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Dear Dr. Yael,

I am writing to you today about people with Asperger syndrome and the necessity for them to learn how to communicate. It is an essential life tool and especially important if they want to marry.

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Asperger’s is on the autism spectrum and is a social and communicative disorder. The acquisition and mastering of financial and job skills by people with this disorder is sometimes trying. Put marriage and kids into the mix, and those who can’t even master social and verbal skills are pushing it.

One of the hardest things is figuring out how to give people who suffer from Asperger’s what they need, as all too often parents hide their child’s difficulties out of shame. Often it takes a lot of intervention and collaborative effort between parents and educators to help these children.

What could be helpful is a curriculum that the students should follow. People with Asperger’s need intense therapy and lessons in developing social and verbal skills which include: 1. Communication in expressing needs. 2. Relating to people. 3. Expressing ideas in a communicative way. 4. Dating and life sharing.

Life skills must be fully developed for a successful marriage, yet because Asperger’s inhibits speech and communication, some of these marriages are on shaky ground from the get-go.

I hope this column helps parents realize that their children can overcome their social difficulties with intervention and that they help them in that goal so they can become more functional adults.

A Reader

 

Dear Reader,

Asperger syndrome is a previously used diagnosis, which now falls under the umbrella diagnosis of Autism Spectrum Disorder (ASD). Below is a description of the syndrome from the Autism Speaks website:

“Typical to strong verbal language skills and intellectual ability distinguish Asperger syndrome from other forms of autism.

It generally involves: Difficulty with social interactions; Restricted interests; Desire for sameness; Distinctive strengths.

Strengths can include: Remarkable focus and persistence; Aptitude for recognizing patterns; Attention to detail.

Challenges can include: Hypersensitivities (to lights, sounds, tastes, etc.); Difficulty with the give and take of conversation; Difficulty with nonverbal conversation skills (distance, loudness, tone, etc.); Uncoordinated movements or clumsiness; Anxiety and depression.

The tendencies described above vary widely among people. Many learn to overcome their challenges by building on their strengths.”

There is a large variation of what someone with Asperger syndrome struggles with. Many are very functional and can work and maintain adult relationships. That being said, there are some individuals who would have benefited from more intensive services when they were younger to help build their social skills. However, for many years there were no services for these children. Asperger syndrome was only added to the DSM in 1994, though it was identified earlier. Intensive interventions for Autism are fairly new, so it’s difficult to ascertain if today’s adults would have benefited in their youth.

You are correct that children on the autism spectrum can benefit from many interventions such as Cognitive Behavior Therapy (CBT) to target anxiety and other personal issues that may arise; Social Skills Training to help improve conversational skills and the understanding of social cues; Speech Therapy to help with speech development in lower functioning individuals and voice modulation in higher functioning individuals; Physical and Occupational Therapy to help with low tone or coordination difficulties, and psychotropic medication to manage any comorbid issues (if there are any) such as anxiety, depression, Obsessive Compulsive Disorder (OCD) and Attention Deficit Hyperactivity Disorder (ADHD).

Additionally, we agree that if someone with Asperger syndrome (more correctly, someone who is on the Autism Spectrum) marries someone who is not on the spectrum, there can be difficulties. It would be essential to have a professional assist in understanding how the relationship is being affected. This can help relieve the blame, frustration, shame, pain and confusion felt by one or both partners.

Accepting the diagnosis is the second step and is integral to helping the couple make the relationship work. Additionally, it’s imperative to understand that ASD is a biologically-based, neurological difference and not a psychological mental disorder. It’s also very important to piece apart which challenges are due to the ASD and which are general marriage difficulties. Due to its complex nature, learning about ASD is a lifelong journey.

All of this can only be done once we have ascertained if either partner is suffering from any mental health issues. If yes, they need to be diagnosed appropriately and treated with medication (if needed) and therapy. People with ASD are at an increased risk for depression, anxiety, OCD, and ADHD, so diagnosis and treatment are key to successful marriages.

It is also very important for the partner who is not on the spectrum to understand why he/she chose to be in a relationship with someone who is. Many people in this situation are “managers” or “rescuers” with a need to take care of others. Learning the role one plays in the relationship and how to change is helpful in solving relationship difficulties. Planning time to be together, talk, and date is integral when in a relationship with someone with ASD as schedules will minimize the ASD partner’s tendency to get self-involved or engrossed with work/special interests.

Lastly, as you mentioned, improving communication is crucial. Someone with ASD may have trouble predicting, understanding, and responding to a partner’s feelings and may also unintentionally say or do things that can come across as insensitive or hurtful. He or she may also have a hard time picking up on facial cues, body language, and vocal intonations. Scheduling time for daily conversation can be helpful.

In every marriage, managing your expectations can be extremely useful. In a “mixed” marriage, that is even truer. A professional counselor can help both parties interpret misunderstandings and implement strategies to improve their relationship. Hatzlocha!

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Dr. Yael Respler is a psychotherapist in private practice who provides marital, dating and family counseling. Dr. Respler also deals with problems relating to marital intimacy. Letters may be emailed to deardryael@aol.com. To schedule an appointment, please call 917-751-4887. Dr. Orit Respler-Herman, a child psychologist, co-authors this column and is now in private practice providing complete pychological evaluations as well as child and adolescent therapy. She can be reached at 917-679-1612. Previous columns can be viewed at www.jewishpress.com and archives of Dr. Respler’s radio shows can be found at www.dryaelrespler.com.