Title: The Complete Guide to Asperger’s Syndrome
Author: Tony Attwood
Tony Attwood is widely regarded as the leading expert in Asperger syndrome (AS) today. Other names such as Uta Frith or Lorna Wing are synonymous also with AS, but Attwood has assumed the mantle of contemporary lead commentator.
The Complete Guide to Asperger’s Syndrome builds on his original work Asperger’s Syndrome: A Guide for Parents and Professionals published in 1998. As one would expect, the content is greatly expanded, is much more in–depth and contains significantly more insight into the various issues impacting upon people with Asperger.
As with his original work the core subjects remain largely the same: Diagnosis, Social Behaviour, Language, Interests, Cognition, Sensory Sensitivity, Movement and Co–ordination.
All, however, have been researched in much greater detail and many have been sub–divided with specific areas and afforded chapters of their own. Examples of the latter include Teasing & Bullying, Understanding & Expression of Emotions and Theory of Mind.
Other areas have been added as well and which add to the insight of people with Asperger working in management capacities – Life After School, Long Term Relationships and Psychotherapy (or the benefits of formal interventions). Pleasingly, on a personal basis, my book Managing With Asperger Syndrome is referred to, albeit fleetingly.
As one would expect, the book is comprehensive, insightful and of immense relevance and benefit to anyone with, or associated with, Asperger syndrome. Though written primarily from the perspective of assisting children and parents, the book makes regular references to issues which impact on adults. Though only referred to directly on relatively few occasions, most of the content is extendable and applicable to people with Asperger working in management.
The opening chapter – What is AS? – goes over familiar ground such as the difficulties of social integration and the propensity to apportion blame to the self as a consequence of having AS.
Social Understanding & Friendship looks at the difficulty of assimilation in the social world and the tendency to withdraw socially. It highlights the increased risk of being targeted negatively or being bullied by doing so and of being less likely to attain peer support.
Fewer friends mean more enemies. This highlights the importance for a manager to build a variety of working relationships, particularly as part of a team via empathy and shared responsibility. There are practical tips in this area such as the importance and value of giving compliments.
Central to team work is flexibility of thought and acceptance of doing things differently. The relevant chapter also relates strongly to conflict and how taking on–board concepts such as compromise and negotiation and offering apologies when in the wrong can be instrumental in avoiding confrontation. The benefits of active listening are also emphasised along with the non–disclosure of sensitive, personal information.
The section of Teasing & Bullying expands on conflict and identifies some of the tenets which make people with AS more likely to be singled out: being more likely to remain passive in response to being a target and less likely to retaliate or report being victimised. Related to this is a reduced ability to identify who to avoid or sufficient understanding as to why people behave in such a way.
Useful strategies are suggested: gain access and remain part of a team by gaining the support of peers to isolate the bully, educating oneself about anti–bullying methods, identifying corporate policies such as formal reporting procedures and, importantly, non–sensitively evaluating the facts objectively. In addition, avoiding potentially troublesome situations, yet not hiding or running away and so encouraging the bully; not retaliating or trying to justify doing so, but instead responding firmly and assertively. Elsewhere the importance of not reacting to potential conflict – or “first striking” is stressed to avoid triggering aggression initially.
A whole chapter is devoted to Theory of Mind. Among the points relating to management here include: interpretation of the physical, rather than, the social world; disrespect towards others; the higher levels of honesty and social justice demonstrated by a manager with AS which can conflict with the prevailing organisational culture, line manager or colleagues’ views.
The importance of empathy and understanding the perspective of others in relation to conflict is re–emphasised in this section, along with weaker repair mechanisms and unwillingness/difficulty in forgiving and forgetting. The ability of emotion to exacerbate difficulties when in pressurised situations is alluded to along with the benefit of practising responses outside of a work context.
The emotional tendency of someone with AS to respond fast and impulsively and press the panic button too quickly which negatively affects people around them is well described, along with the need to be subtle when responding – an invaluable tool from a business perspective and one which can be hugely advantageous for a manager with AS faced with pressurised scenarios.
Definitive advice about solutions is relatively sparse, though this may be a reflection of the lack of development that has been undertaken in the filed in general. CBT is the key ameliorative tool suggested and is strongly advocated.
Central to its use is the need of becoming consciously aware of one’s emotional state and how to respond positively to it. Identifying and evaluating the connection between emotion and thoughts can greatly enhance positive behaviour in specific situations and enable control to be assumed.
Cognitive re–structuring is outlines as being important in correcting distorted conceptualizations and dysfunctional beliefs to manage emotions and repair mechanisms are suggested: identifying the cues that spark the emotive reaction, i.e. provocative verbiage, considering alternative viewpoints, putting things in perspective – “if you remain calm, you remain smart”. Identifying appropriate responses to specific situations is beneficial advice as is getting an honest person to act as a broker, and taking a break from stressful situations and then returning once a greater degree of inner equilibrium psychologically has been achieved.
The value of a special interest to provide knowledge that is of benefits in a business context is emphasised, along with the tendency to focus on detail, as opposed to, the wider picture – or Weak Central Coherence retreats into one’s own world should be managed and limited. An important message emanating from these two facets is the importance managerially of evaluating and gaining a thorough understanding of the wider picture and all related information to perform effectively.
The section however also highlights the importance of ensuring that a specific interest is continually referred to so as to avoid instigating antipathy from others so helping to promote social inclusion. Related to this is the need, when a point is new, and outside a verbal script, that conversation is concise to enable conversational flow to promulgate and retain interest among colleagues.
This point revolves around language, a subject that is discussed extensively; in particular, difficulties relating to the interpretation, recall and execution of increasingly complex oral directions. This is especially so when placed in stressful situations which mean that speed of language processing can be intense and counterproductive.
The need to moderate language according to social context is emphasised to achieve a “balanced conversation” – incorporating the knowledge, interests and intentions of the other person, along with social conventions that determine what to say and how, and to listen attentively.
Other barriers include the tendency for big pauses between responses, interrupting, switching subject matter and, also, starting, maintaining and finishing – not “switch off” – until the [prescribed] script is finished.
The section provides more useful ameliorative tips than others. Repair mechanisms suggested include not asking for clarification; ensuring that irrelevant comments do not intrude into the conversation and; making statements in an over critical fashion and omitting key information. Practicing role playing in a supportive environment; developing exit conversational strategies; and identifying relevant cues to end conversations are all suggested.
Perhaps the most insightful and beneficial chapter from the perspective of a manager with Asperger is on Cognition (Learning) which starts with the statistic that 1 in 5 children are “visualizers” and that learning is undertaken by observation.
The chapter starts with the observation that there is relative delay in acquiring a [particular] ability due to difficulty understanding a concept. From a personal perspective, this is highly pertinent.
Environment – of the business context – plays a key role here. For someone with AS, limitations in the executive function – organising resources and knowledge, planning and prioritizing within a specified time frame – can be a hindrance.
How the relative inability to attend impacts is also highlighted. 75% of children are quoted as having a learning profile which incorporates ADHD and how attention levels will vary according to motivation. If the subject matter is of interest, learning will be effective. Breaking assignments down into small units to accommodate attention spans is suggested to minimise environmental disruptions so as to facilitate attention and learning.
The impaired executive function is said to hinder appropriate responses to situations due to insufficient thought to context, consequences and past experience. The points highlight the important need to conspicuously work to incorporate and address these factors, along with the efforts to reduce inflexibility with regard to problem solving by developing the skill to seek alternatives.
Different aspects of learning are also explored and how learning in general may be immature. In primary school for example, history involves learning facts; by middle school it is about discerning insight, comparing perspectives and interpretations, the latter all being invaluable techniques in management.
Shortcomings in the latter area can lead to problems appear with the planning of work going forward: “potholes down the road are not seen” and how this can mean a feeling of drowning in tasks without appropriate support. As a result distress may occur where there is insufficient time to mentally rehearse or prepare for change. Allocating time to self–reflect on a task by having a mental conversation to solve a problem is advocated as one solution.
The above issues are all thought to contribute to the AS “my way” approach to problem solving being implemented and which can present real obstacles for an AS manager. Wanting to be a perfectionist leads to fear of making mistakes and not taking on tasks unless they can be done perfectly. Refusing to accept being wrong leads others perceiving arrogance and the offering of any advice being perceived as criticism. Conversely, there is the tendency to point out errors in other people which leads to the breaking social conventions.
All of these points bear relevance for me. By cognitively adjusting one’s approach in the above areas – actively seeking alternative approaches to problems and considering alternative solutions – can not only I believe lead to more effective decision–making but also smooth significantly relations with others.
Another point that resonated was the suddenness of learning achievements. I have always found that it takes longer to learn certain concepts and techniques than others. Something that seemingly cannot be learnt for ages suddenly just clicks.
This point emphasises for me personally the need for, and benefit of, perseverance. The right answer can be identified and the solution implemented over time. Providing the task is adhered to and completed.
Related to this is the problem of translating the mental processes into speech to identify solutions. I have found that often I “know” the solution in my head, but cannot translate this into an effective external communication. No solutions are suggested, though personally I have found building the answer spatially beneficial.
Other cognitive factors explored include monotropism. Large areas of potential information are not cognitively registered leading to narrow focus of attention and a fragmented view of any given situation meaning that limited, isolated factors only are learnt.
This again emphasises the need to look and assimilate the wider picture. Normal children will take complex information, put it into a coherent framework and process if at a deeper level to identify a coherent, central theme. People with AS take longer suggesting that perseverance with any management task is required.
Suggested strategies that will provide support include learning in quiet places to avoid perceptual overload and the identification and use of supportive peers, along with accessing specialist advice and training. A supportive teacher in particular is hugely advantageous as other people don’t have the required approach or mindset. According to Hans Asperger, “mere teaching efficiency is not enough”.
Among other topics explored are employment, long–term relationships and psychotherapy all of which offer beneficial insight.
With employment the pre–disposition and importance of taking advantage of the predestination for a particular profession is emphasised – work grows naturally out of special abilities. Interestingly though the point that “there is no career that is impossible for a person with AS” is made which provides important encouragement.
Proper preparation for a new role, the loyalty of ones’ line manager and having the correct support when initially starting in a role and new organisation are all re–emphasised, along with the need to develop a positive attitude and securing the time to enable both parties to adjust to achieve long term successful employment.
Long Term Relationships
A final chapter looks at long–term relationships. Though focusing largely on social and intimate factors, the section does extend to, and offer invaluable advice, in a business context.
How the characteristics of Asperger syndrome can impact on partners leading them to feel emotionally exhausted and neglected is a lesson well worth assimilating to and taking on board. The point about how a relationship may be fine for a person with AS but who, in turn, may not fully understand the needs of the other person is highly relevant in relation to the management of both superiors and sub–ordinates.
Among the criteria suggested for building successful relationships, and which are every bit as applicable to business, are ensuring that:
* Both parties understand AS;
* Motivation to change and learn;
* Willingness to implement suggested changes.
Basically it is about building emotional support and how a person with AS needs reassurance but does not naturally afford it to others; how they can easily criticise but not compliment and; why there is a need to show interest in the emotional concerns/needs of others.
The final point perhaps highlights one of the key issues inherent within Asperger syndrome, the successful resolution of which, can genuinely improve the performance of an AS manager – building empathy with others.
Though written for people with Asperger in general, the book’s main points are extendable and highly pertinent to management. Highly recommended.