Asperger syndrome, an autism spectrum disorder characterized by difficulties in social interaction and communication, has been thrown into the media spotlight since fiery Taipei Mayor Ko Wen-je (柯文哲), a self-proclaimed sufferer of the syndrome, took office and vowed to usher in drastic changes.
Heated discussion has surrounded the developmental disorder, particularly after a diplomatic faux pas in late January, in which Ko, after receiving a pocket watch from British Minister of State for Transport Susan Kramer at a public event in Taipei, told reporters that he might give the watch to someone else or “sell it to a scrap metal dealer for some money, because it would be useless to me.”
Supporters of the surgeon-turned-mayor, who is known for often making off-the-cuff remarks, are quick to cite Asperger syndrome to justify Ko’s comments, while others accuse the mayor of using the disorder as a pretext for deliberate rudeness.
National Taiwan University Hospital Jhudong Branch pediatric psychiatrist Chen Shao-chien (陳劭芊) said that, while etiquette and social grace come easily to most people, they are the equivalent of a foreign language to individuals with Asperger syndrome.
“Asperger-affected children are characterized by social difficulties and an unusual obsession with a certain hobby, routine or object,” Chen said. “They might strike some people as insensitive, rude and being completely incapable of reading others, but that is just because the ability to identify emotions and sarcasm, or interpret facial expressions and body language, does not come as instinctive to them as it does to the rest of the population.”
For example, when a mother says to her children, who have been eating candy before their dinner, that they “might as well eat all the candy in the house,” most children understand their mother’s tone and react appropriately, Chen said.
“But not a child with Asperger’s,” Chen said. “He or she would most likely take that message literally and go ahead and eat all the candy they can find.”
While some Asperger’s sufferers are able to, over time, gradually get a rough grasp of what behavior and language are considered socially acceptable, there will still be occasions when they erroneously think it is okay to speak their minds or be brutally honest, Chen said.
Despite sometimes being used as a byword for social awkwardness, Asperger syndrome has been associated with genius and remarkable achievements.
That is primarily because many high-profile figures in history have also been diagnosed or suspected of suffering from the syndrome, such as German-born theoretical physicist Albert Einstein; English physicist and mathematician Isaac Newton; Microsoft founder Bill Gates; US artist Andy Warhol; and US actor and comedian Robin Williams.
However, the belief that individuals with Asperger syndrome are smarter than the rest of us could be just a myth.
Cardinal Tien Hospital psychiatrist Tom Yang (楊聰財), who also serves as the Mental Health Foundation convener, said there is still no scientific evidence suggesting that people with Asperger syndrome generally have a higher intelligence quotient (IQ).
“On the contrary, some research indicates that about one in every four people with autism-related disorders, including Asperger’s, tend to have a below-average IQ level,” Yang said.
Nevertheless, Yang said it has been found that a large proportion of autistic savants, referring to individuals with autism who are exceptionally gifted in a specific field, also have Asperger syndrome.
The skills such individuals master tend to originate from the right hemisphere of the brain, such as art and mathematics, he said.
“In addition, the inclination of individuals with Asperger to be obsessed with particular topics also makes them more likely than their non-affected counterparts to invest themselves in a specific field and stand out from their peers, even if they have the same IQ level,” Yang said.
According to statistics compiled by the Ministry of the Interior, the number of Taiwanese diagnosed with autism-related disorders has more than doubled in recent years, from a little more than 6,100 in 2006 to nearly 13,400 in 2013.
Wang Fang Hospital psychiatrist Billy Pan (潘建志) explains that the noticeable increase could be partially due to the recent expansion of diagnosis criteria for autism spectrum disorders in the nation.
“In the past, only people who exhibited typical autistic behavior — completely shutting out the outside world and not talking to others — would be diagnosed with a disorder,” Pan said. “However, now, even individuals with mild autistic symptoms meet the diagnostic criteria, which is driving up the number of autism-related diagnoses.”
Pan said that, while a medical cure for Asperger syndrome is still beyond the reach of modern medicine, children or adults with the condition can still turn to behavioral therapy to improve their social adaptability and interpersonal skills.
Nevertheless, Pan said that the extra care and attention devoted parents give sufferers during their childhood — as they often experience language development delays — is what really makes the difference.
“Improvement in an Asperger patient’s condition is not possible without professional assistance and, most important of all, compassion and understanding from those around them,” he said.
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