Review – A Guide to Asperger Syndrome

A Guide to Asperger Syndrome – Christopher Gillberg

A Guide to Asperger Syndrome

This is an overall guide to Asperger Syndrome that seems to be predominantly aimed at professionals and parents. The book covers topics from the definitions of Aspergers Syndrome and the criteria as outlined in the DSMIV, ICD-10, and from Gillberg himself, through to attitudes, interventions and treatments, long term outcomes and brief case vignettes.

There’s a lot of information in this book, in fact the very first paragraph in the introduction taught me something I didn’t know:

Hans Asperger appears to have been unaware of the writings of Ewa Suchawera when he published his first paper on the condition that he referred to as ‘autistic psychopathy’ in 1944. Indeed, there is no indication that he ever learnt about the 1926 publication by the Russian neurology scientific assistant about a condition that she referred to as ‘schizoid personality of childhood’ (…) It seems clear that the two physicians were really describing the same phenomenon.

Gillberg talks at length about the various problems involved in diagnosis and, in particular, the diagnostic criteria. This includes pointing out that girls and women may have different presentations of symptoms (in particular Special Interests), and that motor skills should not necessarily be a criteria due to the uneven presentation of below average, average, and above average motor skills across people with Aspergers. He also points out that using the DSM-IV/ICD-10 can cause problems due to overlap of symptoms:

The ICD-10 and DSM-IV are also problematic in that only three symptoms (out of the total of eight listed items) are required for diagnosis. This means that, from the symptomatic point of view, very little is required for a diagnosis of disorder to be made. Some children with depression, conduct disorder, exaggerated shyness or selective mutism actually have ‘enough’ symptoms to fit the diagnostic symptom criteria for Asperger syndrome in these manuals.

The book (or rather the author) can be quite rigid and inflexible in the perception of Aspergers, and there are some sections that are bordering on inaccuracy through generalisation:

It is only when you get to know them in a more personal way that the typical Asperger personality will ‘let on’. Under the friendly, superficially unobtrusive surface resides a rigid, stiff, obsessional, greedy and, quite often, overvaluing attitude. They may be perceived as ‘obsessive-compulsive’ or ‘passive-aggressive’.

Which is obviously not a very flattering way of presenting Aspergers.There are dashes of these sorts of entries throughout the book, not enough to make the book completely off-putting but enough that I didn’t exactly rush to finish the book. I did find I kept putting this book aside (figuratively) to read other books and I think it was also in part due to the sheer amount of information covered in the 160ish pages of the book. Alongside the information is advice, which seems to be aimed primarily at professionals, although parents would benefit from the information too.

Gillberg also discusses areas like setting up support groups for Aspergers Syndrome and how the professional should be involved in it (minimally – but remaining available) and other options available to help treat conditions comorbid with Aspergers such as depression, anxiety and debilitating tics.

The penultimate chapter is a brief touch on the fact that a number of famous people have been posthumously diagnosed with autism/Aspergers, and Gillberg looks at Ludwig Wittgenstein in this regard, which is an interesting read. The book’s final chapter then looks at brief case vignettes of boys, girls, men and women of a variety of ages who presented to doctors and were diagnosed with Aspergers.

As I said, very information heavy and it is difficult to sit and read through it in one go. This is probably more of a read specific sections at a time book.

Is it worth reading? For professionals it would be worth a read, and parents might benefit from the information and advice. Some of the sections (like the one quoted) aren’t entirely accurate depictions of Aspergers, but there is a good chunk of decent information.

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