door onze redacteur Gerhard Wilts Verbolgen over de vooringenomenheid van westerse media, heeft de directie van de Eindhovense Chinese school HanTang gisteren een brandbrief gestuurd naar een groot aantal Nederlandse kranten. ,,Alle Chinezen in de hele wereld staan inzake Tibet achter de Chinese regering.'' WAALRE - ,,We krijgen het gevoel dat de westerlingen arrogant op een berg staan en ons Chinezen een goddelijke morele boodschap proberen te overhandigen'', schrijft een groep van 22 docenten uit China en Taiwan, die in Waalre de Chinese taal onderwijzen aan Nederlanders en Chinezen. Ze zeggen ,,erg gefrustreerd'' te zijn over de manier waarop de Spelen van Peking voor het voetlicht komen. De westerse media zijn eenzijdig, hebben geen kennis van de geschiedenis van China en Tibet en ,,misgunnen China een plaats in de wereld''.
Dr. Shan-Hwei Nienhuys-Cheng, directeur van HanTang, legt uit wat de aanleiding was om in de pen te klimmen. ,,Veel Chinezen in Amerika en Europa vinden het niet eerlijk wat er in de media wordt verteld over Tibet. Over het grote oproer in de Tibetaanse hoofdstad Lhasa, waarbij mensen zijn verbrand en driehonderd gebouwen beschadigd, zwijgen westerse kranten. Er verschijnen wel veel berichten over protestacties in het buitenland, georganiseerd door Tibetanen van de tweede of derde generatie die buiten Tibet geboren zijn en er nooit geweest zijn. Zij hebben hun informatie van hun ouders, die het land verlaten hebben in een tijd dat het in China niet zo goed was. Maar in dertig jaar is er veel veranderd: China heeft ontzettend veel geld in Tibet gestopt. De demonstranten hebben weinig recht van spreken en gebruiken geweld om hun kritiek kracht bij te zetten.''
Leugens
In uw brief beticht u de westerse media van eenzijdigheid. De Chinese pers verzwijgt ook onwelgevallige feiten en op Chinese websites is bijna niets te lezen of te zien van protesten.
,,Dat is juist, zij hebben evengoed vooroordelen. Maar de westerse media luisteren alleen naar wat de dalai lama zegt. Veel westerlingen willen niet geloven dat de meeste berichten gewoon leugens zijn.''
Westerse journalisten mogen zich niet vrij bewegen in Tibet. En op internet valt niet te achterhalen wat zich allemaal precies heeft afgespeeld. Hoe kunnen zij dan achter de waarheid komen?
,,Ik vind dat China op dat punt niet goed gehandeld heeft. Na de onlusten in Lhasa is Peking echter heel bezorgd over de veiligheid van toeristen en buitenlandse journalisten. Om hen te beschermen zijn zij naar andere plaatsen gebracht. Maar voor journalisten had Peking misschien meer bewegingsvrijheid moeten toestaan.''
In uw brief wordt gerept van 'ontwikkelingshulp' van Chinese steden aan plaatsen in Tibet. Hoe vrijwillig is die hulp?
,,Dit zeggen de wetten van China. Rijke provincies en steden moeten andere plaatsen helpen. In 1994 is een nieuw systeem voor ontwikkelingshulp aan Xizang (het Tibetaans Autonoom Gebied) opgezet. Het benodigde personeel werd gelokt met allerlei mooie extra's, onder andere de garantie dat ze maar drie jaar in Tibet hoefden blijven en daarna zonder probleem weer terug mochten gaan. Deze ontwikkelingswerkers worden door de dalai lama beschouwd als Chinese immigranten die de Tibetaanse cultuur om zeep helpen. Maar door al deze hulp is het gemiddelde inkomen in Tibet zelfs bijna het hoogste van heel China.''
Heeft Tibet daar ooit zelf om gevraagd?
,,Dat weet ik niet. Dit is gewoon beleid van de regering.''
In China ontstaat nu antipathie jegens de westerse wereld. Westerlingen zouden China geen plaats gunnen. Hoe komt u daarbij?
,,Wat China is aangedaan door westerse landen, Rusland en Japan vanaf de Opiumoorlog (1840) tot 1949, door misbruik en oneerlijke verdragen, kunnen de Chinezen niet vergeten. Vanaf 1978 is China open en veel rijker geworden. De volksrepubliek krijgt grote invloed in de wereld, maar veel landen vinden dat niet goed en werken het land expres tegen.''
Vanwege jaloersheid of angst?
,,Precies.''
Als u schrijft dat 'China de kans moet krijgen zich te verdedigen', waarom keert het land zich dan tegen vrije nieuwsgaring over Tibet? Wie het goede doet, hoeft toch niets te verbergen?
,,De sfeer in China is al een klein beetje veranderd. Er komt al meer naar buiten dan pakweg tien dagen geleden.''
Geweldloosheid
De dalai lama heeft zich uitgesproken tegen een boycot van de Spelen en tegen gewelddadige protesten. Vertrouwt u hem?
,,Ik weet het niet. Hij heeft vaker gezegd tegen geweld te zijn. Maar hij heeft een Tibetaanse jeugdorganisatie in India opgezet die niet langer gelooft in vreedzaam verzet en die hij niet langer onder de duim kan houden. Sommigen zeggen dat de dalai lama uiteindelijk toestemming heeft gegeven voor agressief optreden. Hij doet tegenstrijdige uitspraken over wel of geen Olympische Spelen in China.''
Ligt het dan niet voor de hand dat Peking de dialoog met de dalai lama zoekt?
,,Dat is ook iets wat westerlingen niet goed weten. Peking is helaas niet zo goed in public relations. De dalai lama wil geen onafhankelijk Tibet, maar een autonoom gebied zonder leger en diplomaten. Wat hij daarmee bedoelt, is: een theocratisch Tibet waarin hijzelf de dienst uitmaakt, terug naar de tijd van voor 1959. Lhasa was toen een wijkplaats voor gevluchte misdadigers. Westerlingen zeggen ook dat in dat jaar Tibet is ingepalmd door China; maar Tibet is niet ingelijfd, het heeft altijd bij China gehoord. Bovendien wil hij een Groot Tibet in plaats van het huidige, kleinere Tibet.''
Hoe is de stemming onder Chinezen in Nederland?
,,Als we met elkaar praten, zijn we allemaal boos over de westerse media. Een grote krant in Hongkong heeft ons aangeraden eindelijk onze mond open te doen. Want dat durfden we niet, uit angst dat we het verwijt kregen dat ook wij gehersenspoeld zouden zijn door Peking. Misschien vinden veel westerlingen dat ze de gewone Chinezen niet bekritiseren, alleen maar de Chinese regering. Wat ze niet weten, is dat eigenlijk alle Chinezen in de hele wereld op dit punt achter de Chinese regering staan. Ze voelen zich óók bekritiseerd. Als er sprake is van hersenspoelen, dan zijn de dalai lama en de westerse media de daders.''
Nederlands Dagblad
Het is duidelijk dat Chinezen niet kunnen omgaan met kritiek. De Chinese cultuur is nog altijd hartstikke confusianistisch en collecrivistisch. Je wordt niet geacht er een eigen mening op na te houden of machthebbers tegen te spreken in deze cultuur.
dinsdag 15 april 2008
Gewoon werk voor mensen met beperking mogelijk
14 april 2008, 17:07 uur | FD.nl
Veel meer mensen met een kwetsbare positie op de arbeidsmarkt kunnen aan het werk. Zolang er maar een goede regeling komt voor compensatie van kosten voor onder meer begeleiding en voor de geringere productiviteit. Het kabinet moet een regeling maken, waarop iedere werkgever een beroep kan doen.
Dat is een van de aanbevelingen uit het TNO-onderzoek 'Europese ervaringen met sociale economie'.
Om ervoor te zorgen dat ook reguliere werkgevers meer mensen met een kwetsbare arbeidsmarktpositie in dienst nemen, is het nodig dat het algemene werkgelegenheidsbeleid verder wordt uitgebouwd, concludeert TNO. Daarbij moeten niet de beleidsdoelstellingen van de overheid centraal staan, maar de behoeften van de markt.
Specifieke wet- en regelgeving
Uit het TNO-onderzoek blijkt verder dat er bij de meeste sociale ondernemingen in het buitenland mensen met én zonder beperking samenwerken op de werkvloer. In sommige landen stuurt de overheid daarop met specifieke wet- en regelgeving. In andere landen kiezen de bedrijven daar zelf voor.
In Nederland stimuleert de overheid het sociaal ondernemerschap veel minder. Het kabinet heeft de Commissie Fundamentele Herbezinning Wsw ingesteld om nog voor de zomer te adviseren over de benodigde maatregelen.
Veel meer mensen met een kwetsbare positie op de arbeidsmarkt kunnen aan het werk. Zolang er maar een goede regeling komt voor compensatie van kosten voor onder meer begeleiding en voor de geringere productiviteit. Het kabinet moet een regeling maken, waarop iedere werkgever een beroep kan doen.
Dat is een van de aanbevelingen uit het TNO-onderzoek 'Europese ervaringen met sociale economie'.
Om ervoor te zorgen dat ook reguliere werkgevers meer mensen met een kwetsbare arbeidsmarktpositie in dienst nemen, is het nodig dat het algemene werkgelegenheidsbeleid verder wordt uitgebouwd, concludeert TNO. Daarbij moeten niet de beleidsdoelstellingen van de overheid centraal staan, maar de behoeften van de markt.
Specifieke wet- en regelgeving
Uit het TNO-onderzoek blijkt verder dat er bij de meeste sociale ondernemingen in het buitenland mensen met én zonder beperking samenwerken op de werkvloer. In sommige landen stuurt de overheid daarop met specifieke wet- en regelgeving. In andere landen kiezen de bedrijven daar zelf voor.
In Nederland stimuleert de overheid het sociaal ondernemerschap veel minder. Het kabinet heeft de Commissie Fundamentele Herbezinning Wsw ingesteld om nog voor de zomer te adviseren over de benodigde maatregelen.
maandag 14 april 2008
Asperger’s Syndrome: Do I have it? And how do I live with it?
By Susan J. Golubock and Tara J. Marshall
Members of the Phoenix Adult Asperger’s Support Group
I suspect I may have, or have been diagnosed with, Asperger’s Syndrome, but I’m not really sure what it is:
* Please note that Asperger’s Syndrome (sometimes called Asperger’s Disorder) is a neurobiological collection of behavioral differences (thus the word syndrome). It is classified in the ICD-10 and the DSM-IV as a Pervasive Developmental Disorder, alongside Autistic Disorder. This is why some consider Asperger’s Syndrome as part of an Autistic Spectrum Disorder. There is no known cause, although both genetic and environmental factors are suspected to be involved. It is a condition that continues throughout the lifespan. It is not a mental illness.
Diagnostic criteria for Asperger’s Disorder from DSM-IV (1994)
A. Qualitative impairment in social interaction, as manifested by at least two of the following:
(1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
(2) failure to develop peer relationships appropriate to developmental level
(3) a lack of spontaneous seeking to share enjoyment, interests or achievements with other people (e.g. by a lack of showing, bringing, or pointing out objects of interest to other people)
(4) lack of social or emotional reciprocity
B. Restricted repetitive and stereotyped patterns of behaviour, interests and activities,
as manifested by at least one of the following:
(1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(2) apparently inflexible adherence to specific, nonfunctional routines or rituals
(3) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(4) persistent preoccupation with parts or objects
C. The disturbance causes clinically significant impairment in social, occupation, or other important areas of functioning
D. There is no clinically significant general delay in language (e.g. single words used by age 2 years, communicative phrases used by age 3 years)
E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood
F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia
These clinical definitions were developed for the purpose of determining the degree to which a child is “disabled” and therefore eligible to receive services. They may not mean much or be of much help to adults who suspect that they have Asperger’s Syndrome. The important thing to understand is that Asperger’s Syndrome represents a mild to significant difference in how we process sensory input, communicate, and generally perceive social experiences from those with neurologically typical nervous systems. Like “neurotypicals,” we have our own strengths and limitations. Unfortunately, our “different-ness” often makes us appear more limited and our strengths harder to perceive.
Learning Style differences: Most of us have one very strong learning style, and may pick up very little information from other senses or teaching styles. We may be very strong visual thinkers, very strong auditory thinkers, very strong mathematical thinkers, or very strong in our language skills. One recent study found that some 70% of people diagnosed with Asperger’s Syndrome also met the criteria for nonverbal learning disorder. The vast majority of us have what neurotypicals consider weak social skills, primarily because we don’t pick up the unspoken social cues the way that neurotypicals do. This difference can contribute to failures in relationships and employment, and may also lead to a high co-morbidity of depressive disorder. Most people with Asperger’s Syndrome (colloquially known as “aspies”) have some degree of sensory processing dysfunction, meaning that various of the senses (sight, hearing, smell, touch, taste, proprioception, and vestibular) may be over-or-under sensitive to stimuli in comparison to those of neurotypicals (people not on the autistic spectrum). Synaesthesia (mixing of sensory information, such as smelling sounds) may also be present.
Tony Attwood, a clinical psychologist, and Carol Gray, an educator, both of whom work extensively with individuals on the autism spectrum, took a reverse look at the DSM-IV criteria for receiving a diagnosis of Asperger’s Syndrome and pointed out how what others view as “limitations” could also be viewed as strengths.
From: Discovery of “Aspie” Criteria
Carol Gray and Tony Attwood, 1999
As found at http://www.tonyattwood.com.au/index.htm,
“Tony’s Publications”
A. A qualitative advantage in social interaction, as manifested by a majority of the following:
(1) peer relationships characterized by absolute loyalty and impeccable dependability
(2) free of sexist, “age-ist”, or culturalist biases, ability to regard others at “face value”
(3) speaking one’s mind irrespective of social context or adherence to personal beliefs
(4) ability to pursue personal theory or perspective despite conflicting evidence
(5) seeking an audience or friends capable of enthusiasm for unique interests and
topics, consideration of details, spending time discussing a topic that may not be of primary interest
(6) listening without continual judgement or assumption
(7) interested primarily in significant contributions to conversation, preferring to avoid “ritualistic small talk” or socially trivial statements and superficial conversation
(8) seeking sincere, positive, genuine friends with an unassuming sense of humour
B. Fluent in “Aspergese”, a social language characterized by at least three of the following:
(1) a determination to seek the truth
(2) conversation free of hidden meaning or agenda
(3) advanced vocabulary and interest in words
(4) fascination with word-based humour, such as puns
(5) advanced use of pictorial metaphor
C. Cognitive skills characterized by at least four of the following:
(1) strong preference for detail over gestalt
(2) original, often unique perspective in problem solving
(3) exceptional memory and/or recall of details often forgotten or disregarded by others, for example: names, dates schedules, routines
(4) avid perseverance in gathering and cataloging information on a topic of interest
(5) persistence of thought
(6) encyclopaedic or “CD-ROM” knowledge of one or more topics
(7) knowledge of routines and a focused desire to maintain order and accuracy
(8) clarity of values/decision making unaltered by political or financial factors
D. Additional possible features:
(1) acute sensitivity to specific sensory experiences and stimuli, for example, hearing touch, vision and/or smell
(2) strength in individual sports or games, particularly those involving endurance or visual accuracy, including rowing, swimming, bowling, chess
(3) “social unsung hero” with trusting optimism: frequent victim of social weaknesses of others, while steadfast in the belief of the possibility of genuine friendship
(4) increased probability over general population of attending university after high school
(5) often take care of others outside the range of typical development
Note: Many Famous People Are Suspected To Have Characteristics of Asperger’s Syndrome:
Temple Grandin, Ursula LeGuin, Albert Einstein, Gene Roddenberry, Charles Darwin, Thomas Edison, Mark Twain, M.C. Escher, Johann S. Bach, Max Planck, Helen Keller, J.R.R. Tolkien, Jean Ayres, Dylan Thomas, Pablo Picasso, Linus Torvald, Galileo, Arthur C. Clarke, Franz Kafka, Glenn Gould, Benjamin Franklin, Margaret Mead, Aristotle
From “Sparks of Genius” - The 13 Thinking Tools of the World’s Most Creative People
Robert and Michele Root-Bernstein, (2001) Marriner Books
[For clarification: Temple Grandin has been diagnosed as autistic since she was a child. She has on many occasions stated that if she were to be diagnosed today, as an adult, she believes that she would fit the criteria for Asperger’s Syndrome. The others on this list have not been diagnosed as having Asperger’s Syndrome, but many suspect that, based on observation of their social and learning characteristics, they fit the diagnostic definition of someone with Asperger’s Syndrome. ]
Why have I received diagnoses from doctors that suggest that I have something other than or more than Asperger’s Syndrome?
Asperger’s Syndrome is often diagnosed when all other disorders can be ruled out. People who have, or suspect they have, Asperger’s Syndrome may have been previously diagnosed with:
Autistic Disorder, High Functioning (HFA)
Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS)
Attention Deficit Disorder (ADD)
Schizoid Personality Disorder
Nonverbal Learning Disorder
Right Hemisphere Learning Disorder
Semantic Pragmatic Language Disorder
Clumsy Child Disorder
Additionally, if you have a medical history which includes a past head injury, you may be diagnosed with Traumatic Brain Injury (TBI). A warning for those previously diagnosed with Autistic Disorder or PDD-NOS: being re-diagnosed as having Asperger’s Syndrome can lead to being considered ineligible for various benefits (such as supported employment) that you may have previously benefited from.
There are several disorders that are frequently co-morbid with Asperger’s Syndrome. These include:
Attention Deficit (Hyperactive) Disorder (ADHD or ADD)
Tourette’s Syndrome
Obsessive Compulsive Disorder (OCD)
Depressive Disorder
Dysthymia Disorder (minor depressive disorder)
Sensory Integration Dysfunction
Seizure Disorder/Epilepsy
Several of us have also been considered to have “autistic characteristics” as children, but may never have received any special education or other services. In addition, some people may have asperger tendencies, but not have Asperger’s Syndrome. Engineers and computer programmers are often thought to exhibit asperger-like characteristics. A diagnosis of Asperger’s Syndrome simply reflects the severity of the differences between those with the diagnosis and those without. Current research suggests that there are 10-15 genes related to autism. The severity of your differences may relate to how many genes are affected and/or your other inherited traits, environmental exposures, and life experiences.
The inability to clearly define the difference between autism and Asperger’s Syndrome is why many consider both to be part of an autism spectrum, with Asperger’s Syndrome representing the high end of the spectrum. Based on DSM-IV criteria used to make a diagnosis, those with Asperger’s Syndrome have normal to above normal intelligence and fewer limitations in their use of speech and ability to communicate than those diagnosed with autism. Significant delays in the development of speech and communication, beyond the age of 2 years, are considered characteristic of autism. Some people on the autism spectrum display a splinter skill (also known as a savant skill) related to mathematics, calendars, or music, although this is not necessary for a diagnosis of autism.
Those who do develop speech but continue to have difficulties in communication and/or performing daily living activities are often classified as having “high functioning” autism. This is a delineation that many adults on the spectrum are not comfortable with as it implies that those with more severe difficulties in communicating and performing daily living activities are “low functioning.” The assumption is, and they are often treated as though, they are mentally retarded, and thus not given the mental and academic stimulation they deserve and need to achieve their true potential. Yet many “low functioning” individuals with autism have been discovered to be quite intelligent once the environmental or biochemical stresses interfering with their ability to communicate or perform daily living activities are lessened. With Asperger’s Syndrome, because of our high verbal skills, the expectations are often just the opposite. The assumption is that we are intelligent enough to do more than we demonstrate and are just not trying hard enough, when the truth is that we are “passing” for close to normal only because we are trying so hard and, in most cases, can’t do more than we are doing. For this reason, learning self-advocacy skills to clearly communicate to others just what you can and can not do is very important.
Why would I want an official diagnosis of Asperger’s Syndrome?:
If you are currently not experiencing any major problems in your relationships or employment, you may not want to get diagnosed as having Asperger’s Syndrome. However, getting an official diagnosis from a psychiatric or medical professional will be necessary if you are considering applying for social benefits, such as Social Security Disability or Vocational Rehabilitation. Please note that the diagnosis of Asperger’s Syndrome alone will not qualify you for any form of services. It is generally some co-morbid (accompanying) symptom (as mentioned above) that affects your ability to function in your work or home environment that is considered disabling. Despite the fact that functioning in a neurotypical world can be very difficult, a diagnosis of Asperger’s Syndrome does not mean a person is unable to learn to function, especially if they are fortunate enough to have people in their lives that provide the support they need.
Getting a diagnosis can be useful if you need accommodations in order to perform the tasks or deal with the environment in an employment situation. Such accommodations may include alternative ways of communicating, a more isolated space, breaks, etc.
If you are having considerable difficulty with relationships, especially with regards to understanding the other person’s perspective, then perhaps it is worthwhile investigating whether you have Asperger’s Syndrome and/or how it might be affecting communication between you and the person with whom you are trying to relate. You may also need to explore what it is you expect and need from a relationship and learn how to advocate for what you want in a non-demanding manner. Of equal importance is learning how to give what the other person wants in order to get what you want. If you decide to seek help in this regard, be sure that the psychiatrist, psychologist or counselor has experience with and is accepting of Asperger’s Syndrome differences.
Who you contact for a diagnosis will depend on what you are seeking from this person. Psychologists or neuropsychologists will arrive at a diagnosis through testing. This can be helpful if you are looking for more information on your areas of learning strength and differences. A neuropsychologist looks at the neurological as well as psychological issues. This type of testing can give you helpful information about yourself, but only IF the psychologist or neuropsychologist is familiar with neurological differences associated with Asperger’s Syndrome. Otherwise, their report is not likely to give you an accurate picture of yourself that you can relate to and use. A psychiatrist will often diagnose you after getting a history and talking with you, or others who know you. A psychiatrist is a medical doctor who can prescribe medication that may be helpful to you in calming your anxieties or bringing you out of depression (or treating co-morbid disorders).
The choice should always be left up to you as to whether you want to try medication. Medication can have side effects you need to be aware of and long-term use can sometimes result in a form of tics. Psychotropic medications (the ones that influence your brain chemistry) must never be stopped suddenly as your brain adapts to them and must be very slowly decreased to avoid withdrawal symptoms. You always have the choice of trying natural supplements that have a similar influence on your brain chemistry (check out http://www.phxautism.org/vitamin/frame.htm for more information on this). Unfortunately the manufacturers of supplements are unregulated so your doctor is unable to support their use and your insurance is not going to cover their cost.
Where can I go to get a diagnosis?:
If you are considering getting an official diagnosis, you should bring the following items with you: medical history/records and parents or teacher’s notes on your childhood behavior (including any kind of “baby development log” your parents may have kept, noting important milestones such as crawling, walking, first words, etc.). School records from Kindergarten through High School that show your abilities, both weak and strong, can be helpful. If you keep a diary, or have written personal essays on your experiences in dealing with other people, these may also be useful. There may be others who work with adults with Asperger’s Syndrome, but the following references are the ones we are aware of at this time (this does not constitute an endorsement of these doctors, only an awareness that they are said to work with adults with Asperger’s Syndrome):
Mark Wellek, M.D., psychiatrist, 4202 N. 32 St., Phoenix, AZ 85018, Phone: 602-955-1070, Fax: 602-957-9614. He accepts Out-of-Plan Referrals but payment is required at the time of services.
Bruce Rigler Holzman, M.D., 525 N. 18th Street, Suite 303, Phoenix, AZ 85006-3734
Phone: 602-254-9986, Fax: 602-254-4439. He is a provider in PPO, HMO or Network Plans and Accepts Out-of-Plan Referrals
William Graff, Ed.D., Well Being Systems, 2701 East Camelback Road, Phoenix, AZ 85016, Phone: (602) 957-2368. [Be aware that Dr. Graff is not a medical doctor if this is what you are looking for to work with you long-term, but he has his own approach, like most professionals, that he believes can help.]
Do NOT feel obliged to continue to see any professional that makes you feel uncomfortable or who pushes on you their agenda for what they think is best for you. You have both control over and responsibility for how you chose to live your life. Continue to seek what you find helpful, and look elsewhere when it is not or stops being helpful.
Should I tell people that I have Asperger’s Syndrome?:
This is a sensitive subject. In regards to employment, you do not need to disclose your diagnosis until after you have actually been hired. If you know that you will require certain accommodations in order to do your best at work (e.g., incandescent, rather than fluorescent, lighting, a flat-screen computer, etc.). If you need to disclose your diagnosis in order to request accommodations, the best person to start with may be your immediate supervisor. Sometimes simply stating that you “do best” when [a particular accommodation is provided] is enough. Some businesses require you to disclose your disability to personnel in order to receive accommodations that are not typically made for others. Be aware that some aspies have found that disclosing their diagnosis with the expectation that others will better understand and provide for their needs was not helpful, and often backfired. It is always best if YOU decide what you need and politely, with reasonable explanations that do not need to include your diagnosis, ask for it,. Don’t expect them to know what you need, based on a diagnosis that they may not understand. You are the only one that can know your needs.
In relationships, disclosure of a diagnosis Asperger’s Syndrome has been known to save relationships that are in trouble, but it has also been known to lead to a faster break-up or divorce if the non-Asperger’s Syndrome partner is unwilling to deal with the changes or issues inherent with this new knowledge about you. Experiences have been mixed.
A book on this issue that you might want to check out is: Ask and Tell: Self-Advocacy and Disclosure for People on the Autism Spectrum, Stephen M. Shore, editor, by Autism Asperger Publishing Company (www.asperger.net).
Where can I meet others who have Asperger’s Syndrome?
Asperger’s Syndrome/HFA/PDD Support Groups:
In Phoenix, contact: Trish Gelvin, 602-421-2215, trish_crew@yahoo.com
In Tucson, contact: Jerry Newport, 520-795-0396, wholphin48@hotmail.com
Internet Sites:
Patty's Home Page, adult autism issues, advocacy for adult autistics, autism information, http://www.autistics.cc/
Frank Klein’s Autistic Advocacy, http://home.att.net/~ascaris1/
Autism Network International, http://ani.autistics.org/
M. Jane Meyerding’s Home Page, http://staff.washington.edu/mjane/
Dave Spicer - autistic writer and speaker - http://bellsouthpwp.net/d/s/dspicer/
The MAZE - Ooops... Wrong Planet! Syndrome Master Link Page, http://www.isn.net/~jypsy/autilink.htm
autistics.org Links Autistic_Culture-People, http://www.autistics.org/links2/Autistic_Culture/People/
I want friends but making friends seems hard. Why?:
Personal friendships are generally built on one or more things of shared interest between two people. Personal friends share their thoughts and feelings as well as experiences. Not everyone who calls themselves friends are personal friends. Aspies tend to be very open and honest and willing to share themselves with others, which are traits that close personal friends will value. Social and work friends, however, may not value this trait. They may not be ready to be open and honest and share personal information about themselves with you, so it makes them feel uncomfortable when you offer these things to them. Some Neurotypicals like to take the development of friendships slowly (see the stages of relationships below). When someone asks you questions about yourself, like where you were born or went to school or what things you like, they are indicating that they have a possible interest in becoming your friend. That doesn’t mean they will become your friend, only that they are interested in finding out if you both share enough interests to possibly become friends.
Some Neurotypicals, on the other hand, can be very open to making friends quickly. If someone wants to be your friend quickly, and then asks you to do something for them, like give them money or do something crazy or hurt someone, be aware that true friends don’t do that! True friends help you to feel good about yourself and protect you from doing things that are not in your best interest, or in the best interest of others. As mentioned in “Aspie Strengths”, we tend to be very loyal to our friends. However, our loyalty can (and has) been abused by those with various social weaknesses, such as greed or jealousy or low self-esteem. It is always a good idea to pay attention to your instincts. If you feel even the slightest bit uncomfortable about something, even if you can’t identify what it is, it is best to seek advice from someone you do trust who understands how some people can take advantage of others.
Many aspies have particularly strong interests in certain areas. Unfortunately very few people around them may share that interest. This makes it harder for aspies to find friends. An excellent place to look for friends are clubs where people with your special interest are likely to gather. Some aspies recognize that having a lot of friends is not that important to them. Other aspies blame themselves or think badly about themselves if they don’t have friends or make friends easily. Making friends has less to do with whether people like you than it does with whether you have interests or experiences that are similar to theirs AND whether you are also willing to share in the interests they have that are different from your own. It is easy to lose potential friends if you share more than what the other person wants to receive, or don’t give the other person equal time to share their interests with you. Friends who are close personal friends will stick up for each other in front of others, answer questions honestly (in a kind way), help each other when there is a need, and will enjoy just spending time together. Most people, neurotypical or aspie, only have a few friends that meet this definition of a close personal friend. These are the best friends to have and to seek.
Another reason that aspies may have a more difficult time making friends is because our sensory processing and body movements are different from neurotypicals. Friendly pats on the back and reaching out to touch your arm are common ways for neurotypicals to “connect” with each other through the sense of touch. If touch is perceived as uncomfortable, or even threatening, your reaction to their well-intentioned effort to relate to you is not going to be easily understood. This is where aspies need to self-advocate, to let others know what makes us uncomfortable. Most neurotypicals ARE willing to respect these differences, IF they know about them. For those who struggle with verbal communication, a card that explains what you need can be carried in your wallet or purse and shared with others as you choose. The “down side” is, because it is hard for neurotypicals to relate to these differences in perception, it may limit how many potential friends will be willing to work that hard to become a close personal friend. Aspies often find it easier to socialize and become friends with other aspies, simply because we understand each other’s way of thinking and perceiving.
“Missed” communication can also make it harder for aspies to make and keep friends. Our more limited body movements can be misread by neurotypicals who look for “body language” cues when communicating with others. Aspies also tend to find it difficult to attend to all the body language cues neurotypicals give. Thus, we may misread their “intended” messages to us if all we are paying attention to are the words they use. A good source for learning about body language is Teaching Your Child the Language of Social Success by M. P. Duke, S. Nowicki, Jr., and E. A. Martin (1996) Peachtree Publishers, Atlanta, Georgia.
Understanding the social rules that neurotypicals follow can also help in making and keeping friends (as well as working with others on the job). A good source for this is “The Rules of the (Social) Road” (Chapter 9) in Asperger Syndrome and Adolescence, by Teresa Bolick, (2001) Fair Winds Press, Gloucester, MA. Some typical social rules that aspies can break that neurotypicals find “off-putting” (but won’t tell you about to avoid hurting your feelings) are: 1) poor grooming habits, including not brushing teeth, not bathing or washing one’s hair, not wearing clean clothes, and not wearing deodorant; 2) telling people things about yourself that are considered “private”, such as that you do not have friends, have never had sexual intercourse, or use self-gratification to meet your needs; 3) appearing desperate or too eager to establish a close relationship with someone you don’t know really well (which may be a dangerous thing for you as this is the type of behavior that people who will abuse you look for); 4) asking others about their current relationships (unless they bring it up first); and 5) dressing too fancy or too casually for the situation, such as wearing too much make-up or seductive clothes to work or a picnic, or wearing jeans to a job interview.
Even though your sensory processing differences may be the reason for your grooming habits or clothes choices, unless you take the time to explain these differences to others (and even then they may not understand or accept what you say), people will judge you based on your appearance. That doesn’t mean you can’t find ways to compromise, such as adding a jacket to dress up blue jeans. Clothes that are clean and unwrinkled (which can be accomplished by hanging clothes on a hanger while they are still warm and wet after 10 minutes in the dryer) are more important than being “in fashion.” You can accomplish the “snug-fit” your body seems to prefer by wearing biking shorts or a wet suit under your clothes rather than overly tight fitting clothes that might be viewed as “suggestive.”
It might also be helpful to note that toxin build-up due to gut digestion difficulties may contribute to a “body odor” problem even when you are careful about your grooming. If this is the case, consider reading Children with Starving Brains, by Jacquelyn McCandless, M.D., for more information on the medical conditions that can affect the functioning of individuals on the autism spectrum. You may also want to check out the book Biological Basis of Autism by William Shaw, Ph.D., available from Great Plains Laboratory (913) 341-8949, www.greatplainslaboratory.com, for more information on yeast/bacterial infections and diets.
I’m interested in dating and an eventual commitment to another person. Will Asperger’s Syndrome make that more difficult for me?:
Many aspies, both male and female, are married or in long-term relationships. Many are not. Often it is only when aspies have children that they recognize their own aspie traits and are themselves diagnosed. It is also worth noting that aspies have a tendency to belong to “other minority groups”, and may be homosexual or have alternative lifestyles, in statistically greater numbers than the general population. Some aspies do not feel particularly attached to their sexuality. They do not identify with a particular sex or seek relationships with a particular sex. Other aspies simply choose to not pursue relationships other than friendships. Temple Grandin has spoken often of her own preference to not seek a sexual relationship. You should not feel pressured to act outside of what you are comfortable with when it comes to developing relationships with other people.
Whatever your relationship preferences are, relationship difficulties are not something unique to those on the autism spectrum. Neurotypicals have their own share of relationship difficulties. It is important to remember that all relationships have stages. It can be confusing to you if you are not sure which stage in a relationship you are with someone. It can be confusing and even overwhelming to others if you appear to be in a more advanced stage in the relationship than they are ready for. According to the book, Speaking Skills for Prospective Teachers1, the stages in a relationship are: 1) coming together, 2) staying together, and 3) moving apart. Coming together is a 5-step process: 1) initiating contact; 2) discovery of common interests; 3) intensifying our interest and involvement;
4) integrating this person into our life’s activities; 5) bonding or committing to the relationship (usually leading to marriage if the interest in the relationship is sexual). Staying together is described as a long-term situation that requires effort from both partners to keep the relationship going. There are nine characteristics that long-term relationships often have, none of which are always present to the same degree: 1) amusement (making the relationship fun and enjoyable); 2) affection (pleasure in being together); 3) commitment equity (equal dedication to the relationship); 4) fidelity equity (faithfulness to each other); 5) contracting (fulfilling any agreements made to each other); 6) twosome (relying on each other as partners); 7) recognition (publicly making others aware of your commitment to each other); 8) frankness (revealing your inner self to each other); and 9) averaging (good and bad times should average out). It is possible for a relationship to come apart at almost any stage. Under normal conditions, relationships come apart in five steps: 1) differentiating (disagreements and differences become the focus of attention); 2) circumscribing (talk diminishes, with less revealing of self and fewer commitments to each other); 3) stagnation (relationship loses its life and partners move apart physically); 4) avoiding (partners stop seeing each other); and 5) termination (the relationship is over).
Communication is always thought of as a key to successful relationships. So is attitude, according to this same book. This is where the differences in how asperger people and neurotypical people perceive similar experiences can cause problems in relationships. Neurotypicals value the following attitudes in a relationship: being genuine (being honest and open about ones feelings); being committed (having a desire for the relationship to continue and to share the responsibilities and make compromises when problems occur); talking together (to achieve understanding and appreciation of each other and discuss conflicts, expectations, and anxieties that bother each other); and 4) being empathic (seeing the world through the other person’s perspective, listening non-judgmentally and trying to understand the other person in the way they perceive themselves). It is a common, but very false perception, on the part of many neurotypicals that people with Asperger’s Syndrome lack these abilities! It is extremely difficult for ANYONE to understand and perceive what one has never experienced. Because of differences in the way that our brains process and respond to experiences, neurotypicals have just as much difficulty understanding and appreciating the asperger person’s perspective as the asperger person has understanding and appreciating the neurotypical’s perspective.
That doesn’t mean that both sides can’t learn to respect those differences and even understand them somewhat on an intellectual level. Communication becomes the most important factor in helping each other to understand and appreciate these differences. Again, this is a major contributor to relationship difficulties between asperger people and neurotypical people. Neurotypical people learn about and experience social interactions on a non-thinking level. To articulate how and what they know or feel on a thinking level is not something they often need to, or know how to, do with other neurotypicals. They simply “understand” because they tend to perceive these experiences in a similar fashion. Aspies tend to process a lot of input on an intellectual level because it is harder for them to pick up multiple information and process it quickly on a non-thinking level as neurotypicals do. Ironically, even though the mental effort of verbal communication can be very fatiguing for aspies, they are the ones who are expected to “explain” their differences to neurotypicals since neurotypicals see themselves as “normal” and therefore consider themselves easy to understand. Unfortunately, neither party has strengths in the areas that the other person needs for effective communication to take place.
Neurotypical and Asperger’s Syndrome people can develop meaningful and fulfilling relationships. It requires that both parties have to have a strong desire to make the relationship work and to work hard at communicating their different perspectives. Attitudes are not where the problems lie, even though they may often be expressed differently. It’s both parties willingness to communicate, in a non-judgmental way, that is essential to the understanding of, and increased appreciation for, the differences that contribute to the problems in neurotypical-asperger relationships. If you are interested, the movie The Mirror Has Two Faces may be worth watching as an example of an aspie and a neurotypical in a relationship, even though the main character is not identified as having Asperger’s Syndrome (but the characteristics are there). Liane Holliday Willey, in Pretending to be Normal, was already a wife and mother when she discovered, along with her daughter, that she had Aspeger’s Syndrome. Jerry and Mary Newport, in Autism-Asperger’s & Sexuality, have shown that two people with Asperger’s Syndrome can fall in love and have a meaningful committed relationship. All relationships, to be successful in the long-term, require a commitment to compromise and sharing, but having Asperger’s Syndrome does not lessen your chances of having such a relationship if this is truly what you want. It is important to recognize whether a relationship is what YOU want and are willing to work toward and not what you think society expects of you. It is equally important that you know your own limitations to know just how much you have and are willing to give to a relationship. Relationships, even in the neurotypical world, that are built on unrealistic expectations and only getting, not giving, rarely work.
What about having children? What are my chances that they will also have Asperger’s Syndrome?:
Many of us have been diagnosed after having children, particularly if we had a child who was diagnosed as having an Autism Spectrum Disorder. While there are no statistics on the likelihood of aspies having ASD children in general, the statistics for parents of autistic children (at least some of whom are probably undiagnosed aspies) run between 3-5% for Autistic Disorder, and up to 10% for ASD and “language delays”. There is also no data on how our “neurotypical” children turn out, but personal stories told by those on the spectrum of their children seem to indicate that these children pick up the body language and other social information they need from the outside world and do not suffer any “adverse effects” from their parent(s) autistic characteristics.
Where can I go to get the support that I need to live in a neurotypical world?:
[Disclaimer: Because something is listed does not imply that it is endorsed or even known to live up to whatever claims are made as regards providing needed support. They are listed because they are known through word-of-mouth to exist. It is your responsibility to check out these services/agencies for yourself to determine if they could be of any help to you. If there are resources for adults that you are aware of that should be included here, or excluded, please contact sgolubock4@msn.com or gpcasa@hotmail.com ]
Greater Phoenix Chapter (GPC) of the Autism Society of America: This group is for all people interested in autism, including parents of children/adults, and people with autism/Asperger’s. Monthly meetings, newsletter, annual conference. Call (602) 940-1093 http://www.phxautism.org
Tucson Chapter of the Autism Society of America, (520) 770-1541. This group serves people with autism of all ages, and holds monthly meetings. http://aztec.asu.edu/asa-pcc
Asperger Parent Network, resource for families and professionals in the Greater Phoenix Area. Monthly meetings, e-group and web site. www.apn.150m.com
Autism Assistance Program - This program provides financial assistance to low-income children and adults with autism/Asperger's who live in Arizona. The program is funded by a tax-credit in Arizona. Tax-payers may donate up to $200 per year, and receive a dollar-for-dollar reduction in their taxes; i.e., donate $200, and pay $200 less in Arizona taxes. http://www.eas.asu.edu/~autism/AAFA/AAFA.html.
Emily Anderson Family Learning Center: a lending library for information on disabilities. Located on the main corridor of Phoenix Children’s Hospital, 1919 E. Thomas Rd, Phoenix (SW corner of 20th St and Thomas Road). Call them at 602-546-1400 for hours. http://www.phxchildrens.com/about/services/emilycenter/
Phoenix Public Library: Special Needs Center: 1221 N. Central Ave., Phoenix, AZ 85004, Tel: 602-261-8690, Fax: 602-534-4520, E-mail: mmccain@phxlib.org
Arizona Center for Disability Law: Advocates for the legal rights of persons with disabilities to 1) be free from abuse, neglect and discrimination and 2) have access to education, health care, housing and jobs, and other services in order to maximize independence and achieve equality, http://www.acdl.com/, Phoenix: 602) 274-6287 Tucson: (520) 327-9547
Council for Jews with Special Needs: Provides a range of services, 480-629-5343. www.cjsn.org/. Email: info@cjsn.org. 12701 North Scottsdale Rd., Suite 205, Scottsdale, AZ 85254.
Arizona Division of Developmental Disabilities (DDD): Provides many services to people with developmental disabilities, including speech therapy, physical therapy, and occupational therapy. 602-870-1721
Social Security Disability Program: Contact 1-800-772-1213. http://www.ssa.gov/applyfordisability/adult.htm
Mental Health Association of Arizona
6411 E. Thomas Rd., Scottsdale, AZ 85251, Tel: 480-994-4407. Fax: 480-994-4744. E-mail: jsinclair@mhaarizona.org; web site: www.mhaarizona.org
Life Development Institute: Offers basic life training and training for employment. Contact Rob Crawford, M.Ed., Chief Executive Officer, 18001 N. 79th Ave., E-71, Glendale, AZ 85308, rcrawford@life-development-inst.org, www.life-development-inst.org, Phone (623) 773-2774, Fax (623) 773-2788.
Occupational Therapy (Sensory Integration) -
The Children’s Center for Neurodevelopment Studies – Offers occupational therapy, music therapy, speech therapy and horticultural therapy services which focus on the sensory processing strengths and limitations of those on the spectrum and development of a Sensory Diet to improve one’s ability to stay functional. http://www.thechildrenscenteraz.org. 560 W. Brown Rd., Suite 4007, Mesa, AZ 85201, 480-315-0730; or 5430 W. Glenn Dr., Glendale, AZ 85301, 623-915-0345.
Baio Enterprises, Inc., Marti A. Baio, M.A., CCC-SLP, Director
Pediatric Speech & Occupational Therapy, Adult Therapy
1745 S. Alma School Rd., Suite 145, Mesa, AZ 85210, Tel (480) 963-3634, Fax (480) 855-8384 www.baioenterprises.com
Auditory Integration Training –
Harper Hearing Services, Sandra Ann Harper, 1007 East Warner Road, Ste. 105, Tempe, AZ 85284-3242, ph: 480-838-1212, fax: 480-838-4334, email: saharper@dancris.com
Rebecca D. Welker, M.S., CCC/SLP, 1791 East Hampton, Tucson, AZ 85719
ph: 520-325-4402, fax: 520-323-6915, email: speechbyRDW@aol.com
Premier Care Rehab, Kristin Davis-Cole, 1024 Willow Creek Road, Suite D, Prescott, AZ 86301, ph: 520-778-9666, fax: 520-771-9620
Naturopaths, Homeopaths & Sources for Nutritional Supplements -
Mixtures Pharmacy & Compounding Center – specializes in medication not available in the traditional retail setting; focuses on sensitivities/allergies as well as supplements, secretin, and chelation therapy. 16515 S. 40th St., #123, Phoenix, AZ 85048. Tel: 480-706-0620, Fax: 480-706-0489, E-mail: pharmacist@mixturesrx.com; Web site: www.mixturesrx.com.
Mesa Health and Wellness Center, Dr. Sung, Dr. Armanti, and Dr. Rodriguez, (naturopathic doctors) 560 W. Brown Rd., Suite 3006, Mesa, AZ 85201, 480-461-1255.
Stanley R. Olsztyn, M.D.(H.), P.C. , Preventative Medicine, 4350 E. Camelback, Rd., Suite B-220, Phoenix, 85018, Phone (602) 840-8424, Fax (602) 840-8545
Stephen Davidson, D.D., Homeopathy, 1303 W. Bethany Home Rd., (602) 246-8977
Todd Rowe, M.D.(H.), CCH, DHE, Homeopathy, 5501 N. 19th Ave., #425, (602) 864-1776
Arizona Resources from the National Dissemination Center for Children with Disabilities (NICHCY) website:
State Vocational Rehabilitation Agency, Skip Bingham, Administrator
Rehabilitation Services Administration, Department of Economic Security
1789 W. Jefferson, 2nd Floor, NW (930A), Phoenix, AZ 85007,
(602) 542-3332; (800) 563-1221, E-mail: sbingham@azdes.gov
Web: www.de.state.az.us/rsa
State Developmental Disabilities Program, Ric Zaharia, Assistant Director
Department of Economic Security, Division of Developmental Disabilities
P.O. Box 6123, Site Code (791A), Phoenix, AZ 85005
(602) 542-6853, Web: www.de.state.az.us/ddd
Regional ADA & IT Technical Assistance Center, Erica C. Jones, Director
Pacific Disability and Business Technical Assistance Center, Public Health Institute, 555 12th Street, Suite 1030, Oakland, CA 94607-4046, (510) 285-5600 (V/TTY); (800) 949-4232 (V/TTY), E-mail: adatech@pdbtac.com,
Web: www.pacdbtac.org
Technology-Related Assistance, Jill S. Oberstein, Director, Randy Collins, Outreach/Training Coordinator, Ed Myers, Policy and Funding Specialist
Arizona Technology Access Program (AZTAP), 4105 N. 20th Street, Suite 260
Phoenix, AZ 85016, (602) 728-9534; (602) 728-9536 (TTY)
(800) 477-9921 (toll-free), E-mail: jill.oberstein@nau.edu, Web: www.nau.edu/ihd/aztap/
To find out the contact information for the Statewide Independent Living Council (SILC) in your state, contact:
Independent Living Research Utilization Project, The Institute for Rehabilitation and Research, 2323 South Sheppard, Suite 1000, Houston, TX 77019, (713) 520-0232 (V); (713) 520-5136 (TTY), E-mail: ilru@ilru.org, Web: www.ilru.org
To find out the contact information for centers for independent living (CILs) in your state, contact:
National Council on Independent Living, 1916 Wilson Boulevard, Suite 209
Arlington, VA 22201, (703) 525-3406; (703) 525-4153 (TTY), E-mail: ncil@ncil.org, Web: www.ncil.org
Where can I read more about these topics?:
ABOUT ASPERGER’S SYNDROME:
Tony Attwood, Asperger’s Syndrome: A Guide for Parents and Professionals, (1998) Jessica Kingsley Publishers, www.jkp.com
K. Stewart, Helping a Child with Nonverbal Learning Disorder or Asperger’s Syndrome: A Parent’s Guide, (2002) New Harbinger Publications, www.newharbinger.com
LIVING WITH ASPERGER’S SYNDROME:
L. Holliday Willey, Pretending to be Normal, (1999) Jessica Kingsley Publishers, www.jkp.com
Jerry Newport, Your Life is Not a Label: A Guide to Living Fully with Autism and Asperger’s Syndrome for Parents, Professionals, and You!, Future Horizons, Inc., www.FutureHorizons-autism.com.
Stephen Shore, Beyond the Wall: Personal Experiences with Autism and Asperger Syndrome, (1961) Autism Asperger Publishing Co., www.asperger.net
Temple Grandin, Thinking In Pictures: and Other Reports from My Life with Autism, (1996) Vintage Books.
Jean Kearns Miller, editor, Women from Another Planet: Our Lives in the Universe of Autism,(2003) 1stBooks Library.
WORK AND ASPERGER’S SYNDROME:
Temple Grandin & Kate Duffy, Developing Talents: Careers for Individuals with Asperger Syndrome and High-Functioning Autism, (2004) Autism Asgerger Publishing Co., www.asperger.net
How to Find Work That Works for People with Asperger Syndrome: The Ultimate Guide for Getting People With Asperger Syndrome into the Workplace (and Keeping Them There!) by Gail Hawkins. www.amazon.com
Stephen M. Shore (editor), Ask and Tell: Self-Advocacy and Disclosure for People on the Autism Spectrum, (2004) Autism Asperger Publishing Co., www.asperger.net
RELATIONSHIPS AND ASPERGER’S SYNDROME:
J. Newport and M. Newport, Autism-Asperger’s & Sexuality, (2002) Future Horizons, www.futurehorizons-autism.com.
Jeanette McAfee, Navingating the Social World: A Curriculum for Individuals with Asperger’s Syndrome, High Functioning Autism and Related Disorders, (2002) Future Horizons, Inc., www.futurehorizons-autism.com
LIVING IN A NEUROTYPICAL WORLD WITH ASPERGER’S SYNDROME:
Teresa Bolick, Asperger Syndrome and Adolescence: Helping Preteens and Teens Get Ready for the Real World, (2001) Fair Winds Press, Gloucester, MA
J. Dimitrius and M. Mazzarella, Reading People: How to Understand People and Predict Their Behavior—Anytime, Anyplace, (1999) Ballantine Publishing Group, www.randomhouse.com/BB/
Brenda Smith Myles, Melissa L. Trautman, Ronda L. Schelvan, The Hidden Curriculum: Practical Solutions for Understanding Unstated Rules in Social Situaitons, Autism Asperger Publishing Company (2004).
Rebekah Heinrichs, Perfect Targets: Asperger Syndrome and Bullying, (2003) Autism Asperger Publishing Co.
THE BIOCHEMISTRY OF AUTISM
Children with Starving Brains, by Jacquelyn McCandless, M.D.
Biological Basis of Autism by William Shaw, Ph.D., available from Great Plains Laboratory (913) 341-8949, www.greatplainslaboratory.com
SENSORY ISSUES IN AUTISM/ASPERGER’S SYNDROME:
B. Smith Myles, K. Tapscott Cook, N. E. Miller, L. Rinner, L. A. Robbins, Asperger Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World, (2000) Autism Asperger Publishing Co., www.asperger.net
J. L. Savner, and B. Smith Myles, Making Visual Supports Work in the Home and Community: Startegies for Individuals with Autism and Asperger Syndrome, (2000) Autism Asperger Publishing Co., www.asperger.net
Members of the Phoenix Adult Asperger’s Support Group
I suspect I may have, or have been diagnosed with, Asperger’s Syndrome, but I’m not really sure what it is:
* Please note that Asperger’s Syndrome (sometimes called Asperger’s Disorder) is a neurobiological collection of behavioral differences (thus the word syndrome). It is classified in the ICD-10 and the DSM-IV as a Pervasive Developmental Disorder, alongside Autistic Disorder. This is why some consider Asperger’s Syndrome as part of an Autistic Spectrum Disorder. There is no known cause, although both genetic and environmental factors are suspected to be involved. It is a condition that continues throughout the lifespan. It is not a mental illness.
Diagnostic criteria for Asperger’s Disorder from DSM-IV (1994)
A. Qualitative impairment in social interaction, as manifested by at least two of the following:
(1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
(2) failure to develop peer relationships appropriate to developmental level
(3) a lack of spontaneous seeking to share enjoyment, interests or achievements with other people (e.g. by a lack of showing, bringing, or pointing out objects of interest to other people)
(4) lack of social or emotional reciprocity
B. Restricted repetitive and stereotyped patterns of behaviour, interests and activities,
as manifested by at least one of the following:
(1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(2) apparently inflexible adherence to specific, nonfunctional routines or rituals
(3) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(4) persistent preoccupation with parts or objects
C. The disturbance causes clinically significant impairment in social, occupation, or other important areas of functioning
D. There is no clinically significant general delay in language (e.g. single words used by age 2 years, communicative phrases used by age 3 years)
E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood
F. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia
These clinical definitions were developed for the purpose of determining the degree to which a child is “disabled” and therefore eligible to receive services. They may not mean much or be of much help to adults who suspect that they have Asperger’s Syndrome. The important thing to understand is that Asperger’s Syndrome represents a mild to significant difference in how we process sensory input, communicate, and generally perceive social experiences from those with neurologically typical nervous systems. Like “neurotypicals,” we have our own strengths and limitations. Unfortunately, our “different-ness” often makes us appear more limited and our strengths harder to perceive.
Learning Style differences: Most of us have one very strong learning style, and may pick up very little information from other senses or teaching styles. We may be very strong visual thinkers, very strong auditory thinkers, very strong mathematical thinkers, or very strong in our language skills. One recent study found that some 70% of people diagnosed with Asperger’s Syndrome also met the criteria for nonverbal learning disorder. The vast majority of us have what neurotypicals consider weak social skills, primarily because we don’t pick up the unspoken social cues the way that neurotypicals do. This difference can contribute to failures in relationships and employment, and may also lead to a high co-morbidity of depressive disorder. Most people with Asperger’s Syndrome (colloquially known as “aspies”) have some degree of sensory processing dysfunction, meaning that various of the senses (sight, hearing, smell, touch, taste, proprioception, and vestibular) may be over-or-under sensitive to stimuli in comparison to those of neurotypicals (people not on the autistic spectrum). Synaesthesia (mixing of sensory information, such as smelling sounds) may also be present.
Tony Attwood, a clinical psychologist, and Carol Gray, an educator, both of whom work extensively with individuals on the autism spectrum, took a reverse look at the DSM-IV criteria for receiving a diagnosis of Asperger’s Syndrome and pointed out how what others view as “limitations” could also be viewed as strengths.
From: Discovery of “Aspie” Criteria
Carol Gray and Tony Attwood, 1999
As found at http://www.tonyattwood.com.au/index.htm,
“Tony’s Publications”
A. A qualitative advantage in social interaction, as manifested by a majority of the following:
(1) peer relationships characterized by absolute loyalty and impeccable dependability
(2) free of sexist, “age-ist”, or culturalist biases, ability to regard others at “face value”
(3) speaking one’s mind irrespective of social context or adherence to personal beliefs
(4) ability to pursue personal theory or perspective despite conflicting evidence
(5) seeking an audience or friends capable of enthusiasm for unique interests and
topics, consideration of details, spending time discussing a topic that may not be of primary interest
(6) listening without continual judgement or assumption
(7) interested primarily in significant contributions to conversation, preferring to avoid “ritualistic small talk” or socially trivial statements and superficial conversation
(8) seeking sincere, positive, genuine friends with an unassuming sense of humour
B. Fluent in “Aspergese”, a social language characterized by at least three of the following:
(1) a determination to seek the truth
(2) conversation free of hidden meaning or agenda
(3) advanced vocabulary and interest in words
(4) fascination with word-based humour, such as puns
(5) advanced use of pictorial metaphor
C. Cognitive skills characterized by at least four of the following:
(1) strong preference for detail over gestalt
(2) original, often unique perspective in problem solving
(3) exceptional memory and/or recall of details often forgotten or disregarded by others, for example: names, dates schedules, routines
(4) avid perseverance in gathering and cataloging information on a topic of interest
(5) persistence of thought
(6) encyclopaedic or “CD-ROM” knowledge of one or more topics
(7) knowledge of routines and a focused desire to maintain order and accuracy
(8) clarity of values/decision making unaltered by political or financial factors
D. Additional possible features:
(1) acute sensitivity to specific sensory experiences and stimuli, for example, hearing touch, vision and/or smell
(2) strength in individual sports or games, particularly those involving endurance or visual accuracy, including rowing, swimming, bowling, chess
(3) “social unsung hero” with trusting optimism: frequent victim of social weaknesses of others, while steadfast in the belief of the possibility of genuine friendship
(4) increased probability over general population of attending university after high school
(5) often take care of others outside the range of typical development
Note: Many Famous People Are Suspected To Have Characteristics of Asperger’s Syndrome:
Temple Grandin, Ursula LeGuin, Albert Einstein, Gene Roddenberry, Charles Darwin, Thomas Edison, Mark Twain, M.C. Escher, Johann S. Bach, Max Planck, Helen Keller, J.R.R. Tolkien, Jean Ayres, Dylan Thomas, Pablo Picasso, Linus Torvald, Galileo, Arthur C. Clarke, Franz Kafka, Glenn Gould, Benjamin Franklin, Margaret Mead, Aristotle
From “Sparks of Genius” - The 13 Thinking Tools of the World’s Most Creative People
Robert and Michele Root-Bernstein, (2001) Marriner Books
[For clarification: Temple Grandin has been diagnosed as autistic since she was a child. She has on many occasions stated that if she were to be diagnosed today, as an adult, she believes that she would fit the criteria for Asperger’s Syndrome. The others on this list have not been diagnosed as having Asperger’s Syndrome, but many suspect that, based on observation of their social and learning characteristics, they fit the diagnostic definition of someone with Asperger’s Syndrome. ]
Why have I received diagnoses from doctors that suggest that I have something other than or more than Asperger’s Syndrome?
Asperger’s Syndrome is often diagnosed when all other disorders can be ruled out. People who have, or suspect they have, Asperger’s Syndrome may have been previously diagnosed with:
Autistic Disorder, High Functioning (HFA)
Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS)
Attention Deficit Disorder (ADD)
Schizoid Personality Disorder
Nonverbal Learning Disorder
Right Hemisphere Learning Disorder
Semantic Pragmatic Language Disorder
Clumsy Child Disorder
Additionally, if you have a medical history which includes a past head injury, you may be diagnosed with Traumatic Brain Injury (TBI). A warning for those previously diagnosed with Autistic Disorder or PDD-NOS: being re-diagnosed as having Asperger’s Syndrome can lead to being considered ineligible for various benefits (such as supported employment) that you may have previously benefited from.
There are several disorders that are frequently co-morbid with Asperger’s Syndrome. These include:
Attention Deficit (Hyperactive) Disorder (ADHD or ADD)
Tourette’s Syndrome
Obsessive Compulsive Disorder (OCD)
Depressive Disorder
Dysthymia Disorder (minor depressive disorder)
Sensory Integration Dysfunction
Seizure Disorder/Epilepsy
Several of us have also been considered to have “autistic characteristics” as children, but may never have received any special education or other services. In addition, some people may have asperger tendencies, but not have Asperger’s Syndrome. Engineers and computer programmers are often thought to exhibit asperger-like characteristics. A diagnosis of Asperger’s Syndrome simply reflects the severity of the differences between those with the diagnosis and those without. Current research suggests that there are 10-15 genes related to autism. The severity of your differences may relate to how many genes are affected and/or your other inherited traits, environmental exposures, and life experiences.
The inability to clearly define the difference between autism and Asperger’s Syndrome is why many consider both to be part of an autism spectrum, with Asperger’s Syndrome representing the high end of the spectrum. Based on DSM-IV criteria used to make a diagnosis, those with Asperger’s Syndrome have normal to above normal intelligence and fewer limitations in their use of speech and ability to communicate than those diagnosed with autism. Significant delays in the development of speech and communication, beyond the age of 2 years, are considered characteristic of autism. Some people on the autism spectrum display a splinter skill (also known as a savant skill) related to mathematics, calendars, or music, although this is not necessary for a diagnosis of autism.
Those who do develop speech but continue to have difficulties in communication and/or performing daily living activities are often classified as having “high functioning” autism. This is a delineation that many adults on the spectrum are not comfortable with as it implies that those with more severe difficulties in communicating and performing daily living activities are “low functioning.” The assumption is, and they are often treated as though, they are mentally retarded, and thus not given the mental and academic stimulation they deserve and need to achieve their true potential. Yet many “low functioning” individuals with autism have been discovered to be quite intelligent once the environmental or biochemical stresses interfering with their ability to communicate or perform daily living activities are lessened. With Asperger’s Syndrome, because of our high verbal skills, the expectations are often just the opposite. The assumption is that we are intelligent enough to do more than we demonstrate and are just not trying hard enough, when the truth is that we are “passing” for close to normal only because we are trying so hard and, in most cases, can’t do more than we are doing. For this reason, learning self-advocacy skills to clearly communicate to others just what you can and can not do is very important.
Why would I want an official diagnosis of Asperger’s Syndrome?:
If you are currently not experiencing any major problems in your relationships or employment, you may not want to get diagnosed as having Asperger’s Syndrome. However, getting an official diagnosis from a psychiatric or medical professional will be necessary if you are considering applying for social benefits, such as Social Security Disability or Vocational Rehabilitation. Please note that the diagnosis of Asperger’s Syndrome alone will not qualify you for any form of services. It is generally some co-morbid (accompanying) symptom (as mentioned above) that affects your ability to function in your work or home environment that is considered disabling. Despite the fact that functioning in a neurotypical world can be very difficult, a diagnosis of Asperger’s Syndrome does not mean a person is unable to learn to function, especially if they are fortunate enough to have people in their lives that provide the support they need.
Getting a diagnosis can be useful if you need accommodations in order to perform the tasks or deal with the environment in an employment situation. Such accommodations may include alternative ways of communicating, a more isolated space, breaks, etc.
If you are having considerable difficulty with relationships, especially with regards to understanding the other person’s perspective, then perhaps it is worthwhile investigating whether you have Asperger’s Syndrome and/or how it might be affecting communication between you and the person with whom you are trying to relate. You may also need to explore what it is you expect and need from a relationship and learn how to advocate for what you want in a non-demanding manner. Of equal importance is learning how to give what the other person wants in order to get what you want. If you decide to seek help in this regard, be sure that the psychiatrist, psychologist or counselor has experience with and is accepting of Asperger’s Syndrome differences.
Who you contact for a diagnosis will depend on what you are seeking from this person. Psychologists or neuropsychologists will arrive at a diagnosis through testing. This can be helpful if you are looking for more information on your areas of learning strength and differences. A neuropsychologist looks at the neurological as well as psychological issues. This type of testing can give you helpful information about yourself, but only IF the psychologist or neuropsychologist is familiar with neurological differences associated with Asperger’s Syndrome. Otherwise, their report is not likely to give you an accurate picture of yourself that you can relate to and use. A psychiatrist will often diagnose you after getting a history and talking with you, or others who know you. A psychiatrist is a medical doctor who can prescribe medication that may be helpful to you in calming your anxieties or bringing you out of depression (or treating co-morbid disorders).
The choice should always be left up to you as to whether you want to try medication. Medication can have side effects you need to be aware of and long-term use can sometimes result in a form of tics. Psychotropic medications (the ones that influence your brain chemistry) must never be stopped suddenly as your brain adapts to them and must be very slowly decreased to avoid withdrawal symptoms. You always have the choice of trying natural supplements that have a similar influence on your brain chemistry (check out http://www.phxautism.org/vitamin/frame.htm for more information on this). Unfortunately the manufacturers of supplements are unregulated so your doctor is unable to support their use and your insurance is not going to cover their cost.
Where can I go to get a diagnosis?:
If you are considering getting an official diagnosis, you should bring the following items with you: medical history/records and parents or teacher’s notes on your childhood behavior (including any kind of “baby development log” your parents may have kept, noting important milestones such as crawling, walking, first words, etc.). School records from Kindergarten through High School that show your abilities, both weak and strong, can be helpful. If you keep a diary, or have written personal essays on your experiences in dealing with other people, these may also be useful. There may be others who work with adults with Asperger’s Syndrome, but the following references are the ones we are aware of at this time (this does not constitute an endorsement of these doctors, only an awareness that they are said to work with adults with Asperger’s Syndrome):
Mark Wellek, M.D., psychiatrist, 4202 N. 32 St., Phoenix, AZ 85018, Phone: 602-955-1070, Fax: 602-957-9614. He accepts Out-of-Plan Referrals but payment is required at the time of services.
Bruce Rigler Holzman, M.D., 525 N. 18th Street, Suite 303, Phoenix, AZ 85006-3734
Phone: 602-254-9986, Fax: 602-254-4439. He is a provider in PPO, HMO or Network Plans and Accepts Out-of-Plan Referrals
William Graff, Ed.D., Well Being Systems, 2701 East Camelback Road, Phoenix, AZ 85016, Phone: (602) 957-2368. [Be aware that Dr. Graff is not a medical doctor if this is what you are looking for to work with you long-term, but he has his own approach, like most professionals, that he believes can help.]
Do NOT feel obliged to continue to see any professional that makes you feel uncomfortable or who pushes on you their agenda for what they think is best for you. You have both control over and responsibility for how you chose to live your life. Continue to seek what you find helpful, and look elsewhere when it is not or stops being helpful.
Should I tell people that I have Asperger’s Syndrome?:
This is a sensitive subject. In regards to employment, you do not need to disclose your diagnosis until after you have actually been hired. If you know that you will require certain accommodations in order to do your best at work (e.g., incandescent, rather than fluorescent, lighting, a flat-screen computer, etc.). If you need to disclose your diagnosis in order to request accommodations, the best person to start with may be your immediate supervisor. Sometimes simply stating that you “do best” when [a particular accommodation is provided] is enough. Some businesses require you to disclose your disability to personnel in order to receive accommodations that are not typically made for others. Be aware that some aspies have found that disclosing their diagnosis with the expectation that others will better understand and provide for their needs was not helpful, and often backfired. It is always best if YOU decide what you need and politely, with reasonable explanations that do not need to include your diagnosis, ask for it,. Don’t expect them to know what you need, based on a diagnosis that they may not understand. You are the only one that can know your needs.
In relationships, disclosure of a diagnosis Asperger’s Syndrome has been known to save relationships that are in trouble, but it has also been known to lead to a faster break-up or divorce if the non-Asperger’s Syndrome partner is unwilling to deal with the changes or issues inherent with this new knowledge about you. Experiences have been mixed.
A book on this issue that you might want to check out is: Ask and Tell: Self-Advocacy and Disclosure for People on the Autism Spectrum, Stephen M. Shore, editor, by Autism Asperger Publishing Company (www.asperger.net).
Where can I meet others who have Asperger’s Syndrome?
Asperger’s Syndrome/HFA/PDD Support Groups:
In Phoenix, contact: Trish Gelvin, 602-421-2215, trish_crew@yahoo.com
In Tucson, contact: Jerry Newport, 520-795-0396, wholphin48@hotmail.com
Internet Sites:
Patty's Home Page, adult autism issues, advocacy for adult autistics, autism information, http://www.autistics.cc/
Frank Klein’s Autistic Advocacy, http://home.att.net/~ascaris1/
Autism Network International, http://ani.autistics.org/
M. Jane Meyerding’s Home Page, http://staff.washington.edu/mjane/
Dave Spicer - autistic writer and speaker - http://bellsouthpwp.net/d/s/dspicer/
The MAZE - Ooops... Wrong Planet! Syndrome Master Link Page, http://www.isn.net/~jypsy/autilink.htm
autistics.org Links Autistic_Culture-People, http://www.autistics.org/links2/Autistic_Culture/People/
I want friends but making friends seems hard. Why?:
Personal friendships are generally built on one or more things of shared interest between two people. Personal friends share their thoughts and feelings as well as experiences. Not everyone who calls themselves friends are personal friends. Aspies tend to be very open and honest and willing to share themselves with others, which are traits that close personal friends will value. Social and work friends, however, may not value this trait. They may not be ready to be open and honest and share personal information about themselves with you, so it makes them feel uncomfortable when you offer these things to them. Some Neurotypicals like to take the development of friendships slowly (see the stages of relationships below). When someone asks you questions about yourself, like where you were born or went to school or what things you like, they are indicating that they have a possible interest in becoming your friend. That doesn’t mean they will become your friend, only that they are interested in finding out if you both share enough interests to possibly become friends.
Some Neurotypicals, on the other hand, can be very open to making friends quickly. If someone wants to be your friend quickly, and then asks you to do something for them, like give them money or do something crazy or hurt someone, be aware that true friends don’t do that! True friends help you to feel good about yourself and protect you from doing things that are not in your best interest, or in the best interest of others. As mentioned in “Aspie Strengths”, we tend to be very loyal to our friends. However, our loyalty can (and has) been abused by those with various social weaknesses, such as greed or jealousy or low self-esteem. It is always a good idea to pay attention to your instincts. If you feel even the slightest bit uncomfortable about something, even if you can’t identify what it is, it is best to seek advice from someone you do trust who understands how some people can take advantage of others.
Many aspies have particularly strong interests in certain areas. Unfortunately very few people around them may share that interest. This makes it harder for aspies to find friends. An excellent place to look for friends are clubs where people with your special interest are likely to gather. Some aspies recognize that having a lot of friends is not that important to them. Other aspies blame themselves or think badly about themselves if they don’t have friends or make friends easily. Making friends has less to do with whether people like you than it does with whether you have interests or experiences that are similar to theirs AND whether you are also willing to share in the interests they have that are different from your own. It is easy to lose potential friends if you share more than what the other person wants to receive, or don’t give the other person equal time to share their interests with you. Friends who are close personal friends will stick up for each other in front of others, answer questions honestly (in a kind way), help each other when there is a need, and will enjoy just spending time together. Most people, neurotypical or aspie, only have a few friends that meet this definition of a close personal friend. These are the best friends to have and to seek.
Another reason that aspies may have a more difficult time making friends is because our sensory processing and body movements are different from neurotypicals. Friendly pats on the back and reaching out to touch your arm are common ways for neurotypicals to “connect” with each other through the sense of touch. If touch is perceived as uncomfortable, or even threatening, your reaction to their well-intentioned effort to relate to you is not going to be easily understood. This is where aspies need to self-advocate, to let others know what makes us uncomfortable. Most neurotypicals ARE willing to respect these differences, IF they know about them. For those who struggle with verbal communication, a card that explains what you need can be carried in your wallet or purse and shared with others as you choose. The “down side” is, because it is hard for neurotypicals to relate to these differences in perception, it may limit how many potential friends will be willing to work that hard to become a close personal friend. Aspies often find it easier to socialize and become friends with other aspies, simply because we understand each other’s way of thinking and perceiving.
“Missed” communication can also make it harder for aspies to make and keep friends. Our more limited body movements can be misread by neurotypicals who look for “body language” cues when communicating with others. Aspies also tend to find it difficult to attend to all the body language cues neurotypicals give. Thus, we may misread their “intended” messages to us if all we are paying attention to are the words they use. A good source for learning about body language is Teaching Your Child the Language of Social Success by M. P. Duke, S. Nowicki, Jr., and E. A. Martin (1996) Peachtree Publishers, Atlanta, Georgia.
Understanding the social rules that neurotypicals follow can also help in making and keeping friends (as well as working with others on the job). A good source for this is “The Rules of the (Social) Road” (Chapter 9) in Asperger Syndrome and Adolescence, by Teresa Bolick, (2001) Fair Winds Press, Gloucester, MA. Some typical social rules that aspies can break that neurotypicals find “off-putting” (but won’t tell you about to avoid hurting your feelings) are: 1) poor grooming habits, including not brushing teeth, not bathing or washing one’s hair, not wearing clean clothes, and not wearing deodorant; 2) telling people things about yourself that are considered “private”, such as that you do not have friends, have never had sexual intercourse, or use self-gratification to meet your needs; 3) appearing desperate or too eager to establish a close relationship with someone you don’t know really well (which may be a dangerous thing for you as this is the type of behavior that people who will abuse you look for); 4) asking others about their current relationships (unless they bring it up first); and 5) dressing too fancy or too casually for the situation, such as wearing too much make-up or seductive clothes to work or a picnic, or wearing jeans to a job interview.
Even though your sensory processing differences may be the reason for your grooming habits or clothes choices, unless you take the time to explain these differences to others (and even then they may not understand or accept what you say), people will judge you based on your appearance. That doesn’t mean you can’t find ways to compromise, such as adding a jacket to dress up blue jeans. Clothes that are clean and unwrinkled (which can be accomplished by hanging clothes on a hanger while they are still warm and wet after 10 minutes in the dryer) are more important than being “in fashion.” You can accomplish the “snug-fit” your body seems to prefer by wearing biking shorts or a wet suit under your clothes rather than overly tight fitting clothes that might be viewed as “suggestive.”
It might also be helpful to note that toxin build-up due to gut digestion difficulties may contribute to a “body odor” problem even when you are careful about your grooming. If this is the case, consider reading Children with Starving Brains, by Jacquelyn McCandless, M.D., for more information on the medical conditions that can affect the functioning of individuals on the autism spectrum. You may also want to check out the book Biological Basis of Autism by William Shaw, Ph.D., available from Great Plains Laboratory (913) 341-8949, www.greatplainslaboratory.com, for more information on yeast/bacterial infections and diets.
I’m interested in dating and an eventual commitment to another person. Will Asperger’s Syndrome make that more difficult for me?:
Many aspies, both male and female, are married or in long-term relationships. Many are not. Often it is only when aspies have children that they recognize their own aspie traits and are themselves diagnosed. It is also worth noting that aspies have a tendency to belong to “other minority groups”, and may be homosexual or have alternative lifestyles, in statistically greater numbers than the general population. Some aspies do not feel particularly attached to their sexuality. They do not identify with a particular sex or seek relationships with a particular sex. Other aspies simply choose to not pursue relationships other than friendships. Temple Grandin has spoken often of her own preference to not seek a sexual relationship. You should not feel pressured to act outside of what you are comfortable with when it comes to developing relationships with other people.
Whatever your relationship preferences are, relationship difficulties are not something unique to those on the autism spectrum. Neurotypicals have their own share of relationship difficulties. It is important to remember that all relationships have stages. It can be confusing to you if you are not sure which stage in a relationship you are with someone. It can be confusing and even overwhelming to others if you appear to be in a more advanced stage in the relationship than they are ready for. According to the book, Speaking Skills for Prospective Teachers1, the stages in a relationship are: 1) coming together, 2) staying together, and 3) moving apart. Coming together is a 5-step process: 1) initiating contact; 2) discovery of common interests; 3) intensifying our interest and involvement;
4) integrating this person into our life’s activities; 5) bonding or committing to the relationship (usually leading to marriage if the interest in the relationship is sexual). Staying together is described as a long-term situation that requires effort from both partners to keep the relationship going. There are nine characteristics that long-term relationships often have, none of which are always present to the same degree: 1) amusement (making the relationship fun and enjoyable); 2) affection (pleasure in being together); 3) commitment equity (equal dedication to the relationship); 4) fidelity equity (faithfulness to each other); 5) contracting (fulfilling any agreements made to each other); 6) twosome (relying on each other as partners); 7) recognition (publicly making others aware of your commitment to each other); 8) frankness (revealing your inner self to each other); and 9) averaging (good and bad times should average out). It is possible for a relationship to come apart at almost any stage. Under normal conditions, relationships come apart in five steps: 1) differentiating (disagreements and differences become the focus of attention); 2) circumscribing (talk diminishes, with less revealing of self and fewer commitments to each other); 3) stagnation (relationship loses its life and partners move apart physically); 4) avoiding (partners stop seeing each other); and 5) termination (the relationship is over).
Communication is always thought of as a key to successful relationships. So is attitude, according to this same book. This is where the differences in how asperger people and neurotypical people perceive similar experiences can cause problems in relationships. Neurotypicals value the following attitudes in a relationship: being genuine (being honest and open about ones feelings); being committed (having a desire for the relationship to continue and to share the responsibilities and make compromises when problems occur); talking together (to achieve understanding and appreciation of each other and discuss conflicts, expectations, and anxieties that bother each other); and 4) being empathic (seeing the world through the other person’s perspective, listening non-judgmentally and trying to understand the other person in the way they perceive themselves). It is a common, but very false perception, on the part of many neurotypicals that people with Asperger’s Syndrome lack these abilities! It is extremely difficult for ANYONE to understand and perceive what one has never experienced. Because of differences in the way that our brains process and respond to experiences, neurotypicals have just as much difficulty understanding and appreciating the asperger person’s perspective as the asperger person has understanding and appreciating the neurotypical’s perspective.
That doesn’t mean that both sides can’t learn to respect those differences and even understand them somewhat on an intellectual level. Communication becomes the most important factor in helping each other to understand and appreciate these differences. Again, this is a major contributor to relationship difficulties between asperger people and neurotypical people. Neurotypical people learn about and experience social interactions on a non-thinking level. To articulate how and what they know or feel on a thinking level is not something they often need to, or know how to, do with other neurotypicals. They simply “understand” because they tend to perceive these experiences in a similar fashion. Aspies tend to process a lot of input on an intellectual level because it is harder for them to pick up multiple information and process it quickly on a non-thinking level as neurotypicals do. Ironically, even though the mental effort of verbal communication can be very fatiguing for aspies, they are the ones who are expected to “explain” their differences to neurotypicals since neurotypicals see themselves as “normal” and therefore consider themselves easy to understand. Unfortunately, neither party has strengths in the areas that the other person needs for effective communication to take place.
Neurotypical and Asperger’s Syndrome people can develop meaningful and fulfilling relationships. It requires that both parties have to have a strong desire to make the relationship work and to work hard at communicating their different perspectives. Attitudes are not where the problems lie, even though they may often be expressed differently. It’s both parties willingness to communicate, in a non-judgmental way, that is essential to the understanding of, and increased appreciation for, the differences that contribute to the problems in neurotypical-asperger relationships. If you are interested, the movie The Mirror Has Two Faces may be worth watching as an example of an aspie and a neurotypical in a relationship, even though the main character is not identified as having Asperger’s Syndrome (but the characteristics are there). Liane Holliday Willey, in Pretending to be Normal, was already a wife and mother when she discovered, along with her daughter, that she had Aspeger’s Syndrome. Jerry and Mary Newport, in Autism-Asperger’s & Sexuality, have shown that two people with Asperger’s Syndrome can fall in love and have a meaningful committed relationship. All relationships, to be successful in the long-term, require a commitment to compromise and sharing, but having Asperger’s Syndrome does not lessen your chances of having such a relationship if this is truly what you want. It is important to recognize whether a relationship is what YOU want and are willing to work toward and not what you think society expects of you. It is equally important that you know your own limitations to know just how much you have and are willing to give to a relationship. Relationships, even in the neurotypical world, that are built on unrealistic expectations and only getting, not giving, rarely work.
What about having children? What are my chances that they will also have Asperger’s Syndrome?:
Many of us have been diagnosed after having children, particularly if we had a child who was diagnosed as having an Autism Spectrum Disorder. While there are no statistics on the likelihood of aspies having ASD children in general, the statistics for parents of autistic children (at least some of whom are probably undiagnosed aspies) run between 3-5% for Autistic Disorder, and up to 10% for ASD and “language delays”. There is also no data on how our “neurotypical” children turn out, but personal stories told by those on the spectrum of their children seem to indicate that these children pick up the body language and other social information they need from the outside world and do not suffer any “adverse effects” from their parent(s) autistic characteristics.
Where can I go to get the support that I need to live in a neurotypical world?:
[Disclaimer: Because something is listed does not imply that it is endorsed or even known to live up to whatever claims are made as regards providing needed support. They are listed because they are known through word-of-mouth to exist. It is your responsibility to check out these services/agencies for yourself to determine if they could be of any help to you. If there are resources for adults that you are aware of that should be included here, or excluded, please contact sgolubock4@msn.com or gpcasa@hotmail.com ]
Greater Phoenix Chapter (GPC) of the Autism Society of America: This group is for all people interested in autism, including parents of children/adults, and people with autism/Asperger’s. Monthly meetings, newsletter, annual conference. Call (602) 940-1093 http://www.phxautism.org
Tucson Chapter of the Autism Society of America, (520) 770-1541. This group serves people with autism of all ages, and holds monthly meetings. http://aztec.asu.edu/asa-pcc
Asperger Parent Network, resource for families and professionals in the Greater Phoenix Area. Monthly meetings, e-group and web site. www.apn.150m.com
Autism Assistance Program - This program provides financial assistance to low-income children and adults with autism/Asperger's who live in Arizona. The program is funded by a tax-credit in Arizona. Tax-payers may donate up to $200 per year, and receive a dollar-for-dollar reduction in their taxes; i.e., donate $200, and pay $200 less in Arizona taxes. http://www.eas.asu.edu/~autism/AAFA/AAFA.html.
Emily Anderson Family Learning Center: a lending library for information on disabilities. Located on the main corridor of Phoenix Children’s Hospital, 1919 E. Thomas Rd, Phoenix (SW corner of 20th St and Thomas Road). Call them at 602-546-1400 for hours. http://www.phxchildrens.com/about/services/emilycenter/
Phoenix Public Library: Special Needs Center: 1221 N. Central Ave., Phoenix, AZ 85004, Tel: 602-261-8690, Fax: 602-534-4520, E-mail: mmccain@phxlib.org
Arizona Center for Disability Law: Advocates for the legal rights of persons with disabilities to 1) be free from abuse, neglect and discrimination and 2) have access to education, health care, housing and jobs, and other services in order to maximize independence and achieve equality, http://www.acdl.com/, Phoenix: 602) 274-6287 Tucson: (520) 327-9547
Council for Jews with Special Needs: Provides a range of services, 480-629-5343. www.cjsn.org/. Email: info@cjsn.org. 12701 North Scottsdale Rd., Suite 205, Scottsdale, AZ 85254.
Arizona Division of Developmental Disabilities (DDD): Provides many services to people with developmental disabilities, including speech therapy, physical therapy, and occupational therapy. 602-870-1721
Social Security Disability Program: Contact 1-800-772-1213. http://www.ssa.gov/applyfordisability/adult.htm
Mental Health Association of Arizona
6411 E. Thomas Rd., Scottsdale, AZ 85251, Tel: 480-994-4407. Fax: 480-994-4744. E-mail: jsinclair@mhaarizona.org; web site: www.mhaarizona.org
Life Development Institute: Offers basic life training and training for employment. Contact Rob Crawford, M.Ed., Chief Executive Officer, 18001 N. 79th Ave., E-71, Glendale, AZ 85308, rcrawford@life-development-inst.org, www.life-development-inst.org, Phone (623) 773-2774, Fax (623) 773-2788.
Occupational Therapy (Sensory Integration) -
The Children’s Center for Neurodevelopment Studies – Offers occupational therapy, music therapy, speech therapy and horticultural therapy services which focus on the sensory processing strengths and limitations of those on the spectrum and development of a Sensory Diet to improve one’s ability to stay functional. http://www.thechildrenscenteraz.org. 560 W. Brown Rd., Suite 4007, Mesa, AZ 85201, 480-315-0730; or 5430 W. Glenn Dr., Glendale, AZ 85301, 623-915-0345.
Baio Enterprises, Inc., Marti A. Baio, M.A., CCC-SLP, Director
Pediatric Speech & Occupational Therapy, Adult Therapy
1745 S. Alma School Rd., Suite 145, Mesa, AZ 85210, Tel (480) 963-3634, Fax (480) 855-8384 www.baioenterprises.com
Auditory Integration Training –
Harper Hearing Services, Sandra Ann Harper, 1007 East Warner Road, Ste. 105, Tempe, AZ 85284-3242, ph: 480-838-1212, fax: 480-838-4334, email: saharper@dancris.com
Rebecca D. Welker, M.S., CCC/SLP, 1791 East Hampton, Tucson, AZ 85719
ph: 520-325-4402, fax: 520-323-6915, email: speechbyRDW@aol.com
Premier Care Rehab, Kristin Davis-Cole, 1024 Willow Creek Road, Suite D, Prescott, AZ 86301, ph: 520-778-9666, fax: 520-771-9620
Naturopaths, Homeopaths & Sources for Nutritional Supplements -
Mixtures Pharmacy & Compounding Center – specializes in medication not available in the traditional retail setting; focuses on sensitivities/allergies as well as supplements, secretin, and chelation therapy. 16515 S. 40th St., #123, Phoenix, AZ 85048. Tel: 480-706-0620, Fax: 480-706-0489, E-mail: pharmacist@mixturesrx.com; Web site: www.mixturesrx.com.
Mesa Health and Wellness Center, Dr. Sung, Dr. Armanti, and Dr. Rodriguez, (naturopathic doctors) 560 W. Brown Rd., Suite 3006, Mesa, AZ 85201, 480-461-1255.
Stanley R. Olsztyn, M.D.(H.), P.C. , Preventative Medicine, 4350 E. Camelback, Rd., Suite B-220, Phoenix, 85018, Phone (602) 840-8424, Fax (602) 840-8545
Stephen Davidson, D.D., Homeopathy, 1303 W. Bethany Home Rd., (602) 246-8977
Todd Rowe, M.D.(H.), CCH, DHE, Homeopathy, 5501 N. 19th Ave., #425, (602) 864-1776
Arizona Resources from the National Dissemination Center for Children with Disabilities (NICHCY) website:
State Vocational Rehabilitation Agency, Skip Bingham, Administrator
Rehabilitation Services Administration, Department of Economic Security
1789 W. Jefferson, 2nd Floor, NW (930A), Phoenix, AZ 85007,
(602) 542-3332; (800) 563-1221, E-mail: sbingham@azdes.gov
Web: www.de.state.az.us/rsa
State Developmental Disabilities Program, Ric Zaharia, Assistant Director
Department of Economic Security, Division of Developmental Disabilities
P.O. Box 6123, Site Code (791A), Phoenix, AZ 85005
(602) 542-6853, Web: www.de.state.az.us/ddd
Regional ADA & IT Technical Assistance Center, Erica C. Jones, Director
Pacific Disability and Business Technical Assistance Center, Public Health Institute, 555 12th Street, Suite 1030, Oakland, CA 94607-4046, (510) 285-5600 (V/TTY); (800) 949-4232 (V/TTY), E-mail: adatech@pdbtac.com,
Web: www.pacdbtac.org
Technology-Related Assistance, Jill S. Oberstein, Director, Randy Collins, Outreach/Training Coordinator, Ed Myers, Policy and Funding Specialist
Arizona Technology Access Program (AZTAP), 4105 N. 20th Street, Suite 260
Phoenix, AZ 85016, (602) 728-9534; (602) 728-9536 (TTY)
(800) 477-9921 (toll-free), E-mail: jill.oberstein@nau.edu, Web: www.nau.edu/ihd/aztap/
To find out the contact information for the Statewide Independent Living Council (SILC) in your state, contact:
Independent Living Research Utilization Project, The Institute for Rehabilitation and Research, 2323 South Sheppard, Suite 1000, Houston, TX 77019, (713) 520-0232 (V); (713) 520-5136 (TTY), E-mail: ilru@ilru.org, Web: www.ilru.org
To find out the contact information for centers for independent living (CILs) in your state, contact:
National Council on Independent Living, 1916 Wilson Boulevard, Suite 209
Arlington, VA 22201, (703) 525-3406; (703) 525-4153 (TTY), E-mail: ncil@ncil.org, Web: www.ncil.org
Where can I read more about these topics?:
ABOUT ASPERGER’S SYNDROME:
Tony Attwood, Asperger’s Syndrome: A Guide for Parents and Professionals, (1998) Jessica Kingsley Publishers, www.jkp.com
K. Stewart, Helping a Child with Nonverbal Learning Disorder or Asperger’s Syndrome: A Parent’s Guide, (2002) New Harbinger Publications, www.newharbinger.com
LIVING WITH ASPERGER’S SYNDROME:
L. Holliday Willey, Pretending to be Normal, (1999) Jessica Kingsley Publishers, www.jkp.com
Jerry Newport, Your Life is Not a Label: A Guide to Living Fully with Autism and Asperger’s Syndrome for Parents, Professionals, and You!, Future Horizons, Inc., www.FutureHorizons-autism.com.
Stephen Shore, Beyond the Wall: Personal Experiences with Autism and Asperger Syndrome, (1961) Autism Asperger Publishing Co., www.asperger.net
Temple Grandin, Thinking In Pictures: and Other Reports from My Life with Autism, (1996) Vintage Books.
Jean Kearns Miller, editor, Women from Another Planet: Our Lives in the Universe of Autism,(2003) 1stBooks Library.
WORK AND ASPERGER’S SYNDROME:
Temple Grandin & Kate Duffy, Developing Talents: Careers for Individuals with Asperger Syndrome and High-Functioning Autism, (2004) Autism Asgerger Publishing Co., www.asperger.net
How to Find Work That Works for People with Asperger Syndrome: The Ultimate Guide for Getting People With Asperger Syndrome into the Workplace (and Keeping Them There!) by Gail Hawkins. www.amazon.com
Stephen M. Shore (editor), Ask and Tell: Self-Advocacy and Disclosure for People on the Autism Spectrum, (2004) Autism Asperger Publishing Co., www.asperger.net
RELATIONSHIPS AND ASPERGER’S SYNDROME:
J. Newport and M. Newport, Autism-Asperger’s & Sexuality, (2002) Future Horizons, www.futurehorizons-autism.com.
Jeanette McAfee, Navingating the Social World: A Curriculum for Individuals with Asperger’s Syndrome, High Functioning Autism and Related Disorders, (2002) Future Horizons, Inc., www.futurehorizons-autism.com
LIVING IN A NEUROTYPICAL WORLD WITH ASPERGER’S SYNDROME:
Teresa Bolick, Asperger Syndrome and Adolescence: Helping Preteens and Teens Get Ready for the Real World, (2001) Fair Winds Press, Gloucester, MA
J. Dimitrius and M. Mazzarella, Reading People: How to Understand People and Predict Their Behavior—Anytime, Anyplace, (1999) Ballantine Publishing Group, www.randomhouse.com/BB/
Brenda Smith Myles, Melissa L. Trautman, Ronda L. Schelvan, The Hidden Curriculum: Practical Solutions for Understanding Unstated Rules in Social Situaitons, Autism Asperger Publishing Company (2004).
Rebekah Heinrichs, Perfect Targets: Asperger Syndrome and Bullying, (2003) Autism Asperger Publishing Co.
THE BIOCHEMISTRY OF AUTISM
Children with Starving Brains, by Jacquelyn McCandless, M.D.
Biological Basis of Autism by William Shaw, Ph.D., available from Great Plains Laboratory (913) 341-8949, www.greatplainslaboratory.com
SENSORY ISSUES IN AUTISM/ASPERGER’S SYNDROME:
B. Smith Myles, K. Tapscott Cook, N. E. Miller, L. Rinner, L. A. Robbins, Asperger Syndrome and Sensory Issues: Practical Solutions for Making Sense of the World, (2000) Autism Asperger Publishing Co., www.asperger.net
J. L. Savner, and B. Smith Myles, Making Visual Supports Work in the Home and Community: Startegies for Individuals with Autism and Asperger Syndrome, (2000) Autism Asperger Publishing Co., www.asperger.net
zondag 13 april 2008
Understanding Asperger's Syndrome
by Johanna Sorrentino
For parents of children on the Autism spectrum, consider this: maybe it's not only about your child's understanding of the world, maybe it's the world's understanding of your child.
Michael John Carley has come full circle with this concept. He was diagnosed with Asperger's Syndrome at the age of 36, just one week after his 4-year-old son received the same diagnosis. “Not only was my son being presented with an explanation, but I was finally presented with an explanation of what I'd endured my entire life. I don't have the words to describe the biblical weight being lifted off me,” Carley says.
Asperger's is a neurological condition, and is one of five diagnoses that comprise what's called “the autism spectrum.” The “autism” label has carried some serious baggage. So much so that in the 1960s there was born a movement of “antilabelism” where children were no longer stamped with a diagnosis, and instead their condition was referred to only as “special.” Carley says this trend swung too far in the other direction--“that's the comic tragic thing.” Now, he says, it's time to embrace terms like “Asperger's” and “Autism,” so that those with the condition can begin dealing with exactly what it is that makes them different—both the negatives and the positives.
And that's why the ideas he presents in his book, Asperger's from the Inside Out, are so new. In the book he provides a table of common Asperger's characteristics and the positive and negative interpretations that go along with it. For example, one of the characteristics that Carley discusses is an intense absorption in a topic or field of interest. While the negative interpretation is that the individual is obsessed, the positive interpretation is that this individual is passionate about something. Another common element of Asperger's is the inability to read nonverbal communications such as facial expressions, body gestures, and shifting vocal tones. The downside is that many miscommunications with what Carley calls the "neurotypical" world are guaranteed, leading to failed socialization and lost opportunties. The upside is that communicating using text--either in reading or writing--is heightened. Often, those with Asperger's say whatever comes into their head, unaware of the potential damage the statement might cause. To many, this is construed as rude, but could it not also be seen as honest? And on this list goes.
Carley says the point of all this isn't to invalidate the challenges, but to consider how those with Asperger's can function in society, rather than thinking about all the ways they can't. "Yes, life is harder rather than easier, but we don't consider this a blanket negative," Carley says.
And society is beginning to catch on to the idea that people should be seen for who they are, Asperger's and all. When Carley was a child, before the word Asperger's made it onto anyone's list, his behavior was explained away as emotional difficulties due to his father's death in Vietnam.
Carley says his son will benefit from living in a world that knows more about this neurological condition. “The upshot to knowing more and more is really just that you're weirdness has an explanation. You know you're just wired differently, you're not rude. You process thought differently, instead of being an insensitive creep,” he says. “It's a much better way of thinking about yourself.”
This self-awareness is critical, according to Carley, because being able to educate others about your condition is an imperative life skill for people on the spectrum. “You want to be creating in kids the best self-advocates they possibly can be because we hope that they're going to leave home, and they need to be the ones to explain why they come across as different to that potential landlord, significant other, or employer,” Carley says.
What else can parents of children on the spectrum do to handle stress, embrace their child fully and help to raise an independent adult? Carley, who has worked with thousands of families as Executive Director of GRASP (The Global and Regional Asperger Syndrome Partnership), offers this advice:
1.Read up on the history of Autism Spectrum Disorders to find out how the iconography has developed over the years. Carley says depending on the challenges of their particular child, parents will feel some sense of pressure to change that child—maybe due to an outburst in the supermarket or an awkward conversation with the neighbors. “We can all forgive ourselves when want to secede to societal pressure. What's important is loving your child for who she is. That can't begin until we look at how iconography has affected us,” Carley says.
2.Make sure you're taken care of. Carley says there's a good reason that airlines instruct passengers to put the oxygen mask on themselves first, before assisting their children. “If you can't be there in a healthy, operating way, you're not much good to your child,” he says.
3.One of the biggest challenges for individuals with Asperger's, Carley says, is an ability to shrug off life's failures. But, parents can help their children process failure better. “Praise, and praise, and praise for trying,” Carley says. “Very often parents say 'This is a special child, and I want to shield him from failure.' It's a good thought, but it's not the final resting ground. The final resting ground is independence and bravery.”
4.Finally, Carley says joining a support group can be a great way for families to relieve stress. “When someone tells you 'I understand. I've been there.' Nothing feels better at that moment,” he says. GRASP, the world's largest support organization for Asperger's, has a list of families and clinicians on their website. Check it out at www.grasp.org.
For parents of children on the Autism spectrum, consider this: maybe it's not only about your child's understanding of the world, maybe it's the world's understanding of your child.
Michael John Carley has come full circle with this concept. He was diagnosed with Asperger's Syndrome at the age of 36, just one week after his 4-year-old son received the same diagnosis. “Not only was my son being presented with an explanation, but I was finally presented with an explanation of what I'd endured my entire life. I don't have the words to describe the biblical weight being lifted off me,” Carley says.
Asperger's is a neurological condition, and is one of five diagnoses that comprise what's called “the autism spectrum.” The “autism” label has carried some serious baggage. So much so that in the 1960s there was born a movement of “antilabelism” where children were no longer stamped with a diagnosis, and instead their condition was referred to only as “special.” Carley says this trend swung too far in the other direction--“that's the comic tragic thing.” Now, he says, it's time to embrace terms like “Asperger's” and “Autism,” so that those with the condition can begin dealing with exactly what it is that makes them different—both the negatives and the positives.
And that's why the ideas he presents in his book, Asperger's from the Inside Out, are so new. In the book he provides a table of common Asperger's characteristics and the positive and negative interpretations that go along with it. For example, one of the characteristics that Carley discusses is an intense absorption in a topic or field of interest. While the negative interpretation is that the individual is obsessed, the positive interpretation is that this individual is passionate about something. Another common element of Asperger's is the inability to read nonverbal communications such as facial expressions, body gestures, and shifting vocal tones. The downside is that many miscommunications with what Carley calls the "neurotypical" world are guaranteed, leading to failed socialization and lost opportunties. The upside is that communicating using text--either in reading or writing--is heightened. Often, those with Asperger's say whatever comes into their head, unaware of the potential damage the statement might cause. To many, this is construed as rude, but could it not also be seen as honest? And on this list goes.
Carley says the point of all this isn't to invalidate the challenges, but to consider how those with Asperger's can function in society, rather than thinking about all the ways they can't. "Yes, life is harder rather than easier, but we don't consider this a blanket negative," Carley says.
And society is beginning to catch on to the idea that people should be seen for who they are, Asperger's and all. When Carley was a child, before the word Asperger's made it onto anyone's list, his behavior was explained away as emotional difficulties due to his father's death in Vietnam.
Carley says his son will benefit from living in a world that knows more about this neurological condition. “The upshot to knowing more and more is really just that you're weirdness has an explanation. You know you're just wired differently, you're not rude. You process thought differently, instead of being an insensitive creep,” he says. “It's a much better way of thinking about yourself.”
This self-awareness is critical, according to Carley, because being able to educate others about your condition is an imperative life skill for people on the spectrum. “You want to be creating in kids the best self-advocates they possibly can be because we hope that they're going to leave home, and they need to be the ones to explain why they come across as different to that potential landlord, significant other, or employer,” Carley says.
What else can parents of children on the spectrum do to handle stress, embrace their child fully and help to raise an independent adult? Carley, who has worked with thousands of families as Executive Director of GRASP (The Global and Regional Asperger Syndrome Partnership), offers this advice:
1.Read up on the history of Autism Spectrum Disorders to find out how the iconography has developed over the years. Carley says depending on the challenges of their particular child, parents will feel some sense of pressure to change that child—maybe due to an outburst in the supermarket or an awkward conversation with the neighbors. “We can all forgive ourselves when want to secede to societal pressure. What's important is loving your child for who she is. That can't begin until we look at how iconography has affected us,” Carley says.
2.Make sure you're taken care of. Carley says there's a good reason that airlines instruct passengers to put the oxygen mask on themselves first, before assisting their children. “If you can't be there in a healthy, operating way, you're not much good to your child,” he says.
3.One of the biggest challenges for individuals with Asperger's, Carley says, is an ability to shrug off life's failures. But, parents can help their children process failure better. “Praise, and praise, and praise for trying,” Carley says. “Very often parents say 'This is a special child, and I want to shield him from failure.' It's a good thought, but it's not the final resting ground. The final resting ground is independence and bravery.”
4.Finally, Carley says joining a support group can be a great way for families to relieve stress. “When someone tells you 'I understand. I've been there.' Nothing feels better at that moment,” he says. GRASP, the world's largest support organization for Asperger's, has a list of families and clinicians on their website. Check it out at www.grasp.org.
The Boundaries between Asperger and Nonverbal Learning Disability Syndromes
by Bonny Forrest, Ph.D
email: BonForrest@aol.com
The purpose of this article is to review similarities and differences between Asperger (AS) and Nonverbal Learning Disability (NVLD) Syndromes. The existence of AS as a separate diagnostic entity from Autism remains controversial. Much of this controversy stems from the presence of children who have social deficits characteristic of Autism but exhibit lesser degrees of language impairments, and from the use of the age of onset of language deficits to distinguish between the two syndromes. Perhaps even more contestable is whether a distinction exists between AS and NVLD. The latter, which has not yet been recognized by the DSM-IV-TR as a diagnostic entity, has been most frequently defined in the literature by a specific neuropsychological profile. This profile can be very similar to that of children with AS. The main difference between the two disorders, as they are most frequently defined clinically, is the absence in children with NVLD of restricted interests or special skills. The diagnostic situation is further complicated, however, by the complex and still-changing definitions of the social deficits observed in NVLD.
Asperger Syndrome
Behavioral Consequences
Attempts have been made to distinguish children with AS on the basis of the functional aspects of their social impairments. Their social interactions have been described as lacking in empathy, exhibiting poor nonverbal communication and use of speech, and being overly reliant on rote language abilities. These children are usually aware of their inability to connect to others (Volkmar and Klin, 2000). In addition, the child with AS tends to become an expert in a specific area of interest (e.g., the weather or subway lines). Although one subgroup of the children with nonverbal disorders of learning described by Johnson and Myklebust (1967) exhibits social deficits, this group does not generally exhibit restricted interests or special skills that would meet the criteria for diagnostic classification as AS.
Neuropsychological Profiles
Few studies have attempted to validate a neuropsychological profile of children with AS. The results of this handful of studies, although far from providing a definitive template, seem to suggest that individuals with AS have deficits in fine and gross motor skills, visual motor integration, visual-spatial perception, nonverbal concept formation, and visual memory. Language skills are generally intact (Klin, Volkmar and Sparrow, 2000). This profile of neuropsychological assets and deficits is very similar to the NVLD profile described by Rourke (1995), as discussed below.
Nonverbal Learning Disabilities
Behavioral Characteristics
Johnson and Myklebust (1967) were the first to posit the existence of discrete subtypes of nonverbal learning disorders, including one sub-group of children with nonverbal deficits who have deficiencies in social perception. They defined social perception broadly as the inability of a child to interpret both the emotions expressed by another person and the perception of oneself in relation to the behavior of others. Such children cannot pretend, anticipate, evaluate the significance of certain aspects of their environment, or comprehend the meaning of facial expressions and gestures or the subtleties of emotions. They further described the children with difficulties in social perception as having average or above average abilities in language but difficulty using those language skills.
Neuropsychological Profiles
Byron Rourke’s (1995) recent research has focused primarily on the combination of neuropsychological assets and deficits that produces as a byproduct the poor social relatedness that Johnson and Myklebust (1967) described as characteristic of only one group of children with NVLD. Rourke described the neuropsychological deficits in NVLD more specifically in terms of primary, secondary, and tertiary deficits. The children he studied had primary deficits in tactile perception, visual perception, complex psychomotor activities and the ability to process novel material. Secondary deficits (secondary because they were related to the basic deficits) included difficulties in tactile attention, visual attention and exploratory behavior. Tertiary deficits included tactile memory, visual memory, concept formation and problem solving. According to Rourke (1995), when these neuropsychological deficits interact with assets in auditory perception, simple motor skills and the ability to process rote material, socioemotional or adaptational deficits result. Children with NVLD as described by Rourke (1995) often exhibit extreme difficulty in processing new or complex social situations and interpreting facial expressions. In novel situations, they rely on repetitious or rote behaviors, because they excel in these skills. Their interactions with other children are stereotypical and lacking in reciprocity (Rourke and Tsatsanis, 2000). Children encompassed in Rourke’s (1995) description may manifest these symptoms from birth or as a result of neuropsychological injury or disease.
The young boy examined in the following case report provides a graphic illustration of the difficulties presented when attempting to diagnose a child who exhibits some but not all of the characteristics associated with both AS and NVLD.
Case Report
M is an eight-year, eight-month-old right-handed male. He has worn glasses since the age of 9 ½ months. M was slow to crawl (11 ½ months) but walked independently at 14 months. His parents were also concerned that his social skills lagged behind his peers. M frequently observed other children but was hesitant to engage them in play. School personnel corroborated these concerns as early as preschool.
M had three comprehensive assessments, followed by additional testing as part of a research study.
At the time of the first assessment at four years and ten months, later motor milestones, such as undressing, dressing, and copying shapes, were beginning to emerge. Language skills were described as quite good. His verbal abilities were assessed at the 99th percentile. M’s performance revealed deficits, however, in gross and fine motor abilities and sensory integration.
M underwent a neuropsychological evaluation at the age of 5 years, 4 months. At that evaluation, numbers and their applications (e.g., number of cars in a train) intrigued M. All verbal skills during this second evaluation were Average to High Average for his age. Nonverbal skills, in contrast, ranged from 2 ½- to 4-year-old levels. A diagnosis of PDD-NOS was ruled out during that assessment because of his language skills. Asperger Syndrome was also ruled out because of his lack of restricted repetitive and stereotyped patterns of behaviors or interests. M was given a formal diagnosis at that time of NVLD. A supplemental assessment by the school approximately 6 months later at 5 years, 10 months showed math abilities at the 56th percentile.
Finally, at the age of 6 years, 11 months, M underwent a second neuropsychological evaluation. His performance on the WISC-III is set forth below. Additional testing revealed above average verbal and significantly impaired nonverbal skills. Math reasoning abilities on the Wechsler Individual Achievement Test were at the 27th percentile with a standard score of 91. He also had poor vocal tone, prosody and awareness of the pragmatic uses of language. M’s social relations were better than when he was younger; however, he was reported to have no best friend. A diagnosis of Learning Disorder, Not Otherwise Specified was given and the prior diagnosis of NVLD was confirmed.
Overall Intellectual Function-WISC-III Scaled and Standard Scores
Information 14 Picture Completion 08 VC 116
Similarities 10 Coding 02 PO 75
Arithmetic 07 Picture Arrangement 05 FD 93
Vocabulary 16 Block Design 01 PS 75
Comprehension 11 Object Assembly 08 VIQ 110
Digit Span 10 Symbol Search 08 PIQ 69
FSIQ 88
Additional testing completed as part of a research study resulted in the following scores:
Achievement-standard scores.
WRAT-3 Key-Math Revised
Reading 85 Concepts 99
Spelling 91 Operations 88
Arithmetic 71 Applications 100
Executive Functions-Z, scaled, T or percentage scores as reported by instrument.
Trails A -.9
Trails B -.32
NEPSY-Tower 10
NEPSY-Auditory Attention 10
NEPSY-Visual Attention 06
NEPSY-Core Domain Score 90
NEPSY-Design Fluency 09
NEPSY-Knock and Tap <2%
Behavior Rating Inventory of Executive Function- Parent Form
Elevated T scores in Behavioral Regulation, Initiation, Planning and Organization and Working Memory
Language-scaled scores.
NEPSY-Speeded Naming 08
NEPSY-Comprehension of Instructions 09
NEPSY-Verbal Fluency 15
Sensorimotor-scaled or z scores and percentages as appropriate to the instrument.
NEPSY-Visiomotor Precision 04
NEPSY-Finger Discrimination
Dominate >75%
Nondominate >75%
NEPSY-Imitating Hand Positions 01
Grooved Pegboard Test
Right -10
Left -5.8
Visual-spatial-scaled, standard or percentage scores.
VMI 87
VMI-Visual 109
VMI-Motor 72
NEPSY-Arrows 06
NEPSY-Block Construction 08
NEPSY-Route Finding 10-25%
Memory and Learning-scaled scores.
NEPSY-Memory for Names 06
NEPSY-Sentence Repetition 11
NEPSY-List Learning 09
NEPSY-Memory for Faces 12
Social and Emotional Functioning-z scores.
Child and Adolescent Social Perception Measure
Total Emotion Score -.50
Total Nonverbal Cue Score -2.25
Personality Inventory for Children
Elevated levels for Intellectual Screening and Psychosis
Discussion
Although M fits the general neuropsychological profile for both AS and NVLD, he does not have some of the behavioral characteristics required for a diagnosis of AS: he lacks ascribed interests or special skills in the presence of nonverbal cognitive deficits. Although M’s interest in numbers at one point was considered a possible precursor to a restricted interest that might be indicative of AS, by the age of 8 that interest was not considered clinically significant. When three neuropsychologists at separate major Northeastern University Hospitals diagnosed M, each ruled out AS because of M’s behavioral characteristics and relied on the neuropsychological profile and the deficits in social skills to assign an NVLD diagnosis. A diagnosis of Autism was never discussed.
In their reports, however, each alluded to the difficulties of diagnosing M with NVLD because he did not exhibit all of its characteristics. These difficulties would have been even more pronounced if these clinicians had attempted to apply more recent descriptions of NVLD by Rourke (2000a) or his proposed ICD-10 criteria.
Consistent with Rourke’s (1995) neuropsychological descriptions of NVLD, M’s verbal skills were above average, his mechanical math score on the WRAT-3 was at least 8 standard points lower than his reading score, and he had difficulties with graphomotor activities, tone and prosody. But M does not exhibit some of the other tertiary and secondary neuropsychological deficits described by Rourke (1995). In addition, a number of M’s strengths are inconsistent with more recent descriptions of the developmental progression of NVLD (Rourke, 2000a). Finally, M’s social abilities are inconsistent with those described in Rourke’s (2000a) proposed ICD-10 criteria.
As to M’s other neuropsychological abilities, his visual memory and visual motor integration abilities are relatively intact and are therefore inconsistent with the secondary deficits described by Rourke (1995). (These abilities may also be inconsistent with a diagnosis of AS.) His oral-motor praxis abilities were also average. Finally, although M had mechanical arithmetic difficulties on the WRAT-3, these difficulties did not result in deficits in mathematics in general as described by Rourke (1995). The difficulties are consistent, however, with descriptions by Badian (1983) of children with poor social skills and anarithmetria.
Rourke’s recent developmental definitions of NVLD suggest that most children with NVLD manifest language deficits at an early age. M did not. This age-of-onset criterion, which is not present in earlier descriptions of NVLD, makes NVLD appear more similar to Autism. See http://www.nldontheweb.org/Byron_Rourke_QA15.htm.
Rourke has also proposed ICD-10 criteria for NVLD that include behavioral characteristics of a distorted sense of time and extreme social impairment. See http://www.nldontheweb.org/Byron_Rourke_QA15.htm and http://www.nldontheweb.org/Byron_Rourke_QA18.htm. How the social deficits in these criteria are qualitatively different from those observed in Autism or AS is unclear. M did not have a distorted sense of time (e.g., when asked how long it took to tie his shoes, M replied, “For most kids they can do it in about 20 seconds, me it takes about two minutes.”) M’s social deficits could also not be characterized as extreme. M did have difficulty adapting to new situations, engaging in reciprocal conversations and judging personal space distances. On the Personality Inventory for Children (Wirt et al., 1977), however, he did not have elevated levels of depression or withdrawal. His mood lability resulted in a clinically significant elevation of psychosis. M could name some of the emotions exhibited in the Child and Adolescent Social Perception Measure (Magill-Evans et al., 1995), although he could not tell you how he knew what children in the scenes were feeling. M’s subtle social deficits seem to be more like those of the subgroup of children described by Johnson and Myklebust (1967) than those described by Rourke (2000b).
Future studies that attempt to distinguish AS and NVLD might investigate any differences in social abilities between the two groups (Volkmar and Klin, 1998). M’s social abilities were poor but they also seemed less compromised than those typically observed in AS. Rourke and Tsatsanis (2000) have stated that the psychosocial deficits experienced by children who exhibit NVLD “are viewed as the direct result of the interaction” of the neuropsychological assets and deficits (p. 237). The nonverbal cognitive profile in AS and NVLD has also been described, however, as limiting a child’s ability to make full use of social cues because it affects their ability to process nonverbal stimuli in various modalities. (Volkmar and Klin, 1998). Still others have said that children with the NVLD profile may or may not exhibit social deficits. (Pennington, 1991). Future research should provide better descriptions of the nature and extent of the social abilities in children with AS and NVLD. It would also appear that M might not meet the criteria for PDD-NOS specified in the practice parameters by the American Academy of Child and Adolescent Psychiatry and the DSM-IV-TR because his social deficit is not severe and pervasive. See http://www.guidelines.gov/VIEWS/summary.asp?guideline=001367.
We are left to speculate as to whether the discrepancies in M’s verbal and performance scores were relied on too heavily in indicating a diagnosis of NVLD. Given M’s history of poor motor development and current test performance, it appears that most of his cognitive difficulties stem from his motor dyspraxia. His social difficulties are more appropriately addressed, however, by an NVLD diagnosis. In the absence of social disability criteria independent of Autism, AS or NVLD, an NVLD diagnosis is frequently used to fill the void and obtain the necessary services.
In sum, M meets some but not all of the proposed criteria for NVLD. How many he meets depends on the description of NVLD one uses. As this article has indicated, the changing and sometimes conflicting protocols and descriptions of NVLD complicate the diagnostic process.
For example, M meets at least five of the eight current criteria for NVLD or “probable NVLD” as described in Rourke’s protocol for children slightly older (nine) than M. See www.nldontheweb.org/Byron_Rourke_QA18.htm. That protocol is separate from and less comprehensive than Rourke’s qualitative descriptions at www.nldontheweb.org/Byron_Rourke_QA2.htm. The neuropsychological diagnosis of NVLD is often complicated by the fact that this protocol requires deficits on the Tactile Performance Test and the Target Test, which are infrequently used in assessments.
Additionally, M meets approximately five of the ten “characteristics” described in children under the age of six, and seven of eight of the characteristics described in children seven and above. See http://www.nldontheweb.org/Byron_Rourke_QA15.htm. Finally, he meets approximately 6 of 10 of the ICD-10 criteria proposed by Rourke. See http://www.nldontheweb.org/Byron_Rourke_QA15.htm. Qualitatively, M is more accurately captured by the descriptions of children with social deficits and nonverbal disorders of learning provided by Johnson and Myklebust (1967) and Badian (1983).
Conclusions
Although the neuropsychological descriptions of children with AS and NVLD are similar, behavioral criteria may be used to distinguish the two disorders. The diagnosis is complicated, however, by three factors.
First, at present, most clinicians see NVLD as a neuropsychological rather than behavioral diagnosis.
Second, the exact nature and causes of the behavioral and social deficits associated with NVLD are poorly understood. In fact, it is not clear that all children with NVLD have these deficits. According to Johnson and Myklebust (1967), children with nonverbal deficits of learning such as visual-spatial difficulties may or may not experience social deficits. Rourke’s (1995) criteria do not seem to require a behavioral or social deficit, and, in the vast majority of his work, he discusses social deficits primarily as a consequence of neuropsychological problems. Rourke’s (2000a) more recent descriptions, however, seem to include a requirement of extreme social deficits for a diagnosis of NVLD.
Third, different definitions of NVLD carry with them different conclusions about the ability to distinguish it from AS. Rourke and Tsatsanis (2000) have noted that the NVLD description applies to children with AS. Rourke’s proposed ICD-10 criteria would seem to imply, however, that NVLD is a separate diagnostic entity from AS.
Given the present state of research into and definitions of AS and NVLD, AS and NVLD can most usefully be seen clinically -- as M’s diagnostic history indicates -- as behaviorally distinct with neuropsychological similarities.
References
Badian, N. A. (1983). Dyscalculia and nonverbal disorders of learning. In H. R. Myklebust (Ed.). Progress in learning disabilities, Vol. 5 (pp. 235-264). New York: Grune & Stratton.
Johnson, D. & Myklebust, H. (1967). Learning disabilities: Educational principles and practices. New York: Grune & Stratton.
Klin, A, Volkmar, F.R., and Sparrow, S.S. (2000). Asperger Syndrome. New York: The Guilford Press.
Klin, A, Volkmar, F.R., Sparrow, S.S., Cicchetti, D.V. & Rourke, B.P. (1995). Validity and neuropsychological characterization of Asperger syndrome: Convergence with NVLD syndrome. J. Child Psychology and Psychiatry, 36 (7) 1127-1140.
Magill-Evans, J., Koning, C., Cameron-Sadava, A. & Manyk, K. (1995). The Child and Adolescent Social Perception Measure. Journal of Nonverbal Behavior, 19 (3), 151-169.
Pennington, B. (1991). Diagnosing learning disorders. New York: Guilford Press.
Rourke, B. (2000a). Webpage at http://www.nldontheweb.org/Byron_Rourke_QA15.htm located within: http://www.nldontheweb.org/Byron_Rourke_hompage.htm.
Rourke, B. (2000b). Conference on nonverbal learning disabilities. Speech and materials presented in New Haven, CT.
Rourke, B. (Ed.) (1995). Syndrome of Nonverbal Learning Disabilities: Neurodevelopmental Manifestations. New York: The Guilford Press.
Rourke, B. (1987). Syndrome of nonverbal learning disabilities: The final common pathway of white-matter disease/dysfunction? Clinical Neuropsychologist, 1(3), 209-234.
Rourke, B.P. & Tsatsanis, K.D. (2000). Nonverbal learning disabilities and Asperger Syndrome. In Klin, A., Volkmar, F. and Sparrow, S. (Eds.) Asperger Syndrome (pp. 231-253). New York: The Guilford Press.
Volkmar, F.R. & Klin, A. (1998). Asperger Syndrome and nonverbal learning disabilities. In Schopler, E. and Mesibov, G. B. (Eds.) Asperger Syndrome or High Functioning Autism? Current issues in autism (pp. 107-121). New York: Plenum Press.
Volkmar, F.R. & Klin, A. (2000). Diagnostic Issues. In Klin, A., Volkmar, F. and Sparrow, S. (Eds.) Asperger Syndrome (pp. 25-71). New York: The Guilford Press.
Wirt, R., Lachar, D., Klinedinst, J. and Seat, P. (1977). Personality inventory for children. Los Angeles: Western Psychological Corporation.
email: BonForrest@aol.com
The purpose of this article is to review similarities and differences between Asperger (AS) and Nonverbal Learning Disability (NVLD) Syndromes. The existence of AS as a separate diagnostic entity from Autism remains controversial. Much of this controversy stems from the presence of children who have social deficits characteristic of Autism but exhibit lesser degrees of language impairments, and from the use of the age of onset of language deficits to distinguish between the two syndromes. Perhaps even more contestable is whether a distinction exists between AS and NVLD. The latter, which has not yet been recognized by the DSM-IV-TR as a diagnostic entity, has been most frequently defined in the literature by a specific neuropsychological profile. This profile can be very similar to that of children with AS. The main difference between the two disorders, as they are most frequently defined clinically, is the absence in children with NVLD of restricted interests or special skills. The diagnostic situation is further complicated, however, by the complex and still-changing definitions of the social deficits observed in NVLD.
Asperger Syndrome
Behavioral Consequences
Attempts have been made to distinguish children with AS on the basis of the functional aspects of their social impairments. Their social interactions have been described as lacking in empathy, exhibiting poor nonverbal communication and use of speech, and being overly reliant on rote language abilities. These children are usually aware of their inability to connect to others (Volkmar and Klin, 2000). In addition, the child with AS tends to become an expert in a specific area of interest (e.g., the weather or subway lines). Although one subgroup of the children with nonverbal disorders of learning described by Johnson and Myklebust (1967) exhibits social deficits, this group does not generally exhibit restricted interests or special skills that would meet the criteria for diagnostic classification as AS.
Neuropsychological Profiles
Few studies have attempted to validate a neuropsychological profile of children with AS. The results of this handful of studies, although far from providing a definitive template, seem to suggest that individuals with AS have deficits in fine and gross motor skills, visual motor integration, visual-spatial perception, nonverbal concept formation, and visual memory. Language skills are generally intact (Klin, Volkmar and Sparrow, 2000). This profile of neuropsychological assets and deficits is very similar to the NVLD profile described by Rourke (1995), as discussed below.
Nonverbal Learning Disabilities
Behavioral Characteristics
Johnson and Myklebust (1967) were the first to posit the existence of discrete subtypes of nonverbal learning disorders, including one sub-group of children with nonverbal deficits who have deficiencies in social perception. They defined social perception broadly as the inability of a child to interpret both the emotions expressed by another person and the perception of oneself in relation to the behavior of others. Such children cannot pretend, anticipate, evaluate the significance of certain aspects of their environment, or comprehend the meaning of facial expressions and gestures or the subtleties of emotions. They further described the children with difficulties in social perception as having average or above average abilities in language but difficulty using those language skills.
Neuropsychological Profiles
Byron Rourke’s (1995) recent research has focused primarily on the combination of neuropsychological assets and deficits that produces as a byproduct the poor social relatedness that Johnson and Myklebust (1967) described as characteristic of only one group of children with NVLD. Rourke described the neuropsychological deficits in NVLD more specifically in terms of primary, secondary, and tertiary deficits. The children he studied had primary deficits in tactile perception, visual perception, complex psychomotor activities and the ability to process novel material. Secondary deficits (secondary because they were related to the basic deficits) included difficulties in tactile attention, visual attention and exploratory behavior. Tertiary deficits included tactile memory, visual memory, concept formation and problem solving. According to Rourke (1995), when these neuropsychological deficits interact with assets in auditory perception, simple motor skills and the ability to process rote material, socioemotional or adaptational deficits result. Children with NVLD as described by Rourke (1995) often exhibit extreme difficulty in processing new or complex social situations and interpreting facial expressions. In novel situations, they rely on repetitious or rote behaviors, because they excel in these skills. Their interactions with other children are stereotypical and lacking in reciprocity (Rourke and Tsatsanis, 2000). Children encompassed in Rourke’s (1995) description may manifest these symptoms from birth or as a result of neuropsychological injury or disease.
The young boy examined in the following case report provides a graphic illustration of the difficulties presented when attempting to diagnose a child who exhibits some but not all of the characteristics associated with both AS and NVLD.
Case Report
M is an eight-year, eight-month-old right-handed male. He has worn glasses since the age of 9 ½ months. M was slow to crawl (11 ½ months) but walked independently at 14 months. His parents were also concerned that his social skills lagged behind his peers. M frequently observed other children but was hesitant to engage them in play. School personnel corroborated these concerns as early as preschool.
M had three comprehensive assessments, followed by additional testing as part of a research study.
At the time of the first assessment at four years and ten months, later motor milestones, such as undressing, dressing, and copying shapes, were beginning to emerge. Language skills were described as quite good. His verbal abilities were assessed at the 99th percentile. M’s performance revealed deficits, however, in gross and fine motor abilities and sensory integration.
M underwent a neuropsychological evaluation at the age of 5 years, 4 months. At that evaluation, numbers and their applications (e.g., number of cars in a train) intrigued M. All verbal skills during this second evaluation were Average to High Average for his age. Nonverbal skills, in contrast, ranged from 2 ½- to 4-year-old levels. A diagnosis of PDD-NOS was ruled out during that assessment because of his language skills. Asperger Syndrome was also ruled out because of his lack of restricted repetitive and stereotyped patterns of behaviors or interests. M was given a formal diagnosis at that time of NVLD. A supplemental assessment by the school approximately 6 months later at 5 years, 10 months showed math abilities at the 56th percentile.
Finally, at the age of 6 years, 11 months, M underwent a second neuropsychological evaluation. His performance on the WISC-III is set forth below. Additional testing revealed above average verbal and significantly impaired nonverbal skills. Math reasoning abilities on the Wechsler Individual Achievement Test were at the 27th percentile with a standard score of 91. He also had poor vocal tone, prosody and awareness of the pragmatic uses of language. M’s social relations were better than when he was younger; however, he was reported to have no best friend. A diagnosis of Learning Disorder, Not Otherwise Specified was given and the prior diagnosis of NVLD was confirmed.
Overall Intellectual Function-WISC-III Scaled and Standard Scores
Information 14 Picture Completion 08 VC 116
Similarities 10 Coding 02 PO 75
Arithmetic 07 Picture Arrangement 05 FD 93
Vocabulary 16 Block Design 01 PS 75
Comprehension 11 Object Assembly 08 VIQ 110
Digit Span 10 Symbol Search 08 PIQ 69
FSIQ 88
Additional testing completed as part of a research study resulted in the following scores:
Achievement-standard scores.
WRAT-3 Key-Math Revised
Reading 85 Concepts 99
Spelling 91 Operations 88
Arithmetic 71 Applications 100
Executive Functions-Z, scaled, T or percentage scores as reported by instrument.
Trails A -.9
Trails B -.32
NEPSY-Tower 10
NEPSY-Auditory Attention 10
NEPSY-Visual Attention 06
NEPSY-Core Domain Score 90
NEPSY-Design Fluency 09
NEPSY-Knock and Tap <2%
Behavior Rating Inventory of Executive Function- Parent Form
Elevated T scores in Behavioral Regulation, Initiation, Planning and Organization and Working Memory
Language-scaled scores.
NEPSY-Speeded Naming 08
NEPSY-Comprehension of Instructions 09
NEPSY-Verbal Fluency 15
Sensorimotor-scaled or z scores and percentages as appropriate to the instrument.
NEPSY-Visiomotor Precision 04
NEPSY-Finger Discrimination
Dominate >75%
Nondominate >75%
NEPSY-Imitating Hand Positions 01
Grooved Pegboard Test
Right -10
Left -5.8
Visual-spatial-scaled, standard or percentage scores.
VMI 87
VMI-Visual 109
VMI-Motor 72
NEPSY-Arrows 06
NEPSY-Block Construction 08
NEPSY-Route Finding 10-25%
Memory and Learning-scaled scores.
NEPSY-Memory for Names 06
NEPSY-Sentence Repetition 11
NEPSY-List Learning 09
NEPSY-Memory for Faces 12
Social and Emotional Functioning-z scores.
Child and Adolescent Social Perception Measure
Total Emotion Score -.50
Total Nonverbal Cue Score -2.25
Personality Inventory for Children
Elevated levels for Intellectual Screening and Psychosis
Discussion
Although M fits the general neuropsychological profile for both AS and NVLD, he does not have some of the behavioral characteristics required for a diagnosis of AS: he lacks ascribed interests or special skills in the presence of nonverbal cognitive deficits. Although M’s interest in numbers at one point was considered a possible precursor to a restricted interest that might be indicative of AS, by the age of 8 that interest was not considered clinically significant. When three neuropsychologists at separate major Northeastern University Hospitals diagnosed M, each ruled out AS because of M’s behavioral characteristics and relied on the neuropsychological profile and the deficits in social skills to assign an NVLD diagnosis. A diagnosis of Autism was never discussed.
In their reports, however, each alluded to the difficulties of diagnosing M with NVLD because he did not exhibit all of its characteristics. These difficulties would have been even more pronounced if these clinicians had attempted to apply more recent descriptions of NVLD by Rourke (2000a) or his proposed ICD-10 criteria.
Consistent with Rourke’s (1995) neuropsychological descriptions of NVLD, M’s verbal skills were above average, his mechanical math score on the WRAT-3 was at least 8 standard points lower than his reading score, and he had difficulties with graphomotor activities, tone and prosody. But M does not exhibit some of the other tertiary and secondary neuropsychological deficits described by Rourke (1995). In addition, a number of M’s strengths are inconsistent with more recent descriptions of the developmental progression of NVLD (Rourke, 2000a). Finally, M’s social abilities are inconsistent with those described in Rourke’s (2000a) proposed ICD-10 criteria.
As to M’s other neuropsychological abilities, his visual memory and visual motor integration abilities are relatively intact and are therefore inconsistent with the secondary deficits described by Rourke (1995). (These abilities may also be inconsistent with a diagnosis of AS.) His oral-motor praxis abilities were also average. Finally, although M had mechanical arithmetic difficulties on the WRAT-3, these difficulties did not result in deficits in mathematics in general as described by Rourke (1995). The difficulties are consistent, however, with descriptions by Badian (1983) of children with poor social skills and anarithmetria.
Rourke’s recent developmental definitions of NVLD suggest that most children with NVLD manifest language deficits at an early age. M did not. This age-of-onset criterion, which is not present in earlier descriptions of NVLD, makes NVLD appear more similar to Autism. See http://www.nldontheweb.org/Byron_Rourke_QA15.htm.
Rourke has also proposed ICD-10 criteria for NVLD that include behavioral characteristics of a distorted sense of time and extreme social impairment. See http://www.nldontheweb.org/Byron_Rourke_QA15.htm and http://www.nldontheweb.org/Byron_Rourke_QA18.htm. How the social deficits in these criteria are qualitatively different from those observed in Autism or AS is unclear. M did not have a distorted sense of time (e.g., when asked how long it took to tie his shoes, M replied, “For most kids they can do it in about 20 seconds, me it takes about two minutes.”) M’s social deficits could also not be characterized as extreme. M did have difficulty adapting to new situations, engaging in reciprocal conversations and judging personal space distances. On the Personality Inventory for Children (Wirt et al., 1977), however, he did not have elevated levels of depression or withdrawal. His mood lability resulted in a clinically significant elevation of psychosis. M could name some of the emotions exhibited in the Child and Adolescent Social Perception Measure (Magill-Evans et al., 1995), although he could not tell you how he knew what children in the scenes were feeling. M’s subtle social deficits seem to be more like those of the subgroup of children described by Johnson and Myklebust (1967) than those described by Rourke (2000b).
Future studies that attempt to distinguish AS and NVLD might investigate any differences in social abilities between the two groups (Volkmar and Klin, 1998). M’s social abilities were poor but they also seemed less compromised than those typically observed in AS. Rourke and Tsatsanis (2000) have stated that the psychosocial deficits experienced by children who exhibit NVLD “are viewed as the direct result of the interaction” of the neuropsychological assets and deficits (p. 237). The nonverbal cognitive profile in AS and NVLD has also been described, however, as limiting a child’s ability to make full use of social cues because it affects their ability to process nonverbal stimuli in various modalities. (Volkmar and Klin, 1998). Still others have said that children with the NVLD profile may or may not exhibit social deficits. (Pennington, 1991). Future research should provide better descriptions of the nature and extent of the social abilities in children with AS and NVLD. It would also appear that M might not meet the criteria for PDD-NOS specified in the practice parameters by the American Academy of Child and Adolescent Psychiatry and the DSM-IV-TR because his social deficit is not severe and pervasive. See http://www.guidelines.gov/VIEWS/summary.asp?guideline=001367.
We are left to speculate as to whether the discrepancies in M’s verbal and performance scores were relied on too heavily in indicating a diagnosis of NVLD. Given M’s history of poor motor development and current test performance, it appears that most of his cognitive difficulties stem from his motor dyspraxia. His social difficulties are more appropriately addressed, however, by an NVLD diagnosis. In the absence of social disability criteria independent of Autism, AS or NVLD, an NVLD diagnosis is frequently used to fill the void and obtain the necessary services.
In sum, M meets some but not all of the proposed criteria for NVLD. How many he meets depends on the description of NVLD one uses. As this article has indicated, the changing and sometimes conflicting protocols and descriptions of NVLD complicate the diagnostic process.
For example, M meets at least five of the eight current criteria for NVLD or “probable NVLD” as described in Rourke’s protocol for children slightly older (nine) than M. See www.nldontheweb.org/Byron_Rourke_QA18.htm. That protocol is separate from and less comprehensive than Rourke’s qualitative descriptions at www.nldontheweb.org/Byron_Rourke_QA2.htm. The neuropsychological diagnosis of NVLD is often complicated by the fact that this protocol requires deficits on the Tactile Performance Test and the Target Test, which are infrequently used in assessments.
Additionally, M meets approximately five of the ten “characteristics” described in children under the age of six, and seven of eight of the characteristics described in children seven and above. See http://www.nldontheweb.org/Byron_Rourke_QA15.htm. Finally, he meets approximately 6 of 10 of the ICD-10 criteria proposed by Rourke. See http://www.nldontheweb.org/Byron_Rourke_QA15.htm. Qualitatively, M is more accurately captured by the descriptions of children with social deficits and nonverbal disorders of learning provided by Johnson and Myklebust (1967) and Badian (1983).
Conclusions
Although the neuropsychological descriptions of children with AS and NVLD are similar, behavioral criteria may be used to distinguish the two disorders. The diagnosis is complicated, however, by three factors.
First, at present, most clinicians see NVLD as a neuropsychological rather than behavioral diagnosis.
Second, the exact nature and causes of the behavioral and social deficits associated with NVLD are poorly understood. In fact, it is not clear that all children with NVLD have these deficits. According to Johnson and Myklebust (1967), children with nonverbal deficits of learning such as visual-spatial difficulties may or may not experience social deficits. Rourke’s (1995) criteria do not seem to require a behavioral or social deficit, and, in the vast majority of his work, he discusses social deficits primarily as a consequence of neuropsychological problems. Rourke’s (2000a) more recent descriptions, however, seem to include a requirement of extreme social deficits for a diagnosis of NVLD.
Third, different definitions of NVLD carry with them different conclusions about the ability to distinguish it from AS. Rourke and Tsatsanis (2000) have noted that the NVLD description applies to children with AS. Rourke’s proposed ICD-10 criteria would seem to imply, however, that NVLD is a separate diagnostic entity from AS.
Given the present state of research into and definitions of AS and NVLD, AS and NVLD can most usefully be seen clinically -- as M’s diagnostic history indicates -- as behaviorally distinct with neuropsychological similarities.
References
Badian, N. A. (1983). Dyscalculia and nonverbal disorders of learning. In H. R. Myklebust (Ed.). Progress in learning disabilities, Vol. 5 (pp. 235-264). New York: Grune & Stratton.
Johnson, D. & Myklebust, H. (1967). Learning disabilities: Educational principles and practices. New York: Grune & Stratton.
Klin, A, Volkmar, F.R., and Sparrow, S.S. (2000). Asperger Syndrome. New York: The Guilford Press.
Klin, A, Volkmar, F.R., Sparrow, S.S., Cicchetti, D.V. & Rourke, B.P. (1995). Validity and neuropsychological characterization of Asperger syndrome: Convergence with NVLD syndrome. J. Child Psychology and Psychiatry, 36 (7) 1127-1140.
Magill-Evans, J., Koning, C., Cameron-Sadava, A. & Manyk, K. (1995). The Child and Adolescent Social Perception Measure. Journal of Nonverbal Behavior, 19 (3), 151-169.
Pennington, B. (1991). Diagnosing learning disorders. New York: Guilford Press.
Rourke, B. (2000a). Webpage at http://www.nldontheweb.org/Byron_Rourke_QA15.htm located within: http://www.nldontheweb.org/Byron_Rourke_hompage.htm.
Rourke, B. (2000b). Conference on nonverbal learning disabilities. Speech and materials presented in New Haven, CT.
Rourke, B. (Ed.) (1995). Syndrome of Nonverbal Learning Disabilities: Neurodevelopmental Manifestations. New York: The Guilford Press.
Rourke, B. (1987). Syndrome of nonverbal learning disabilities: The final common pathway of white-matter disease/dysfunction? Clinical Neuropsychologist, 1(3), 209-234.
Rourke, B.P. & Tsatsanis, K.D. (2000). Nonverbal learning disabilities and Asperger Syndrome. In Klin, A., Volkmar, F. and Sparrow, S. (Eds.) Asperger Syndrome (pp. 231-253). New York: The Guilford Press.
Volkmar, F.R. & Klin, A. (1998). Asperger Syndrome and nonverbal learning disabilities. In Schopler, E. and Mesibov, G. B. (Eds.) Asperger Syndrome or High Functioning Autism? Current issues in autism (pp. 107-121). New York: Plenum Press.
Volkmar, F.R. & Klin, A. (2000). Diagnostic Issues. In Klin, A., Volkmar, F. and Sparrow, S. (Eds.) Asperger Syndrome (pp. 25-71). New York: The Guilford Press.
Wirt, R., Lachar, D., Klinedinst, J. and Seat, P. (1977). Personality inventory for children. Los Angeles: Western Psychological Corporation.
Het geweld-dadige en het overweldigende bij Heidegger.
Geweld speelt een belangrijke rol in het denken van Heidegger. Al in de inleiding van Sein und Zeit omschrijft hij de vraag naar het zijn als een strijd der giganten vanwege het zijn. (Heidegger citeert hier Plato,De Sofist). Deze strijd der giganten is de strijd van de Griekse filosofen om tot een juist zijnsverstaan te komen. Vanaf het begin van de filosofie lijkt het duidelijk dat de wijze waarop het zijn zich in de alledaagse beleving te verstaan geeft niet het juiste verstaan van het zijn is. Een eigenlijk zijnsverstaan moet verovert worden op de oneigenlijheid waar het Dasein doorgaans in vervalt. Men gaat doorgaans op in het zijnde.”Das Dasein ist von ihm selbst als eigentlichem Selbstseinkönnen zunächst immer schon abgefallen und an die “Welt” verfallen.”(SuZ 175).
Het geweld komt nadrukkelijker naar voren in de Inleiding in de metafysica waar hij het heeft over het geweld-dadige en het overweldigende. Mijn vraag is of het geweld noodzakelijk is bij het aan de orde stellen van de zijnsvraag en van elk eigenlijk zijnsverstaan en indien we deze vraag met ja moeten beantwoorden welke vorm dit geweld dan aan dient te nemen. Voorts vraag ik me af of er een verband is tussen Heideggers politieke engagement en het geweld in zijn filosofie.
Eerst wil ik ingaan op de rol van het geweld in de inleiding tot de metafysica. Heidegger behandelt deze problematiek uitgebreid aan de hand van het eerste koorlied uit de Antigone van Sophocles. Heidegger verwijst naar Sophocles om de bepaling van het mens-zijn bij Parmenides te verhelderen. In dit koorlied geeft Sophocles op dichterlijke wijze een beeld van het mens-zijn waar Parmenides dit op een filosofische wijze doet.
Volgens Heidegger is het zijn het overweldigende dat op geweld-dadige wijze door de mens beheeerst en ontsloten wordt. Het overweldigende koppelt hij aan het begrip δίκη (diké), het geweld-dadige aan het begrip τέχυη (techné). “[...] de geweld-dadigheid is het gebruik van geweld tegen het over-weldigende: het wetend bevechten van het tot dan toe gesloten zijn in het verschijnende als het zijnde.” (IM 185).
Het zijn geeft zich niet vanzelf bloot, maar dient blootgelegt te worden. In de techné wordt het zijn in een zijnd bewerk-stelligt. Dit ontsluiten van het zijn is het weten. Heidegger brengt in dit verband vooral de kunst ter sprake. In het koorlied van Sophocles word het zijn even goed (of beter?) ontsloten dan in een filosofisch betoog. De wetenschap lijkt zich bij Heidegger minder te lenen voor een eigenlijk zijnsverstaan, immers, “de wetenschap denkt niet”.
Het zou te simpel zijn om te zeggen dat het geweld van het zijn van buitenaf op het Dasein afkomt. Het doet ook van binnenuit van zich spreken. “ Dit overal werkzame verliest niets van zijn overweldigend karakter, doordat de mens zelf onmiddelijk in zijn macht neemt en deze als zodanig gebruikt. Daardoor vebergt zich alleen het onhelspellende van de taal, van de hartstochten als datgene, waarin de mens als zijnshistorisch wezen is ingevoegd, terwijl het hem voorkomt als was hij het die daarover beschikt.” (IM 181/182). We stellen onszelf gerust; het zijn lijkt uiteindelijk niet beheersbaar te zijn. We vergissen ons in onszelf en het zijn. “ Hoe weinig de mens thuis is in zijn eigen wezen, verraadt de mening die hij over zichzelf koestert als degene die spreken en verstaan, bouwen en dichten heeft uitgevonden en zou hebben kunnen uitvinden.” (IM 182). We koesteren ons in onze illusie van onze autonomie en denken daarmee de werkelijkheid te bezweren.
Dasein en wereld zijn voor Heidegger onverbrekelijk met elkaar verbonden. Er is geen autonoom subject dat tegenover de wereld als object staat. Dasein is altijd al wezenlijk in-de-wereld-zijn. De “wereld” is een karakterisering van het Dasein zelf. (SuZ 64). Stoelen en tafels zijn wereldloos (weltlos). Alleen de mens als Dasein heeft een wereld. Het is het waarin (worin) waar het Dasein leeft. (SuZ 65). De mens vormt de wereld, maar de wereld vormt ook de mens. De grens tussen binnen en buiten is niet scherp te trekken. Daarom valt er ook geen scherpe grens te trekken tussen het over-weldigende dat van buitenaf zou komen en het geweld-dadige dat van binnenuit af zou komen. Het over-weldigende en het geweld-dadige moeten wel zowel in het zijn als het Dasein zitten.
Het eigenlijke verstaan van het zijn dat door het Dasein heenwerkt lijkt een heroïsche strijd te zijn. Men vindt dit niet in het alledaagse bestaan zoals men dat leeft in een moderne, burgelijke samenleving. Kennelijk vindt men dit in een ordening waarin iedereen zij plaats weet. Heidegger schetst de polis als volgt; “Veeleer is het politiek, dat wil zeggen behorend tot de historische plek, voor zover bijvoorbeeld de dichters slechts, maar dan werkelijk dichter, de denkers slechts, maar dan werkelijk denker, de priesters slechts, maar dan werkelijk priester, de heersers slechts, maar dan werkelijk heerser zijn.” (IM 178). In Heideggers politieke wereld is kennelijk niemand burger. Mensen zitten vast in de hun toegewezen positie in de samenleving en mogen zich niet met de samenleving als geheel bemoeien (tenzij je natuurlijk een heerser bent). “Zijn, dat betekent toch: als geweld-dadige geweld gebruiken en hoog-oprijzende worden in het historische zijn als scheppenden, als mannen van de daad. Hoog-oprijzend op de historische plek worden zij tevens [..], zonder stad en plek, een-zaam, angst-wekkend, zonder uitweg te midden van het zijnde in zijn geheel, tevens zonder statuut en grens, zonder structuur en orde, omdat zij als scheppenden dit alles moeten funderen.” (IM 178). Het is moeilijk om hier niet te denken aan een middeleeuwse standenmaatschappij met een (fascistische) leider aan het hoofd. Heideggers waardering voor de polis sluit naadloos aan bij die van het fascisme. Binnen het fascisme werdt de polis gezien als een tegenpool voor de filosofische trends van de achtiende en negentiende eeuw waarin de individuele vrijheid en de gelijkheid van alle mensen en rassen centraal stonden. Vooral in Sparta zagen de fascisten een lichtend voorbeeld. Men verkoos disipline en een onvoorwaardelijke toewijding aan de plicht boven de vrijheid en gelijkheid van de Verlichting. Mussolini verkoos de leus “geloven, gehoorzamen, vechten” boven “gelijkheid, vrijheid, broederschap”. Men is geen burger meer, maar men maakt onderdeel uit van het volk. Hoewel Heidegger het vooral lijkt te hebben over de relatie van het Dasein als individu tot het zijn , lijkt hij het in relatie tot de geschiedenis over het volk te hebben. Het Duitse volk heeft bij Heidegger,naast het Griekse, daarbij ook nogeens een bijzondere status. Het Duitse volk heeft een bijzondere bestemming. “Dit alles houdt in dat dit [het Duitse] volk als historisch volk zichzelf en daarmee de geschiedenis van het avondland vanuit de kern van haar toekomstig gebeuren verplaatst naar het oorpronkelijke domein waar het zijn heerst.” (IM 64). Het zijnsverstaan wordt hier direct gekoppelt aan de “historische bestemming” van een volk.
Men kan zich afvragen of Heidegger recht doet aan zijn eigen filosofische inzet. Gaat een zijnsverstaan noodzakelijkerwijs gepaart met geweld of de lotsbestemming van een volk? (Wat dat dan ook moge zijn). Ontbreekt er iets aan Heideggers filosofie waardoor hij tot dit soort onverkwikkelijke inzichten komt? Karen Armstrong heeft eens gezegd dat hét criterium waarop men religies moet beoordelen het al dan niet aanwezig zijn van mededogen is. Naar mijn idee kan je iets dergelijks ook voor filosofieën beweren. Bevat Heideggers filosofie mededogen? Mededogen impliceert dat je oog hebt voor de medemens. Nu heeft Heidegger het weliswaar over het mede-zijn (mitsein) ,de zorg (Sorge) en het geweten, deze begrippen lijken toch in eerste instantie betrokken op het zijn en het Dasein. Sorge is voor Heidegger het zijn van het Dasein als “Sich-vorweg-schon-sein-in-(der-Welt-) als Sein-bei (innerweltlich begegnendem Seienden). (SuZ 192). Het gaat om het vooruitlopen van het Dasein op het eigenlijkste zijn-kunnen (Seinkönnen). De ander komt hier niet in het vizier. De Sorge heeft betrekking op het Dasein die het zijn zijn gaat. Bij het geweten (Gewissen) gaat het erom dat het Dasein niet meer luisert naar het Men, maar gehoor geeft aan de roep van het zijn waardoor het aangeroepen wordt. Men wordt geroepen tot het eigenste zelf. “Und woraufhin wird es angerufen? Auf das eigene Selbst. Nicht daraufhin, was das Dasein im öffentlichen Miteinander gilt, kann, besorgt, noch gar auf das, was es ergriffen, wofür es sich eingesetzt hat, wovon es sich hat mitnehmen lassen. Das Dasein, als welches es weltlich verstanden für die Anderen und sich selbst ist, wird in die Anruf übergangen. Der Ruf an das selbst nimmt hiervon nicht die mindenste Kenntnis. Weil nur das Selbst des Man-selbst angerufen und zum Hören gebracht wird, sinkt das Man in sich zusammen.” (SuZ 273). In het Mitsein blijkt dat het Dasein nooit op zichzelf in de wereld staat, maar zich altijd in betrekking tot anderen bevindt. Hier komt de ander in beeld. Dit hoeft bij Heidegger niet altijd positief te zijn. Het Dasein kan zich verliezen in het men (Man). De ander kan echter ook degene zij met wie men een dialoog aangaat, die ons eventueel tegenspreekt. De ander kan ons antwoorden op ons spreken. Het Miteinandersein wordt echter meestal gekenmerkt door het Gerede. Het Dasein zelf wordt er door gekenmerkt. “Das Gerede ist die Seinsart des Miteinanderseins selbst und entsteht nicht erst durch gewisse Umstände, die auf das Dasein “ von außen” einwirken.” (SuZ 177). Ook hier zien we dat de grens tussen binnen en buiten, subject en object, bij Heidegger niet scherp te trekken zijn. Het Mitsein of Miteinandersein lijkt bij Heidegger vaak meer een hinderpaal dan een bevorderende factor te zijn bij een eigenlijk zijnsverstaan. Desalniettemin ljkt zich hier een opening te vinden tot een breder zijnsverstaan waarin de ander betrokken is. Een zijnsverstaan waarin niet de enkeling tegenover de zijnsvraag staat, maar waarbij hij met anderen betrokken is op het zijn. Daarmee zijn we opzich nog niet bij het mededogen aangelandt, maar we komen wel dichter in de buurt. Als we de vraag stellen of het mededogen bij Heidegger zelf valt aan te treffen, dan moet ik zeggen dat ik het in ieder geval niet heb gevonden.
Een filosoof die veel kritiek heeft op Heidegger is Levinas. Levinas is een filosoof met veel oog voor de menselijkheid die zeker de test van het mededogen doorstaat. Volgens Levinas is het probleem met Heidegger, en met hem de westerse filosfie, dat het zijn centraal staat en niet de ander. Volgens hem zou het ethische het primaat moeten hebben en niet de ontologie. “De westerse filosofie is meestal een ontologie geweest: een herleiding van het Ander tot het Zelfde, door bemiddeling van een neutrale middenterm die het verstaan mogelijk maakt.” (De totaliteit en het Oneindige. Pag. 42). De filosofie ven Heidegger valt hier duidelijk ook onder. Levinas bekritiseert Heidegger ook waar het gaat om diens idee van vrijheid. Een vrijheidsidee dat er weliswaar anders uitziet dan het traditonele vrijheidsidee, maar toch tekort schiet. Bij Heidegger ontspringt de vrijheid aan een gehoorzaamheid aan het zijn. Vrijheid is het gehoor geven aan de roep van het geweten (Gewissen) tot het eigenlijkste zijnkunnen. “De vrijheid ontspringt aan een gehoorzaamheid aan het zijn: niet de mens bezit de vrijheid, maar de vrijheid de mens.” ( id. Pag.45). Volgens Levinas impliceert dit een geweld. Het ik moet om zichzelf veilig te stellen het Andere onderdrukken of in bezit nemen. Dit is het geweld dat bij Heidegger aan de orde komt bij zijn bespreking van het koorlied van Sophocles. Volgens Levinas is het antwoord op dit geweld hierin gelegen dat men zich laat aanspreken door het gelaat van de Ander. Hieruit spreekt het gebod “gij zult niet doden”. Dit gelaat is wat Levinas ook wel het Oneindige noemt. Een dergelijke dimensie lijkt bij Heidegger te ontbreken. Als we Levinas volgen dan moeten we zeggen dat Heideggers denken eerder “heidens” dan joods-christelijk van kleur is. Heidegger lijkt aan een soort natuurmystiek te doen en de menselijkheid te verontachtzamen. Levinas wijst er op dat Socrates de stad verkoos boven het platteland omdat men in de stad de mensen ontmoet. Heidegger doet het omgekeerde.
Heidegger lijkt de test van het mededogen niet echt te doorstaan. Toch zijn er genoeg punten in zijn filosofie aan te wijzen die zijn filosofie belangrijk en inspirerend maken. Hij probeert ons de ogen te openen voor het mysterie van het zijn door de zijnsvraag weer aan de orde te stellen. Op deze manier brengt hij de verwondering terug die volgens Plato het begin is van alle filosofie. Hij vecht het primaat van de objectiverende blik aan en maakt duidelijk dat we ons altijd al in een wereld bevinden, dat we bij de dingen zelf zijn. Van zijn denken blijft duidelijk een grote fascinatie uitgaan.
De vraag of Heideggers (geweldadige) zijnsverstaan verbonden is met zijn politieke engagement kunnnen we nu wel met ja beantwoorden. Nu rest ons nog de vraag of een zijnsverstaan zonder geweld mogelijk is. Als dit impliceert dat er een zijnsverstaan mogelijk is waarin er alleen harmonie heerst en alles rozengeur en maneschijn is dan moet het antwoord nee luiden. Heidegger heeft gelijk als hij het zijn angstwekkend en overweldigend noemt. Dit lijkt me echter maar een kant van de zaak te zijn. We zouden het zijnsverstaan van Heidegger kunnen koppelen aan de religieuze ervaring. Ik zou niet willen beweren dat we het zijn van Heidegger automatisch gelijk zouden kunnen stellen aan God. Dat zou te simpel zijn. Er is echter wel een grote gelijkenis tussen het zijn en een bepaald soort Godsbegrip. Ik denk dan vooral aan de God van de mystici. Mystieke ervaringen kunnen zich uiten als een zich verbonden weten met de natuur of een ervaring van de wezensgrond van het zelf.
De psychanalyticus Carl Gustav Jung heeft veel geschreven over de mystieke ervaring. In de religie staan we volgens Jung in levende verbinding met oerkrachten, de onbewuste wortels van ons bestaan. Deze oerkrachten hebben een numineuze, goddelijke lading. Deze krachten zijn overweldigend. Religies zijn een manier om deze krachten te reguleren. Symbolen spelen daarbij een belangrijke rol. In het christendom zijn God en Christus dergelijke symbolen. Er ontstaat wel een probleem als deze symbolen beschouwt worden als een objectieve werkelijkheid. Als men de “Vader in de Hemel” concretiseert en voorstelt als het Absolute dan blijft er van de gelovige in Jungs woorden “bloß ein elendes, minderwertiges, untaugliches Häuflein Mensch zurück[..]”. (Die Beziehungen zwischen dem Ich und dem Unbewußten. Pag.120).
Dan treedt er verstarring op en komt de authentieke ervaring in het gedrang. Heidegger is een denker die die verstarring kan open breken. Zijn denken lijkt me niet toereikend als het gaat om de liefde die het zijn (of God) uiteindelijk is. Een religieus besef in de zin van Jung lijkt me, naast inzichten als die van Levinas daarbij onontbeerlijk.
Literatuur;
Heidegger, M. Sein und Zeit. Tübingen 1986.
Heidegger, M. Inleiding in de metafysica. Nijmegen 1997
Levinas, E. De totaliteit en het Oneindige. Baarn 1987
Levinas, E. Het menselijk gelaat. Baarn 1969
Encyclopaedia Brittanica 1999
Jung, C.G. Die Beziehungen zwischen dem Ich und dem Unbewußten. Olten 1990
Het geweld komt nadrukkelijker naar voren in de Inleiding in de metafysica waar hij het heeft over het geweld-dadige en het overweldigende. Mijn vraag is of het geweld noodzakelijk is bij het aan de orde stellen van de zijnsvraag en van elk eigenlijk zijnsverstaan en indien we deze vraag met ja moeten beantwoorden welke vorm dit geweld dan aan dient te nemen. Voorts vraag ik me af of er een verband is tussen Heideggers politieke engagement en het geweld in zijn filosofie.
Eerst wil ik ingaan op de rol van het geweld in de inleiding tot de metafysica. Heidegger behandelt deze problematiek uitgebreid aan de hand van het eerste koorlied uit de Antigone van Sophocles. Heidegger verwijst naar Sophocles om de bepaling van het mens-zijn bij Parmenides te verhelderen. In dit koorlied geeft Sophocles op dichterlijke wijze een beeld van het mens-zijn waar Parmenides dit op een filosofische wijze doet.
Volgens Heidegger is het zijn het overweldigende dat op geweld-dadige wijze door de mens beheeerst en ontsloten wordt. Het overweldigende koppelt hij aan het begrip δίκη (diké), het geweld-dadige aan het begrip τέχυη (techné). “[...] de geweld-dadigheid is het gebruik van geweld tegen het over-weldigende: het wetend bevechten van het tot dan toe gesloten zijn in het verschijnende als het zijnde.” (IM 185).
Het zijn geeft zich niet vanzelf bloot, maar dient blootgelegt te worden. In de techné wordt het zijn in een zijnd bewerk-stelligt. Dit ontsluiten van het zijn is het weten. Heidegger brengt in dit verband vooral de kunst ter sprake. In het koorlied van Sophocles word het zijn even goed (of beter?) ontsloten dan in een filosofisch betoog. De wetenschap lijkt zich bij Heidegger minder te lenen voor een eigenlijk zijnsverstaan, immers, “de wetenschap denkt niet”.
Het zou te simpel zijn om te zeggen dat het geweld van het zijn van buitenaf op het Dasein afkomt. Het doet ook van binnenuit van zich spreken. “ Dit overal werkzame verliest niets van zijn overweldigend karakter, doordat de mens zelf onmiddelijk in zijn macht neemt en deze als zodanig gebruikt. Daardoor vebergt zich alleen het onhelspellende
Dasein en wereld zijn voor Heidegger onverbrekelijk met elkaar verbonden. Er is geen autonoom subject dat tegenover de wereld als object staat. Dasein is altijd al wezenlijk in-de-wereld-zijn. De “wereld” is een karakterisering van het Dasein zelf. (SuZ 64). Stoelen en tafels zijn wereldloos (weltlos). Alleen de mens als Dasein heeft een wereld. Het is het waarin (worin) waar het Dasein leeft. (SuZ 65). De mens vormt de wereld, maar de wereld vormt ook de mens. De grens tussen binnen en buiten is niet scherp te trekken. Daarom valt er ook geen scherpe grens te trekken tussen het over-weldigende dat van buitenaf zou komen en het geweld-dadige dat van binnenuit af zou komen. Het over-weldigende en het geweld-dadige moeten wel zowel in het zijn als het Dasein zitten.
Het eigenlijke verstaan van het zijn dat door het Dasein heenwerkt lijkt een heroïsche strijd te zijn. Men vindt dit niet in het alledaagse bestaan zoals men dat leeft in een moderne, burgelijke samenleving. Kennelijk vindt men dit in een ordening waarin iedereen zij plaats weet. Heidegger schetst de polis als volgt; “Veeleer is het politiek, dat wil zeggen behorend tot de historische plek, voor zover bijvoorbeeld de dichters slechts, maar dan werkelijk dichter, de denkers slechts, maar dan werkelijk denker, de priesters slechts, maar dan werkelijk priester, de heersers slechts, maar dan werkelijk heerser zijn.” (IM 178). In Heideggers politieke wereld is kennelijk niemand burger. Mensen zitten vast in de hun toegewezen positie in de samenleving en mogen zich niet met de samenleving als geheel bemoeien (tenzij je natuurlijk een heerser bent). “Zijn, dat betekent toch: als geweld-dadige geweld gebruiken en hoog-oprijzende worden in het historische zijn als scheppenden, als mannen van de daad. Hoog-oprijzend op de historische plek worden zij tevens [..], zonder stad en plek, een-zaam, angst-wekkend, zonder uitweg te midden van het zijnde in zijn geheel, tevens zonder statuut en grens, zonder structuur en orde, omdat zij als scheppenden dit alles moeten funderen.” (IM 178). Het is moeilijk om hier niet te denken aan een middeleeuwse standenmaatschappij met een (fascistische) leider aan het hoofd. Heideggers waardering voor de polis sluit naadloos aan bij die van het fascisme. Binnen het fascisme werdt de polis gezien als een tegenpool voor de filosofische trends van de achtiende en negentiende eeuw waarin de individuele vrijheid en de gelijkheid van alle mensen en rassen centraal stonden. Vooral in Sparta zagen de fascisten een lichtend voorbeeld. Men verkoos disipline en een onvoorwaardelijke toewijding aan de plicht boven de vrijheid en gelijkheid van de Verlichting. Mussolini verkoos de leus “geloven, gehoorzamen, vechten” boven “gelijkheid, vrijheid, broederschap”. Men is geen burger meer, maar men maakt onderdeel uit van het volk. Hoewel Heidegger het vooral lijkt te hebben over de relatie van het Dasein als individu tot het zijn , lijkt hij het in relatie tot de geschiedenis over het volk te hebben. Het Duitse volk heeft bij Heidegger,naast het Griekse, daarbij ook nogeens een bijzondere status. Het Duitse volk heeft een bijzondere bestemming. “Dit alles houdt in dat dit [het Duitse] volk als historisch volk zichzelf en daarmee de geschiedenis van het avondland vanuit de kern van haar toekomstig gebeuren verplaatst naar het oorpronkelijke domein waar het zijn heerst.” (IM 64). Het zijnsverstaan wordt hier direct gekoppelt aan de “historische bestemming” van een volk.
Men kan zich afvragen of Heidegger recht doet aan zijn eigen filosofische inzet. Gaat een zijnsverstaan noodzakelijkerwijs gepaart met geweld of de lotsbestemming van een volk? (Wat dat dan ook moge zijn). Ontbreekt er iets aan Heideggers filosofie waardoor hij tot dit soort onverkwikkelijke inzichten komt? Karen Armstrong heeft eens gezegd dat hét criterium waarop men religies moet beoordelen het al dan niet aanwezig zijn van mededogen is. Naar mijn idee kan je iets dergelijks ook voor filosofieën beweren. Bevat Heideggers filosofie mededogen? Mededogen impliceert dat je oog hebt voor de medemens. Nu heeft Heidegger het weliswaar over het mede-zijn (mitsein) ,de zorg (Sorge) en het geweten, deze begrippen lijken toch in eerste instantie betrokken op het zijn en het Dasein. Sorge is voor Heidegger het zijn van het Dasein als “Sich-vorweg-schon-sein-in-(der-Welt-) als Sein-bei (innerweltlich begegnendem Seienden). (SuZ 192). Het gaat om het vooruitlopen van het Dasein op het eigenlijkste zijn-kunnen (Seinkönnen). De ander komt hier niet in het vizier. De Sorge heeft betrekking op het Dasein die het zijn zijn gaat. Bij het geweten (Gewissen) gaat het erom dat het Dasein niet meer luisert naar het Men, maar gehoor geeft aan de roep van het zijn waardoor het aangeroepen wordt. Men wordt geroepen tot het eigenste zelf. “Und woraufhin wird es angerufen? Auf das eigene Selbst. Nicht daraufhin, was das Dasein im öffentlichen Miteinander gilt, kann, besorgt, noch gar auf das, was es ergriffen, wofür es sich eingesetzt hat, wovon es sich hat mitnehmen lassen. Das Dasein, als welches es weltlich verstanden für die Anderen und sich selbst ist, wird in die Anruf übergangen. Der Ruf an das selbst nimmt hiervon nicht die mindenste Kenntnis. Weil nur das Selbst des Man-selbst angerufen und zum Hören gebracht wird, sinkt das Man in sich zusammen.” (SuZ 273). In het Mitsein blijkt dat het Dasein nooit op zichzelf in de wereld staat, maar zich altijd in betrekking tot anderen bevindt. Hier komt de ander in beeld. Dit hoeft bij Heidegger niet altijd positief te zijn. Het Dasein kan zich verliezen in het men (Man). De ander kan echter ook degene zij met wie men een dialoog aangaat, die ons eventueel tegenspreekt. De ander kan ons antwoorden op ons spreken. Het Miteinandersein wordt echter meestal gekenmerkt door het Gerede. Het Dasein zelf wordt er door gekenmerkt. “Das Gerede ist die Seinsart des Miteinanderseins selbst und entsteht nicht erst durch gewisse Umstände, die auf das Dasein “ von außen” einwirken.” (SuZ 177). Ook hier zien we dat de grens tussen binnen en buiten, subject en object, bij Heidegger niet scherp te trekken zijn. Het Mitsein of Miteinandersein lijkt bij Heidegger vaak meer een hinderpaal dan een bevorderende factor te zijn bij een eigenlijk zijnsverstaan. Desalniettemin ljkt zich hier een opening te vinden tot een breder zijnsverstaan waarin de ander betrokken is. Een zijnsverstaan waarin niet de enkeling tegenover de zijnsvraag staat, maar waarbij hij met anderen betrokken is op het zijn. Daarmee zijn we opzich nog niet bij het mededogen aangelandt, maar we komen wel dichter in de buurt. Als we de vraag stellen of het mededogen bij Heidegger zelf valt aan te treffen, dan moet ik zeggen dat ik het in ieder geval niet heb gevonden.
Een filosoof die veel kritiek heeft op Heidegger is Levinas. Levinas is een filosoof met veel oog voor de menselijkheid die zeker de test van het mededogen doorstaat. Volgens Levinas is het probleem met Heidegger, en met hem de westerse filosfie, dat het zijn centraal staat en niet de ander. Volgens hem zou het ethische het primaat moeten hebben en niet de ontologie. “De westerse filosofie is meestal een ontologie geweest: een herleiding van het Ander tot het Zelfde, door bemiddeling van een neutrale middenterm die het verstaan mogelijk maakt.” (De totaliteit en het Oneindige. Pag. 42). De filosofie ven Heidegger valt hier duidelijk ook onder. Levinas bekritiseert Heidegger ook waar het gaat om diens idee van vrijheid. Een vrijheidsidee dat er weliswaar anders uitziet dan het traditonele vrijheidsidee, maar toch tekort schiet. Bij Heidegger ontspringt de vrijheid aan een gehoorzaamheid aan het zijn. Vrijheid is het gehoor geven aan de roep van het geweten (Gewissen) tot het eigenlijkste zijnkunnen. “De vrijheid ontspringt aan een gehoorzaamheid aan het zijn: niet de mens bezit de vrijheid, maar de vrijheid de mens.” ( id. Pag.45). Volgens Levinas impliceert dit een geweld. Het ik moet om zichzelf veilig te stellen het Andere onderdrukken of in bezit nemen. Dit is het geweld dat bij Heidegger aan de orde komt bij zijn bespreking van het koorlied van Sophocles. Volgens Levinas is het antwoord op dit geweld hierin gelegen dat men zich laat aanspreken door het gelaat van de Ander. Hieruit spreekt het gebod “gij zult niet doden”. Dit gelaat is wat Levinas ook wel het Oneindige noemt. Een dergelijke dimensie lijkt bij Heidegger te ontbreken. Als we Levinas volgen dan moeten we zeggen dat Heideggers denken eerder “heidens” dan joods-christelijk van kleur is. Heidegger lijkt aan een soort natuurmystiek te doen en de menselijkheid te verontachtzamen. Levinas wijst er op dat Socrates de stad verkoos boven het platteland omdat men in de stad de mensen ontmoet. Heidegger doet het omgekeerde.
Heidegger lijkt de test van het mededogen niet echt te doorstaan. Toch zijn er genoeg punten in zijn filosofie aan te wijzen die zijn filosofie belangrijk en inspirerend maken. Hij probeert ons de ogen te openen voor het mysterie van het zijn door de zijnsvraag weer aan de orde te stellen. Op deze manier brengt hij de verwondering terug die volgens Plato het begin is van alle filosofie. Hij vecht het primaat van de objectiverende blik aan en maakt duidelijk dat we ons altijd al in een wereld bevinden, dat we bij de dingen zelf zijn. Van zijn denken blijft duidelijk een grote fascinatie uitgaan.
De vraag of Heideggers (geweldadige) zijnsverstaan verbonden is met zijn politieke engagement kunnnen we nu wel met ja beantwoorden. Nu rest ons nog de vraag of een zijnsverstaan zonder geweld mogelijk is. Als dit impliceert dat er een zijnsverstaan mogelijk is waarin er alleen harmonie heerst en alles rozengeur en maneschijn is dan moet het antwoord nee luiden. Heidegger heeft gelijk als hij het zijn angstwekkend en overweldigend noemt. Dit lijkt me echter maar een kant van de zaak te zijn. We zouden het zijnsverstaan van Heidegger kunnen koppelen aan de religieuze ervaring. Ik zou niet willen beweren dat we het zijn van Heidegger automatisch gelijk zouden kunnen stellen aan God. Dat zou te simpel zijn. Er is echter wel een grote gelijkenis tussen het zijn en een bepaald soort Godsbegrip. Ik denk dan vooral aan de God van de mystici. Mystieke ervaringen kunnen zich uiten als een zich verbonden weten met de natuur of een ervaring van de wezensgrond van het zelf.
De psychanalyticus Carl Gustav Jung heeft veel geschreven over de mystieke ervaring. In de religie staan we volgens Jung in levende verbinding met oerkrachten, de onbewuste wortels van ons bestaan. Deze oerkrachten hebben een numineuze, goddelijke lading. Deze krachten zijn overweldigend. Religies zijn een manier om deze krachten te reguleren. Symbolen spelen daarbij een belangrijke rol. In het christendom zijn God en Christus dergelijke symbolen. Er ontstaat wel een probleem als deze symbolen beschouwt worden als een objectieve werkelijkheid. Als men de “Vader in de Hemel” concretiseert en voorstelt als het Absolute dan blijft er van de gelovige in Jungs woorden “bloß ein elendes, minderwertiges, untaugliches Häuflein Mensch zurück[..]”. (Die Beziehungen zwischen dem Ich und dem Unbewußten. Pag.120).
Dan treedt er verstarring op en komt de authentieke ervaring in het gedrang. Heidegger is een denker die die verstarring kan open breken. Zijn denken lijkt me niet toereikend als het gaat om de liefde die het zijn (of God) uiteindelijk is. Een religieus besef in de zin van Jung lijkt me, naast inzichten als die van Levinas daarbij onontbeerlijk.
Literatuur;
Heidegger, M. Sein und Zeit. Tübingen 1986.
Heidegger, M. Inleiding in de metafysica. Nijmegen 1997
Levinas, E. De totaliteit en het Oneindige. Baarn 1987
Levinas, E. Het menselijk gelaat. Baarn 1969
Encyclopaedia Brittanica 1999
Jung, C.G. Die Beziehungen zwischen dem Ich und dem Unbewußten. Olten 1990
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