Tuesday, July 23, 2013

Mental Health in Progressive America: #What is Asperger's Syndrome

Mental Health in Progessive Era America:
What is Asperger's Syndrome?


         “I don’t understand why you two are acting like this and why Cora says he’s stupid. He’s not stupid, he’s wonderful,” Elsa protested. 
         Gideon answered, “Elsa, Franklin has to do things a certain way. Every day of his life he has to follow a strict routine or he will not be able to concentrate on the task he’s asked to do. When he plans to do something it is planned down to the tiniest of details. Sometimes one of those details is so peculiar you would miss it. Not Franklin. He has to complete each step of his plan in precise order.”
         “He was going to propose at the dance, wasn’t he?”
          “He was.”
          Juliette interrupted, “He had it planned all out. How did he react when you told him you knew his intentions?”
         “He was upset. Cora said it was a panic attack.”
         Gideon shook his head, “It was too much for him. Elsa, you are right about my son’s intelligence. He is very smart but there are just some things we don’t tell him because we know it will upset him.”
- From Elsa: (The Secret Heritage Series: Book 1) by: Allison Bruning


 I just love the picture above when thinking about those who were gifted with Asperger's Syndrome during the Progressive Era. As we learned last week the Progressive Era occurred in the United States from the 1890's to 1920's. This era of our history is known as the Progressive Era because of the progressive movement that had swept our country. The Progressives sought to improve the living conditions of women, children, the poor and mentally handicapped that Victorian society had created. The progressive reforms occurred on the local, state and national levels. We will talk more about some of these reforms in other blog postings.

Asperger's Syndrome was not recognized as a mental condition until Austrian Hans Asperger published a definition of autistic psychopathy in 1944 after studying four boys who in his words had "a lack of empathy, little ability to form friendships, one-sided conversations, intense absorption in a special interest, and clumsy movements." Think of these children as little Mr. Spock's from Star Trek. 

Hans Asperger also noted that many children with these characteristic tended to become very successful in their chosen careers in adulthood because they were able to hone in on their special interests. These adults could talk for hours about their specialized interests even when their audience had long lost interest in the topic. Some famous people who had Asperger's Syndrome are Albert Einstein, Bill Gates, Sir Isaac Newton, Alfred Hitchcock, Jane Austin, Hans Christian Anderson, Charles Darwin, Thomas Jefferson, Charles Shultz, Mozart, Thomas Edison, Michael Jackson, Mark Twain and Jim Henson.

Hans Asperger worked with patients who had Asperger's Syndrome until his death on October 21, 1980. Despite his hard work Asperger's Syndrome was not well known until after his death. Scientists Tantam (1988) in the UK, Gillberg and Gilbert in Sweden (1989), and Szatmari, Bartolucci and Bremmer (1989) in North America each conducted the first systematic studies of patients with Asperger's Syndrome which was later published in the years show by their names. In 1989,  Gillberg and Gillberg in Sweden and Szatmari in North America each proposed a criteria establishing the symptoms required to diagnosis someone with Asperger's Syndrome. Yet Asperger's Syndrome would not be widely recognized until it became a distinct diagnosis by it's inclusion in the 0th published edition of the World Health Organization’s diagnostic manual, International Classification of Diseases (ICD-10). It was added to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as Asperger's Disorder in 1994. Asperger's Syndrome was named after Hans Asperger.


So what are the criteria to be diagnosed with Asperger's Syndrome? 

According to the DSM-IV Asperger's Syndrome Criteria is defined as:

(I) Qualitative impairment in social interaction, as manifested by at least two of the following:
(A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
(B) failure to develop peer relationships appropriate to developmental level
(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
(D) lack of social or emotional reciprocity
(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(D) persistent preoccupation with parts of objects

(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.

(IV) 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)

(V) 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.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia."

Unfortunately the DSM-V, released May 2013, has eliminated the term Asperger's Syndrome replacing it with  autism spectrum disorder (ASD). This has brought much controversy from the families, friends and professionals of those who care about someone with Asperger's Syndrome. The new criteria has included three levels of they syndrome ranging in severity. 

Under the new guidelines, Franklin Raymond would be diagnosed as Level 2 ASD with tendencies to drop to a Level 1 when overstimulated. 


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