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Engelska - What is Asperger’s syndrome in adults?

Although Asperger’s syndrome can be regarded as a life-long disability or may be considered to be a personality feature that means that the person perceives reality in a different way and has different preferences and skills, people with Asperger’s syndrome obviously also change with age.

All humans mature, develop and are shaped by their experiences. Actual and experienced problems and difficulties can change, they may increase or decrease and new ones may be added.

Diagnosis at different ages

It is now generally considered that an early diagnosis is important, for example at the age of 4-6 years. This provides the necessary basis for the right efforts to be made by pre-school age, that is to say before things go wrong from both the educational and social points of view, for instance in relationships with classmates.

Being diagnosed during the teenage years is felt by many to be particularly tough, and it may be difficult to accept and process a diagnosis that is perceived to be a stamp of inferiority.

Quite a few ask for an investigation when they are between 20 and 35 years of age. They may perhaps have started on and failed with various studies or jobs and with relationships and have begun to wonder about the reason why. People in this age group seem to find it easier to accept a diagnosis. They think that they have been given an explanation for why they have felt different and as outsiders. Many also learn a great deal about their disability and want to meet and exchange experiences with others with Asperger’s syndrome, for example through chat groups, rendezvous and organisations or through network contacts. There are also a small number of people over the age of 40 who come for investigation.

As the diagnosis of Asperger’s syndrome did not start to be made in Sweden until the early 1990s, many of these people have not received adequate help at all. Most of them have felt mentally unwell for a long time or for periods and are referred to psychiatry or Adult Rehabilitation after being urged to do so by concerned relatives.

Changes and problems in adulthood

A strikingly large number who in childhood were described as hyperactive, inattentive, acting out, uncritical, obstinate or overbearing have instead become passive, compliant, amenable and taciturn as adults. They often have low self-esteem, poor self-confidence and are lacking in independence.

It is not uncommon for them to stay living in the parental home right up until the age of 30-40, either because they do not have a job and therefore financial resources to find a home of their own or else because they are practically and emotionally dependent or immature and cannot cope with an independent adult life. Many of them do not, for example, master the skills that are normal for their actual age and practical problems in the home with such things as cleaning, washing and diet are very common.

Some succeed in applying their intelligence by completing studies and getting a job in which their skill and resources are put to use. However, for many training courses and attempts to find and keep jobs have been completely unsuccessful because they become long-term unemployed or live on sickness benefit. The social difficulties in communicating and mixing with others and being able to establish relations with friends and partners entailed by the disability quite often lead to a feeling of exclusion, loneliness and sometimes also almost total social isolation. The fixation with a small number of limited interests is often reinforced in adulthood, as well as compulsive and ritual actions such as exaggerated hand washing, checking certain things time and time again and collecting things or not being able to get rid of anything at all. It is very common for people with Asperger’s syndrome to have additional mental problems such as depression, anxiety, social phobia, sleep problems, eating disorders and other compulsive behaviour.

Some try to conceal, deny, repress or somatise their difficulties and emotional problems. Positive aspects of the disability People with Asperger’s syndrome are often very intelligent and capable in their special area and are mostly honest and dutiful. They are scrupulous, energetic, persistent and focused on the task they have been given. They express themselves clearly and accurately in speech and writing. However, people with Asperger’s syndrome find it difficult to cope with the change in the demands of the world of work from “work carried out accurately and well” to “getting something off your hands quickly”, being “flexible” and having the ability to “keep many balls in the air at the same time”.

Efforts

It is important to adapt and continue to develop methods and support for adults with Asperger’s syndrome so that the individual’s skills and resources are utilised in a respectful way and social exclusion and mental ill-health are avoided.

Educational and psychological efforts, which are based on abilities instead of deficiencies, may to some extent increase the ability to compensate for the cognitive and executive difficulties the disability beings with it. Personal and/or practical support in the home, at school, at work and in leisure time can make everyday existence easier and be a crucial factor in managing to adapt in society.

Increased insight into oneself and knowledge of one’s disability, like contact with others, can improve the prospects of social and mental adjustment.