Asperger's Syndrome: Emotional and Social Implications

Lesson Four: Restricted and/or Repetitive Patterns of Behavior, Interests and Activities

Preoccupation Unusual in Intensity or Focus

Many people with Asperger's have a preoccupation that is unusual in intensity or focus. They may talk relentlessly about their particular area of fascination, completely unaware of their listener’s fading interest. According to Tony Attwood³, "The most popular special interests of boys with Asperger's Syndrome are types of transport, specialist areas of science and electronics, particularly computers...

Girls with Asperger's Syndrome can be interested in the same topics but clinical experience suggests their special interest can be animals and classic literature." Other common areas of interest are schedules and statistical information, as described in the following examples.

Daniel went through phases of being intensely preoccupied with different odd interests. One of his first preoccupations was peoples’ birthdays. In fact, the first question he would ask upon being introduced to someone was the date of his or her birthday. He had an impressive memory for such information, storing the birth dates of dozens of people he had met. The preoccupation with birthdays seemed to give way after a couple of years to an interest in the hours stores open and close. He would walk down the street, paying close attention if a store’s hours were posted out front. Again, he had an incredible memory for such information, which, his mother joked, had a certain usefulness as far as she was concerned. Daniel’s next fascination concerned movies. He was not particularly interested in the content of movies or in critiquing them, but rather was preoccupied with the ratings (e.g., G, PG, PG13, R) movies received. Similarly, he liked to create lists of the movies in which his favorite actors and actresses appeared. In addition, he had a unique method of categorizing movies, and was able to rattle off which movies fell under his rather unusual headings (e.g., movies that dealt with the subject of weddings, movies in which horses appeared).

Inflexibility Regarding Routines or Rituals

Of all the impairments common to those with Asperger's, probably the one most likely to cause difficulties for others is inflexibility regarding routines and rituals. This particular difficulty has enormous potential to adversely affect the lives of family and friends as shown in the following example.

Evan firmly believed that he must watch certain television programs, especially particular game shows. One day a show that he always watched at a particular time was not on; in fact, it was taken off the air several days in a row. This disappointment was apparently more than Evan could bear and led to prolonged tantrums. His mother called the television station, inquiring about the status of the show but to her dismay, was informed the show had been cancelled.

In light of the individual with Asperger's difficulties with flexibility, it is helpful for those dealing with him or her to be creative and flexible in their interventions. Certainly, it is important for there to be as much consistency and predictability as possible. If changes are necessary, telling the person in advance, whenever possible, is helpful. Sometimes it is possible to reframe an issue in a different way. For example, Sean was insistent that he eat three meals every day. If the family woke up late and his parents wanted to serve brunch and then dinner, this plan was unacceptable to him. His mother learned that offering him a cracker in the middle of the day and calling it lunch was an acceptable arrangement as far as Sean was concerned.

Another useful technique to consider is to involve the individual with Asperger’s in collaborative thinking or negotiation. For an in depth discussion of this approach, the reader is referred to The Explosive Child by Ross Greene, Ph.D⁸. The following interchange is an example of this technique.

Elliot's parents were considering moving him to a new residential home and he was invited to have dinner and meet the staff and students at the new residence. Before returning him to his current placement, his parents’ plan was to take him out for dessert while they had dinner. Elliot found this idea unacceptable; in his world, if he were going to be in a restaurant with people eating dinner, he needed to be eating dinner as well (even though he had just had dinner). His response to his parents' disapproval of his plan was to tell them they needed to take him home and then they could go out to dinner by themselves. After explaining to him that this plan did not work for them (logistically, it would have them driving far out of the way), his mother asked him if he had any ideas as to how they might resolve the problem to everyone's satisfaction. Elliot thought a moment and then asked, "Is it okay if I have a piece of bread and a drink?" His mother thought this was a fine idea. Apparently, Elliot considered bread and a drink sufficient to meet his definition of a meal. If his mother had not involved him in the discussion, they would never have been able to come to this resolution.

Stereotyped and Repetitive Motor Mannerisms

An additional category under the heading of restricted and/or repetitive patterns of behavior, interests and activities is that of stereotyped and repetitive motor mannerisms. There are a number of mannerisms in which the individual with Asperger’s may engage. These mannerisms include hand or finger flapping, rocking, or complex whole body movements such as spinning or jumping. These behaviors differ from tics in that they are voluntary movements in the motor sense; voluntary in this case does not imply that they are easily stopped. In fact, there is considerable support for the notion that these movements have a calming or regulatory effect on the nervous system. An unfortunate consequence is that these behaviors call attention to the oddness of the individual, often resulting in teasing or ostracism.

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