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With Asperger’s syndrome, ‘violence is not something we expect,’ expert says

REUTERS/Lucas Jackson
In the wake of the Newtown tragedy some news outlets have suggested shooter Adam Lanza may have been diagnosed with Asperger's syndrome, but experts are clear that there is no evidence that people with the disorder are more likely to commit a violent crime than those without it.

In the media scramble to gather information about Adam Lanza, the shooter in last week’s Sandy Hook Elementary School tragedy, some news outlets have suggested that the 20-year-old may have been diagnosed with Asperger’s syndrome, a developmental disorder sometimes referred to as “high-functioning autism.”

Whether or not Lanza had received such a diagnosis (and it is all speculation at this point), experts who work closely with the autism community want to make one thing clear: Violent behavior is not a symptom of autism. There is no evidence that people with the disorder are more likely to commit a violent crime than those without it. In fact, people with autism are more likely to be the victims of a crime.

To learn more about Asperger’s syndrome and autism, MinnPost talked with Pat Pulice, director of the Minnesota-based Fraser Center of Autism Excellence. An edited transcript of the conversation follows.

Pat Pulice
Pat Pulice

MinnPost: What is Asperger’s syndrome?

Pat Pulice: Asperger’s is a neurodevelopmental disorder of unknown cause. The disorder describes a constellation of characteristics where the child or adult has challenges in social interactions and with repetitive and stereotyping behavior patterns.

MP: How is it related to autism?

PP: Asperger’s is part of the autism spectrum disorders. We diagnose it using the DSM-4 [Diagnostic and Statistical Manual of Mental Disorders, 4th edition]. It’s a subtype of what we would call the pervasive development disorders. There are five different types: Autism is one. Asperger’s is one. PDD-NOS [pervasive development disorder not otherwise specified] is one. [The other two are Rett syndrome and childhood disintegrative disorder.] They are related in that they have similar characteristics. But the number, intensity and pattern of the characteristics are different among those subtypes.

MP: Does Asperger’s sometimes overlap with other disorders?

PP: You can have other [health issues] as well, both physical and mental-health ones. You could have high-activity or mood regulation [issues], for example. You could have a whole host of things of things in addition to Asperger’s.

MP: Are people with Asperger’s violent?

PP: We don’t expect violence, and the research does not suggest a causal link. So we would not expect that to be part of the picture. Asperger’s really describes a way of processing, a way of understanding and thinking and relating about things. So violence is not something we expect to be part of the picture. It would be something separate.

MP: Do we know what causes autism?

PP: No, we really don’t. And when we look at the wide range of people who demonstrate characteristics of autism, they can look very, very different. Many people say that if you know one person with Asperger’s or one person with autism, you know only one person. The speculation is that it’s a combination of things that contribute to a path that leads to a diagnosis of autism.

MP: But it is not caused by parenting, correct?

PP: Yes. Thanks for clarifying that. There was a time in history when we talked about “refrigerator parents.” That is very much refuted. Parenting does not cause Asperger’s or autism spectrum disorders.

MP: How is Asperger’s treated?

PP: It’s treated by looking at the behavioral issues that are getting in the way of day-to-day functioning. There’s a whole host of behavioral interventions. There are family interventions to support ways to parent, to help provide structure. There are school interventions to look at some of the social and academic issues that may occur in those environments. Much of what we do with people with Asperger’s disorder is to structure the environment or work with the behaviors using cognitive behavioral therapy to address any issues that arise.

MP: How does having a child with Asperger’s affect families?

PP: In a wide variety of ways. It’s difficult enough to understand what a child’s needs are and then come up with ways to successfully promote the child’s development. But when you have a child who does something different and for whom textbook strategies don’t really work, it can cause some stress, not only on parents, but also on siblings. Most families [with a child with Asperger’s] are able to get support services to better understand what’s going to be helpful. They can then create those positive paths and productive interactions. We see a lot of change once families understand how their child is processing information.

MP: Are we making any progress in developing better treatments or even a possible cure?

PP: There is certainly a lot of research going on, and we are definitely making progress in understanding how the characteristics of Asperger’s and autism are impacting day-to-day living. Some of the families who come through our doors are at their wits’ end and very challenged by dealing with their child’s behaviors or learning or relationships. With support and intervention, they are able to turn things around. The goal is to get people with Asperger’s to function at their maximum potential. Many of them have an area of expertise that is far above what you or I might know. If we can channel that into a productive interest or career, these people can really do some wonderful things.

MP: What more needs to be done on a societal level to help people with Asperger’s and their families?

PP: We need [for our communities] to have a basic understanding about the diversity and strengths of people with this disorder. We need to think outside the box about how to arrange employment or school services or social activities. We need to think of alternate ways to get them involved and keep them engaged. For once they’re involved and engaged, they can be highly successful.

MP: You mention the DSM-4. That’s just gone through a controversial rewriting, and a new edition, the DSM-5, is scheduled to come out next year. Autism, Asperger’s and PDD-NOS are going to be replaced by the single umbrella term “autism spectrum disorder.” How will that change affect services for people with Asperger’s and their families?

PP: There is going to be some adjustment. This is the third time we’ve seen autism spectrum in the manual since 1980. We’ve gone through changes before. The initial definition was very broad. In 1994, it became more specific. And now, in 2013, it’s going to get broad again. There’s been a lot of public conversation about this, and I think that’s great. We need to figure out how this is going to work not only for professionals, but also for families. I think the broad definition, as we’ve looked at it, captures many of our clients who are coming through our doors and needing services. Those [whose cases] are complex and who fall into a kind of grey area will continue to be there, too. But if there’s a family needing help and support, we believe that there’s going to be some way to work with those families and continue to get them services.

It’s important to note that the DSM change will not interfere with school eligibility criteria, at least in Minnesota. We have separate criteria that are actually based on a previous manual, the DSM-3. We expect kids to continue to get services despite the DSM change.

MP: How are the families you serve reacting to the speculative reports that Adam Lanza had Asperger’s?

PP: I think people are mostly focused on the issues of keeping our children safe and of making sure that families get what they need. There has certainly been a lot of speculation in the community. I think anytime we’re hit with a horrific incident, we want to try to understand what caused it. We want to know details so we can prevent and control those issues.

The story does impact public perception, of course. But this is an opportunity for all of us to educate and talk about the facts about developmental disorders and child development in a way that is proactive.

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