Hans Asperger

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In 2006 I was diagnosed with Asperger Syndrome, a condition, first identified by Hans Asperger, on the autism spectrum in which social awkwardness, a focus on particular interests to the exclusion of others, and physical clumsiness are combined. But does the term “Asperger Syndrome” refer to a real phenomenon in humans or is it a product of the modern tendency to attach labels to normal variations in personality?

My short answer is “Yes, Asperger Syndrome” is a real set of behavior patterns in some individuals”–but there is more to be said. It is true that Americans, especially, love to label. They love to medicalize. Although Attention Deficit Hyperactivity Disorder is a real condition that truly handicaps some children, there is a temptation to apply the label to children being children, especially by tired teachers or by parents looking for an excuse for their child’s poor behavior. But misdiagnosis does not imply that ADHD is a myth; it means that diagnosis must be done with care and conditions such as ADHD must be carefully defined. Otherwise, some children may be placed on Ritalin or some other drug of which we know very little about long-term effects.

Now Asperger Syndrome can be socially damaging since individuals with Asperger’s do not read other people well. Thus there are some negative effects of the condition that have practical consequences, especially for social relationships, friendships, marriage, and job interviews. There is some evidence that, like full-blown Autism, Asperger Syndrome is correlated with changes in the brain–but one must take care about such correlation. Correlation is not causation. In addition, there is the “chicken-egg” problem of whether changes in the brain affect behavior patters or whether behavior patterns remold the brain. The truth may be a combination of both. Parents with Autism or Asperger’s are more likely to have children with these conditions, so there seems to be a genetic link. A critic, however, may point out that if parents who model behavior for their children have Asperger’s, then the child may model his behavior after the parents and engage in Asperger-like behaviors. Science may not be able to answer every question about Asperger’s and heritability, but from my own experience, watching my maternal grandfather’s behavior, I believe that a tendency to Asperger Syndrome can be inherited, but whether science confirms this conclusively will depend on future research.

Asperger Syndrome is not a disease. In part, I think of the term as a pragmatic label that helps people “wrap their minds around” a certain combination of behavior patterns. Placing those patterns under the Asperger’s label helps both scientists and individuals with Asperger’s and their families to place past, present, and future behaviors into a meaningful “pigeonhole.” Pigeonholes are not always bad things as long as people are not overly legalistic about them. If a pigeonhole helps someone make sense of his life or his loved one’s life, and if it points to an actual pattern of natural human behavior, then the pigeonhole is pragmatically useful.

But is the label “Asperger’s” true? Does it refer to a “natural kind” with stable properties? I lean toward that position. I realize the dangers of over-medicalization of normal variations (and I think Asperger’s is an extreme of normal personality) and of labeling. From my own experience and from the experience of others, Asperger Syndrome does refer to a pattern that is ontologically real–“really real,” so to speak. Now whether Asperger’s is overdiagnosed is an empirical question that can, in principle, be resolved by careful study. More rigorous tests can make diagnosis more accurate. But for those who are accurately diagnosed, they should take comfort that their condition is not just a label–and accept the strengths that arise from having Asperger’s–and work on the weaknesses.