ADHD and Asperger Syndrome in Smart Kids and Adults

Twelve Stories of Struggle, Support, and Treatment

Thomas E. Brown

• Publisher: Routledge
• Year: 2021
• ISBN:
  9781000416138
• Edition: 1
• Topic: Psychologie
• Subtopic: Aufmerksamkeitsdefizitsyndrom (ADS-ADHS)

ADHD and Asperger Syndrome in Smart Kids and Adults offers detailed examples of individuals who have above-average cognitive intelligence, but struggle with executive function impairments of ADHD and significant social-emotional impairments of Asperger syndrome.

The book centers around twelve case studies of bright children, teens, and adults treated for both ADHD and Asperger syndrome. Each chapter describes diverse examples of their strengths and their difficulties and explains how these individuals can be helped with appropriate treatment to overcome their ADHD impairments and to improve their ability to understand and interact more effectively with others. Case examples are followed by updated, science-based descriptions of these disorders.

Providing science-based information about ADHD and Asperger syndrome in clearly understandable, accessible language, this text is ideal for clinicians, educators, social workers, medical and mental health service providers, and parents of those struggling with such impairments. It alsoadvocates for restoring the diagnosis of Asperger Syndrome to diagnostic manuals of the American Psychiatric Association and World Health Organization.

Part I

Starting Points and Potential Destinations

DOI: 10.4324/9781003141976-2

1 Smart Adults with Late-Recognized Asperger Syndrome and Success

DOI: 10.4324/9781003141976-3

In this chapter are excerpts from autobiographical writings by four very successful adults with social-emotional impairments (Asperger syndrome), which offer examples of their strengths and difficulties. Although none of these four writers was identified previous to their adult years as having ADHD, each includes in their writings clear examples of difficulties that make it likely that they have had ADHD as well as Asperger syndrome.

One autobiographical description of growing up smart with Asperger syndrome has been provided by Tim Page who, despite dropping out of school after seventh grade, became a Pulitzer Prize-winning writer who eventually served as chief music critic for the Washington Post. He is currently a professor of journalism at the University of Southern California. In his Parallel Play: Growing Up with Undiagnosed Aspergers, Page wrote of his difficulties interacting with peers:

my life has been spent in a perpetual state of parallel play, alongside, but distinctly apart from the rest of humanity … I could establish no connection with most of my classmates … [later] I learned that there were others like me—people who yearned for steady routines, repeated patterns … and a few cherished subjects.

(Page, 2009, pp. 3–5)

In spite of scoring in the top 2% for his age on an IQ test, in his earlier school years Page had chronic difficulty in sustaining attention and focus for most of his schoolwork. He reported that

If I wasn’t deeply interested in a subject, I couldn’t concentrate on it at all … Late in each quarter, when it became obvious to me that I had no clue to what I was supposed to have learned, I’d attend some makeup sessions and try desperately to pay attention … My grades only worsened as teachers expected more of me … The school was perplexed by my behavior, for it was increasingly obvious that I was not “normal” … I lagged consistently at or near that bottom of the class, decidedly out of control—either asleep or aggressively assertive—much of the time. Grade seven was the last one I was able to complete.

(Page, 2009, pp. 37, 38, 56)

Yet despite his continuing difficulty with most of his schoolwork, Page demonstrated extraordinary talents in some fields which held great interest for him. “I took to the piano naturally and joyfully, and was composing before I formally knew how” (Page, 2009, p. 39). He felt repulsed by popular music of those days, but he read all the opera books in the local university library and became fully familiar with classical and contemporary music as well as the history of silent film. During his early teens Page also developed interest in making home movies, one of which gained some recognition on a national level.

In his mid to late teens, Page found some friends who shared his interest in music. With them he became increasingly involved in a protracted period of excessive drinking and using marijuana. During that time he also experienced episodes of acute anxiety and deep depression. This exacerbated after he was involved in a tragic motor vehicle accident in which two of his friends were killed. In his late teens Page resumed his education and eventually graduated from Columbia University

It was not until midlife that Page learned that he had Asperger syndrome. He wrote of the surprise and relief he felt when he first received that diagnosis and read a book that described it:

I felt as though I had stumbled upon my secret biography. Here it all was—the computer-like retention, the physical awkwardness, the difficulties with peers and lovers, the need for routine and repetition, the narrow, specialized interests—I was forty-five years old when I learned that I wasn’t alone.

(Page, 2009, p.178)

Another autobiographical account was provided by Temple Grandin in her book Thinking in Pictures: My Life with Autism. Grandin describes herself as having the symptoms of classic autism when she was two years old: no speech, poor eye contact, tantrums, appearance of deafness, no interest in people, and constantly staring off into space. Yet, she noted that as an adult she would probably be diagnosed as having Asperger Syndrome (Grandin, 2006, p. 49). She provides a good example of how level of impairment in persons with autistic characteristics can improve considerably over the course of development.

Grandin described high school as “the worst time of my life … High functioning teenagers on the spectrum often get bullied in high school … I was kicked out of a large girls’ high school after I threw a book at a girl who teased me” (Grandin, 2006, p. 120). In her autobiography Grandin notes the role of her mother and various teachers and other mentors in helping her develop her impressive potential:

It was Mr. Carlock, one of my science teachers, who became my most important mentor in high school. After I was thrown out of regular high school, my parents enrolled me in a small boarding school for gifted students with emotional problems. Even though I scored 137 (99th percentile) on the Wechsler IQ test when I was twelve, I was totally bored with schoolwork and I continued to get lousy grades … but Mr. Carlock took my interests as motivators for doing schoolwork … I have observed that high-functioning autistic individuals who become successful have two important factors in their lives: mentoring and the development of talents.

( Grandin, 2006, pp. 104, 116)

When she arrived at Arizona State University, Grandin struggled to learn the rules and expectations in the university community. “College was a confusing place, and I strove to use visual analogies to understand the rules of collegiate society.”

For people with autism, rules are very important, because we concentrate intensely on how things are done … Since I don’t have any social intuition, I rely on pure logic, like an expert computer program, to guide my behavior. It is a complex algorithmic decision- making tree. There is a process of using my intellect and logical decision-making for every social decision. Emotion does not guide my decision; it is pure computing.

(Grandin, 2006, p. 108)

Ultimately, Grandin was quite successful at Arizona State University; she went on to earn a bachelor’s degree in psychology and a master’s degree in animal science. Her specialty was studying the behavior of cattle in feedlots as they were put through various types of cattle chutes. She designed widely used equipment to manage them more humanely. Despite her occupational success, Grandin struggled with increasing anxiety, often accompanied by bouts of colitis or severe headaches. She wrote that her nervous system was constantly under stress. “I was like a frightened animal, and every little thing triggered a fear reaction … In my late twenties, these severe attacks became more and more frequent” (Grandin, 2006, p. 124). In 1981 Grandin found medication that helped to alleviate her chronic anxiety.

My body was no longer in a state of hyperarousal. Before taking the drug, I had been in a constant state of physiological alertness, as if ready to flee a non-existent predator … Taking the medication is like adjusting the idle adjustment screw on an old-fashioned automobile engine. Before I took it, my engine was racing all the time, doing so many revolutions per minute that it was tearing itself up. Now my nervous system is running at 55 mph instead of 200 mph, as it used to … about half of high functioning autistic adults have severe anxiety and panic … Today there are many new drug treatments can be really helpful to people with autism … Unfortunately, many medical professionals do not know how to prescribe them properly … people with autism often require lower doses of anti-depressants than nonautistic people.

(Grandin, 2006, pp. 126, 128, 130)

A third autobiographical account of growing up smart with Asperger syndrome comes from Cynthia Kim, author of Nerdy, Shy and Socially Inappropriate: A User Guide to an Asperger Life. She reports that she did not know she had Asperger syndrome until she was 40 years old. She came to know about this syndrome from hearing a radio program about it. As she listened, she recognized aspects of herself which, despite her successes, had been problematic for her since childhood.

I grew up in an era when my diagnosis—Asperger’s syndrome—didn’t yet exist. Kids like me were labeled nerdy, shy, or gifted. Year after year I brought home report cards that said I didn’t work and play well with others, didn’t participate in class. Because I was quiet and did well academically, the adults in my life attributed my difficulties to extreme shyness and timidity … [now] on the face of it, I’m a typical suburban middle-aged woman. I’m happily married, a successful small business owner, and proud mom of a terrific young woman … [yet] I have all of the telltale signs of Asperger’s: poor social skills, communication difficulties, sensory sensitivities, a deep love of routines, lots of subtle stims, the working memory of a goldfish … the list is long and varied.

(Kim, 2015, pp. 13–14)

Kim describes her growing up as a time of considerable social isolation:

I was definitely different from my peers. For one thing, I spent hours alone. Some of my happiest memories are of long bike rides around my rural neighborhood, exploring in the woods, and playing games in my room, all by myself. I remember quite a few fiercely contested games of Risk and Monopoly that pitted me against myself …

She’s just shy! I heard that phrase over and over again. If I didn’t participate in discussions in school, it was because I was shy. If I sat on the sidelines at a birthday party or went off to read in an empty bedroom, it was because I was shy. If I didn’t want to be in the school play or I didn’t have many friends—all part of my shyness. I was a good girl. I didn’t make waves.

(Kim, 2015, pp. 20–23)

However, Kim also described herself as repeatedly teased or bullied in elementary school. She reported that she often felt like an antelope surrounded by a pack of hungry lions coming to attack her:

When you’re a kid who has little idea how social group dynamics work, it’s easy to feel like the whole world is out to get you. For years I put up with the bullying because I didn’t know how to stop it.

One day, when one of the mean girls in the neighborhood said something nasty to me, I said something nasty right back … And it worked … After a few nasty exchanges we became something like friends … I found frenemies—developing relationships with other girls that thrived on getting along one day and cutting each other to shreds with insults the next. Soon all my friends were other mean girls … When we got bored with harassing each other, we went looking for easy targets … kids who were loners and outcasts. Kids who stand out because of their looks. Kids who don’t have allies to defend them. It’s easy to spot a victim when you’ve been one yourself.

(Kim, 2015, p. 27)

In describing her years in elementary school, Kim observes:

For kids who are developmentally disabled but intellectually gifted, expecting them to get by on intelligence alone is the equivalent of throwing them in the deep end of the pool without teaching them to swim first. It’s leaving them to drown—emotionally and mentally—all the while telling them how smart they are.

(Kim, 2015, p. 32)

Kim reported that in high school she found interests she could pursue together with people who did not tease or bully her:

The other mean girls drifted away one ...