as far as she’s concerned. I haven’t gotten any friends. That’s okay. I’ll have imaginary friends and imagine reference a better than no friends.

[00:23:43] And I had a 12 year old girl that mum said she’s developing puberty and schizophrenia. And I said, I’ll see her as fast as I can. But what do you mean by schizophrenia? She’s hallucinating in class. She talks to someone called Sarah who does not exist, [00:24:00] but she talks to her aloud in class. Unaware of the effect it’s having on other people.

[00:24:07] I think she’s developing schizophrenia, she’s hallucinating. So I saw her as soon as I could. When I said, when you’re talking to Sarah, what do you talk about? And she said, well, we, we, we, we talk about the new school principal and the new rules. And, and we talk about what books we’re going to need for homework.

[00:24:21] And, and we talk about our favorite TV shows. And I said to mum, that’s not schizophrenia. That’s loneliness. She’s escaping into a world of imagined. And she is so good at it of off with which is unfair. She becomes a successful author, and I know a number of authors with Asperger’s syndrome that that’s their way of coping is to escape into an imaginary world.

[00:24:47] You have control of that is safe and you can explore many aspects of life. Also, girls tend to apologize. Boys around me. So if I makes a social mistake, he [00:25:00] gets upset. Agitated. He’s referred for a diagnostic assessment, the Gogo. Oh, I’m sorry. Oh, I’m so sorry. I hurt your feelings. And because she apologizes so profusely, we forgive and forget, but there’s a pattern developing.

[00:25:12] She didn’t know. Or she appeases mum says you’re going to a birthday party with your cousins. You really don’t know them. Will it be okay now you haven’t seen them for five years. You show you’ll be okay. Now, I’m not going to take your brother to football. I’ll be gone for two hours. You sure you’ll be okay.

[00:25:31] But look at the terror in her eyes, she’s much braver than the boys in trying to cope with that situation. And she’s a chameleon trying to adapt to different situations. Now there are going to be problems that develop early on in. And sometimes what will happen is that that may be camouflaged or not understood.

[00:25:56] And the diagnosis occurs later in life in the adult years, [00:26:00] sometimes with a relative diagnosed sometimes it’s mum or dad. And as far as the wife is concerned, this explains my husband. This is why it’s like hugging a block of. This is why he’s always criticizing me and never compliments me, et cetera.

[00:26:15] So it can explain a lot of marital issues. But it may be a cousin. It may be a niece or nephew diagnosed with Asperger’s that leads to a diagnostic pathway. Sometimes it’s underachieving and employment because they can’t get through the job interview because of difficulty with social skills or difficulty getting relationships.

[00:26:36] And when the teenagers say, how do I get a girlfriend? And I do that, I say quite clearly, As far as girls, your age, teenage girls are concerned. You’re not cool. You’re not trendy. You’re not risky. You’re not the type they go for. Cause you’re honest, trustworthy, and reliable. Wait till they become maternal in their mid twenties.

[00:26:58] And then they’ll fall in love with you [00:27:00] because you’re a Virgin now.

[00:27:04] Another issue can be depression. There’s high level of depression. Depression occurs for a variety of reasons. One is you may early on seven or eight years old, realize I’m different. And then think I’m defective. And the seeds of depression can be there because of rejection from your peers and you’re different and so are bad.

[00:27:25] But when I analyze the inner thoughts and feelings by those with Asperger’s who are clinically depressed, Is your opinion of yourself and song, I go, wow, you didn’t get that belief about yourself from your parents. You didn’t get that from your teachers. You got that from other kids. The tragedy is, it was said so often you started to believe it and you didn’t have friends to contradict.

[00:27:56] So the fret, not the acquaintances, the [00:28:00] rejection, the bullying and teasing is a major cause of depression. Another cause of depression in this group. The third one is energy depletion because they use up so much energy, managing anxiety processing, facial expressions that they are exhausted and that long-term energy depletion leads to depression.

[00:28:18] Fortunately, we have programs to help on this. How long have I got. Two minutes. Oh, ah, a little bit longer. Oh, good. Right. So depression can be an issue for this group. And to be honest, when we’ve looked at, I hope there aren’t any psychologists in here because actually what we found was far better than psychology was physical exercise is better than Prozac and it’s better than CBT.

[00:28:53] But these guys don’t get much. Physical activity really is very important. So depression, we also [00:29:00] get referrals for relationship problems, but there are other issues too. And that is the high levels of anxiety. If not dealt with effectively may lead the person. And this is what happened with our son who has Asperger’s.

[00:29:18] Our son with his social difficulties at high school. There’s two groups go guys, bad guys, good guys, closed door. Won’t allow you in, unless you’re socially skilled, bad guys will always accept you. As long as you’re stupid, silly. Risk-taking easy to see. That’s the group he went to onset of puberty had a huge tsunami of anxiety coming in, but that group, when we.

[00:29:46] William’s anxiety from zero to 10, he was always 8, 9, 10, 8, 9, 10. That group were the first group to use alcohol and marijuana for the [00:30:00] first time in his life, CI zero and one. And so self-medication. Alcohol marijuana. Then it went on to speed ice and morphine and a whole range of things. And he’s been a drug addict now for 15 years, if I could have turned back time, I’d have tried to get to him before he tried alcohol and marijuana.

[00:30:24] That has been his stand for, despite his intelligence he’s unemployable he’s been in and out of. Getting money by armed robbery and so on for his drugs. So what we’re looking at is how do you get down to there by yoga and meditation. And I’m encouraging schools today to teach kids in general, yoga and meditation, to experience that and for the aspects who value intelligence highly, it’s not that you’ll feel good.

[00:30:51] It makes you a smarter because if you are calm and relaxed, you make good decisions. If you get. Your [00:31:00] IQ drops. 30 points. Yes. It drops into the normal range. So[00:31:09] we also have issues of gender identity. Some of the boys will say, girls are nice. Girls are kind, girls have lots of friends. Girls have adopted me. If I became a girl, would I be cured? So they think about changing gender or we had one girl who desperately wanted to be a boy. And then we worked it out. She was bullied and teased mercilessly by a group of girls who didn’t bully the boys.

[00:31:33] So she thought if I become a boy, I won’t be bullied and teased. We also get Asperger’s in anorexia nervosa and there it’s a special interest in weight, numbers, control, kilojoules, and so on. Or I prefer to remain gender neutral under tomboy. I don’t want to develop femininity. Anorexia nervosa will inhibit that we also [00:32:00] get, how do you react to being different?

[00:32:03] And the kids know that they’re different when they’re seven or eight years old. And when they’re seven and eight years old, they’ve got one of four alternatives to internalizing, to externalizing, one internalizing different defective depression and the self-esteem of aspects is based on the criticisms of peer.

[00:32:24] With an absence of compliments. So that whole self-esteem is based on criticisms from their peers and that leads to depression. Another group will escape into imagination and that imagination is so vivid, so real, so enjoyable. And they’re unaware of the context that they engage in conversations and interactions with what appear to be hallucinations that they diagnosed with schizophrenia personality.

[00:32:52] There’s another group who do the opposite of depression and their way of self comforting and cope coping with life is to recognize their [00:33:00] intelligence and see themselves as superior to others. This is what I call the Sherlock syndrome. Sherlock is classically ASPE, not a sociopath. It’s he’s very good at logic because he’s asked me he doesn’t get emotions.

[00:33:16] So he denigrates them is of no great importance. And this. Comfort themselves with their intelligence and are diagnosed with narcissistic personality disorder, because that’s a way of coping, but another group will copy and imitate and they win an Oscar for their ability to take on accents and to be successful in acting.

[00:33:42] Okay. So is it Asperger’s hopefully you now know whether it is okay.[00:34:00]

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