AS: Adults Vs. Children

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I find myself somewhat annoyed with something and I'm sure many adults with AS have run into issues with this at one time or another.

Many of you may be aware that the DSM-IV criteria for AS was written specifically with children in mind, and there seems to be a misconception among some in the mental health field that adults with AS would be no different.

How silly is it to think though, that once one is made aware of their condition, they should remain blind to that which their condition is and never seek to correct anything about it.

Needless to say, most individuals with AS are of at least average intelligence, and often times above average intelligence, and I think it's quite insulting for people to assume of us that we would remain oblivious to our condition even if we should read about it in depth.

I'm very aware of myself and the things I should and shouldn't do. I'm able to recognize all of my "symptoms" of AS and have strived to address them to the best of my ability where I see appropriate. I make an effort to look people in the eye in certain social situations. I try to be hypervigilant about reading non-verbal cues...and I've gotten better at it I think. I know not to talk AT people and try more to talk to them, and I think I'm capable of pretty good conversations...as an adult.

The difference between those such as myself, and everyone else is, these were not natural abilities. These were not things I was capable of as a child, and these were things I had to learn in a very academic like fashion as a teenager/young adult.

The difference between those such as myself and everyone else is, even with this realization and my efforts to correct myself, I will still mess up sometimes. I will still have moments where I can't tell if someone is joking or being serious. I will still occasionally misread a gesture. I will still not say the right things when I should and say the wrong things when I shouldn't. I will still have my "odd" interests, not be able to wear wool, hate loud music, not really care if I don't have a large number of friends, be fairly content being alone most of the time, be horribly clumsy, come off a tad awkward, have "stilted" speech, and so on.

But by golly, I will shake your hand, look you in the eyes and smile like a car salesperson with bad veneers if it really pleases people.

There's a difference between adults and children.

(Yeah, humor, I get that too, by the way)

Yeah, there's a difference, and that difference is that adults look and behave even more strangely compared to their peers.

The peers grew up at the normal time socially, whereas the individual with AS lags far, far behind in social adaptive functioning.

It's easier to overlook things when the individual is young, but it's not when older, even if the behaviour isn't as pronounced compared to as when he or she was a child.

When an adult seeks a diagnosis they are asked about their childhood, so I don't see what the big deal is.
I could recount what I was like in my childhood and had my mother to help me.

It really really doesn't bother me that the criteria is written more to diagnose children.

I think that would depend on the diagnostician. There are those here that had comprehensive assessments and those who who were dismissed after a short conversation with the doctor because "they made eye contact". One was dismissed because "she knew too much about AS". As far as sticking out more in adulthood, I imagine that would differ individually as people have different skill levels and desires in fitting in. To truly assess someone on that level, you might have to follow them around for a while and observe how they interact.BTW Didn't Tony Attwood come up with a diagnostic criteria for adults?

At age 19 I'm certainly more confident, sociable and perceptive than I was as a young teenager. The diagnosis is flawed because AS traits can wear off with age. Ironically I'm happier than I was years ago because my peers can now discuss more intellectual and meaningful things. Also I've matured but at a slower rate of course. A more suitable list would be inability to make close friendships, social phobia, obsessions but not necessarily the eye contact thing.

Chronos,

I agree with what you say and know how it is.

I built a series of "coping strategies" when younger, many flawed and incorrect, that helped me through life but as I grew older began to fall apart. It is only now I am learning to ask questions rather than assume, I still have problems with body language and tome often being reminded something was a joke as I can take it too literally. Having these issues I am "vulnerable" in certain social situations not knowing the visual cues to affection and interest from others, often not wanted.

I'm learning too to have a conversation and not just talk to someone, its hard but I catch myself and hope for the best.

It's actually quite horrible. In the run up to assessment, I was actually afraid that over the years, I had compensated too much and as a result would not meet the criteria. In one way, it would be an achievement, but after all those years I really wanted aknowledgement and for someone to tell me "yes, it did suck. it wasn't normal".

Having the diagnosis meant I could finally move on and say to my parents "look, I wasn't just a brat. There was something more to it than that". My younger brother had ADHD, diagnosed from a very early age and so he was given a lot of supportive (sometimes indulgent) treatment for it. I was constantly told to speak up and be more sociable. My mum tore strips off me occasionally when I wouldn't say much when we bumped into friends of hers when out walkingk, and that would send me into a rare 'meltdown'.

I still don't think they've accepted me. I am a lot more sociable now anyway (in situations where I have to be sociable) so she has less to complain about (now it's just my choice of clothing ) . My dad's family is all slightly nuts, so he thinks I've just inherited a personality trait, that's all.

But for me, it's a great weight off my shoulder and I now feel free to improve as much as I can, without fear of 'missing out' on a diagnosis because of it.

I'm much more social now, than I was in my teens. I think that the difference is, that kids are more like one another, so aspie kids don't stand out, as much as aspie adults. Kids dress the same, and go to school, and they watch the same kids shows and listen to the same kids music. Adults are more likely to be individuals, and adult aspies are even more likely to be individuals, and some of us grow up to like a slightly earlier time, preferring the clothes and the music, of what ever time that we like. That should not be taken away from us, by anybody.

Here's a social thing I learned that may seem a little ironic. If you're quiet and non smiling and don't initiate conversations, some people will categorize you as a snob and will resent you for it. Some of these people will see you as a challenge that needs to be overcome. I learned that when seeing people a quick glances towards the eyes and a brief smile will satisfy them.It's like paying a social ante.I think this is especially true in school where kids are always looking out for someone they can target as "different". Any number of people here have related incidents where a moment or two of perfunctory politeness would have saved them from a lot of aggravation.

This does seem to be a common problem - that's why I would recommend someone interested in being diagnosed absolutely insist on clinical testing rather than accept the opinion of a doctor who may not have years of experience with Autistic patients of varying ages. Why it wouldn't occur to any college educated professional that an adult growing up with undiagnosed Autism would learn to unconsciously hide the behaviors that had pegged them as obviously 'different' over the years baffles me, but I guess education doesn't make up for stupidity.

As I was remarking a few days ago, you can look at the fictional behaviors of Sheldon Cooper on Big Bang Theory and Gregory House on HOUSE to see the marked differences in the behaviors one might expect from a child or adolescent with AS (Sheldon) and an adult (House) who's gone undiagnosed well into middle age. Similar, but different - and both make acceptable eye contact.

I agree that with a lot of things in the criteria we usually learn some things to cover it up, like learning to recognize certain expressions, figuring out some things to say in a conversation, some people learning to force eye contact, etc. The wording on some of the criteria kind of is geared more toward kids.. But, all in all, i have to agree with Daniel on this one. I fit most of the criteria more obviously now than i did as a kid, and now no one can dismiss it now as "oh, she's just a shy little girl.." Sure, there are a couple criteria that probably were worse as a kid. The one about not seeking to share enjoyment is something i probably would have matched much more closely as a kid, because now i do try to share enjoyment with others, but it's still doesn't come as naturally to me as others. So, yeah, things like that can improve over time... But then, with the one about nonverbal behavior, i've learned what certain expressions mean and, when i think to, i sometimes even make expressions. But, like daniel was saying, i've lagged so far behind everyone else that even with that, something i've made improvements on, the gap has only become wider between me and everyone else, so it's probably just as much, or more, pronounced. When i was a kid, people told me to "smile" all the time, but people could dismiss it because i was just a little kid. Now that all my peers have developed so much socially, it's obvious that i'm far behind them, and the gap just got bigger and bigger as i grew up. I developed a little, while they developed a lot. And some like not developing relationships appropriate to developmental level are just more and more obvious. When i was little i could at least sustain friendships with the neighborhood kids, because none of them were in the same grade as me and our parents all knew eachother. As you get older it gets harder and you have to do it all on your own, so it just gets more difficult and easier to see than there's an issue. And, maybe it's due to increasing stress, i don't know, but i stim as an adult more than i ever did as a kid.

Society has different expectations for people according to their age too. Nobody really notices if someone middle aged is non social. According to that part of the criteria, I am far worse, but people are more likely to view my lack of a social life with less concern than if I were in my 20's.

So at 29 that makes me wonder what they will find. Being any adult and after all these years I may have very well been able to cover up different things. Exmaple I never knew that I did this but when I go out to eat to places that have loud music and a lot of people talking I try to have to topic on just something I like and I keep on talking about it.

When it's not about something I like I start to kind of shut down to the point of some would say looking spaced out or sad. Like I'm there but I'm not really there. I just never knew I did that. It's kind of like I just want to get out of there because it's just to much for me to take. But if over time you had people help you over come those faluts how much of the Aspergers would they really find.

They should really have one test aimed for adults and one for kids. I mean if you are 45 years old and a married with kids and find out you have Aspergers after doing a lot of reading stuff when you get tested are they really going to see it as much of a problem.

When I read the DSM, I don't see any thing which is specifically geared for children.

It does speak of various childhood milestones such as speech non-impairment, cognitive abilities and environment curiousities. But those wouldn't limit diagnosis to children. You either met them as a child or you didn't. Your past doesn't change when you become an adult. So it wouldn't limit diagnosis to children.

Correct me if I'm wrong, but to prevent everyone from being classified as mentally ill, the DSM is very careful to define a disorder as "something that causes problems and distress for the person." They do NOT define it as "a particular neurological profile that can sometimes cause problems," even though that's what "autism" actually is. So if a person with AS adapts well enough to the NT world, by DSM standards, he or she will no longer "have autism," despite being the same person with the exact same neurological profile as before. Because adults have had more time to adapt and learn how to pass, they are less likely to fit the sort of autism definition the DSM would want to use. Kids haven't; thus, it focuses more on children. Just a thought.

The issue I was trying to raise was that an adult has had more time and often times, but not always, more ability to be or become aware of themselves than a child, and take the initiative to correct certain behaviors. So an inexperienced clinician, or a bad one, or someone with a critical thinking deficit (you know, the ones who think things like sick=bed ridden, not bed ridden=not sick), may erroneously declaire a wrong diagnosis.

For example, our fictionary patient Johny gets fired from his job over an AS related miscommunication. Johny does not have an "official" diagnosis, but knows he has AS, and would like to file a wrongful dismissal suit so he goes to get a diagnosis.

Now a while back, Johny realized he didn't make eye contact with people, talked about his life long passion, bus routs, to everyone, and realized sweat pants and a Barney T-Shirt wasn't very becoming of a 40 year old man, so he began to make eye contact, stopped talking so much about bus routs, and started dressing a little more appropriate for his age.

He goes to get a diagnosis wearing a brand new suit, and on being called into the office, looks the clinician in the eye, smiles, extends his hand and with the charisma of Bill Clinton, he says "Hello, I'm John Smith. How are you today?"

During the whole process, he's very composed. He doesn't rock or fiddle with his fingers like he used to. He maintains eye contact, and doesn't talk contanstantly about bus routs. He pauses frequently and takes a moment to ask himself if the clinician is communicating anything to him non-verbally, and at the end of the process the clinician declares "Well despite your history you certainly don't appear like someone with AS in my book. Maybe you were just one of those quirky kids and went through a few phases"

Of course we all know Johny is going to go right home, take off that itchy suit, and map new bus routs as he wonders how many more people are going to fire him for doing exactly what they told him to do.