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    Default Aspergers syndrome: any INTjs relate?

    Asperger syndrome
    From Wikipedia, the free encyclopedia
    Jump to: navigation, search
    Asperger syndrome ICD-10 F84.5
    ICD-9 299.8
    OMIM 608638
    DiseasesDB 31268
    MedlinePlus 001549
    eMedicine ped/147
    Asperger syndrome – also called Asperger's syndrome, AS, or just Asperger's – is one of five neurobiological pervasive developmental disorders (PDD), and is characterized by normal intelligence and language development, but deficiencies in social and communication skills. The diagnosis of Asperger syndrome is complicated by the lack of a standard diagnostic screen, and the use of several different screening instruments and sets of diagnostic criteria. The exact cause of AS is unknown, and the prevalence is not firmly established, due partly to the use of differing sets of diagnostic criteria.

    The management of AS consists of therapies that address the core symptoms of the disorder: poor communication skills, obsessive or repetitive routines, and physical clumsiness. Most children and adults with AS can learn to cope with their differences, but may continue to need support to maintain an independent life.

    Asperger syndrome was named in honor of Hans Asperger, an Austrian psychiatrist and pediatrician, by researcher Lorna Wing, who first used the eponym in a 1981 paper. In 1994, AS was recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM).


    Hans Asperger, after whom the syndrome is named, described his patients as "little professors".Contents [hide]
    1 Classification and diagnosis
    2 Characteristics
    2.1 Social impairments
    2.2 Narrow, intense interests
    2.3 Speech and language peculiarities
    2.4 Writing peculiarities
    2.5 Emotional peculiarities
    2.6 Other characteristics
    3 Causes
    4 Treatment
    5 Prognosis
    6 Epidemiology
    7 History
    8 Cultural and sociological aspects
    8.1 Social impact
    8.2 Notable cases
    9 See also
    10 References
    11 External links



    [edit]
    Classification and diagnosis
    See also: Autism spectrum disorder
    AS is an autism spectrum disorder, one of five neurological conditions characterized by impairment in language and communication skills, as well as repetitive or restrictive patterns of thought and behavior. The four related disorders are autism, Rett syndrome, childhood disintegrative disorder, and PDD-NOS (pervasive developmental disorder not otherwise specified).[1]

    AS is defined in section 299.80 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) by six main criteria. These criteria define AS as a condition in which there is a 1) qualitative impairment in social interaction and 2) significant impairment in important areas of functioning, as well as 3) the presence of restricted, repetitive and stereotyped behaviors and interests, but with 4) no significant delay in language or 5) cognitive development, self-help skills, or adaptive behaviors (other than social interaction). The symptoms must 6) not be better accounted for by another specific pervasive developmental disorder or schizophrenia.[2]

    The diagnosis of AS is complicated by the use of several different screening instruments.[1] The diagnostic criteria of the Diagnostic and Statistical Manual are criticized for being vague and subjective.[3][4] Other sets of diagnostic criteria for AS are the ICD 10 World Health Organization Diagnostic Criteria, Szatmari Diagnostic Criteria,[5] Gillberg Diagnostic Criteria,[6] and Attwood & Gray Discovery Criteria.[7] The ICD-10 definition has similar criteria to the DSM-IV version.[7] In the ICD-10 the phrase Asperger's syndrome is synonymous with Autistic psychopathy and Schizoid disorder of childhood. [8]

    Some doctors believe that AS is not a separate and distinct disorder, referring to it as high functioning autism (HFA).[1] Szatmari suggests that AS was promoted as a diagnosis to spark more research into the syndrome: "It was introduced into the official classification systems in 1994 and has grown in popularity as a diagnosis, even though its validity has not been clearly established. It is interesting to note that it was introduced not so much as an indication of its status as a 'true' disorder, but more to stimulate research ... its validity is very much in question."[9] The diagnoses of AS or HFA are used interchangeably, complicating prevalence estimates: the same child can receive different diagnoses, depending on the screening tool the doctor uses, and some children will be diagnosed with HFA instead of AS, and vice versa.[1]

    [edit]
    Characteristics
    AS is characterized by:[1][2]

    limited interests or preoccupation with a subject to the exclusion of other activities;
    repetitive behaviors or rituals;
    peculiarities in speech and language;
    socially and emotionally inappropriate behavior and interpersonal interaction
    problems with non-verbal communication; and
    clumsy and uncoordinated motor movements.
    The most common and important characteristics of AS can be divided into several broad categories: social impairments, narrow but intense interests, and peculiarities of speech and language. Other features are commonly associated with this syndrome, but are not always regarded as necessary for diagnosis. This section mainly reflects the views of Attwood, Gillberg, and Wing on the most important characteristics of AS; the DSM-IV criteria represent a slightly different view. Unlike most forms of PDDs, AS is often camouflaged, and many people with the disorder blend in with those that do not have it. The effects of AS also depend on how an individual with the syndrome responds to it.[7]

    [edit]
    Social impairments
    Although there is no single feature that all people with AS share, difficulties with social behavior are nearly universal and are one of the most important defining criteria. People with AS lack the natural ability to see the subtexts of social interaction (e.g., resulting in well-meaning remarks that may offend, or finding it hard to know what is "acceptable") and may lack the ability to communicate their own emotional state. The unwritten rules of social behavior, that mystify so many with AS, have been termed "The Hidden Curriculum".[10] People with AS must learn these social skills intellectually rather than intuitively.[11]

    Non-autistics are able to gather information about other people's cognitive and emotional states based on clues gleaned from the environment and the other people's facial expression and body language, but in this respect, people with AS are impaired; this is sometimes called mind-blindness.[12] Mind-blindness involves an impaired ability to: read others' feelings, understand intended meanings and gauge level of interest in a conversation; take into account others' level of knowledge and predict someone's reaction to a comment or action.[13]

    Some people with AS make very little eye contact because they find it overwhelming, whereas others have unmodulated, staring eye contact that can cause discomfort in other people.[14] Similarly, the use of gestures may be almost nonexistent or may seem exaggerated and differ from what would normally be considered the most appropriate for a situation.[15]

    [edit]
    Narrow, intense interests
    AS can involve an intense and obsessive level of focus on things of interest. For example, one person might be obsessed with 1950s professional wrestling, another with national anthems of African dictatorships, and another with building models out of matchsticks. Particularly common interests are means of transport (for example, trains), computers, mathematics, astronomy, geography, history, and dinosaurs. Note that all of these are normal interests in ordinary children; the difference in Asperger children is the unusual intensity of their interest.[16]

    Sometimes these interests are lifelong; in other cases, they change at unpredictable intervals. In either case, there are normally one or two interests at any given time. In pursuit of these interests, people with AS often manifest extremely sophisticated reasoning, an almost obsessive focus, and a remarkably good memory for apparently trivial facts (occasionally even eidetic memory).[17][18] Hans Asperger called his young patients "little professors" because he thought his thirteen-year-old patients had as comprehensive and nuanced an understanding of their field of interest as university professors.[19]

    Some clinicians do not entirely agree with this description; for example, Wing and Gillberg both argue that these areas of intense interest typically involve more rote memorization than real understanding,[17] despite occasional appearances to the contrary. However, such a limitation is an artifact of the diagnostic criteria, even under Gillberg's criteria.[6]

    People with Asperger syndrome may have little patience for things outside these narrow interests. In school, they may be perceived as highly intelligent underachievers or overachievers, clearly capable of outperforming their peers in their field of interest yet persistently unmotivated to do regular homework assignments (sometimes even in their areas of interest). Others may be hypermotivated to outperform peers in school. The combination of social problems and intense interests can lead to unusual behavior, such as greeting a stranger by launching into a lengthy monologue about a special interest rather than introducing oneself in the socially-accepted way. However, in many cases adults can outgrow this impatience and lack of motivation and develop more tolerance to new activities and meeting new people.[20]

    [edit]
    Speech and language peculiarities
    People with AS typically having a highly pedantic way of speaking, using a far more formal register of language than appropriate for a context. A five-year-old child with this condition may regularly speak in language that could easily have come from a university textbook, especially concerning his or her special area of interest.[21]

    Literal interpretation is another common, but not universal hallmark of this condition. Attwood gives the example of a girl with AS who answered the telephone one day and was asked, "Is Paul there?" Although the Paul in question was in the house, he was not in the room with her, so after looking around to ascertain this, she simply said "no" and hung up. The person on the other end had to call back and explain to her that he meant for her to find him and get him to pick up the telephone.[22]

    People with AS sometimes use words idiosyncratically, including new coinages and unusual juxtapositions. This can develop into a rare gift for humor (especially puns, wordplay, doggerel and satire). A potential source of humor is the eventual realization that their literal interpretations can be used to amuse others. Some are so proficient at written language as to qualify as hyperlexic. Tony Attwood refers to a particular child's skill at inventing expressions, e.g., "tidying down" (the opposite of tidying up) or "broken" (when referring to a baby brother who cannot walk or talk).[23]

    Another typical behavioural characteristic is echolalia, which causes the subject to repeat words, or parts of words, like an echo, and palilalia repeating one's own words.[24] Children with AS may show advanced abilities for their age in language, reading, mathematics, spatial skills, or music, sometimes into the 'gifted' range, although these talents may be counterbalanced by appreciable delays in the developmental of other cognitive functions. [20]

    [edit]
    Writing peculiarities
    Further information: Dysgraphia
    A 2003 study investigated the written language of children and youth with AS. They were compared in a standardized test of written language skills and legibility of handwriting. In written language skills, no significant differences were found between standardized scores of both groups; however, in hand-writing skills, the AS participants produced significantly fewer legible letters and words than the neurotypical group. Another analysis of written samples found that people with AS appear to be able to write quantitatively similar to their neurotypical peers using grammatical rules, but have difficulty in producing qualitative writing.[25]

    Tony Attwood states that a teacher may spend considerable time interpreting and correcting an AS child's indecipherable scrawl. The child is also aware of the poor quality of their handwriting, and may be reluctant to engage in activities that involve extensive writing. Unfortunately for some children and adults, high school teachers and prospective employers may consider the neatness of handwriting a measure of intelligence and personality. People with AS then become embarrassed or angry at their inability to write neatly. The child may require assessment by an occupational therapist and remedial exercises, but modern technology can help minimise this problem. A parent or teacher aide could also act as the child's scribe or proofreader to ensure the legibility of the child's written answers or homework.[26]

    People with AS may be very skilled at using computers and keyboards. This allows for possible special dispensation in schoolwork to type rather than write homework and examinations. The presentation of their work is then comparable to that of other children.[26]

    [edit]
    Emotional peculiarities
    A person with AS may have trouble understanding the emotions of other people: the messages that are conveyed by facial expression, eye contact and body language are often missed. They also might have trouble showing empathy with other people. Thus, people with AS might be seen as egotistical, selfish or uncaring. In most cases, these are unfair labels, because affected people are neurologically unable to understand other people's emotional states. They are usually shocked, upset and remorseful when told that their actions are hurtful or inappropriate. It is clear that people with AS do not lack emotions. However, the concrete nature of attachments they might have (i.e., to objects rather than to people) often seems curious, or even can be cause of concern, to people who do not share their perspective.[27]

    Failing to show affection—or not doing so in conventional ways—does not necessarily mean that people with AS do not feel it. Understanding this can lead partners or carers to feel less rejected and to be more understanding. There are usually ways to work around the problems, such as being more explicit about one's needs. For instance, when describing emotions, it can be helpful to be direct and to avoid vague terms such as "upset" when the emotion being described is anger (some individuals with AS would interpret "upset" as mere annoyance, or even nausea). It is often effective to present in clear language what the problem is and to ask the partner with AS to describe what emotions are being felt, or to ask why a certain emotion was being felt. It is helpful if the family member or significant other reads as much as he or she can about AS and any comorbid disorders.[28] Sometimes, the opposite problem occurs; the person with AS is unusually affectionate to significant others and misses or misinterprets signals from the other partner, causing the partner stress.[29]

    [edit]
    Other characteristics
    Those affected by AS may show a range of other sensory, developmental, and physiological anomalies. Children with AS may evidence a slight delay in the development of fine motor skills. In some cases, people with AS may have an odd way of walking, and may display compulsive finger, hand, arm or leg movements.[30]

    In general, orderly things appeal to people with AS. Some researchers mention the imposition of rigid routines (on self or others) as a criterion for diagnosing this condition. It appears that changes to their routines cause inordinate levels of anxiety for some people with this condition.[31]

    Some people with AS experience varying degrees of sensory overload and are extremely sensitive to touch, smells, sounds, tastes, and sights. They may prefer soft clothing, familiar scents, or certain foods. Some may even be pathologically sensitive to loud noises (as some people with AS have hyperacusis) or strong smells or dislike being touched; for example, certain children with AS exhibit a strong dislike of having their head touched or their hair disturbed while others like to be touched but dislike loud noises. Sensory overload may exacerbate problems faced by such children at school, where levels of noise in the classroom can become intolerable for them.[30] Some are unable to block out certain repetitive stimuli, such as the constant ticking of a clock. Whereas most children stop registering this sound after a short time and can hear it only if they consciously attend to it, a child with AS can become distracted, agitated, or even (in cases where the child has problems with regulating emotions such as anger) aggressive if the sound persists.[32]

    People with severe AS symptoms may frequently be diagnosed with clinical depression, oppositional defiant disorder, antisocial personality disorder, Tourette syndrome, ADHD, general anxiety disorder, bipolar disorder, obsessive compulsive disorder, or obsessive-compulsive personality disorder. Dysgraphia, Dyspraxia, Dyslexia, or Dyscalculia may also be diagnosed; however, while elements from all of these conditions are associated with AS, the cause is usually the syndrome itself, rather than a separate condition.[33] While there may be a correlation between them, the disorders are distinct. Research indicates people with AS may be far more likely to have the associated conditions, but the connection appears to be largely one of resemblance. For example, the "obsessions" common to those with AS are usually focused on a special interest; these differ in nature to those specific to OCD, which tend to be based on anxieties, such as a fear of germs.[34]

    [edit]
    Causes
    Main article: Causes of autism
    Twin and family studies suggest there is a genetic vulnerability to AS and the related disorders, but a specific gene for AS has not been identified. Multiple genes are thought to be responsible for causing AS, since the symptoms and the severity of symptoms vary widely among individuals.[1] Current research points to structural abnormalities in the brain as a cause of AS.[1][35] These abnormalities impact neural circuits that control thought and behavior. Researchers think that gene/environment interactions cause some genes to turn on or turn off, or turn on too much or too little in the wrong places, and this interferes with the normal migration and wiring of embryonic brain cells during early development.[1]

    Researchers at the University of California have proposed that AS stems from abnormal changes that happen during critical stages of fetal development. Defects in the genes that control and regulate normal brain growth create abnormal growth patterns; these may cause overgrowth in some brain structures and reduced growth or excessive cell loss in others.[1] Using advanced brain imaging techniques, scientists have revealed structural and functional differences in specific brain regions between the brains of normal versus AS children. One study found a lack of activity in the frontal lobe of AS children when asked to respond to tasks that required them to use their judgment. Another found differences in brain activity when children were asked to respond to facial expressions. Other methods of investigating brain function have revealed abnormal levels of particular proteins in the brains of adults with AS, which correlate with obsessive and repetitive behaviors.[1]

    [edit]
    Treatment
    Main article: Autism therapies
    Treatment for AS coordinates therapies that address the core symptoms of the disorder: poor communication skills, obsessive or repetitive routines, and physical clumsiness. There is no one best treatment modality for all persons with AS, but most professionals agree that early intervention is beneficial for children.[1]

    An effective treatment program generally includes:[1]

    social skills training, to teach children with AS skills to interact more successfully with other children
    cognitive behavioral therapy, to help explosive or anxious children to manage their emotions better and cut back on obsessive interests and repetitive routines
    medication, for co-existing conditions such as depression and anxiety
    occupational or physical therapy, for children with sensory integration problems or poor motor coordination
    specialized speech therapy, to help children who have trouble with the give and take of normal conversation
    parent training and support, to teach parents behavioral techniques to use at home.
    AS and high-functioning autism may be considered together for the purpose of clinical management.[36] Some treatments are controversial, based on claims that they may do more harm than good.[37][38]

    [edit]
    Prognosis
    Persons with AS appear to have normal lifespans, but an increased prevalence of comorbid psychiatric conditions, such as depression, mood disorders, and obsessive-compulsive disorder.[36]

    Children with AS can learn to manage their differences, but they may continue to find social situations and personal relationships challenging. Many adults with AS are able to work successfully in mainstream jobs, although they may continue to need encouragement and moral support to maintain an independent life.[1]

    Individuals with AS may make great intellectual contributions: published case reports suggest an association with accomplishments in computer science, mathematics, and physics. The deficits associated with AS may be debilitating, but many individuals experience positive outcomes, particularly those who are able to excel in areas not dependent on social interaction, such as mathematics, music, and the sciences.[36]

    [edit]
    Epidemiology
    The prevalence of AS is not well established, but conservative estimates using the DSM-IV criteria indicate that two to three of every 10,000 children have the condition, making it rarer than autistic disorder; three to four times as many boys having AS as girls.[1][39] The universality of AS across races, and validity of epidemiologic studies to date, is questioned.[40]

    A 1993 broad-based population study in Sweden found that 36 per 10,000 school-aged children met Gillberg's criteria for AS, rising to 71 per 10,000 if suspected cases are included.[4] The estimate is convincing for Sweden, but the findings may not apply elsewhere because they are based on a homogeneous population. The Sweden study demonstrated that AS may be more common than once thought and underdiagnosed.[36] Gillberg estimates 30-50% of all AS is undiagnosed.[20] A survey found that 36 per 10,000 of adults with IQ of 100 or above may meet criteria for AS.[41]

    Leekam et al. documented significant differences between Gillberg's criteria and the ICD-10 criteria.[42] Considering its requirement for "normal" development of cognitive skills, language, curiosity and self-help skills, ICD-10 is considerably more narrow than Gillberg's criteria, which more closely matches Hans Asperger's own descriptions.

    Like other autism spectrum disorders, AS prevalance estimates for males are higher than for females,[1] but some clinicians believe that this may not reflect the actual incidence among females. Tony Attwood suggests that females learn to better compensate for their impairments because of differences in socialization.[43] The Ehlers & Gillberg study[4] found a 4:1 male to female ratio in subjects meeting Gillberg's criteria for AS, but a lower 2.3:1 ratio when suspected or borderline cases were included.

    The prevalence of AS in adults is not well understood, but Baron-Cohen et al. documented that 2% of adults score higher than 32 in his Autism Spectrum Quotient (AQ) questionnaire, developed in 2001 to measure the extent to which an adult of normal intelligence has the traits associated with autism spectrum conditions.[44] All interviewed high-scorers met at least 3 DSM-IV criteria, and 63% met threshold criteria for an ASD diagnosis; a Japanese study found similar AQ Test results.[45]

    Most patients presenting in clinical settings with AS have other comorbid psychiatric disorders.[46] Children are likely to present with attention-deficit hyperactivity disorder (ADHD), while depression is a common diagnosis in adolescents and adults.[46] A study of referred adult patients found that 30% presenting with ADHD had ASD as well.[47]

    [edit]
    History

    Asperger syndrome is named after Hans Asperger.In 1944, an Austrian pediatrician named Hans Asperger observed four children in his practice who had difficulty integrating socially. Although their intelligence appeared normal, the children lacked nonverbal communication skills, failed to demonstrate empathy with their peers, and were physically clumsy. Their way of speaking was either disjointed or overly formal, and their all-absorbing interest in a single topic dominated their conversations. Dr. Asperger called the condition “autistic psychopathy” and described it as a personality disorder primarily marked by social isolation. [19]

    Hans Asperger and Leo Kanner identified essentially the same population, although the group identified by Asperger was perhaps more "socially functional" than Kanner's.[48] Traditionally, Kannerian autism is characterized by significant cognitive and communicative deficiencies, including delays in or lack of language.[49] However, a person with AS will not show delays in language.


    Leo Kanner identified another form of autism around the same time as Hans Asperger.Asperger’s observations, published in German, were not widely known until 1981, when an English doctor named Lorna Wing published a series of case studies of children showing similar symptoms, which she called “Asperger’s” syndrome. [17] Wing’s writings were widely published and popularized. In 1992, the tenth published edition of the World Health Organization’s diagnostic manual and the International Classification of Diseases (ICD-10) included AS, making it a distinct disease and diagnosis. Later, in 1994, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the American Psychiatric Association’s diagnostic reference book also added AS.[2]

    Uta Frith (an early researcher of Kannerian autism) wrote that people with AS seem to have more than a touch of autism to them.[50] Others, such as Lorna Wing and Tony Attwood, share Frith's assessment. Dr. Sally Ozonoff, of the University of California at Davis's MIND institute, argues that there should be no dividing line between "high-functioning" autism and AS,[51] and that the fact that some people do not start to produce speech until a later age is no reason to divide the two groups because they are identical in the way they need to be treated.

    [edit]
    Cultural and sociological aspects
    Further information: Autistic culture
    People with AS may refer to themselves in casual conversation as "aspies", coined by Liane Holliday Willey in 1999,[52] or as an "Aspergian".[53] The term neurotypical (NT) describes a person whose neurological development and state are typical, and is often used to refer to people who are non-autistic.

    Autistic people have contributed to a shift in perception of autism spectrum disorders as complex syndromes rather than diseases that must be cured.[54] Proponents of this view reject the notion that there is an 'ideal' brain configuration and that any deviation from the norm is pathological. They demand tolerance for what they call their neurodiversity in much the same way physically handicapped people have demanded tolerance.[55] These views are the basis for the autistic rights and autistic pride movements.[56] Researcher Simon Baron-Cohen has argued that high-functioning autism is a difference and not necessarily a disability.[57] He contends that the term "difference" is more neutral and value-free, and that this small shift in a term could mean the difference between a diagnosis of AS being received as a family tragedy, or interesting information, such as learning that a child is left-handed.

    A Wired magazine article, The Geek Syndrome,[58] suggested that AS is more common in the Silicon Valley, a haven for computer scientists and mathematicians. It posited that AS may be the result of assortative mating by geeks in mathematical and technological areas. However, AS can be found in all occupations, and is not limited to those in the math and science fields.[59]

    [edit]
    Social impact
    AS may lead to problems in social interaction with peers. These can be severe or mild depending on the individual. Children with AS are often the target of bullying at school because of their idiosyncratic behavior, language, interests, and their impaired ability to perceive and respond in socially expected ways to nonverbal cues, particularly in interpersonal conflict. Children with AS may be extremely literal and may have difficulty interpreting sarcasm. A child or teen with AS is often puzzled by this mistreatment, unaware of what has been done incorrectly. Unlike other pervasive development disorders, most children with AS want to be social but fail to socialize successfully, which can lead to later withdrawal and asocial behavior, especially in adolescence.[60]

    Children with AS often display advanced abilities for their age in language, reading, mathematics, spatial skills, and/or music—sometimes into the "gifted" range—but this may be counterbalanced by considerable delays in other developmental areas. This combination of traits can lead to problems with teachers and other authority figures. A child with Asperger’s might be regarded by teachers as a "problem child" or a "poor performer". The child’s extremely low tolerance for what they perceive to be ordinary and mediocre tasks, such as typical homework assignments, can easily become frustrating; a teacher may well consider the child arrogant, spiteful, and insubordinate. Lack of support and understanding, in combination with the child's anxieties, can result in problematic behavior (such as severe tantruming, violent outbursts, and withdrawal.[61]

    Adults with AS are not treated as regularly as children, yet may have similar problems. They may find it difficult gaining a job or entering undergraduate or graduate schools because of poor interview skills or a low score on standardized or personality tests. They also may be more vulnerable to poverty than the general population, because of their difficulty getting a job, lack of proper education, and premature social skills.[41] If they do get a job they might be misunderstood and become subject to bullying. They may also have difficulty finding a life partner and getting married because of poor social skills. People with AS report a feeling of being unwillingly detached from the world around them. On the other hand there are Asperger adults who do get married, get a doctorate from a fine university, and hold a job. The intense focus and tendency to work things out logically, a characteristic of Asperger syndrome, often grants people with the syndrome a high level of ability in their field of interest. When these special interests coincide with a materially or socially useful task, the person with Asperger's often can lead a profitable life. The child obsessed with naval architecture may grow up to be an accomplished shipwright.[62] More research is needed on adults with AS.[63]

    [edit]
    Notable cases

    Albert Einstein may have had Asperger syndrome.Main articles: List of autistic people and People speculated to have been autistic
    AS is sometimes viewed as a syndrome with both advantages and disadvantages,[64] and notable adults with AS or autism have achieved success in their fields. Prominent Asperger-diagnosed individuals include Nobel Prize-winning economist Vernon Smith,[65] industrial rocker Gary Numan,[66] Vines frontman Craig Nicholls,[67] and Satoshi Tajiri, the creator of Pokémon.[68]

    Some AS researchers speculate that well-known figures, including Albert Einstein, Isaac Newton and Ludwig Wittgenstein, had AS because they showed some AS-related tendencies or behaviors, such as intense interest in one subject, or social problems.[69][70][71][72] Stanley Kubrick[73] is also speculated to have had the syndrome. However, posthumous diagnoses remain controversial, and autistic rights activists use such speculative diagnoses to argue that it would be a loss to society if autism were cured.[74]

    [edit]
    See also
    List of further reading on Asperger syndrome

    From Wikipedia, the free encyclopedia
    Jump to: navigation, search
    Asperger syndrome ICD-10 F84.5
    ICD-9 299.8
    OMIM 608638
    DiseasesDB 31268
    MedlinePlus 001549
    eMedicine ped/147
    Asperger syndrome – also called Asperger's syndrome, AS, or just Asperger's – is one of five neurobiological pervasive developmental disorders (PDD), and is characterized by normal intelligence and language development, but deficiencies in social and communication skills. The diagnosis of Asperger syndrome is complicated by the lack of a standard diagnostic screen, and the use of several different screening instruments and sets of diagnostic criteria. The exact cause of AS is unknown, and the prevalence is not firmly established, due partly to the use of differing sets of diagnostic criteria.

    The management of AS consists of therapies that address the core symptoms of the disorder: poor communication skills, obsessive or repetitive routines, and physical clumsiness. Most children and adults with AS can learn to cope with their differences, but may continue to need support to maintain an independent life.

    Asperger syndrome was named in honor of Hans Asperger, an Austrian psychiatrist and pediatrician, by researcher Lorna Wing, who first used the eponym in a 1981 paper. In 1994, AS was recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM).


    Hans Asperger, after whom the syndrome is named, described his patients as "little professors".Contents [hide]
    1 Classification and diagnosis
    2 Characteristics
    2.1 Social impairments
    2.2 Narrow, intense interests
    2.3 Speech and language peculiarities
    2.4 Writing peculiarities
    2.5 Emotional peculiarities
    2.6 Other characteristics
    3 Causes
    4 Treatment
    5 Prognosis
    6 Epidemiology
    7 History
    8 Cultural and sociological aspects
    8.1 Social impact
    8.2 Notable cases
    9 See also
    10 References
    11 External links



    [edit]
    Classification and diagnosis
    See also: Autism spectrum disorder
    AS is an autism spectrum disorder, one of five neurological conditions characterized by impairment in language and communication skills, as well as repetitive or restrictive patterns of thought and behavior. The four related disorders are autism, Rett syndrome, childhood disintegrative disorder, and PDD-NOS (pervasive developmental disorder not otherwise specified).[1]

    AS is defined in section 299.80 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) by six main criteria. These criteria define AS as a condition in which there is a 1) qualitative impairment in social interaction and 2) significant impairment in important areas of functioning, as well as 3) the presence of restricted, repetitive and stereotyped behaviors and interests, but with 4) no significant delay in language or 5) cognitive development, self-help skills, or adaptive behaviors (other than social interaction). The symptoms must 6) not be better accounted for by another specific pervasive developmental disorder or schizophrenia.[2]

    The diagnosis of AS is complicated by the use of several different screening instruments.[1] The diagnostic criteria of the Diagnostic and Statistical Manual are criticized for being vague and subjective.[3][4] Other sets of diagnostic criteria for AS are the ICD 10 World Health Organization Diagnostic Criteria, Szatmari Diagnostic Criteria,[5] Gillberg Diagnostic Criteria,[6] and Attwood & Gray Discovery Criteria.[7] The ICD-10 definition has similar criteria to the DSM-IV version.[7] In the ICD-10 the phrase Asperger's syndrome is synonymous with Autistic psychopathy and Schizoid disorder of childhood. [8]

    Some doctors believe that AS is not a separate and distinct disorder, referring to it as high functioning autism (HFA).[1] Szatmari suggests that AS was promoted as a diagnosis to spark more research into the syndrome: "It was introduced into the official classification systems in 1994 and has grown in popularity as a diagnosis, even though its validity has not been clearly established. It is interesting to note that it was introduced not so much as an indication of its status as a 'true' disorder, but more to stimulate research ... its validity is very much in question."[9] The diagnoses of AS or HFA are used interchangeably, complicating prevalence estimates: the same child can receive different diagnoses, depending on the screening tool the doctor uses, and some children will be diagnosed with HFA instead of AS, and vice versa.[1]

    [edit]
    Characteristics
    AS is characterized by:[1][2]

    limited interests or preoccupation with a subject to the exclusion of other activities;
    repetitive behaviors or rituals;
    peculiarities in speech and language;
    socially and emotionally inappropriate behavior and interpersonal interaction
    problems with non-verbal communication; and
    clumsy and uncoordinated motor movements.
    The most common and important characteristics of AS can be divided into several broad categories: social impairments, narrow but intense interests, and peculiarities of speech and language. Other features are commonly associated with this syndrome, but are not always regarded as necessary for diagnosis. This section mainly reflects the views of Attwood, Gillberg, and Wing on the most important characteristics of AS; the DSM-IV criteria represent a slightly different view. Unlike most forms of PDDs, AS is often camouflaged, and many people with the disorder blend in with those that do not have it. The effects of AS also depend on how an individual with the syndrome responds to it.[7]

    [edit]
    Social impairments
    Although there is no single feature that all people with AS share, difficulties with social behavior are nearly universal and are one of the most important defining criteria. People with AS lack the natural ability to see the subtexts of social interaction (e.g., resulting in well-meaning remarks that may offend, or finding it hard to know what is "acceptable") and may lack the ability to communicate their own emotional state. The unwritten rules of social behavior, that mystify so many with AS, have been termed "The Hidden Curriculum".[10] People with AS must learn these social skills intellectually rather than intuitively.[11]

    Non-autistics are able to gather information about other people's cognitive and emotional states based on clues gleaned from the environment and the other people's facial expression and body language, but in this respect, people with AS are impaired; this is sometimes called mind-blindness.[12] Mind-blindness involves an impaired ability to: read others' feelings, understand intended meanings and gauge level of interest in a conversation; take into account others' level of knowledge and predict someone's reaction to a comment or action.[13]

    Some people with AS make very little eye contact because they find it overwhelming, whereas others have unmodulated, staring eye contact that can cause discomfort in other people.[14] Similarly, the use of gestures may be almost nonexistent or may seem exaggerated and differ from what would normally be considered the most appropriate for a situation.[15]

    [edit]
    Narrow, intense interests
    AS can involve an intense and obsessive level of focus on things of interest. For example, one person might be obsessed with 1950s professional wrestling, another with national anthems of African dictatorships, and another with building models out of matchsticks. Particularly common interests are means of transport (for example, trains), computers, mathematics, astronomy, geography, history, and dinosaurs. Note that all of these are normal interests in ordinary children; the difference in Asperger children is the unusual intensity of their interest.[16]

    Sometimes these interests are lifelong; in other cases, they change at unpredictable intervals. In either case, there are normally one or two interests at any given time. In pursuit of these interests, people with AS often manifest extremely sophisticated reasoning, an almost obsessive focus, and a remarkably good memory for apparently trivial facts (occasionally even eidetic memory).[17][18] Hans Asperger called his young patients "little professors" because he thought his thirteen-year-old patients had as comprehensive and nuanced an understanding of their field of interest as university professors.[19]

    Some clinicians do not entirely agree with this description; for example, Wing and Gillberg both argue that these areas of intense interest typically involve more rote memorization than real understanding,[17] despite occasional appearances to the contrary. However, such a limitation is an artifact of the diagnostic criteria, even under Gillberg's criteria.[6]

    People with Asperger syndrome may have little patience for things outside these narrow interests. In school, they may be perceived as highly intelligent underachievers or overachievers, clearly capable of outperforming their peers in their field of interest yet persistently unmotivated to do regular homework assignments (sometimes even in their areas of interest). Others may be hypermotivated to outperform peers in school. The combination of social problems and intense interests can lead to unusual behavior, such as greeting a stranger by launching into a lengthy monologue about a special interest rather than introducing oneself in the socially-accepted way. However, in many cases adults can outgrow this impatience and lack of motivation and develop more tolerance to new activities and meeting new people.[20]

    [edit]
    Speech and language peculiarities
    People with AS typically having a highly pedantic way of speaking, using a far more formal register of language than appropriate for a context. A five-year-old child with this condition may regularly speak in language that could easily have come from a university textbook, especially concerning his or her special area of interest.[21]

    Literal interpretation is another common, but not universal hallmark of this condition. Attwood gives the example of a girl with AS who answered the telephone one day and was asked, "Is Paul there?" Although the Paul in question was in the house, he was not in the room with her, so after looking around to ascertain this, she simply said "no" and hung up. The person on the other end had to call back and explain to her that he meant for her to find him and get him to pick up the telephone.[22]

    People with AS sometimes use words idiosyncratically, including new coinages and unusual juxtapositions. This can develop into a rare gift for humor (especially puns, wordplay, doggerel and satire). A potential source of humor is the eventual realization that their literal interpretations can be used to amuse others. Some are so proficient at written language as to qualify as hyperlexic. Tony Attwood refers to a particular child's skill at inventing expressions, e.g., "tidying down" (the opposite of tidying up) or "broken" (when referring to a baby brother who cannot walk or talk).[23]

    Another typical behavioural characteristic is echolalia, which causes the subject to repeat words, or parts of words, like an echo, and palilalia repeating one's own words.[24] Children with AS may show advanced abilities for their age in language, reading, mathematics, spatial skills, or music, sometimes into the 'gifted' range, although these talents may be counterbalanced by appreciable delays in the developmental of other cognitive functions. [20]

    [edit]
    Writing peculiarities
    Further information: Dysgraphia
    A 2003 study investigated the written language of children and youth with AS. They were compared in a standardized test of written language skills and legibility of handwriting. In written language skills, no significant differences were found between standardized scores of both groups; however, in hand-writing skills, the AS participants produced significantly fewer legible letters and words than the neurotypical group. Another analysis of written samples found that people with AS appear to be able to write quantitatively similar to their neurotypical peers using grammatical rules, but have difficulty in producing qualitative writing.[25]

    Tony Attwood states that a teacher may spend considerable time interpreting and correcting an AS child's indecipherable scrawl. The child is also aware of the poor quality of their handwriting, and may be reluctant to engage in activities that involve extensive writing. Unfortunately for some children and adults, high school teachers and prospective employers may consider the neatness of handwriting a measure of intelligence and personality. People with AS then become embarrassed or angry at their inability to write neatly. The child may require assessment by an occupational therapist and remedial exercises, but modern technology can help minimise this problem. A parent or teacher aide could also act as the child's scribe or proofreader to ensure the legibility of the child's written answers or homework.[26]

    People with AS may be very skilled at using computers and keyboards. This allows for possible special dispensation in schoolwork to type rather than write homework and examinations. The presentation of their work is then comparable to that of other children.[26]

    [edit]
    Emotional peculiarities
    A person with AS may have trouble understanding the emotions of other people: the messages that are conveyed by facial expression, eye contact and body language are often missed. They also might have trouble showing empathy with other people. Thus, people with AS might be seen as egotistical, selfish or uncaring. In most cases, these are unfair labels, because affected people are neurologically unable to understand other people's emotional states. They are usually shocked, upset and remorseful when told that their actions are hurtful or inappropriate. It is clear that people with AS do not lack emotions. However, the concrete nature of attachments they might have (i.e., to objects rather than to people) often seems curious, or even can be cause of concern, to people who do not share their perspective.[27]

    Failing to show affection—or not doing so in conventional ways—does not necessarily mean that people with AS do not feel it. Understanding this can lead partners or carers to feel less rejected and to be more understanding. There are usually ways to work around the problems, such as being more explicit about one's needs. For instance, when describing emotions, it can be helpful to be direct and to avoid vague terms such as "upset" when the emotion being described is anger (some individuals with AS would interpret "upset" as mere annoyance, or even nausea). It is often effective to present in clear language what the problem is and to ask the partner with AS to describe what emotions are being felt, or to ask why a certain emotion was being felt. It is helpful if the family member or significant other reads as much as he or she can about AS and any comorbid disorders.[28] Sometimes, the opposite problem occurs; the person with AS is unusually affectionate to significant others and misses or misinterprets signals from the other partner, causing the partner stress.[29]

    [edit]
    Other characteristics
    Those affected by AS may show a range of other sensory, developmental, and physiological anomalies. Children with AS may evidence a slight delay in the development of fine motor skills. In some cases, people with AS may have an odd way of walking, and may display compulsive finger, hand, arm or leg movements.[30]

    In general, orderly things appeal to people with AS. Some researchers mention the imposition of rigid routines (on self or others) as a criterion for diagnosing this condition. It appears that changes to their routines cause inordinate levels of anxiety for some people with this condition.[31]

    Some people with AS experience varying degrees of sensory overload and are extremely sensitive to touch, smells, sounds, tastes, and sights. They may prefer soft clothing, familiar scents, or certain foods. Some may even be pathologically sensitive to loud noises (as some people with AS have hyperacusis) or strong smells or dislike being touched; for example, certain children with AS exhibit a strong dislike of having their head touched or their hair disturbed while others like to be touched but dislike loud noises. Sensory overload may exacerbate problems faced by such children at school, where levels of noise in the classroom can become intolerable for them.[30] Some are unable to block out certain repetitive stimuli, such as the constant ticking of a clock. Whereas most children stop registering this sound after a short time and can hear it only if they consciously attend to it, a child with AS can become distracted, agitated, or even (in cases where the child has problems with regulating emotions such as anger) aggressive if the sound persists.[32]

    People with severe AS symptoms may frequently be diagnosed with clinical depression, oppositional defiant disorder, antisocial personality disorder, Tourette syndrome, ADHD, general anxiety disorder, bipolar disorder, obsessive compulsive disorder, or obsessive-compulsive personality disorder. Dysgraphia, Dyspraxia, Dyslexia, or Dyscalculia may also be diagnosed; however, while elements from all of these conditions are associated with AS, the cause is usually the syndrome itself, rather than a separate condition.[33] While there may be a correlation between them, the disorders are distinct. Research indicates people with AS may be far more likely to have the associated conditions, but the connection appears to be largely one of resemblance. For example, the "obsessions" common to those with AS are usually focused on a special interest; these differ in nature to those specific to OCD, which tend to be based on anxieties, such as a fear of germs.[34]

    [edit]
    Causes
    Main article: Causes of autism
    Twin and family studies suggest there is a genetic vulnerability to AS and the related disorders, but a specific gene for AS has not been identified. Multiple genes are thought to be responsible for causing AS, since the symptoms and the severity of symptoms vary widely among individuals.[1] Current research points to structural abnormalities in the brain as a cause of AS.[1][35] These abnormalities impact neural circuits that control thought and behavior. Researchers think that gene/environment interactions cause some genes to turn on or turn off, or turn on too much or too little in the wrong places, and this interferes with the normal migration and wiring of embryonic brain cells during early development.[1]

    Researchers at the University of California have proposed that AS stems from abnormal changes that happen during critical stages of fetal development. Defects in the genes that control and regulate normal brain growth create abnormal growth patterns; these may cause overgrowth in some brain structures and reduced growth or excessive cell loss in others.[1] Using advanced brain imaging techniques, scientists have revealed structural and functional differences in specific brain regions between the brains of normal versus AS children. One study found a lack of activity in the frontal lobe of AS children when asked to respond to tasks that required them to use their judgment. Another found differences in brain activity when children were asked to respond to facial expressions. Other methods of investigating brain function have revealed abnormal levels of particular proteins in the brains of adults with AS, which correlate with obsessive and repetitive behaviors.[1]

    [edit]
    Treatment
    Main article: Autism therapies
    Treatment for AS coordinates therapies that address the core symptoms of the disorder: poor communication skills, obsessive or repetitive routines, and physical clumsiness. There is no one best treatment modality for all persons with AS, but most professionals agree that early intervention is beneficial for children.[1]

    An effective treatment program generally includes:[1]

    social skills training, to teach children with AS skills to interact more successfully with other children
    cognitive behavioral therapy, to help explosive or anxious children to manage their emotions better and cut back on obsessive interests and repetitive routines
    medication, for co-existing conditions such as depression and anxiety
    occupational or physical therapy, for children with sensory integration problems or poor motor coordination
    specialized speech therapy, to help children who have trouble with the give and take of normal conversation
    parent training and support, to teach parents behavioral techniques to use at home.
    AS and high-functioning autism may be considered together for the purpose of clinical management.[36] Some treatments are controversial, based on claims that they may do more harm than good.[37][38]

    [edit]
    Prognosis
    Persons with AS appear to have normal lifespans, but an increased prevalence of comorbid psychiatric conditions, such as depression, mood disorders, and obsessive-compulsive disorder.[36]

    Children with AS can learn to manage their differences, but they may continue to find social situations and personal relationships challenging. Many adults with AS are able to work successfully in mainstream jobs, although they may continue to need encouragement and moral support to maintain an independent life.[1]

    Individuals with AS may make great intellectual contributions: published case reports suggest an association with accomplishments in computer science, mathematics, and physics. The deficits associated with AS may be debilitating, but many individuals experience positive outcomes, particularly those who are able to excel in areas not dependent on social interaction, such as mathematics, music, and the sciences.[36]

    [edit]
    Epidemiology
    The prevalence of AS is not well established, but conservative estimates using the DSM-IV criteria indicate that two to three of every 10,000 children have the condition, making it rarer than autistic disorder; three to four times as many boys having AS as girls.[1][39] The universality of AS across races, and validity of epidemiologic studies to date, is questioned.[40]

    A 1993 broad-based population study in Sweden found that 36 per 10,000 school-aged children met Gillberg's criteria for AS, rising to 71 per 10,000 if suspected cases are included.[4] The estimate is convincing for Sweden, but the findings may not apply elsewhere because they are based on a homogeneous population. The Sweden study demonstrated that AS may be more common than once thought and underdiagnosed.[36] Gillberg estimates 30-50% of all AS is undiagnosed.[20] A survey found that 36 per 10,000 of adults with IQ of 100 or above may meet criteria for AS.[41]

    Leekam et al. documented significant differences between Gillberg's criteria and the ICD-10 criteria.[42] Considering its requirement for "normal" development of cognitive skills, language, curiosity and self-help skills, ICD-10 is considerably more narrow than Gillberg's criteria, which more closely matches Hans Asperger's own descriptions.

    Like other autism spectrum disorders, AS prevalance estimates for males are higher than for females,[1] but some clinicians believe that this may not reflect the actual incidence among females. Tony Attwood suggests that females learn to better compensate for their impairments because of differences in socialization.[43] The Ehlers & Gillberg study[4] found a 4:1 male to female ratio in subjects meeting Gillberg's criteria for AS, but a lower 2.3:1 ratio when suspected or borderline cases were included.

    The prevalence of AS in adults is not well understood, but Baron-Cohen et al. documented that 2% of adults score higher than 32 in his Autism Spectrum Quotient (AQ) questionnaire, developed in 2001 to measure the extent to which an adult of normal intelligence has the traits associated with autism spectrum conditions.[44] All interviewed high-scorers met at least 3 DSM-IV criteria, and 63% met threshold criteria for an ASD diagnosis; a Japanese study found similar AQ Test results.[45]

    Most patients presenting in clinical settings with AS have other comorbid psychiatric disorders.[46] Children are likely to present with attention-deficit hyperactivity disorder (ADHD), while depression is a common diagnosis in adolescents and adults.[46] A study of referred adult patients found that 30% presenting with ADHD had ASD as well.[47]

    [edit]
    History

    Asperger syndrome is named after Hans Asperger.In 1944, an Austrian pediatrician named Hans Asperger observed four children in his practice who had difficulty integrating socially. Although their intelligence appeared normal, the children lacked nonverbal communication skills, failed to demonstrate empathy with their peers, and were physically clumsy. Their way of speaking was either disjointed or overly formal, and their all-absorbing interest in a single topic dominated their conversations. Dr. Asperger called the condition “autistic psychopathy” and described it as a personality disorder primarily marked by social isolation. [19]

    Hans Asperger and Leo Kanner identified essentially the same population, although the group identified by Asperger was perhaps more "socially functional" than Kanner's.[48] Traditionally, Kannerian autism is characterized by significant cognitive and communicative deficiencies, including delays in or lack of language.[49] However, a person with AS will not show delays in language.


    Leo Kanner identified another form of autism around the same time as Hans Asperger.Asperger’s observations, published in German, were not widely known until 1981, when an English doctor named Lorna Wing published a series of case studies of children showing similar symptoms, which she called “Asperger’s” syndrome. [17] Wing’s writings were widely published and popularized. In 1992, the tenth published edition of the World Health Organization’s diagnostic manual and the International Classification of Diseases (ICD-10) included AS, making it a distinct disease and diagnosis. Later, in 1994, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the American Psychiatric Association’s diagnostic reference book also added AS.[2]

    Uta Frith (an early researcher of Kannerian autism) wrote that people with AS seem to have more than a touch of autism to them.[50] Others, such as Lorna Wing and Tony Attwood, share Frith's assessment. Dr. Sally Ozonoff, of the University of California at Davis's MIND institute, argues that there should be no dividing line between "high-functioning" autism and AS,[51] and that the fact that some people do not start to produce speech until a later age is no reason to divide the two groups because they are identical in the way they need to be treated.

    [edit]
    Cultural and sociological aspects
    Further information: Autistic culture
    People with AS may refer to themselves in casual conversation as "aspies", coined by Liane Holliday Willey in 1999,[52] or as an "Aspergian".[53] The term neurotypical (NT) describes a person whose neurological development and state are typical, and is often used to refer to people who are non-autistic.

    Autistic people have contributed to a shift in perception of autism spectrum disorders as complex syndromes rather than diseases that must be cured.[54] Proponents of this view reject the notion that there is an 'ideal' brain configuration and that any deviation from the norm is pathological. They demand tolerance for what they call their neurodiversity in much the same way physically handicapped people have demanded tolerance.[55] These views are the basis for the autistic rights and autistic pride movements.[56] Researcher Simon Baron-Cohen has argued that high-functioning autism is a difference and not necessarily a disability.[57] He contends that the term "difference" is more neutral and value-free, and that this small shift in a term could mean the difference between a diagnosis of AS being received as a family tragedy, or interesting information, such as learning that a child is left-handed.

    A Wired magazine article, The Geek Syndrome,[58] suggested that AS is more common in the Silicon Valley, a haven for computer scientists and mathematicians. It posited that AS may be the result of assortative mating by geeks in mathematical and technological areas. However, AS can be found in all occupations, and is not limited to those in the math and science fields.[59]

    [edit]
    Social impact
    AS may lead to problems in social interaction with peers. These can be severe or mild depending on the individual. Children with AS are often the target of bullying at school because of their idiosyncratic behavior, language, interests, and their impaired ability to perceive and respond in socially expected ways to nonverbal cues, particularly in interpersonal conflict. Children with AS may be extremely literal and may have difficulty interpreting sarcasm. A child or teen with AS is often puzzled by this mistreatment, unaware of what has been done incorrectly. Unlike other pervasive development disorders, most children with AS want to be social but fail to socialize successfully, which can lead to later withdrawal and asocial behavior, especially in adolescence.[60]

    Children with AS often display advanced abilities for their age in language, reading, mathematics, spatial skills, and/or music—sometimes into the "gifted" range—but this may be counterbalanced by considerable delays in other developmental areas. This combination of traits can lead to problems with teachers and other authority figures. A child with Asperger’s might be regarded by teachers as a "problem child" or a "poor performer". The child’s extremely low tolerance for what they perceive to be ordinary and mediocre tasks, such as typical homework assignments, can easily become frustrating; a teacher may well consider the child arrogant, spiteful, and insubordinate. Lack of support and understanding, in combination with the child's anxieties, can result in problematic behavior (such as severe tantruming, violent outbursts, and withdrawal.[61]

    Adults with AS are not treated as regularly as children, yet may have similar problems. They may find it difficult gaining a job or entering undergraduate or graduate schools because of poor interview skills or a low score on standardized or personality tests. They also may be more vulnerable to poverty than the general population, because of their difficulty getting a job, lack of proper education, and premature social skills.[41] If they do get a job they might be misunderstood and become subject to bullying. They may also have difficulty finding a life partner and getting married because of poor social skills. People with AS report a feeling of being unwillingly detached from the world around them. On the other hand there are Asperger adults who do get married, get a doctorate from a fine university, and hold a job. The intense focus and tendency to work things out logically, a characteristic of Asperger syndrome, often grants people with the syndrome a high level of ability in their field of interest. When these special interests coincide with a materially or socially useful task, the person with Asperger's often can lead a profitable life. The child obsessed with naval architecture may grow up to be an accomplished shipwright.[62] More research is needed on adults with AS.[63]

    [edit]
    Notable cases

    Albert Einstein may have had Asperger syndrome.Main articles: List of autistic people and People speculated to have been autistic
    AS is sometimes viewed as a syndrome with both advantages and disadvantages,[64] and notable adults with AS or autism have achieved success in their fields. Prominent Asperger-diagnosed individuals include Nobel Prize-winning economist Vernon Smith,[65] industrial rocker Gary Numan,[66] Vines frontman Craig Nicholls,[67] and Satoshi Tajiri, the creator of Pokémon.[68]

    Some AS researchers speculate that well-known figures, including Albert Einstein, Isaac Newton and Ludwig Wittgenstein, had AS because they showed some AS-related tendencies o
    Well I am back. How's everyone? Don't have as much time now, but glad to see some of the old gang are still here.

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    anyone who can/will read all of that scores a few points in the asperger's direction (kidding...)

    the INTj I was with has asperger's syndrome
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    although i'm basically certain im INTp by now, it has been suggested to me that I have asperger's syndrome. from what i know about it, it seems possible but i haven't investigated the condition very thoroughly.

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    Creepy-pokeball

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    That isnt the most current version of DSM...

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    I thought there would have been a line "The subjects asks on the internet how to hit on girls in real-time"
    Obsequium amicos, veritas odium parit

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    Quote Originally Posted by niffweed17
    it has been suggested to me that I have asperger's syndrome.
    "hey dude"

    "what's up"

    "i think you have aspergers syndrome dude."

    "what is that?"

    "it's like quasi-autism"

    "awesome.....wait, what?"
    asd

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    "Children with AS may be extremely literal and may have difficulty interpreting sarcasm"

    Shocking.

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    I was diagnosed with Autism by a couple neuroligists when I was younger.

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    I can relate to it a very small bit, but I doubt that I have it.

    "problems with non-verbal communication"

    This for instance is characteristic of me. I learned to deal with this by watching the person in question's facial reactions to various stimuli given by me, then I watch them interact with other people and try to see what other stimuli given by others gets them to exhibit the same expressions. I do this for a while and then decide what a particular expression of theirs means based on its exhibition and the frequency of similarity of the stimuli.

    I thought everyone did this to one degree or another, but my husband informs me that apparently this is not so.
    All Hail The Flying Spaghetti Monster

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    I think people with asperger's syndrome (lol sounds like ass burger) can look INTj or esspecially INTp when they are not. They have weak Fe, regardless of type.
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    Quote Originally Posted by oyburger
    I can relate to it a very small bit, but I doubt that I have it.

    "problems with non-verbal communication"

    This for instance is characteristic of me. I learned to deal with this by watching the person in question's facial reactions to various stimuli given by me, then I watch them interact with other people and try to see what other stimuli given by others gets them to exhibit the same expressions. I do this for a while and then decide what a particular expression of theirs means based on its exhibition and the frequency of similarity of the stimuli.

    I thought everyone did this to one degree or another, but my husband informs me that apparently this is not so.
    I do that too.
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    Quote Originally Posted by Dioklecian
    I do that too.
    Excellent, you proved my husband wrong. You get a cookie! .
    All Hail The Flying Spaghetti Monster

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    Quote Originally Posted by oyburger
    Quote Originally Posted by Dioklecian
    I do that too.
    Excellent, you proved my husband wrong. You get a cookie! .
    *tastes it"

    mmmmmmmmmmmmm doughnuts ......
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    Quote Originally Posted by heath
    Quote Originally Posted by niffweed17
    it has been suggested to me that I have asperger's syndrome.
    "hey dude"

    "what's up"

    "i think you have aspergers syndrome dude."

    "what is that?"

    "it's like quasi-autism"

    "awesome.....wait, what?"
    lol

    not exactly...

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    when I told the INTj I was with that I thought he had asperger's, asked what it is. I read a brief description. He said "I've been telling people my whole life that I'm autistic. No one would believe me. Ha! I was right!"
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    Quote Originally Posted by soggy-flakes
    I think I'm one of those closet aspies. Its not obvious to most people that I have some asperger traits and I can pass for neurotypical. However, the people (which are few) that know me really well can tell there's something different in the way I think and process info.
    Whats' different if I may ask?
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    Quote Originally Posted by soggy-flakes
    Quote Originally Posted by Dioklecian
    Quote Originally Posted by soggy-flakes
    I think I'm one of those closet aspies. Its not obvious to most people that I have some asperger traits and I can pass for neurotypical. However, the people (which are few) that know me really well can tell there's something different in the way I think and process info.
    Whats' different if I may ask?
    I take a more logical and mathematical approach to things than most. Some think I lack common sense which isn't really true but might appear that way to others because I have my own methods of doing things that work well for me but aren't used by others.

    In spite of my N preference, I take many things very literally. Some figures of speech confuse me. I want people to say what they mean and mean what they say. Sometimes filling out applications and forms confuses me because I am not clear what they are really looking for in a particular field even though its obvious to others what is being implied.

    I don't read peoples' feelings very well. Just tell me straight out if something I'm doing bugs you or if you are unhappy. Don't make me guess.

    I appear emotionally detached and in my own world to many people. I am very caring and passionate in reality but this side of me doesn't seem to get expressed enough.
    Wow, it seems like we're the same person!
    All Hail The Flying Spaghetti Monster

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    "Asperger Syndrome" = gay political discrimination

    For example, in France, INT types are considered sick, especially when they have a strong IT preference.

    Some french people pretends all logical types, including extroverts, are sick, because they value excessive hippie relativism ; that's related to the GREEN vMEME.

    There are sick and healthy versions of all types. Officially being INT in France would be "being sick for life".

    If anyone says again I'm autist, I'll break his teeth in. lol

    In fact, under stress, an INT type tend to be somewhat agressive... If any logical type seem not liking you, it's because you don't deserve it, not because he's sick. That pretty unserious and gay : people don't want to be responsible, so they find classifications for the people they don't like.

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    Asperger Syndrome seems to be semantic terrorism ; when a neurologist said I actually have AS, my parents believed him, because they are pretty naive ; they are both F-types (ISFj and ENFj), and you know, F-types are more subject to T-oriented manipulation.

    So why INT ? INT is negativist. Gulenko said (if I'm not mistaken) that negativist types (ISF INT ENF EST) were reserved, and positivist types (ESF ENT INF IST) were sociable. INT is negativist, obstinate, task-oriented. INT is actually hated in relativistic societies. This expliains why a INT is considered sick in France, even when healthy.

    In France, we don't know socionics ; and we don't even know Myers-Briggs. We prefer to call INT a disorder, because we don't like INT types. In France, we know mainly the Process Com model, which seems to say being an INT is undesirable, and must be treated harshly. But did the Process Com's founder (Taibi Kahler) ever think they don't obey to their bosses because they like them, but rather because they need money to survive ?

    Maybe, Hans Asperger could have tried to date an INT woman and failed ; so he began to hate them and call that a disorder.

    http://www.youtube.com/watch?v=T9Yd8E-IlVw

    And, as said in this video, non-INT types can actually be called aspies, because society doesn't like them. That's bi-polar thinking. "X = Good, non-X = Evil"

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    From that video... who doesn't have asperger's syndrome?
    SEE-Se, 852 sx/so

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    Quote Originally Posted by Joy
    From that video... who doesn't have asperger's syndrome?
    who doesn't ? those who are liked by society.

    reasoning in means, I can say that : by saying "Aspie = Evil" and "non-Aspie = Good", you actually imply "Evil = Aspie" and "Good = non-Aspie". Asperger is actually (i.e. semantic) terrorism.

    I'm a thinking type, but I'm pretty sensitive to injustice. when I see something wrong, I can become agressive. (weak accepting and )

    Asperger also seems to correlate with all enneagram categories, except 2 and 3. You must be a 2 or a 3 to be considered healthy. But what will happen if we exterminate all 4-5-6-7-8-9-1's ?

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    Saying that society hates Ti is also saying that society hates Fe... this is not only illogical, but also pretty much impossible, imo. Society is all about Fe, and Fe is all about society.

    Maybe you're thinking more about introversion? Or IxTxs perhaps?
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    To tell you the truth, the categories in that video seemed more "biased" against intuitive types than anything.
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    Quote Originally Posted by Joy
    Saying that society hates Ti is also saying that society hates Fe... this is not only illogical, but also pretty much impossible, imo. Society loves Fe, and Fe loves society.

    Maybe you're thinking more about introversion? Or IxTxs perhaps?
    no, because IF types are socially accepted ; even more than ET types. Relativistic societes uses the term "introversion" to say "logic", because they don't like task-oriented people. I'm logical and some persons (especially women) said I'm heartless.

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    I guess I don't know what a "Relativistic" society is.
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    Quote Originally Posted by Joy
    I guess I don't know what a "Relativistic" society is.
    a GREEN vMeme-based society

    you'll understand, if you know Spiral Dynamics

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    Spiral Dynamics© is a way of thinking about the complexities of human existence and understanding the order and chaos in human affairs. It explains deep forces in human nature which shape our values, and lays out both a pattern and trajectory for change. SD will help you gain a greater understanding of how people, organizations and cultures function from the inside out—and will empower you to help them work, learn, and live better.
    Sounds sorta Ni and Te, imo (meaning that the type which I believe to appear most "asperger", INTp, by your theory isn't?)

    Edit: To clarify, INTjs are just as "asperger" in appearance as INTps.
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    Quote Originally Posted by machintruc
    no, because IF types are socially accepted ; even more than ET types. Relativistic societes uses the term "introversion" to say "logic", because they don't like task-oriented people. I'm logical and some persons (especially women) said I'm heartless.
    Machin, F functions are "social" functions by defintion, that's why they are...social!
    Obsequium amicos, veritas odium parit

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    I'd say Fe is more social and Fi is more about relationships. Of course, Fi types will have strong Fe as well.
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    Quote Originally Posted by Joy
    I'd say Fe is more social and Fi is more about relationships. Of course, Fi types will have strong Fe as well.
    Do you call that social ? Discriminating strong logical types ? lol

    For example, one could make a test of 40 questions, but only to differentiate the T-F dichotomy. The asperger-threshold would be at 35 choices related to logical types lol... Basically if your T trait is very strong you're an Asperger. I was actually diagnosed aspie, and my highest trait of my type is T.

    An INTp could be an Asperger, but an ESTj actually can... I don't think that's related to introversion, but to logic. Lytov said Eysenck's extroversion was actually related to S and F.

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    It's quite possible for a type to hate/suppress their dual. From a distance, you may only see that your dual excels in your weaknesses, and resent that.



    LII-Ne

    "Come to think of it, there are already a million monkeys on a million typewriters, and the Usenet is NOTHING like Shakespeare!"
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    Giving this a casual bump. Here is a list of things:

    • Limited interests or preoccupation with a subject to the exclusion of other activities;
    • Repetitive behaviors or rituals;
    • Peculiarities in speech and language;
    • Socially and emotionally inappropriate behavior and interpersonal interaction
    • Problems with non-verbal communication; and
    • Clumsy and uncoordinated motor movements.


    And also this:http://www.help4aspergers.com/pb/wp_..._4a3112c8.html

    Anyone on this forum (esp. INTjs) feel they have a lot of these symptoms - you don't necessarily have to have it, just associate with a few of those symptoms.
    Warm Regards,



    Clowns & Entropy

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    From the above link:

    Personal / Physical

    Repetitive routines or rituals
    Not really

    Can engage in tasks (sometimes mudane ones) for hours and hours
    Other people may find them mundane but I don't

    Flat, or blank expression much of the time
    Maybe

    Doesn't always recognize faces right away (even close loved ones)
    Sometimes. If you're not distinctive looking enough or important in someway, I'll likely forget.

    Strong sensitivity to sound, touch, taste, sight, and smell (e.g. fabrics—won’t wear certain things, fluorescent lights)
    Sounds, yes. Not so much the rest.

    Sensitivity to the texture of foods
    No

    Eccentric personality
    Depends on who you ask

    Idiosyncratic attachment to inanimate objects
    No

    Being "in their own world" / Preoccupied with their own agenda
    Yes

    Highly gifted in one or more areas, e.g. math, music, etc
    Yes- in math

    Single-mindedness
    Sometimes

    Likes and dislikes can be very rigid
    Maybe a few but overall, not really

    Can spend hours in the library researching, loves learning and information
    Why do you suppose I became a LIIbrarian?

    May have difficulty staying in college despite a high level of intelligence
    No, graduated in four years Magna Cum Laude

    Limited interests / Intense focus on one or two subjects
    Limited interests- no
    Intense focus on a couple subjects- yes

    Unusual preoccupations
    Yes

    Collects things
    Yes, but why is this aspie?

    Clumsiness / Uncoordinated motor movements
    Somewhat. Damn you 1-D Se!

    Speech and language peculiarities / hyperlexia (little professors) or, early in life may have a speech impediment
    No

    Non-verbal communication problems: difficulty reading body language, facial expression and tone
    Yes, particularly with body language.

    Word repetition (they may frequently repeat what you've just said)
    No

    Excellent rote memory
    Depends on what it is.


    FOCUSING ON THE POSITIVE:

    Focus and diligence – The Asperger ability to focus on tasks for a long period of time without needing supervision or incentive is legendary.
    Yes, particularly when something really interests me.

    Internal motivation – as opposed to being motivated by praise, money, bills or acceptance. This ensures a job done with conscience, with personal pride.
    For the most part, yes although external things like praise and money are nice too.

    Independent, unique thinking – people with AS tend to spend a lot of time alone and will likely have developed their own unique thoughts as opposed to a ‘herd’ mentality.
    Yes

    Higher fluid intelligence – scientists in Japan have recently discovered that AS children have a higher fluid intelligence than non-autistic children. Fluid intelligence is "the ability to find meaning in confusion and solve new problems. It is the ability to draw inferences and understand the relationships of various concepts, independent of acquired knowledge.” (Wikipedia 2009) Experts say that those with AS have a higher than average general IQ as well.
    Both a high fluid intelligence and a high overall IQ

    Visual, three-dimensional thinking – some with AS are very visual in their thought processes, which lends itself to countless useful and creative applications.
    Yes, but I don't do anything useful or creative with it

    Attention to detail – sometimes with painstaking perfection.
    Depends on what it is. If it pertains to my interests and my own theories and systems I develop, yes.

    Honesty – the value of being able to say “the emperor isn’t wearing any clothes.”
    Yes, sometimes to a fault

    Logic over emotion – although people with AS are very emotional at times, we spend so much time ‘computing’ in our minds that we get quite good at it. We can be very logical in our approach to problem-solving.
    Yes


    Relationships

    We Can often be distant physically and/or emotionally.
    Yes

    Often are attracted to another purely because they are attracted to us
    No, but I have hard time being attracted to someone who isn't attracted to me.

    Alternatively, we can be obsessive
    Rarely

    May have a hard time saying I love you, showing physical affection
    Maybe. I haven't been in a whole lot of relationships. What I have trouble with is taking the initiative in these things. Once the other takes initiative and I know I'm loved, I don't have a problem returning it.

    We can be very critical
    Yes

    We takes things personally
    Yes

    We can be very loyal to one person
    Yes

    Often times we will make no motions to keep a friendships going
    Yes

    We need to withdraw and have solitude
    Yes

    Men in particular find emotions messy and unquantifiable; If partner tries to share her love for him, he may find her need to “connect” smothering
    I'm a female and I identify with this

    Our attention is narrowly focused on our own interests
    Yes

    Men with undiagnosed AS often feel as if their partner is being ungrateful or “bitchy” when she complains he is uncaring or never listens to her
    N/A

    He can become quite defensive when she asks for clarification or a little sympathy. The defensiveness can turn into verbal abuse (usually not physical abuse) as the man attempts to control the communication to suit his view of the world.
    No

    Social Interactions

    Desire for friendships and social contact but difficulty acquiring and maintaining them
    Somewhat. Moreso when younger.

    Shuts down in social situations
    Occasionally like this

    Social withdrawal / may avoid social gatherings
    Depends on the gathering- what it is and who will be there. Will avoid gatherings revolved around drinking or rowdy parties or overly formal ones. Will welcome small, low-key, informal gatherings like getting together to play cards.

    Lack of interest in other people
    Depends on the context, but in a general sense, no.

    Lack of empathy at times
    Occasionally- if your actions involve a great deal of stupidity on your part

    Difficulty understanding others’ feelings
    Depends on what they are and the underlying context.

    Can obsess about having friends to prove they’re “normal”
    I was like this in middle school/high school but not anymore

    Rigid social behavior due to an inability to spontaneously adapt to variations in social situations
    Moreso when younger. I don't know if rigid is the right word. More awkward I say. I still have some problems now and then but not nearly as much so as when I was younger.

    Has an urge to inform that can result in being blunt / insulting
    I suppose I can come off as rather blunt when informing. I would never insult people on purpose. There have been a few times when people thought I was acting like a know-it-all and they were offended which was not intentional.

    Preoccupied with their own agenda
    Yes

    Great difficulty with small-talk and chatter
    Sometimes


    I'm fairly aspie-like but I think in most situations I cover it up nicely and can pass for normal. Until people really get to know me.

    Which type do you think tends more towards Aspergers: LII or ILI?
    LII-Ne with strong EII tendencies, 6w7-9w1-3w4 so/sp/sx, INxP



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    no to most of that. i have not suffered from any of these syndromes or likewise defects.

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    Ever since I got into MBTI/Socionics/IM, I've had this lurking notion that any people who are typed in the NT column automatically qualify for AS due to strong Ti and weak ethics + sensing, as general social connection is often based on those.
    Basically taking an inclusive view point, viewing it as a feature, rather than a bug. Whereas clinical psychology often is exclusive and aims to exclude/isolate deviations.
    Unlike autism, AS has not been linked to a genetic mutation/cause yet, although it is speculated.
    The rest seems to be down to upbringing and the close communities through which we learn. (Which is also implied in the "treatment" section of the OP.)

    While I may be off, this is something I've observed in friends who are LII and ILI, as well as my own history as ILE.


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    Me and my Aspergers-ness:

    Personal / Physical

    Repetitive routines or rituals
    Rarely

    Can engage in tasks (sometimes mudane ones) for hours and hours
    Not really, although I can distract myself from the fact I'm doing something mundane for ages.

    Flat, or blank expression much of the time
    Unless I feel social pressure to emote.

    Doesn't always recognize faces right away (even close loved ones)
    Doesn't really happen. I do get the "I can't remember your name" that everyone gets - more so than others.

    Strong sensitivity to sound, touch, taste, sight, and smell (e.g. fabrics—won’t wear certain things, fluorescent lights)
    Yes to sounds, don't like being touched, become annoyed when there are bad smells. Not strongly sensitive, just particular.

    Sensitivity to the texture of foods
    No

    Eccentric personality
    Some might say.

    Idiosyncratic attachment to inanimate objects
    I once lost my watch at the beach and sat despondently for the rest of the day.

    Being "in their own world" / Preoccupied with their own agenda
    Yes

    Highly gifted in one or more areas, e.g. math, music, etc
    Yes- in math

    Single-mindedness
    Sometimes

    Likes and dislikes can be very rigid
    What, like people suddenly decide "Oh, I do like sports now"?

    Can spend hours in the library researching, loves learning and information
    Yus.

    May have difficulty staying in college despite a high level of intelligence
    Nah, I'm smashing it.

    Limited interests / Intense focus on one or two subjects
    Limited interests- somewhat, I find it hard to care about what people are doing and talk to people about their lives. More interested into the way the world works: "Oh, you went to Japan, well there's cheap flights because of X. They say Japanese people are more Y than Australians, do you find that?" Etc.
    Intense focus on a couple subjects- Socionicssssss

    Unusual preoccupations
    I don't know what this means

    Collects things
    Trying not to

    Clumsiness / Uncoordinated motor movements
    Yes.

    Speech and language peculiarities / hyperlexia (little professors) or, early in life may have a speech impediment
    Yes and yes

    Non-verbal communication problems: difficulty reading body language, facial expression and tone
    Somewhat. Although it's more of an unconscious incompetence atm.

    Word repetition (they may frequently repeat what you've just said)
    No

    Excellent rote memory
    Terrible rote memory


    FOCUSING ON THE POSITIVE:

    Focus and diligence – The Asperger ability to focus on tasks for a long period of time without needing supervision or incentive is legendary.
    Yep.

    Internal motivation – as opposed to being motivated by praise, money, bills or acceptance. This ensures a job done with conscience, with personal pride.
    Yes - and also that's a thing imo.

    Independent, unique thinking – people with AS tend to spend a lot of time alone and will likely have developed their own unique thoughts as opposed to a ‘herd’ mentality.
    Yes

    Higher fluid intelligence – scientists in Japan have recently discovered that AS children have a higher fluid intelligence than non-autistic children. Fluid intelligence is "the ability to find meaning in confusion and solve new problems. It is the ability to draw inferences and understand the relationships of various concepts, independent of acquired knowledge.” (Wikipedia 2009) Experts say that those with AS have a higher than average general IQ as well.
    Dunno

    Visual, three-dimensional thinking – some with AS are very visual in their thought processes, which lends itself to countless useful and creative applications.
    Yes

    Attention to detail – sometimes with painstaking perfection.
    Not really. Unless I feel it's important. It's often an "all-or-nothing" level of attention to detail.

    Honesty – the value of being able to say “the emperor isn’t wearing any clothes.”
    Not really. I'll lie to get you to like me.

    Logic over emotion – although people with AS are very emotional at times, we spend so much time ‘computing’ in our minds that we get quite good at it. We can be very logical in our approach to problem-solving.
    Yes


    Relationships

    We Can often be distant physically and/or emotionally.
    Yes - also Fe-suggestive

    Often are attracted to another purely because they are attracted to us
    No. Trust me. (ha)

    Alternatively, we can be obsessive


    May have a hard time saying I love you, showing physical affection
    Yes. The word has too many connotations.

    We can be very critical
    Yes

    We takes things personally
    Yes

    We can be very loyal to one person
    Yes

    Often times we will make no motions to keep a friendships going
    Yes - and I definitely want to keep the friendship going, I just cbs.

    We need to withdraw and have solitude
    Yes

    Men in particular find emotions messy and unquantifiable; If partner tries to share her love for him, he may find her need to “connect” smothering
    Yes

    Our attention is narrowly focused on our own interests
    Yes

    Men with undiagnosed AS often feel as if their partner is being ungrateful or “bitchy” when she complains he is uncaring or never listens to her
    ...yes. Not often, but it's happened.

    He can become quite defensive when she asks for clarification or a little sympathy. The defensiveness can turn into verbal abuse (usually not physical abuse) as the man attempts to control the communication to suit his view of the world.
    Something like this happened once.

    Social Interactions

    Desire for friendships and social contact but difficulty acquiring and maintaining them
    Yes

    Shuts down in social situations
    Sometimes.

    Social withdrawal / may avoid social gatherings
    Everyone hates awkward gatherings.

    Lack of interest in other people
    Lack of interest in common conversation topics

    Lack of empathy at times
    Yes

    Difficulty understanding others’ feelings
    Yes

    Can obsess about having friends to prove they’re “normal”
    Yes

    Rigid social behavior due to an inability to spontaneously adapt to variations in social situations
    Yes

    Has an urge to inform that can result in being blunt / insulting
    Informing people is a great way to fill awkward silences.

    Preoccupied with their own agenda
    Yes

    Great difficulty with small-talk and chatter
    Sometimes


    Yeah, I reckon that LII often seem pretty Aspergers-y, but I can imagine SLIs, ILIs and even IEIs also being similar potentially. It is interesting and heartening that Aspergers can be seen as a feature rather than a defect, in oppose to Autism. Makes you wonder if socionics and dominant IEs will become a good explanation for certain ways of thinking.
    Warm Regards,



    Clowns & Entropy

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    I've noticed that the ppl in my life who are most aspie-like are ENTp, INTp, INTj. Reading a book or two abt how to deal with aspies helped me understand those ppl a little better, even though they are certainly not technically autistic.

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    I know an LIE and an ILE and they're for sure not Aspergers. They're definitely "of the world", rather than living with their head in the clouds creating crazy concepts.
    Warm Regards,



    Clowns & Entropy

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    Quote Originally Posted by aestrivex View Post
    although i'm basically certain im INTp by now, it has been suggested to me that I have asperger's syndrome. from what i know about it, it seems possible but i haven't investigated the condition very thoroughly.
    lol

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    Quote Originally Posted by Words View Post
    lol
    lol?
    Warm Regards,



    Clowns & Entropy

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