Aspergers: Friendship skllls
This article was published in the Jenison Autism Journal, 2002 Volume 14 Number 3. The Jenison Autism Journal is available in the USA from 616 457-8955.
When we observe and examine the social play and friendship skills of children with Asperger’s Syndrome, we first asses whether there is a delay in the conceptual stage of friendship. The child may have an overall intellectual ability within the normal range, but their conception of friendship resembles a much younger child. Indeed the natural choice of companion or friend may be someone from within their level of friendship maturity and be considerably younger than their chronological age. However, it is not simply a matter of developmental delay. While the diagnostic criteria in DSM IV, the primary diagnostic text, includes the criterion failure to develop peer relationships appropriate to development level it includes reference to a qualitative impairment in social interaction. Thus, there are aspects that are conspicuously unusual for any of the stages. The diagnostic criteria refer to qualitative impairments in behaviour to regulate the interaction and a lack of social or emotional reciprocity. What are qualitative differences at each stage from the perspective of the child with Asperger’s Syndrome and their peers?
Stage 1 The child with Asperger’s Syndrome can be genuinely pleased to be left alone enjoying solitude; or their preference can be to interact with adults. The author’s sister-in-law has Asperger’s Syndrome and she recalls that, “ ... as a child, a teenager, and a young adult, I seldom got along well with my peers, preferring the company of older adults. Probably because they are likely to be more mellow in temperament and of course quieter.” The child’s motivation may not be to engage in social play, but to learn. Adults (and books) provide information about the world. Their peers may have little knowledge on the topic that they find interesting.
There can be a difference in perception and priorities. The child with Asperger’s Syndrome can walk into a room and focus on the toys to play with rather than potential friends. Observation indicates that the child’s play is constructive, but not interactive. The child’s “friend” are objects. My sister-in-law recalls, “ ... it’s easy to bestow love onto objects rather than people because although they can’t love back they can’t rebuke either. It is very safe from idolisation where no-one can get hurt.”.
To the child with Asperger’s Syndrome social play, at this stage, can be quite unpleasant. They have difficulty coping with the noise, interruptions, new ideas of their peers and apparent chaos. They may be more tolerant and interactive in a room with just one playmate.
Children with Asperger’s Syndrome have a clear end product in mind when playing with toys, but may fail to effectively communicate this to the other child, or tolerate or incorporate their suggestions, which would produce an unanticipated outcome. The child with Asperger’s Syndrome wants predictability while their peers want spontaneity and variety. A description is perhaps the “Frank Sinatra approach“- My Way. The child becomes very agitated and possibly aggressive when thwarted by having to change their ideas or play to accommodate the intentions or preferences of the other child. Liane Holliday-Wiley explains in her autobiography, Pretending to be Normal (1999), “ ... the fun came from setting up and arranging things. Maybe this desire to organise things rather than play with things, is the reason I never had a great interest in my peers. They always wanted to use the things I had so carefully arranged. They would want to rearrange and redo. They did not let me control thee environment“(p. 19).
The child has a clear determination to control the activity. The concepts of sharing, waiting and turn taking are not apparent in their play with peers at this stage, but it may be apparent in their interactions with adults. Their play can be considered as self-centred rather than selfish, with social play avoided to maintain control. As one young lady said, “My friends don’t let me do what I want to do.” They tend not to see themselves as part of a group but as an individual who prefers to relate to adults. Other children are considered as bewildering, ignorant or a nuisance. The bewilderment is due to difficulties reading the social cues of their peers. They may not read the social expressions and body language to indicate feelings that would be intuitively recognised by much younger typical children. Other children instantly recognise overt and subtle signs of anger, fear, delight and disgust, yet these signals may not be perceived or considered as factors to modify the interaction by the child with Asperger’s Syndrome.
Children with Asperger’s Syndrome clearly have difficulty knowing how to socialise with their peers. Their frustration can lead to aggression but it can also lead to anxiety. This can be so severe that the child develops elective mutism at school or school refusal. Programs to encourage friendship skills should be part of treatment programs for anger and anxiety management.
One of the characteristics of Asperger’s Syndrome is to have a literal interpretation of the comment or request of other children. A girl with Asperger’s Syndrome came home from school extremely agitated and told her mother they must pack all their belongings and move house immediately. When her mother asked why, she said that at school, a boy said, “I’m going to marry you”.
When other children approach the child with Asperger’s Syndrome, they see a child who does not look any different in terms of size and facial characteristics. They may be engaged in complex constructive play but when approached they may not offer the expected welcome or inclusion in the activity. The child with Asperger’s Syndrome is perceived as bossy, sounding and behaving more like a teacher than a friend. Other children’s attempts to become a friend “fall on deaf ears” and they may be inclined to move on and play with someone more responsive and less insular or dictatorial. The child with Asperger’s Syndrome therefore misses an opportunity to use and develop the maturity of their friendship skills.
Stage 2 In stage 1 the child with Asperger’s Syndrome may have limited motivation to play with other children and develop friendships. In stage 2 they can actively want to join in but lack specific abilities. They want to interact harmoniously but are not sure what to do. Sometimes they become acutely aware of a lack of friendship and become quite distresses if their naïve attempts at social interaction are unsuccessful. They can develop compensatory mechanisms that range from denial and arrogance to low self-esteem and withdrawal.
Their initial myopic optimism for friendship can also turn to paranoia, especially if they fail to make the distinction between accidental and intentional acts. The research on Asperger’s Syndrome has established a difficulty with Theory of Mind tasks; that is conceptualising the thoughts, feelings, knowledge and beliefs of others. Other children may recognise from the context and often knowledge of the character of the other person whether the comment or action had benevolent or malicious intention. For example other children know when someone is teasing with friendly or unfriendly intentions. This knowledge may not be available to the child with Asperger’s Syndrome.
The author has noted that such children can have limited ability for character judgements. Other children will know which children are not good role models and should be avoided. The child with Asperger’s Syndrome can be somewhat naïve in character judgements and prone to be attracted to and imitate children who may not demonstrate good friendship skills.
Another aspect of this stage is a tendency to be possessive in friendships with an intensity that can eventually be intolerable to their chosen friend. They may not understand that the friend is a free agent who sometimes wants to play with other children and may refuse an invitation to play. When these situations occur the child with Asperger’s Syndrome may refuse any further contact with the person whom they perceive as having broken the rigid social rule that a friend will always play with you. A child with Asperger’s Syndrome said, “He can’t play with me one day and then other friends another day – that wouldn’t be a true friend”.
They may also be intolerant of their friend’s errors and quick to criticise but conversely, hate being criticised themselves. Other children are starting to learn to “think it not say it” so as not to hurt their friends feelings. At this stage, the concept of a “white lie” is a feature of friendship, but children with Asperger’s Syndrome seek honesty and truth as more important than someone’s feelings. They can be unaware of why their honest comment made their friend upset.
Children at this stage are playing more complex interactive games and children with Asperger’s Syndrome can become exceptionally emotional if they lose. Their concept of being fair is somewhat egocentric. They may always want to win or be first, not necessarily for dominance but to know the outcome. The person hates surprises or the unknown. In competitive games, of unknown outcome, the child wants certainty.
When one considers the friendship profile of the child with Asperger’s Syndrome at this stage, they are unusual in comparison to their peers in having fewer friends and often not seeking contact with friends out of school hours. Contact may be organised by parents rather than arranged spontaneously by the child.
In their attempts to make friends, the child’s intentions can be misinterpreted. The author’s sister-in-law explains that as a child she was “longing to make friends, when someone complimented a drawing I had done, I started giving people drawings until someone accused me of bragging – a rebuke I never forgot. I was only trying to win friendship”. They are so vulnerable to exploitation, prepared to comply with requests that other children would recognise as inappropriate. They may tolerate being tormented just to have company. Sometimes they may fail to recognise that the other children are not displaying signs of friendship and are quite resistant to the suggestion that their “associates” are not genuine friends in their attitude and actions.
From the perspective of their peers, the child with Asperger’s Syndrome can be unusual in other ways. In stage 2, children are starting to talk more to each other while they are playing. The choice of conversational topic can be quite unusual for the child with Asperger’s Syndrome who may want to play or talk almost exclusively on some aspect of their special interest. There is a lack of reciprocity in the choice of activity or topic of conversation. They can also appear to be ill mannered or ungracious and somewhat autocratic. It is at this stage that empathy becomes recognised as an aspect of friendship and the typical child can expect words or gestures of compassion, compliments and offers of help. Observation of children with Asperger’s Syndrome suggests that they may not recognise the cues or know how to respond. Their friend may perceive them as uncaring.
Stage 3 The child’s problems in peer relationships can be re-enacted at home, taking on the role of antagonist with younger siblings. They may appear to be a Dr. Jekyl and Mr. Hyde in behaving calmly and sociably with their peers at school but extremely autocratic and intolerant when interacting with their family. There can also be a vehement denial that they have any difficulties. When the subject of friendship is bought up at home or school the child is adamant that they have similar friendships to their peers. We do not know if this is a reflection of their lack of an accurate perception of the nature of their peers friendships or an attempt to convince themselves, more than others that they are successful. This denial or arrogance can be impenetrable.
Another reaction was explained by the author’s sister-in-law, “The fact is, no one likes others to know their weakness, but with an affliction like mine, it’s impossible to always avoid making a fool of yourself or looking indignant/undignified. Because I never know when the next “fall” is going to occur, I avoid climbing up onto a “confidence horse” so to speak”. At this stage the child with Asperger’s Syndrome may be socially withdrawn and clinically depressed as a reaction to their insight into their difficulties with friendship. Socialising with their peers can also be exhausting. Stephen comments, “It takes all my brain power to be a friend”.
During stage 3, friends are learning to constructively manage conflict, but experience has shown that children with Asperger’s Syndrome have considerably difficulty with the subtle arts of persuasion, negotiation, knowing when to back down, trying another way, admitting making a mistake and making personal sacrifices for the sake of friendship. These interpersonal management skills require a comprehensive understanding of another person’s thoughts and feelings. This aspect of stage 3 can be quite elusive for the person with Asperger’s Syndrome.
Peers expect an allegiance to the group. For the child with Asperger’s Syndrome, their allegiance is to the rules. They can be perceived as the class policeman, not a popular role with peers. As regards to the choice of a friend, there is an expectation among their peers of choosing someone of the same sex, age, and values; social conventions not readily recognised by the child with Asperger’s Syndrome. He may have several friends, including girls who are kind and sociable. The friend may be considerably younger or older, or from a different cultural background. Their choice of friend may cause them to be ridiculed, as their peer group may not value their chosen friend.
From the perspective of their peers, the child with Asperger’s Syndrome is “poor” in terms of the currency of friendship. S/he may not wear fashionable clothes or be interested in the popular television programs or merchandise. In return, the child with Asperger’s Syndrome perceives peers as having limited currency for his or her culture, namely knowledge. Peta, a girl who has an encyclopaedic knowledge of the weather finds other girls her age boring, as they only want to talk about magazines and make up. She wants to talk about meteorology, which is perceived as equally boring by her peers.
Stage 4 For typical teenagers this stage begins in high school and continues throughout adult years. The difficulties encountered by someone with Asperger’s Syndrome include the practical issues of finding someone with the same interests, experiences and thought processes. They can express strong feelings of loneliness and yearning to have a genuine friend. One adult said, “It’s not that I’m antisocial, It’s that I don’t meet many people that I like”. Another characteristic can be a lack of personal hygiene and an eccentric personal appearance, which obviously has an effect on other people’s perception of them. During this stage there should be an ability and fluency with self disclosure and the concept of self. As Geoff describes, “When there is a social conversation it’s like a different language.” There can be real difficulty in knowing what to say and the translation and communication of the social language.
The author’s experience of psychotherapy with young adults with Asperger’s Syndrome indicates considerable difficulty with the concept of self and introspection. A difficulty conceptualising the thoughts and feelings of others (Theory of Mind skills) can include a difficulty verbalising their own thoughts and feelings. The different way of thinking can include an advanced method of visualisation that means in educational terms, a picture is worth a thousand words. However, as Daniel described, in his mind he has a picture but not the thousand words. The person with Asperger’s Syndrome does experience emotions that would be relevant to include a conversation, but not the vocabulary or eloquence to convey those feelings using speech.
At this stage the person with Asperger’s Syndrome can become acutely aware of their problems and errors in social interaction. This can lead to anxiety and a genuine social phobia. They may seek excessive reassurance that their intention was understood and dwell on potential social errors. One young lady commented, “The worst thing about disappointing yourself is that you never forgive yourself fully”.
The person can be gullible and vulnerable with regard to the misinterpretation of signals and intentions. A friendly remark or gesture may be perceived as meaning more than was intended. A friendly smile or touch during conversation could be conceived as indicating the person would like to progress to a more intimate relationship. Others would know that such actions or gestures were simply signs of an effusive personality. The person with Asperger’s Syndrome can misinterpret the actions and develop an emotional attachment that progresses to a special interest in that person which may be mis-perceived by the others as an infatuation. There can also be desperation to be included in a group, but this can be a group whose values and lifestyle can lead the person to be in conflict with the law. They can act the part, and wear the costume of a marginalised group. Members of that group realise that they are not the genuine article and encourage them to break their strict adherence to their moral and legal code, knowing they are not “street wise” and more likely to be caught by the authorities.
When a friendship becomes a boyfriend-girlfriend relationship there can be misinterpretation of the other person’s feelings and body language. A young man with Asperger’s Syndrome, Corey, had a girlfriend; but the relationship with the girl had ended. His mother was concerned that Corey was not reading the signals and compounding the situation by buying her expensive presents. When I explored Corey’s perception of his girlfriend’s body language, he described someone who expressed the subtle signs of embarrassment. When I asked him how he though she was feeling, he said “ ... sad ... that’s why I buy her presents, to cheer her up”.
If people with Asperger’s Syndrome are unsuccessful in finding a friend, they may develop a friendship with animals that accept them for who they are, whose feelings are more easily understood and unlikely to take offence. Their substitute friends and “family” can be a menagerie of animals. At some point they meet someone who shares some of the characteristics of Asperger’s Syndrome. At last they have a friend from their own culture who understands! They are a member of their natural peer group and friendships with other individuals with Asperger’s Syndrome can be remarkably successful and durable.
To the typical young adult, the person with Asperger’s Syndrome can appear to be quite eccentric, requiring considerable patience and understanding. However, in return this person can be a valued friend, renowned for their knowledge, integrity and loyalty. My sister-in-law explains, "Because of the way I talk and my dislike of things that are loud, people don’t always accept me or often judge me before even knowing me. If people with Asperger’s find it hard to integrate into society and socialise, it could have a lot to do with discrimination on the part of others." With mutual understanding there can be genuine, reciprocal friendships, free of ignorance and discrimination.