Professional Documents
Culture Documents
349-357
Monica P. Buettel
University of Northern Colorado
You didn't give the kids a reason to make fun of you but they just in-
stinctively had to. They could tell you were just a bit off. You still
had some natural instincts. When kids would make fun of you I
would still hurt, but you tried to make yourself as cold and unemo-
tional and strong as possible.
349
350 BUETTEL
aware of their social inadequacy (Klin et al., 2000). As more children be-
come identified as having AS, schools and professionals working with
these children are challenged with finding effective ways to adapt and to
encourage success in this population.
In her edited book Learning and Behavior Problems in Asperger Syndrome,
Margot Prior addresses this challenge with a compilation of current re-
search and theory, combining the knowledge and expertise of numerous
acclaimed authors and researchers in the area of AS and other Autism
Spectrum Disorders with the practical experience and insight of practi-
tioners and of one individual diagnosed with AS. According to Prior,
"the contents of this volume reflect the wealth of knowledge and skills
that has developed over 50 years of searching for the best ways to help
children with ASD" (2003, p. 6). The book is organized into two main
sections, with the first sharply detailing current thought and research on
diagnostic challenges, cognitive and academic assessment, implications
of specific learning difficulties, and the emotional and behavioral chal-
lenges of AS. The second section, entitled "Asperger Syndrome in the
Schools," includes a poignant personal portrayal of the school experi-
ence of one individual with AS, a discussion of practical advice and
guidelines for optimizing student success and for creating the "ideal
classroom" for students with AS, and ends with an examination of
educational and occupational outcomes.
differentiate from HFA and could be removed from the next edition of
the DSM, with HFA continuing to be denoted as an Axis I diagnosis of
autism without an Axis II diagnosis of mental retardation. It further con-
cludes that autism is best described as existing on a continuum with
most relevant differences among subtypes explained by IQ and
symptom severity.
This chapter includes studies on the impact of age and IQ on autistic
symptoms, the insignificance of speech delays, and the diagnostic reli-
ability and validity of the DSM-IV (concluding that the different sub-
types are empirically unsubstantiated). In general, it has been found that
children with higher IQs present with milder autistic symptoms and
tend to be identified later and that children at all phases of the autistic
spectrum show restricted interests and obsessive preoccupations. As
different labels are being used by different clinicians for the same child,
there is understandable confusion for both parents and professionals.
Mayes and Calhoun provide a succinct, though well-supported and
convincing, argument for redefining AS as indistinguishable from HFA
and for visualizing a single spectrum disorder, instead of differing sub-
types with intrinsically different characteristics. While addressing the
literature supporting the current DSM-IV diagnostic criteria, they point
out the limitations in those studies while detailing the wealth of research
underlying their position. This chapter could provide a useful tool for
practitioners involved in both the diagnosis and treatment of those with
Autism Spectrum Disorders.
The next two chapters contain ample information on learning charac-
teristics of those with AS and on strategies and instruments for assessing
children with AS who may experience school distress from both the
complexity of social demands and from an academic curriculum that is
designed for "typical" students. Children with AS have been found to
have core deficits regarding attention impairment, information process-
ing, organization and planning, the inability to complete academic tasks
satisfactorily, disconnectedness from other children, pragmatic lan-
guage, and problemsolving. These deficits can present a risk for aca-
demic failure and low self-esteem. Using a longitudinal study compar-
ing children with AS and HFA, as well as an examination of case studies,
these chapters closely examine the cognitive and academic abilities of
children with AS.
To encourage the appropriate assessment of this population of chil-
dren, the authors present an overview of the assessment process and of
specific instruments to use in the overall assessment as well as a descrip-
tion of assessment guidelines. These chapters stress the importance of
qualitative data received during the assessment process, especially in re-
gard to planning/organization, tangentiality on verbal tasks, and rigid
352 BUETTEL
AS CHARACTERISTICS
Regardless of the diagnostic definition, the most salient features of this
syndrome have been described with remarkable consistency, with the
majority of features falling into the categories of language-related, so-
cial, sensory, motor, and cognitive-processing characteristics, including
the ever-present circumscribed interests. Common social characteristics
include awkward interactions with their peers, a lack of desire to inter-
act with their peers, a lack of appreciation for social cues, socially and
emotionally inappropriate behavior, limited gesture use, limited facial
expression, and inappropriate expression with a peculiar, stiff gaze
(Mesibov, Shea, & Adams, 2001). Individuals with AS interpret lan-
guage literally and make sense of the world as a series of facts (Attwood,
1998). They can have odd speech patterns that may be pedantic, repeti-
tive, perseverative, monotonous, or characterized by unnatural rythmn
or rate (Attwood, 1998; Moyes, 2002), and their understanding of social
or pragmatic language can be quite limited (Attwood, 1998; Moyes,
2002).
Although a sizable body of literature exists on the characteristics of
AS, as well as on its effect on learning and behavior, this book effectively
gathers this information into one volume, while providing thorough,
and even some unique, guidance on managing and supporting these is-
BOOK REVIEW 353
tem, all of which reflect an attempt to soothe anxiety from the confusing
social world through achieving coherence and making order out of
chaos. These interests can benefit both the children and society as they
pursue their interests with single-minded determination, often reach-
ing a high degree of excellence in their areas of interest. They also lend
fluency and animation to conversations that they conceptualize as a
means of exchanging information rather than for promoting social cohe-
sion. Attwood goes on to discuss strategies and reasons for either
reducing or utilizing these interests in the classroom.
Chapter 7 presents a complete and well-organized discussion of the
assessment and treatment of comorbid emotional and behavior prob-
lems, focusing on cognitive deficits and AS comorbidity with atten-
tion-deficit/ hyperactivity disorder and various psychiatric disorders,
including obsessive-complusive disorder, phobic disorders, bipolar
disorder, and schizophrenia. The author, Digby Tantam, proceeds to
touch briefly on issues around transition, crisis, and trauma; reactions to
the AS diagnosis; friendships; sexuality; aggression; and identity from
her expertise and experience. Although a broad spectrum of weighted,
and only marginally related topics was introduced in this chapter, the
inclusion of issues rarely discussed in relationship to AS provides a
unique contribution. Especially interesting is new, though empirically
unsupported, information on the common attribution by children with
AS of social exclusion to the "badness" of people, and on the tendency to
count brief acquaintances and professionals as "friends." The possible
delay of sexual puberty and resulting infatuations and fetishes and the
role of rigid routines supports identity development in the child with
AS.
References
American Psychiatric Association. (APA). (2000). Diagnostic and statistical manual of mental
disorders (4th ed., text rev.). Washington, DC: Author.
Attwood, T. (1998). Asperger's Syndrome. Philadelphia: Jessica Kingsley Publishers.
Buettel, M. (2004). "Off by a Hair": Understanding the Life Experience of an Adult Male with
Asperger Syndrome. Manuscript submitted for publication.
Carrington, S., Templeton, E., & Papinczak, T. (2003). Adolescents with Asperger syn-
drome and perceptions of friendship. Focus on Autism & Other Developmental Dis-
abilities, 18(4), 211-219.
Klin, A., Volkmar, F., & Sparrow, S. (2000). Asperger Syndrome. New York: The Guilford
Press.
Mesibov, G.B., Shea, V., & Adams, L.W. (2001). Understanding Asperger Syndrome and
high-functioning autism. New York: Kluwer Academic/Plenum Publishers.
BOOK REVIEW 357
Moyes, R. (2002). Addressing the challenging behavior of children with high-functioning au-
tism/Asperger Syndrome in the classroom. Philadelphia: Jessica Kingsley Publishers.
Ozonoff, S., Dawson, G., & McPartland, J. (2002). A parent's guide to Asperger Syndrome and
high-functioning autism: How to meet the challenges and help your child thrive. New
York: The Guilford Press.
Prior, M., Eisenmajer, R., Leekam, S., Wing, L., Gould, J., Ong, B., & Dowe, D. (1998). Are
there subgroups within the autistic spectrum? A cluster analysis of a group of chil-
dren with autistic spectrum disorders. Journal of Child Psychology and Psychiatry,
39(6), 893-902.
Volkmar, F., Klin, A., Schultz, R., Bronen, R., Marans, W., Sparrow, S., & Cohen, D. (1996).
Asperger's Syndrome. Journal of the Academy of Child & Adolescent Psychiatry, 35(1),
118-123.