Asperger’s syndrome has a rather peculiar history as a mental health condition. While initially being singled out as a specific mental health issue, it would, later on, be regarded as a part of the attention deficit disorders (ASD) cluster. Consequently, the current definition of Asperger’s syndrome as the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) provides it lacks specificity. Namely, the subject matter is termed as a disorder involving “persistent impairment in reciprocal social communication and social interaction” and “restricted, repetitive patterns of behavior, interests, or activities” (American Psychiatric Association, 2014, p. 53). As a rule, Asperger’s syndrome is more common in males, and it typically manifests itself at an early childhood development stage, involving delays in the acquisition of cognitive and language skills. By promoting active socialization and creating a supportive environment where a child can acquire the necessary skills at a natural pace, one can facilitate a proper quality of life for people with Asperger’s syndrome.
This case features Jamal, a male of African American descent. Jamal was diagnosed with Asperger’s syndrome at the age of nine, when his parents developed a strong concern about his propensity toward minimizing social interactions and being mostly socially inept during rare instances of communication with others, including his peers. Since Jamal’s case of Asperger’s syndrome can be characterized as highly functioning, his life has not been severely impaired by the presence of the specified disorder; however, it still has limited the range of his opportunities, including the chance to build strong emotional connections with his friends and family members.
In the case of Jamal, no prenatal issues were observed during the gestation period, according to the family medical history. However, further analysis of the factors that could have contributed to the development of factors causing Asperger’s syndrome in a fetus has indicated that at least two of Jamal’s older family members, particularly his grandparent and his great-uncle on his mother’s side, were diagnosed wit ASD. The specified situation confirms the existing statement concerning a link between a family history of ASD and the threat of a child developing Asperger’s syndrome (Tseng et al., 2020). However, since Asperger’s syndrome affects primarily communication-related functions, as well as cognitive ones, to a lesser extent, identifying them in infantry is mostly impossible (Tseng et al., 2020). Therefore, Jamal’s development at the ages of 0-3 was not characterized by any remarkable deviations from the set health standards.
Arguably, the fact that the patient avoided eye contact with his mother as he was an infant could eb seen as an early sign of Asperger’s. However, the specified symptom as not recorded properly which is why the specified evidence is based solely on the statements made by the patient’s mother, who admits to having a very vague memory of the specified occurrence. Furthermore, according to the details provided by Jamal’s mother, at the later stages of infantry, Jamal developed a propensity to fixate on objects with his eyes, which is often regarded as a sign of Asperger’s syndrome (Tseng et al., 2020). While the patient did not display other major symptoms of Asperger’s disorder, the observations listed above could already be considered early signs of Asperger’s disorder (). Indeed, studies mention that, while being exceptionally difficult to locate in infants, Asperger’s manifests itself as a condition that entails a reduced extent of interactions with their mothers in infants (Tseng et al., 2020). Specifically, minimized responsiveness and eye contact represent some of the core characteristics indicative of the disorder. In turn, Jamal demonstrated some of the specified characteristics as an infant, which could be seen as early warning signs about the further development of the specified condition.
As Jamal grew older, the signs of Asperger’s syndrome gradually became more pronounced, as his health records demonstrate. Specifically, at the stage of early childhood, major deviations from the expected behaviors and development processes could be observed. Indeed, there are several core characteristics that each developmental milestone must demonstrate in children, and which were obviously distorted in Jamal’s case. According to Piaget’s theory of early childhood development, normal development in early childhood involves passing four core stages, namely, sensorimotor, preoperational, concrete operational, and formal operational ones, and developing the associated skills and abilities (Timm et al., 2022). However, Jamal’s medical records demonstrate a certain deviation from the specified pathway due to the early onset of Asperger’s syndrome and the resulting issues with building crucial cognitive skills.
Admittedly, the earliest stages of Jamal’s development did not provide sufficient evidence to determine the presence of the disorder. Specifically, the sensorimotor and preoperational stages, during which the patient gained the necessary ideas of object permanence and the skill of thinking symbolically, did not offer the information needed to determine the presence of a major issue. However, as the patient grew older, he demonstrated increasing unwillingness to communicate with other children; neither did he display a willingness to communicate with people in general. Instead, he preferred repetitive activities, which correlated with the key symptoms of Asperger’s syndrome, as well as ASD-spectrum disorders, in general (Tseng et al., 2020). Specifically, Jamal’s transition to the Operational stage incorporated clear indications of him being on the ASD spectrum. For instance, at the specified stage, children are expected to understand the notion of a conversation, as well as participate actively in it, according to Piaget (Timm et al., 2022). However, Jamal’s case was quite different; him preferred solitude and refrained from conversing with other children. In addition, Jamal demonstrated certain delays in the development of socioemotional responses, which could be seen as an indication of the presence of ASD-spectrum issues (). Namely, the fact that he would fail to control his emotions quite often and would frequently have emotional outbursts as a response to any issue ranging from a certain discomfort to mild inconvenience represented a viable reason for concern. Unfortunately, it took a while for his parents to recognize the specified behavior not as Jamal being a “brat,” but as a mental health issue.
In turn, at the concrete operational stage, when children typically acquire the ability to converse with others and build relationships, Jamal demonstrated the propensity for preferring solitude to active communication. The observed phenomenon could have been linked to the issues observed in infantry, thus providing the basis for diagnosing Jamal with Asperger’s at an early stage, yet his parents attributed the specified trait of his to being introverted. Therefore, middle childhood was the point at which the core characteristics of Asperger’s’ manifested themselves vividly enough for the parents to pay closer attention to the issue and introduce relevant therapy options and the support of healthcare experts to the child.
Specifically, Jamal continued to prefer solitude as he reached his middle childhood stage, which indicated a significant discrepancy with the established perspectives on childhood development. For instance, Erikson’s theory of development points to the fact that the observed behaviors were rather unusual for a child of the specified age due to the expansion of children’s social world that typically takes place in middle childhood (Timm et al., 2022). Specifically, the theory establishes that the point in the child’s development that is labeled as the industry vs. Inferiority involves the active pursuit of a strong self-concept (Timm et al., 2022). In turn, the latter is shaped as a child interacts with other members of the community and accepts the relevant ideas, behaviors, and constructs, therefore identifying their own place in the social hierarchy (Timm et al., 2022). However, in Jamal’s case, the specified changes were barely noticeable. Specifically, the boy preferred solitude to communication with others, therefore failing to build a proper understanding of the nature, goals, and key specifics of social interactions (Tseng et al., 2020). Though the outlined issues would be corrected later in Jamal’s life, they would still affect his ability to build trust and interact actively with others. The described problems with socialization and the development of social connections align with the key symptoms of Asperger’s, namely, the propensity toward social isolation and the inability to acquire the necessary behaviors and interaction patterns for further integration into the community (Timm et al., 2022). Remarkably, the patient demonstrated difficulties adjusting despite extensive therapy, which could be explained by the lack of sufficient support from his parents and the absence of encouragement from community members. In turn, the outlined issues should be attributed to low levels of awareness about Asperger’s syndrome, as well as ASD disorders, in general (Timm et al., 2022). Indeed, studies show that, to support patients with the specified conditions actively,
Remarkably, due to the effects of the therapy offered to Jamal, his condition improved by the time when he reached adolescence. Specifically, he began to demonstrate a more nuanced understanding of emotions and gained a certain extent of emotional competence. Defined as the ability to differentiate between the emotional states of others and respond accordingly, emotional competence can be regarded as one of the most complicated skills that people with Asperger’s struggle to develop (Velikonja et al., 2019). However. Jamal managed to acquire some of the skills needed to differentiate between emotions and provide reasonable responses (Velikonja et al., 2019). However, the integration of therapy did not help the patient to regulate his emotions more effectively, which can be explained by the specifics of the adolescence period in human development. Namely, the patient experienced development involving passing the stages of Integrity vs. Role Confusion and Intimacy vs. Isolation, respectively, according to Erikson’s framework (). Based on Erikson’s theory, the specified stages are marked by the emphasis on competence, which is achieved by comparing their progress to those of their peers and the pursuit of a strong emotional connection with a significant other (Timm et al., 2022). However, in Jamil’s case, his propensity toward building a strong emotional bond and, ultimately, intimate relationships was nearly nonexistent since the patient did not display a substantial willingness to engage in meaningful relationships with others. The described emotional detachment is emblematic of ASD, in general, as well as Asperger’s syndrome, in particular (). Therefore, Jamal understandably had difficulties seeking and building romantic relationships with others. While his understanding of essential social cues and willingness to interact with others has grown over time, the specified changes represented his understanding of the significance of socialization rather than his enjoying the experience. Thus, while the therapy could eb deemed as successful in one aspect, it failed in another, namely, enhancing the patient’s emotional investment in the process of communicating with others and building connections.
As Jamal graduated from high school and reached the stage of 18, he enrolled in college to pursue a degree in IT, a career of his choice. The specified choice of his professional field is also indicative of the persistence of Asperger’s syndrome and the impact that it had on Jamal’s life. Namely, in contrast to fields linked to social sciences, which focus extensively on communication in the workplace, IT is the sphere that allows working independently for the most part, especially for people employed as freelancers. Although the specified choice could be regarded as a sign of Jamal’s weakness and his decision to refrain from working on his communication issues further, it also represented his desire to create a stress-free environment. In turn, the focus on eliminating stress factors contributed substantially to Jamal’s mental health, minimizing the threats of anxiety and depression (Velikonja et al., 2019). The patient’s further life continued mostly uneventfully, with no major occurrences that either exacerbated his ASD or alleviated it completely. Remarkably, Jamal was inclined toward transferring all of his activities, including business and personal communication, to the digital setting, which he claimed provided him enough distance to feel comfortable. The outlined choice also aligns with the core observations regarding ASD, particularly the propensity toward being overly sensitive toward external stimuli and, therefore, avoiding the outside environment as overly stimulating (Lee et al., 2021). As Jamal aged, he continued to keep distancing himself from his community, yet he managed to find enjoyment in minor interactions with others and developed sufficient emotional intelligence to communicate effectively.
Since the phenomenon of Asperger’s syndrome has not been fully studied yet, and the nature of the disorder is ascribed to a combination of genetic and environmental factors, the condition is likely to deteriorate as the patient ages. Due to the gradual decrease and further loss of certain cognitive functions, a patient with Asperger’s syndrome is highly unlikely to recover as the disorder progresses. Nonetheless, with a combination of therapy and appropriate changes made to the patient’s social setting, positive changes allowing active support and the enhancement of core mental functions become positive. Therefore, patients with Asperger’s must receive consistent help and the relevant information that allows them to manage their condition and maintain high quality of life. With the focus on the core risks that the specified health issue entails, such as obesity and the associated physical health concerns, one will be able to create a framework for patient support that will allow for avoiding essential threats.
For this reason, active nurse-patient communication marked by consistency and robustness is strongly requested in the case of a patient with ASD. As the case above demonstrates, ASD impairs people’s functioning to a significant extent, preventing them from social participation and hindering a range of activities that help the patient feel a member of a community and, therefore, enjoy the proper quality of life. Moreover, the proposed recommendations will enhance the extent of social support that the patient receives by increasing awareness and educating community members on the issue of supporting people with Asperger’s syndrome. Overall, it is expected that the proposed recommendations will improve the patient’s current status and lead to building the premises for a robust and complex support system.
References
American Psychiatric Association. (2014). The diagnostic and statistical manual of mental disorders (DSM-V) (5th ed.). APA.
Lee, S., Jacobsen, E. P., Jia, Y., Snitz, B. E., Chang, C. C. H., & Ganguli, M. (2021). Reading the Mind in the Eyes: A population-based study of social cognition in older adults. The American Journal of Geriatric Psychiatry, 29(7), 634-642. Web.
Timm, J., Block, H., Boanca, G., & Acquaye, H. E. (2022). An exploratory study on the relationship between completion of Erikson’s fourth psychosocial stage and assurance of salvation. Journal of Spirituality in Mental Health, 24(1), 53-73. Web.
Tseng, A., Biagianti, B., Francis, S. M., Conelea, C. A., & Jacob, S. (2020). Social cognitive interventions for adolescents with autism spectrum disorders: A systematic review. Journal of affective disorders, 274, 199-204. Web.
Velikonja, T., Fett, A. K., & Velthorst, E. (2019). Patterns of nonsocial and social cognitive functioning in adults with autism spectrum disorder: A systematic review and meta-analysis. JAMA psychiatry, 76(2), 135-151. Web.