Asperger's Syndrome: Emotional and Social Implications

Lesson Three: Impairment in Communication

This lesson focuses specifically on the social implications of communication difficulties in individuals with Asperger’s.

Inappropriate Questions/Comments

The uttering of inappropriate comments or questions can be a serious problem. Sometimes the remarks are inappropriate to the setting. Sometimes the comments are sexually inappropriate. In any case, the remarks or questions do not take into account the impact on the other person involved. For example, Alex was attending a funeral. Oblivious to the impact his question would have on the grieving friends and relatives, he wondered out loud about the process of bodies decomposing. In another example, Michael found himself attracted to a young woman and proceeded to stare at her. When she asked him what he wanted, he told her in sexually explicit details what he was staring at and the specific nature of his interest.

Lack of Symbolic Play

For most children, play is a crucial area of communication and development. Children with Asperger's generally display problems with imaginative or symbolic play. In autism, there is sometimes a lack of symbolic play. Some autistic children do play imaginatively for brief periods of time, but unlike their typically developing peers, they usually cannot sustain and elaborate on the play. In Asperger’s, there may be rather elaborate imaginative play, especially in girls. According to Tony Attwood, "Girls with Asperger's Syndrome can create imaginary friends and elaborate doll play which superficially resembles the play of other girls but there can be several qualitative differences. They often lack reciprocity in their natural social play and can be too controlling when playing with their peers... While the special interest in collecting and playing with dolls can be assumed to be an age appropriate activity and not indicative of psychopathology, the dominance and intensity of the interest is unusual. Playing with and talking to imaginary friends and dolls can also continue into the teenage years when the person would have been expected to mature beyond such play."³

Some clinicians consider play of paramount importance to the development of the child. Stanley Greenspan, M.D.⁹ has developed a treatment technique which he terms “Floor Time.” In this approach Greenspan utilizes play to “open and close circles of communication”. For example, when one person makes a communicative overture, the expectation is that the other person will respond to this overture in a reciprocal way. He believes play is critical not only for the development of social interaction, but also for the development of logical, flexible and creative thinking.

Literal Thinking

In addition to problems with imaginative play, individuals with Asperger’s have a tendency to think in a literal way. Parents and teachers are sometimes astonished to learn how a child with Asperger’s has misunderstood a commonly used term or expression. Idioms are particularly problematic. Individuals with Asperger’s often have great difficulty with metaphors and with information that is implied but not stated directly. On occasion, the child’s misperception becomes apparent, as in the following examples.

Edward was told by the staff in his group home that wake-up on weekends was 10:00 a.m. Staff were surprised to see that he was lying in bed awake for hours on week-end mornings. When asked about it, he replied that he was not allowed to get out of bed until 10:00, rather than understanding that he could stay in bed as late as 10:00 if he chose to do so.

Similarly, the same child was told by his mother to put on his winter jacket. He found two winter jackets hanging on the banister, but told his mother he did not know which one was his. To her surprise, he said he could not tell which one to wear because they both had a name-tag with his name on it. In fact, he had been wearing one of the jackets all winter; he had outgrown the other one, but his mother had failed to remove his name from inside.

"Theory of Mind"

In addition to the problems in communication mentioned above, individuals with Asperger’s may have trouble with a concept referred to as "theory of mind". Briefly, this notion, first described by Simon Baron-Cohen⁴, refers to difficulty in perspective taking. An example of this difficulty is that individuals with Asperger ‘s may assume other people have the same knowledge as they do, even when there is no basis for this assumption.

For example, Nick was very interested in movies, frequently talking about the latest movies he had seen. He would discuss the content of movies with anyone who would listen, not recognizing that they could not possibly know what he was referring to, since they had not seen the movie under discussion.

A related matter is the inability many with Asperger’s have to recognize how other people are perceiving them. This difficulty contributes to a lack of shame or embarrassment about their behavior.

Can you think of a character who has difficulties with social interaction and communication? What about Data on Star Trek?

The following Star Trek episodes illustrate the difficulties Data has with understanding humor and dealing with the complexity of romantic relationships.

“In Theory”
http://stng.36el.com/st-tng/episodes/199.html

“The Outrageous Okona”
http://stng.36el.com/st-tng/episodes/130.html

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