Asperger’s syndrome at 41 years of age, is it possible?

Mercedes Rodriguez is a woman who sees her life as a process of self-discovery and continuous learning. At 41 years old, she was diagnosed with Asperger’s Syndrome after a specific evaluation that ended up giving a reason to her way of perceiving and relating to the world.

Every February 18th is celebrated the International Asperger Syndrome Day, and on the occasion of this day, Mónica González Agüero, specialist in Psychology, is going to explain in detail what this disorder consists of. Ms. Gonzalez develops her professional activity as Head of the Department of Child and Adolescent Psychology at Avatar Psicólogos, Psychology Unit of Hospital Quirónsalud Marbella directed by Dr. Antonio de Dios Gonzalez.

What is Asperger Syndrome

Asperger’s Syndrome is a neuro-biological developmental disorder, related to autism. In fact, the APA (American Psychiatric Association), in its latest revision of its Diagnostic and Statistical Manual of Mental Disorders (DSM-V), eliminates this diagnostic label and integrates it into ASD (Autism Spectrum Disorders). Therefore, in the diagnostic manual of the American Psychiatric Association, which is a worldwide reference, Asperger’s Syndrome as such disappeared in 2013 (not without some controversy) and now it is referred to as an autistic disorder of greater or lesser severity depending on a number of dimensions and their impact on the person.

In any case, in practice this label is still used and the World Health Organization continues to use it as a distinct disorder to this day.

Who can develop Asperger syndrome?

It is important to understand that it is not a disease and therefore cannot be cured. Although the diagnosis is usually made in childhood in the best of cases, it is something that will accompany the person throughout his life as with other developmental disorders.

The Asperger’s person has a different way of functioning and understanding the world than the general population, which will cause problems in adapting and integrating into society. This is why early diagnosis is essential to avoid the suffering generated in the person by this lack of understanding of the world around him/her.

As for the prevalence of this syndrome, there are many difficulties in determining the reliability of the data in this regard. In recent years there has been a marked increase in the number of new cases, as with other clinical disorders such as allergies and intolerances, diabetes or cancer. But in the case of autistic disorders, greater knowledge and awareness, as well as improved diagnostic tests and lower cut-off points are making it possible to diagnose more cases. Many of which went unnoticed until a few years ago, precisely because they were milder, as is the case with AS. In any case, we can affirm that this increase is real, although the increase in the number of cases is not as exaggerated as the statistics show.

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According to the World Health Organization, 1 in 160 children currently suffers from an ASD, so we can no longer speak of a disorder as rare as it was a few years ago. It is very possible that there is some case among the schoolmates of children or of some more or less direct relative.

It is mostly a male disorder, although the reality is that it is more difficult to diagnose the female sex because of the differences in the manifestation of the disorder between the two sexes.

In women, the behavioral manifestation of Asperger’s is much more subtle. They tend to control their behavior better, something that often favors consulting with men for this type of problems, and socially they are better able to “camouflage” their difficulties. This means that diagnosis in women is made later, and many cases remain undiagnosed. In this sense, there is a pending task, since diagnostic tests are quite masculinized.

Cause of Asperger Syndrome

Although much remains to be known, it is clear that it is a disorder of multifactorial origin, involving both genetic and environmental variables that prevent the Central Nervous System from developing optimally.

It is important to note that it is not caused by aspects related to parenting or parent-child relationships, nor by economic or social factors.

It seems that genetic inheritance plays a very important role in the development of ASD. In clinical practice it is very common to find several cases in the same family, or spectrum traits in one of the parents.

As for the environment, exposure to toxins, drugs or even viruses or infections in the mother during critical moments of intrauterine development are also considered as intervening variables. It has even been hypothesized about the influence of some vaccines, although there is nothing proven in this last aspect.

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The increase in the number of cases of ASD and other diseases gives considerable weight to environmental variables in the cause of these disorders. Exposure to pesticides and heavy metals, or aspects related to food are gaining more and more weight in the hypotheses about the origin of disorders that, although they have always existed and taking into account that we are able to diagnose more and better, the truth is that there are more and more cases.

How Asperger Syndrome manifests itself

The Asperger’s person shows problems especially in social interaction, as a result of the difficulties in the different cognitive and emotional processes presented. The affected areas are common to the rest of autistic disorders, although they are milder in Asperger’s and there are some differences.

  • Difficulty in language is a common feature in autism, and although Asperger’s is correct at a formal level (usually too much, and can become pedantic), there are limitations in its more symbolic and pragmatic sense. Aspergers have difficulties with double meanings, irony or humor, for example, and the use of language is very literal.
  • They show a very egocentric thinking, which makes it very difficult for them to be able to put themselves in the other person’s place and know their intentions. They present difficulties in empathizing and understanding emotion in others and even in themselves, to a greater or lesser degree. This leads them to make inappropriate comments in some social situations, or to be too clear or direct with another person, making them uncomfortable.
  • They manifest a restricted pattern of interests, which often makes it difficult for them to be motivated by academic demands, for example. If they have the opportunity, they may spend all their time focused on the same subject, and they tend to collect and search tirelessly for data on it. In addition, they usually find it difficult to change established routines and may become excessively frustrated if things do not turn out as expected.
  • At the motor level they are usually somewhat clumsy, both in fine and gross motor skills. In many of them a strange way of running can be observed.
  • Regarding the cognitive processes that can be observed in the intelligence batteries, unlike the most severe autism in which mental retardation usually appears, the person with Asperger Syndrome has a cognitive intelligence (IQ) in values around the average. There is a widespread belief that Asperger’s is talented or gifted, which is erroneous. Although it is true that there are cases in which a specific talent is observed, in most cases this is not the case. What they usually show is an exceptional memory, especially visual and for details. In these diagnostic batteries, low measures of processing speed and attentional deficits are usually found.
  • It also highlights the hypersensitivity to sensory level that usually appears very early in development and often alerts parents to observe in the child intolerance to noises that bother them excessively as the sound of the vacuum cleaner or dryer, applause at a school event, etc..
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How is it diagnosed?

The first symptoms may appear very early in development, but early diagnosis is often complicat
ed, precisely because the symptoms are mild and very subtle.

The earlier the diagnosis is made, logically the prognosis will be better, so it is essential that parents know the early signs of both AS and autism in general.

The diagnosis is made through specific tests that, thanks to the observation of the different areas, determine whether the person meets the required criteria. Complete intelligence batteries are also performed to observe the different cognitive processes, interviews and questionnaires to parents to obtain information on the evolutionary development (in the case of a minor), etc.

Being a chronic disorder or syndrome, the diagnosis can be made at any age (also in adults). The earlier it is performed, the more likely the person will be able to have a healthier and more adapted life. In adolescents and adults with no previous diagnosis, it can often finally be performed because they come to consultation for other comorbid problems that appear over time: anxiety or mood problems, behavioral problems, or even patients diagnosed with a personality disorder.

How does a person with Asperger Syndrome feel?

Thanks to the specialists, Mercedes finally got the answers to many of the questions she had been asking herself since she was conscious, and she has reflected them in her publication A World in Diversity, in the Avatar Psychologists Blog.