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|The Missing Piece|
The Missing Piece
Helping Asperger's clients find connection
by Richard Howlin
Looking disheveled and wearing shoes without socks, 25-year-old Steven is brought to their family session by his parents, who are deeply worried about his "his failure to launch." His father begins by describing him as a loner who's far more interested in computer games than people. Apparently, he hangs around his parents' house wearing the same T-shirt every day, staying up to the early hours watching his Three Stooges video collection. He's recently flunked out of college, doesn't have a single friend, has no plans for the future, and seems to have no sense of urgency or concern about his life. Diagnosed with AD/HD in school, he never really fit in socially as a child—he's always seemed odd to others, preferring to play alone.
For most of us, trying to get other people to like and care about us is an inherent psychological instinct that's hardwired. This isn't the case with people like Steven and others who suffer from Asperger's syndrome (AS). The world of social expectation has only a remote significance in Steven's life. This is readily visible in his dress and preference for his own company.
In typical referral cases in which AS is suspected, I meet first with the young adult or adolescent, and then have a session with the parents to assess their perspective and the student's history. In the individual session, I often raise issues that enable me to assess and motivate the client. In my first individual session with him, I ask Steven about his interests "Trains, and especially train timetables and routes," he says, suddenly coming to life. He begins asking me what I know about trains and what trains I've traveled on in Europe (I'm from England), talking now like an excited young child showing off a new toy.
Despite his animation, I sense that Steven isn't really interested in me or in having a real conversation. It seems more as though I'm a new opportunity for him to rant about his single passion in life and that I'm just a receptacle for an endless stream of information. As I sit and listen to him, I realize that, as with many AS clients, this is his idea of socializing and most likely the only form of social interaction he enjoys. This kind of monologue provides an excellent representative sample of the larger picture of AS. Language and intelligence are clearly evident as Steven continues his discussion on trains, and yet something fundamental is missing. It's as if his analytically dominant left brain is running amok; he's speed-processing digital facts, but is blind to the analogue nuances of social communication.