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Adults with ASD: What Other Family Members Need To Know

ASD level 1 (high functioning autism) is typically first diagnosed in children. In contrast to those with ASD level 3, people at level 1 acquire language skills normally, develop appropriately in cognitive abilities, and tend to have higher-than-average verbal skills. The most significant feature of ASD is the inability to interact appropriately on a social basis. If untreated, many difficulties continue into adulthood.

Eccentric people have always existed, but ASD isn't always recognized as a possible cause of strange adult behavior. ASD level 1, one of the neurological disorders on the autism spectrum, can be mild, causing only somewhat unusual behavior - or severe, causing an inability to function in society without some assistance (e.g., from a neurotypical spouse). Adults with ASD, like kids with the disorder, have trouble deciphering the normal rules of society, which impacts their home, work and social lives.

Grown-ups on the autism spectrum have high intellectual functioning, but diminished social abilities. An adult on the spectrum may:
  • appear clumsy
  • follow repetitive routines
  • have limited or unusual interests
  • lack social skills
  • lack the ability to read non-verbal cues
  • seem egocentric
  • use peculiar speech and language

Typical adult symptoms include:
  • "black and white" thinking
  • a tendency to be "in their own world"
  • appear overly concerned with their own agenda
  • difficulty managing appropriate social conduct
  • difficulty regulating emotions
  • follow strict routines
  • great musical ability
  • highly focused in specific fields of interest often to the exclusion of other pursuits
  • inability to empathize
  • inability to understand other perspectives
  • intense interest in one or two subjects
  • outstanding memory

Let’s go into greater detail regarding ASD in adults:

1. Assessment—ASD is a clinical diagnosis versus medical. Neurological and organic causes remain mostly unknown. Psychological interviewing that includes medical, psychiatric and childhood history contributes to an ASD diagnosis, which may coexist with other mood and behavior disorders.

2. Behavior— Grown-ups on the spectrum usually prefer structured lives with well-defined routines and may become agitated or upset when these routines are broken. If, for example, your spouse normally eats breakfast at 9 a.m. and becomes stressed out when asked to eat at an earlier time, this may be indicative of ASD. Unlike adults with level 3 autism, however, an individual at level 1 will probably be able to keep his frustration in check. 
 
Grown-ups with ASD may also be reluctant to initiate conversation and require prodding to talk to you at all, especially if that individual is already engaged in a favored activity when you try to initiate conversation. Eye contact may be rare. An individual with ASD may have obsessive tendencies that manifest in such ways as insisting all of his books be lined up in a certain order on the shelf or that the clothes in his closet are categorized by color, style or season. Reliance on routine, obsession with categories and patterns and limited conversation are all symptoms of ASD that may be observed at home.

3. Cognitive Symptoms— While grown-ups with ASD are often of above-average intelligence, they may process information more slowly than normal, making it difficult to participate in discussions or activities that require quick thinking. These individuals may have trouble with organization and seeing the "big picture," often focusing on one aspect of a project or task. Most are rigid and inflexible, making transitions of any type difficult.
 

4. Common Careers— Adults on the spectrum have sophisticated skills in certain areas, such as those dealing with numbers or art. Most often, these skills do not exist together. Careers that do not rely on short-term memory are better suited for an individual on the spectrum. Appropriate careers include computer and video game design, drafting, commercial art, photography, mechanic, appliance repair, handcraft artisan, engineering and journalism.

5. Communication— Grown-ups with ASD may demonstrate unusual non-verbal communication, such as lack of eye contact, limited facial expressions or awkward body posturing. They may speak in a voice that is monotonous or flat. They may engage in one-sided conversations without regard to whether anyone is listening to them. They are often of high intelligence and may specialize in one area or interest. This leads to a lack of interest in alternate topics and the unwillingness to listen when others are speaking. 
 
Such poor communication skills can lead to problems finding a job or interacting effectively in a workplace environment. Grown-ups with ASD often communicate poorly with others. Many talk incessantly, often about topics that others have no interest in. Their thought patterns may be scattered and difficult to follow and never come to a point. Speech patterns may have a strange cadence or lack the proper inflections. An individual on the spectrum may have difficulty understanding humor and may take what's said too literally.

6. Diagnosis— Most grown-ups with ASD are able to live relatively normal lives. They are often regarded as shy, reserved or even snobbish by others. As these are not considered abnormal behaviors, a real diagnosis may come late in life, or not at all. You can get a more accurate picture of whether your partner has ASD by talking to the people who know him, such as co-workers, college professors, other relatives and friends (though an individual with ASD may have a very limited social circle). 
 
Ask whether your partner initiates conversation, if he seems awkward and unsure of himself during social interactions, and whether he has any strange behaviors his peers may have noticed. If the answers you get make you suspect ASD, you can encourage your partner to seek therapeutic attention to manage the condition better.

7. Emotional Symptoms— Unlike adults with autism level 3, people at level 1 want to fit in with others. Their social and work-related difficulties can cause anxiety, anger, low self-esteem, obsessive compulsive behaviors and depression. They may feel disconnected and distant from the rest of the world, a feeling called "wrong planet" syndrome.

8. Imagination— Grown-ups with ASD may be unable to think in abstract ways. They may be inflexible in their thinking, unable to imagine a different outcome to a given situation than the one they perceive. Such rigid thinking patterns may make predicting outcomes of situations difficult. These individuals may develop strict lifestyle routines and experience anxiety and distress if that routine is disrupted. To avoid such disruption, some adults may keep extensive written to-do lists or keep a mental checklist of their plans.

9. Physical Symptoms— Grown-ups with ASD are often physically awkward. Many have a peculiar walk, poor posture or general clumsiness or difficulty with physical tasks.
 

10. Preoccupations and Obsessions— One of the diagnostic criteria for ASD is an "encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus." A grown-up with the disorder may obsessively latch on to a single hobby or area of interest, often memorizing facts to the smallest detail. Some individuals are successful in their work environment because of their attention to detail and ability to retain information. An inability to be flexible or to deal with changes in routine is also a trait. An adult with the disorder may have difficulties in his home life, often demanding little or no change in routines or schedules.

11. Prognosis— ASD is a continuous and lifelong condition. Individuals on the spectrum should be able to function with the disorder with proper coping skills in place. Adapting their environment to their condition is especially critical. Finding a work environment that de-emphasizes social interactions may be appropriate. In addition, having a regular work routine and schedule may be beneficial. Interventions, such as social skills training, education and/or psychotherapy, may be necessary to better manage symptoms.

12. Relationships— Because grown-ups with ASD struggle to understand emotions in others, they miss subtle cues such as facial expression, eye contact and body language. As a result, an adult on the spectrum appears aloof, selfish or uncaring. Neurologically, adults with ASD are unable to understand other people's emotional states. They are usually surprised, upset and show remorse when informed of the hurtful or inappropriate effect of their actions. 
 
Affected adults show as much interest as others do in intimate relationships. However, most ASD adults lack the social or empathetic skills to effectively manage romantic relationships. An individual with the disorder behaves at younger developmental age in relationships. The subtleties of courtship are unfamiliar and sometimes inappropriate physical contact results.
 

13. Social Interaction— Grown-ups with ASD may have difficulty interacting in social groups. For example, they may choose inappropriate topics to discuss in a group setting or find making small talk difficult or even annoying. As they tend to be literal thinkers, they may have trouble understanding social metaphors, teasing or irony. They may lack empathy or find it hard to relate to other people. Some adults on the spectrum have anger management problems and may lash out in a social setting without regard to another's feelings. They may report feeling detached from the world and having trouble finding and maintaining relationships.

An individual with the disorder lacks the ability to display appropriate non-verbal behaviors, such as eye contact, facial expressions, body postures and gestures. He may have difficulties in initiating and maintaining friendships because of inappropriate social behaviors. He may appear rude or obnoxious to others and at times is left out of social encounters. Unlike adults with autism level 3, who withdraw from other people, adults level 1 often want to fit in but don't know how. The inability to "read" other people's social signals or to display empathy for other's problems leads to awkward social encounters.

14. Speech Patterns— Another feature of ASD is impaired speech. The individual with this disorder may speak in a monotone voice or may speak too loudly and out of place. He may interpret everyday phrases literally. The commonly used phrase "break a leg" will be taken literally to injure one's self. Subtle humor or sarcasm may not be understood or may be misinterpreted. Some individuals display highly developed vocabulary, often sounding overly formal and stilted.

15. Stereotypical Behavior— Grown-ups with this condition often are preoccupied with something to the extreme level. For example, if he likes football, that is all he will talk about--all the time and with everyone. These individuals are also often obsessed with parts of objects. 
 
On another note, they need routines to help them function. They do not like changes in routines, and find them difficult. Other stereotypical behavior in which they engage is body movements; they often flap their fingers, or make complex body movements (e.g., tics).





COMMENTS:

•    Anonymous said… Did you know your spouse had AS? In many of our cases we did not nor did they. It is a relatively new and ever expanding diagnosis and understanding and every case is slightly different. The things that drew me like a magnet to my husband were and still are the things that make him special. I am no slouch and at the time of meeting my husband I was dating several college young men and they pailed in comparison to his whit, intellect and attention to detail. I was also very glad he was not so stuck on himself like many of the people I was dating. he did not care if he wore the latest fashion, etc. I still am intrigued by his ability to comprehend complex thoughts and frankly living with a "normal" person must be quite boring. Marriage is a 2 way street but not every street has level surfaces and some roads have bumps and pot holes. I am not saying that life is easy living with a spouse with AS but it could be much worse. We have never been without a home, vehicles, jobs, or our needs met. He works hard to provide for his family and himself. He knows his limitations but also knows that he can try and make up for it in other ways. Keep researching and trying to find out if a life with your spouse is right for you. Not everyone can be the strong one or the one who has t take care of the finer details of life. But, be encouraged, at least you now know what is going on and can take whatever steps you both desire to achieve your outcome.
•    Anonymous said… Good luck. Keep trying. Pregnancy was not a big deal for my ASH either. On the good side, It was all about me smile emoticon And... I took care of the children by myself and in my younger years I was resentful but when we had our son I actually was thankful. My children have wonderful memories I made for them. We had bonding time that was ours and ours alone and that is okay by me. My ASH could not nurse the babies anyway, LOL. One good thing is they take things literally. You can say exactly what you need. If I want to celebrate a holiday, I say, "it is important to me to celebrate. I want,,," and say specifically what I want, go out to dinner, gift, party, etc. I had a significant birthday last year. I got exactly what I asked for, like a hand written love note at least 3 sentences. It was beautiful!
•    Anonymous said… I also feel like I'm nagging some, not as much as I used to. I finally got over having my house look a certain way. When I want it neat for more than a few minutes and get frustrated, I have to stop and think of all the things I love about him. We separated for about 9 months. It really helped us both see what was important, and he realized that making a habit of a few chores was important to me.
•    Anonymous said… I find that it is really helpful to communicate with my partner with AS via emails and texts especially about important things to do with our relationship but even about things that I need help with for our baby daughter and around the house. It allows him the emotional and mental space he needs to absorb the information and takes away the feelings of frustration that usually arise for me when I can't seem to get through to him.
•    Anonymous said… I simply can't imagine why anyone would knowingly marry into this. I felt conned. Bait and switch. Three years later and two kids later im so burnt out. All advice is for how the NT partner should walk on eggshells. This is BS. Marriage takes TWO. Where are the articles and advice for the work the aspie partner has to do?
•    Anonymous said… I think my biggest challenge is that my spouse needs constant reminding of what needs to be done. He is not the orderly type of AS, but a really messy one. He just does not notice what needs to be done, because it is not important to him. I do have to state what I feel is the obvious, like please take out the trash, because it really does not bother him if it's setting in his path and he has to walk over it or around it. The constant reminding, which I feel is nagging, gets really old to me. I feel like I am the only responsible one a lot, although less than I used to feel. On the other hand, my husband is very honest and communicative. He does not like tension between us, so he makes sure that we are good and I am not upset with him. We have been married for 21 years and he has matured greatly. I have to say that at the time I married him, AS was not a term, he was just quirky. My friends and family were slow to warm to him, and he to them, so sometimes that was uncomfortable for me, too. He is much more social than he used to be. He has more of a sensor now, so he doesn't blurt out intimate details of our life to everybody anymore, which is nice. He has really great friends and is a really great friend. If you are his friend, he will be your friend for life. He is maybe the most caring individual I have ever met. I have to say that our first 5 years were very trying at times, but I had to change my mindset that an argument wasn't about winning, but it was about understanding where the other person is at. I guess we have both really matured over these years. Now we are parenting two kids, one with AS and the other NT. I am so glad that he is my partner for this ride because he really gets our AS child and is such a great dad to both of our children.
•    Anonymous said… The AS realization came only about two months ago. It explains everything of the past three years. Truthfully, it has been terrible. He did enough at the beginning, and then switched off once I got pregnant. He's blowing off going to therapy of any kind. Thats what gets me most angry. He needs to try. And he should. What I liked about him at the beginning was like an illusion. He's not that person at all. Your words give a glimmer of hope though. Thank you again.
•    Anonymous said… The non AS partner does often reach the point of feeling lonely and neglected, without their partner noticing, which adds to the downward spiral. I am looking forward to hearing of any strategies that couples have found helpful in addressing this. On a positive note, this is a second marriage for both of us, and it has lasted longer than both previous relationships partly because we are aware of AS!
•    Anonymous said… This is so very new to me. I just found out my husband has aspergers and we just got married. I am really struggling with this. On one hand I am very glad I finally understand why I do not have this emotional connection with him but on the other hand I am a person who loves affection and I was just thinking if he could get some counceling from the abuse he had when he was a child then maybe I could get it and now I feel like I will never have it. Though my ex husband cheated on me left and right indo know for a fact my husband would never ever cheat so that is a relief. How did you deal w the loss of affection?

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