Lost in the Social World: How Social Cognitive Deficits Affect Social Functioning of People with Asperger Syndrome

Abstract

Were we to visualise autism spectrum disorders as a continuum, Asperger syndrome (AS) would be situated at one of its extremes. What appears to determine each individual’s position in this continuum is his or her symptomatology. In the case of AS symptomatology presents itself more discretely. According to Barthelemy (2000), the abovementioned symptomatology can be grouped in three major areas: a) difficulties in development of social interaction; b) difficulties in verbal and nonverbal communication; and c) presence of fixated interests, routines or rituals and repetitive behaviours. Being a developmental disorder, symptoms vary according to age. While some features tend to disappear with time, others only appear in a posterior stage of development and the changes can be spectacular (Frith, 2006). Citing Frith (2006, p. 16), “the autism affects the development, as well as the development affects autism”. Besides the variability on behaviour, there is also great diversity at a cognitive level, which can range from a medium or superior level of intelligence to profound mental retardation. Approximately 60% of autistic children present an Intelligence Quotient [IQ] under 50; 20% between 50 and 70 and 20% above 70 (Ritvo & Freeman, 1978). More recent data points to the presence of mental retardation in 75% of the cases (Barthelemy, 2000). The existence of a normal level of intelligence (IQ above 70) is the variable that distinguishes classic cases of autism from those considered as the “High Functioning Autism” or the person with AS. However, it is not yet clear if there are significant differences between “High Functioning Autism” and AS from the point of view of cognitive and behavioural profile. According to the working group that is preparing the fifth edition of DSM-V (American Psychiatric Association [APA], 2010), the current field of research reflects two views: 1) That AS is not substantially different from other forms of ‘high functioning’ autism; i.e. Asperger’s is the part of the autism spectrum with good formal language skills and good (at least verbal) IQ, noting that ‘high functioning’ autism is itself a vague term, with underspecification of the area of ‘high functioning’ (performance IQ, verbal IQ, adaptation or symptom severity); 2) That AS is distinct from other subgroups within the autism spectrum: e.g. Klin et al. (2005) suggest the lack of differentiating findings reflects the need for a more stringent approach, with a more nuanced view of onset patterns and early language.