Why do people with Asperger’s syndrome say they don’t mean it means why they don’t say it?

Asperger’s Syndrome is a neuropsychiatric disorder that is generally detected in childhood. It shows similarities with AUTISM in general terms. (Related social communication and interaction; restricted and peculiar interests…) The main difference with autism is the absence of language-cognitive retardation. Semantic-pragmatic abilities are not developed. (We can say that social, cultural, tradition-custom, morality and norm types are missing.) Intelligence level is generally normal and sometimes even superior. DSM-IV and ICD-10 dimensions are as follows:

DSM-IV diagnostic criteria:

• Change in hand, arm, eye, face movement, body shape used for social communication

• In human relations, entertainment, jealousy, self-definition, sharing, lack of game, liking

• Lack of emotional clarity (yes-no)

Developing unusual, stereotyped, limited patterns

Excessive and frequent adaptation to dysfunctional but occasional daily tasks

Motor magnetism (finger snapping, excessive blinking, tongue sticking out, hand flapping)

• Excessive involvement with things, obsession

• Mismatch in social and occupational fields

• Normal language development

• Cognitive development, self-sufficiency, no clinical delay in adjustment

• In sexuality normalization in general (no significant difference.)

ICD-10 criteria:

• No significant language and cognitive developmental retardation

• Self-care, adaptive attitudes, environmental curiosity are compatible with mental development

• There is motor clumsiness

• Acquiring superior abilities if there is special interest in a subject

• Qualitative defect in mutual social interactions

• Narrow interests, extreme weird information, stereotypical patterns

Motor magnetism

Excessive obsession with objects or game tools

Obsessive-compulsive (anankastic) personality disorder, childhood attachment disorder, schizotypal disorder, maladjustment, lack of gestures, motor clumsiness, poor imaginative play, strange speech, different language, ADHD , depression, antisocial violent behavior can also be added to clinical features.

AS is common in paternal grandparents. There is a frequency of 3/7 per thousand (USA). (Determinations of individuals with AS have not been made on the basis of proper and scientific criteria in our country. Almost no statistics are available. State and private health institutions, including universities on the subject… Therefore, most of the available information is taken from the USA and Europe.) Normal If those who are lost in social life close to the borders are added, there may be 1 person in 250. In the USA, the ranking is 1% for school age and 9:1 for men and women.

Improvements in the diagnostic criteria of the disorder, decrease in maternal age, migration, infection, viral agent increase and spread, immune level decrease, chemical toxin and environmental pollution problems. are the main factors. AS is generally detected between the ages of 10-11. The absence of language delay is sometimes not detected until adulthood because of the problems in social relations, especially in nurseries and kindergartens, due to the high incidence of ADHD cases. In this case, the person’s own search is determined through ways such as the determination in the business world and the legal system. Sometimes it is not detectable at all.

Kindergarten, primary school 3.-4. Class, high school, school graduation, job selection, spouse selection, prison situations are effective. Such that, AS should definitely be considered for individuals who have problems such as not being able to find a job after completing 3-4 schools, not being able to withstand work stress, not being able to adapt, not being able to maintain a happy marriage, and difficulty in sexual relations.

Prof. in human relations. Dr. This syndrome should definitely be examined for many ECENTRIC people who experience a serious problem such as “Why people say what they don’t mean, why they mean what they don’t say” with the perfect definition of Barış Korkmaz.

Likewise, especially in school age, “sex, weird, annoying, hair, cow shank, search engine, child like Google, man like property, people who think of no one but themselves”. gruff, disrespectful, moron, not understanding jokes, asking everyone to serve as if it is their natural right, not knowing the concept of age and status (calling İzzet Bey, the school principal…), thinking and thinking that everyone is overjoyed when they are happy, asking private questions to people they do not know, or asking family relations. AS should not be overlooked in every individual who spills, shares, apologizes, borrows, has weak impulse control.

Many different emotional states can be seen one after the other in a relationship with AS. They may not have feelings of self-conceit, humility, shame, or guilt. On the other hand, it may also have basic principles such as being away from gossip, being innocent, honest, not having a sense of ownership, not cheating and flattery.

AS has problems with non-verbal communication types, facial expression, tone of voice, gesture and gaze. Grammar development is normal. He has a non-melodic tone in his speech, he is harsh, sometimes he speaks didactically as if he were giving a lecture. Eye contact is troublesome, his gaze is often tense, irritable, anxious, and aloof. While the eyes shine excessively while carrying the purpose of violence; In situations that require emotion, on the contrary, there are unsuitable, unfocused glances.

Asli’s prosody (melody features of language) are distorted, speech speed and intensity are different. The sound is loud in situations such as funerals and meetings. There is language disorder at the semantic-pragmatic level. (The conceptual-understanding features of the language are not suitable for social usage).

At the speaking stage, current situation, location, connection, appropriate inference cannot be made. He cannot choose the data to be used in recognizing new situations learned in the past, so his mind load increases and his attention is quickly distracted. Due to the difficulty of choosing the words appropriate for this purpose, there are often cases of frequent stance in speaking, waiting for help such as “iii”, “eee” in order to find the appropriate one at the moment.

There is tangential, diagonal, inappropriate speech pattern. He uses the meaningless words he creates. (While it is usually normal for children to say “apat” for shoes and “chopat” for socks in childhood, it gradually improves, this may become permanent in AS).

There are also problems in obtaining information. Attention is low, as said above. He focused on his own area of ​​interest. Different styles of learning are tried many times. More than once he “sees the tree but cannot see the forest”. Due to his obsessions, he often adopted a ritual (ceremony)-routine (daily living order) in order not to fall into difficulties according to his own understanding.

With serious problems in acquiring information, he concentrates on a knowledge that he can learn once. Country flags, train schedule, football match dates and results… Sometimes they have extreme photographic memory. However, this memory is often directed towards something specific. (The names of all violin manufacturers are known, but they cannot play the violin.)

In childhood, situations such as anger, destructive behavior, aggression, and non-compliance with the rules are especially important. it is remarkable. The anxiety level is often very high. It increases with cycloid psychosis, schizophrenia, paranoia, schizoid personality disorder, depression. Substance, drug, alcohol addiction increases. Panic attacks may occur. (Depression 40%, Mania 9%, Bipolar disorder 9%, Suicide 7%, schizophrenia 9%, OCD 14%, paranoia 9%, hypochondriasis 4%.) Sickness, nail biting, mucus mixing, wiping on the table, with stool playing, washing the body frequently, wiping with alcohol, tics and mannerism are common. Throat clearing, strange sound, tourette (especially swearing), winking, grimacing, tapping feet are often seen.

Cognitive-academic problems, specific learning disabilities, dyslexia, dyscalculia, macrography (use of capital letters), low non-verbal learning, inability to adjust time, accuracy, feelings of guilt and fussiness, ADHD, poor working memory (forgetting even the name that has just been said), selective response (hearing what you want).

With advancing age, lack of close friends, low gesture, special face form, inability to conform to traditions, and strange and subjective interests become clear. They stay away from control and manipulation. Childlike curiosity and the inability to be truthful and lie do not change.

AS, a type of autism, causes autistic basic symptoms;

• Socialization

• Verbal communication

• Has types of inadequacy in imagination.

The difference is clear in terms of intelligence development. The rate of mental retardation in standard autism is around 70%. It can be defined as Atypical Autism (ADD-NOS: pervasive developmental disorder not otherwise specified) or predominantly verbal autism.

Negative behaviors such as lack of education, waiting in line (for example, at the bank) due to family raising style, not obeying traffic, making loud noise, polluting the environment, education, family, Although it disappears in normal children with community effects, it continues in AS.

The feeling of failure, criticism and concerns about not being accepted into the group are similar to this picture.

Childhood psychoses (schizophrenia, depression) have similar attitudes. Hallucinations and delusions are common. Avoidance of school, bed-wetting-stool (nocturnal enuresis, encopresis), ADHD, excessive fantasy, lying, loneliness, introversion-extreme single interest seen in schizoids. Ceremonial relationship, autonomous finding, frightening thoughts are similar with OCD (anankastic). Despite his own nature, the avoidant type personality is the same as the person he sees as an opponent or the opposite group, and the way he shows himself as a victim in case of being pushed and left alone.

Psychometric, neuropsychological tests used in AS examination, laterilization (hand, foot, eye), motor skills (hand-eye, shape, visual motor) attention, visual perception, spatial perception, temporal perception, Rorschach, language problems (phonology, prosody, grammar, pragmatics, semantics), CT, MR, Positron Emission tomography, QEEG, QEEG evoked potentials Some techniques used in psychotechnics are used.

There is no definitive treatment with medication. Psychotherapy, group therapy, family therapy are required. However, this process should be continued by people who have received serious training, as they are extremely sensitive about the personality of the teacher or trainer. In the therapy of the person with AS, everything should be clearly explained, numbered and listed, as these people manage social adaptation with verbal intelligence.

Good physical education on motor disability and Mannerism is essential.

EMDR methods to resolve depression should be used in behavioral cognitive therapy. With BIO-FEEDBACK techniques, personal feelings and their clear external expressions should be recognized.

Social communication skills in meeting, helping, compliment, criticism, openness to suggestion, reciprocity, sharing, solving problems, managing-listening, co-sensation, avoidance and termination techniques should be used.

What is the neurobiological dimension in AS? The diagnosis specific to patient complaints or complaints is symptomatic, empirical and phenomenological diagnosis. The one that causes or causes the problem and is based on the cause is called the etiological diagnosis. In this respect, there is no genetic diagnosis of As yet. The diagnosis that determines where the damaged information responsible for the complaints that cause the disease is located in the brain is called localization-oriented diagnosis. The pathological diagnosis determines what kind of damage the factors causing the disease cause in which organ. (It is not clear in AS.) Prognostic diagnosis is about how the disease progresses and whether it will improve. (There is no full recovery in AS.) However, AS and brain structure are as follows;

Basic brain structures are amygdala, superior temporal sulcus, orbital frontal sulcus (ventromedical sulcus), anterior cingulate cortex. There is a low level of metabolism in the frontal region, and neurotransmitters such as serotonin and dopamine are low.

Amygdala: provides fast automatic emotional resolution of uncertain situations and has little effect on Ace. Orbital frontal cortex: involved in giving social meaning to events. It provides access to new information through previous experiences. Learning is disrupted, anxiety increases, and stress rises. The dorsalateral region of the prefrontal lobe is related to analytical thinking, planning and personality traits.

Mirror neurons in the premotor cortex (mirror neurons) provide imitation and empathy. The fusiform gyrus in the right hemisphere and the inferior occipital gyrus are related to face recognition. Superior temporal sulcus is related to facial expression recognition, recognizing others in emotions such as anger and disgust and is low in AS. In As, the right hemisphere of the brain is distressed. In the cerebellum, the part that regulates balance and body movements is seen as troubled.

After all, the above-mentioned psychometric and neuropsychological tests are applied. Therapies such as MRI and NEUROBIOFEEDBACK are tried and the basic structures of the brain should be examined with QEEG.