Category: Uncategorized

Asperger’s Syndrome – Essence And Simplification

This article will consider the concept of reducing Hans Asperger’s syndrome to its simplest definition. Asperger comes to mind as one of just two renowned psychologists who tended to view certain aspects of autism in a more positive light. The other psychologist was Grunya Efimova Suhareva – an expert in child psychology who headed a clinic in the USSR. Other psychologists overwhelmingly dismissed the achievements of some autistic children as mere, mechanical rote-learning. For example, the Dutch psychologist Van Krevelin (who had actually met with some of the Asperger children) wrote:
“However, we should bear in mind that a rich vocabulary and great memory are usually just mechanised attainments. In concrete terms they never achieved anything.” (Van Krevelin)
Similar views were expressed by Lorna Wing or S. Muhnin. The truth is that the intellectual capacity of autistic children varies a great deal. Russian psychologist Viktor Kagan, who migrated to the U.S., divided his case-studies into five categories. The first group is headed “Autistic Psychopathy” – and corresponds to what H. Asperger and G. Suhareva had described. Kagan writes:
“The intellect of these children is generally high (up to 120- 135 on the WISC scale). There is a noted bias towards verbal intellect, compared to non-verbal. Information processing is problematic. Speech develops early on, often before walking and is distinguished by a rich vocabulary. “(V. Kagan)
Kagan also adds that this category (autistic psychopathology) defines a group who have no acceptance in the mainstream or popularity. To that I will simply add my own observation that the same applies in research circles (clinical psychology included)
It should be pointed out that neither Hans Asperger or G. Suhareva lost their sense of perspective on the issue of intelligence. Suhareva noted some of the autistic children she encountered had rich imaginations and often excelled in music or arts, sometimes maths. However, she noted a history of mental (or physical) illness amongst family members, such as epilepsy, schizophrenia or various neurotic conditions. She also noted cases of family instability, alcohol abuse or divorce. Asperger, for his part, tended to play down any connection to encephalitis or schizophrenia as hereditary factors but, rather, stressed the creative characteristics of any grandparents or ancestors. My own view here is Asperger was aware of Nazi Germany’s intention to euthanise the mentally disabled and that, of course, applied to the children he had come to admire within the walls of his Vienna clinic. Asperger’s concluding words stressed the fact his autistic children had something of social value to offer, due to their uniqueness and innate, scientific curiosity.
To return to the central theme, can we define Asperger’s syndrome in simple terms?
In the introductory paragraphs to his essay – “Die Autistischen Psychopathen Im Kindesalter” -, Asperger refers to Jaensch, who distinguished autism on the basis of social integration. This strongly resonated with my own views regarding what Asperger and Suhareva had described. It also ties in nicely with the older term, used by Suhareva “Degenerierte Verschrobene”. In my view, not all types of autism can be summarised as a lack of social integration, since autism can be caused by physiological factors, such as in the case of encephalitis. Despite that, I suggest the following may define in simple terms what Asperger’s Syndrome actually is:
The term “Degenerierte Verschrobene” translates roughly as “cranky degenerates” and this implies a category of human beings who are not socially integrated. This disintegration commences from very early childhood and is defined by strong resistance to any form of social programming. In some cases, both parents and immediate family will be affected. In my experience, it’s not uncommon to find Asperger children marginalised in families, while “normal” siblings gain more parental affection. The phenomenon of non-integration then transfers to the dynamic of school and education, where attempts to educate by means of socialised mechanisms fail. It was at this junction that mainstream schools were forced to send very problematic children to Asperger’s clinic in Austria, with the observation they had proven to be unteachable. In the case of G. Suhareva, similar children in the USSR were directed to her special school (where the staff wore white cloaks). Therefore, this kind of autism impairs overall development, especially in relationship to normal, or neurotypical people. These latter tend to be passive towards family conditioning (initial stage) and constantly adjust and adapt to social communication demands, especially in terms of a shared, collective perspective.
Asperger noted his autistic children certainly didn’t adapt to any of these external factors and could not be “modulated” in this manner, even if they tried to do so. It’s important to recognise such children are not deliberately rebellious. They simply don’t have the mechanisms of social adaptation. As a consequence, intellectual development is hindered, although with this type of autism there is no specific intelligence deficit. The problem centres upon blocked communication, which presents itself as an information barrier. Some children (such as Fritz F) gradually develop alternative ways to assimilate knowledge in isolation from any group or collective. During this phase they spend much of the time alone and read a lot. They develop passionate interests in sometimes odd subjects. The knowledge accumulated will be strongly theoretical, while lacking external experience. It’s advantage can be that a unique, more individualistic perception develops, free from cutural and social bias. The disadvantages can be that highly theoretical, schematic knowledge lacks the input of experience, or application. This is why psychologists such as Lorna Wing and Van Krevelin took a skeptical view. Of course, in subjects such as maths or geometry, or linguistics, highly theoretica! know!edge isn’t a disadvantage, whereas in engineering it is.
The various clinical symptoms of Asperger Syndrome have been well-covered (motor clumsiness, noise-sensitivity, meltdowns et cetera). What matters, however, is the essence of the condition and why it mattered to Asperger. I believe what’s fundamental here is the development of alternative means to process information, outside of the normal socially-driven mechanisms of family, school, institutions, hierarchies and pecking-orders. Added to that, Jaensch’s conception of “the disintegrated” is helpful.

Schizoid Disorder And Asperger Syndrome. The Historical Facts

In this essay, I will try to explain, as clearly as possible, why the autistic children examined by the Ukrainian/Jewish psychologist Grunya Suhareva in 1925 were, in fact, not significantly different than the children described by Hans Asperger in “Die Autistischen Psychopathen Im Kindesalter”.
First, let us consider the diagnostic labels used by Asperger and Suhareva. Here, we will quote Asperger:
“In an attempt to pinpoint and describe rationally that fundamental deviation which – as it seems to us – presents itself as the fundamental essence of the said deviation in children, we chose the term ‘autistic psychopathy’.” (Hans Asperger).
It’s important that I make clear the word “psychopathy” – as understood by psychiatrists at that time – refers to pathological disorders and not psychosis. It doesn’t have the same meaning as it does today in the media. Possibly “psychological pathology” comes close in meaning. So, Hans Asperger diagnosed several children as showing symptoms of autistic psychopathy.
I will now quote directly the diagnostic terms used by Grunya Suhereva. After each case-study was described, she wrote:
“Diagnosis: Psychopathic personality, schizoid. (Verschroben).”(Grunya Suhareva)
So, Grunya Suhareva used the same clinical term as Asperger, in as much as “psychopathy” was implied. She also used another term “verschroben” which, by my understanding, was the oldest designation used to describe autistic psychopathy. More to the point, Suhareva added the term “schizoid”, which we will see is something fundamental to this essay.
Asperger never used the tag “schizoid” so that represents a noticeable difference.
Back in 1925, Grunya Suhareva referred to special children, in her clinic, who suffered from a disorder she called “schizoid, autistic psychopathy”, or just “schizoid psychopathy”. From this, we can conclude that Hans Asperger – some years later – adopted the same term but dropped the added use of “schizoid”. I believe this was intentional. I will do my best here to keep the explanation simple:
The term “schizoid” implies “borderline schizophrenia”. Historically, the symptoms Lorna Wing referred to as “Asperger Syndrome”, in the 1980s, have always been clinically and genetically associated (by German geneticists) with the (negative) symptoms of schizophrenia. Schizoid implies a milder and stable condition of schizophrenia, without the hallucinations or psychotic episodes, or swings, noted at crisis points among schizophrenics. Grunya Suhareva writes:
The term ‘schizoid’ is not new and was used by Bleuler. Neither is there anything new in the fact there is a group of psychopathic personalities who show symptoms not unlike schizophrenia. These are described by Kraepelin in his classification ‘verschroben’, and by Birnbaum in his ‘degenerierte verschroben’.” (Grunya Suhareva)
Hans Asperger in “Die Autistischen Psychopathen Im Kindesalter” made a point of insisting he saw no connection at all between his autistic psychopathy (later Asperger’s Syndrome) and schizophrenia. This explains why he omitted the added use of “schizoid autistic psychopathy”. Such a position I now find to be strange because huge amounts of research had already been carried out by German and European geneticists, based on this question. For example, by A. Schneider who must have been familiar to Asperger. As a result, Grunya Suhereva herself had concluded the syndrome she described in 1925 had a connection to schizophrenia:
“The group designated ‘schizoid psychopaths’ has a certain connection to schizophrenia. The evidence for that can be found in heriditary-gentic data where it’s shown there’s a large quantity of schizoid psychopaths within families of schizophrenics. ” (G. Suhareva)
The question may even be raised as to whether Hans Asperger wished to disassociate his patients from a diagnosis that the German authorities may have perceived as incurable. On more than one occasion, Asperger ruled out any genetic connection between autistic psychopathy and schizophrenia. However, in this area, the research gathered by G.Suhareva seems to me to be more accurate.
So far, therefore, we have seen that both Asperger and Grunya Suhareva used the same diagnostic terms, applied to their groups of autistic children, except that only Suhareva added the additional “schizoid”. So far as symptoms are concerned, the diagnosis “autistic psychopathy” matches well in both cases. Some psychologists have taken the view that the six “odd” children diagnosed by G. Suhareva as suffering schizoid, autistic psychopathy are clinically different from the children Asperger associated with autistic psychopathy. It seems to me improbable that two, remote groups of children (separated by time and geographical location) would all have two distinct diagnoses. That is, no grey areas.
Much later, in the 1980s, Lorna Wing followed Asperger’s line and concluded there was no solid evidence to connect autistic psychopathy (Asperger Syndrome) to schizophrenia:
“Furthermore, the word schizoid was originally chosen to underline the relationship of the abnormal personality to schizophrenia. The latter can occur in a person with Asperger syndrome, but, as already discussed, there is not firm evidence of a special link between this syndrome and schizophrenia, strictly defined. To incorporate such an untested assumption into the name of the condition must give rise to confusion.” (Lorna Wing)
In actual fact, psychologists and geneticists differed over how specifically schizoid personality was linked to schizophrenia. Was the difference just in degree of severity or was there an intrinsic difference? What we do know – translated into modern terms – is that Asperger’s Syndrome is far more common in families where grandparents, or great grandparents, had suffered schizophrenia. We also know that schizoid disorder isn’t passed on recessively, as is the case with schizophrenia.
Wing’s argument seems to be splitting hairs to some degree. It is true some German researchers believed Asperger Syndrome was genetically and otherwise distinct from schizophrenia but, on the other hand, we also know that children in the early stages of schizophrenia are practically identical to Asperger children, in terms of symptoms. Adults diagnosed with schizophrenia (most often around age 20), have often demonstrated Aspergoid symptoms and odd characteristics during childhood. Not only that but even elite psychologists often cannot tell one from the other. Is the child concerned undergoing the early stages of schizophrenia, or is it Asperger’s Syndrome? Asperger himself was once unable to make the distinction:
“We know of only one case where we diagnosed autism with emotional deviations and then two years after he left us, a progressive personality breakdown initiated. Therefore, at the present time we had to diagnose schizophrenia.” (Hans Asperger)
The above quote by Asperger tends to suggest he was less informed on the subject of slow-running (sluggish) schizophrenia or – as stated before – he was intentionally attempting to convince the German authorities that the children in his care didn’t fall under the label of schizophrenia. Rather, Asperger seems to have put a very positive light on his new syndrome, suggesting his “special children” could be useful to the state as future code-breakers or scientists. Moreover, to get some idea of this position, nowadays the term “schizophrenia” still conjures up images of irreversible, anti-social abnormality, delusion and a!ienation. On the other hand, “Asperger’s Syndrome” in its heyday became an almost socially accepted diagnosis, whereas to use the term “schizoid personality” is less palatable.
To conclude this essay, therefore, we may consider:
(1) Grunya Suhareva and Hans Asperger both studied groups of children they referred to as “autistic” and displaying psychopathic behavioural traits.
(2) Grunya Suhareva and her German colleagues accepted some connection between the autistic children and schizophrenia. Even where absolute evidence of a direct link was disputed, the term “schizoid” at the very least implied symptoms in all cases seemed similar.
(3) Hans Asperger took pains to deny his own group of autistic children had anything in common with schizophrenia. However, he admitted to having misdiagnosed one known case.
(4) Hans Asperger on more than one occasion tended to stress to the utmost the giftedness of his patients while distancing them from schizophrenia. This may have been motivated by Germany’s extreme position on abnormality in society.
(5) Lorna Wing seems to have missed the fact very many early researchers had studied groups of families and concluded there were cases of Asperger’s Syndrome against a background of schizophrenia.