Asperger Syndrome and Social Relationships: Adult Friendships

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Asperger Syndrome and Social Relationships
Adult Friendships
Anja Rutten Senior Lecturer Psychology and
Counselling Staffordshire University
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What is Asperger syndrome

• Asperger syndrome (AS) is a high-functioning form
  of Autistic Spectrum Disorder (ASD)
• Triad of impairment
• Precise cause unknown, no cure
• Affects more men than women
• Intellectual ability average or above
• Uneven profile of abilities
• (Attwood, 2006 Baron-Cohen Bolton, 2002 Frith,
  2003 Wing, 1996)

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Asperger syndrome and social relationships

• Many people with AS want social relationships but
  experience problems
• Problems can occur in many areas of social
  relationships, from a young age
• Using imagination (development of play)
• Making and maintaining friendships
• Turn taking
• Negotiating and compromising
• Mutuality

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Social relationships across the lifespan

• Three phases of development
• Childhood
• Adolescence
• Adulthood
• One main type of social relationship outside of
  the family is friendship
• Childhood phases in development of friendship
  skills are vitally important it is necessary to
  talk a bit about these

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Friendship

• Our experience of friendship alters with age
• There has been a substantial amount of research
  and model-making around the development of
  children's abilities to make friends
• Adult friendships have been under-researched
• Adult friendships where one or more of those
  involved have AS have (as far as I am aware) not
  been researched at all

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Development of friendship

• There are a number of theories about how
  friendship develops.
• I will discuss Selman (1980) and Pahl (2000)
• They are not very different, but Selman uses a
  stage approach and Pahl an age approach
• This is important when were talking about
  development of friendships in people with AS

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Stage model of friendship

• Selman (1980) explained friendships and disputes
  in stages
• Stage 0. Everyone you play with is a friend, but
  friendships only last as long as the play
  session! Physical strategies for conflict
  resolution.
• Stage 1. A friend is someone who gives you help,
  but there is no reciprocal exchange at this
  level. Friendships are still quite transient.

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Selman (continued)

• Stage 2. Friendship are longer lasting, due to
  growth of reciprocity, trust and intimacy.
• Stage 3. Friendships can be maintained through
  minor conflicts. More focus on the relationship
  itself. Trust, mutual support, but jealousy.
• Stage 4. Only found at adolescence and adulthood.
  Less possessiveness and jealousy than stage 3,
  due to recognition of individual needs.
  Friendship provides personal identity.

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Age model of typical friendship

• Pahls (2000) Five Stage Model
• Aged 3-4 children start to use the term
  'friendto describe playmates
• Aged 4-7 children start to appreciate that own
  views and identity is different from others
• Aged 6-12 children start to be able to 'put
  themselves in other peoples' shoes (Empathy)

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Pahl (2000) continued

• Aged 9-15 children/young people are able to take
  on the perspective of a 'third person' to look
  at interactions and, thus, to work on
  relationships.
• Aged 12 there is a recognition that individual
  friendship is part of a larger network of
  relationships - and that friends are linked with
  others in 'personal communities'. (Pahl 2000
  99-101)

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Friendship stages and Autistic Spectrum Disorders

• Difficulties can occur in each of Selmans
  stages, but because the stages build on each
  other, there are also cumulative difficulties
• Delays and differences in social development
  (Pahls ages) leaves people with AS out of synch
  with peers
• For many people with Asperger syndrome,
  especially in adolescence, there is a great
  difference between physical and emotional
  maturity

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How does ASD impact on social relationships of
adults?
At 24 years of age, I feel I am a foreign
element here in the world of adults. Im never
sure if I belong in the category of adult,
adolescent, or child. I am caught between the
three. I definitely have the thoughts and
feelings of a man, the personality of an
adolescent, and some of the needs and
vulnerabilities of a child. All these are
apparent at different times. In terms of
development, my therapist asked me where I
thought I feel within these three categories. My
category does not seem to be static. There are
times, situations both social and personal, when
I feel in turns like an adult, an adolescent and
a child. Stoddart (2005316)
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Why are friendships so important?

• Peer relations contribute substantially to
  bothsocial and cognitive development and to the
  effectiveness with which we function as adults.
• Single best childhood predictor of adult
  adaptation is the adequacy with which the child
  gets along with other children.

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• Children who are generally disliked, who are
  aggressive and disruptive, who cant sustain
  close relationships with other children, and who
  cant establish a place for themselves in the
  peer culture, face problems and risks in their
  development (Katz McClellan, 1997).
• Accessible friendship (knowing who you could ask
  to go with you) is not the same as inclusive
  friendship (being asked by others to
  participate). (Malikiosi-Loizos Anderson,
  1999).

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Consequences

• Lack of social support leads to loneliness,
  boredom, lower self-esteem, anxiety and
  depression (Carbery Buhrmester, 1998)
• The majority of people with AS (65) meet
  diagnostic criteria for comorbid psychiatric
  disorders, in particular anxiety and depression
  (Deudney Shah, 2001 Ghaziuddin, 2005)
• People with AS are more like to suffer from
  anxiety and depression
• As part of their AS
• As part of social isolation
• This creates a vicious circle

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Consequences

• In terms of effect on well-being in
  neurotypicals, friends contribute more to the
  well-being of older people than family.
• It appears to be the immediate enjoyment of
  friendship that is important (Larson, Mannell
  Zuzanek, 1986, Hartup Stevens, 1997).
• Adults with AS depend largely on parental and
  family support. They tend to have little access
  to immediate friendship
• This has implications for later life!

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How do NTs form friendships?

• Many NT adults form friendships and intimate
  relationships at work or through work colleagues
• Employment is not accessible to many people with
  AS and so they lose out on valuable opportunities
• Solitude can be important in keeping anxiety
  levels down, but gets in the way of forming and
  maintaining friendships

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What do AS adults say about social situations?

• How stressful?
• No answer or N/A 3
• Extremely stressful 34
• Very stressful 44
• A little 18
• Not at all 1
• Support?
• No answer or N/A 4
• Yes 34
• No 62
• Beardon and Edmonds (2007)

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So what can help?

• Social support specific inclusion of adults
  with AS
• Social groups for adults either AS or AS/NT mix
• Parents teaching and modelling social skills
• Partner
• Befriender, Circle of friends, Buddy system
• Internet groups, Special interest friends

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So what can help?

• Explicit education and skills development
• Friendship skills for adults (although
  development of friendship skills needs to start
  in childhood)
• Social skills what is appropriate behaviour for
  others dating, relationships romantic,
  sexual and friendship
• Other social skills
• Counselling

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In conclusion

• Early help is key but a lifelong approach needs
  to be taken
• It is not just the responsibility of adults with
  AS to develop social skills and reach out
  inclusive friendships are important
• This is, however, no good if it does not meet
  peoples needs!
• Explicit teaching about friendship and how it
  develops is important for people with AS
• Employment is an important way for adults to make
  friends adults with AS need more access to the
  employment market

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References

• Attwood, T. (2006). The Complete Guide to
  Asperger's Syndrome. London Jessica Kingsley.
• Baron-Cohen, S and Bolton, P (2002) Autism The
  Facts. Oxford Oxford University Press
• Beardon, L., Edmonds, G. (2007). ASPECT
  Consultancy Report A National Report on the
  Needs of Adults with Asperger Syndrome.
• Carbery, J. Buhrmester, D. (1998). Friendship
  and need fulfillment during three phases of young
  adulthood. Journal of Social and Personal
  Relationships, 15, 393-409
• Deudney, C., Shah, A. (2001). Mental Health and
  Asperger Syndrome - Information Sheet. London.
• Frith, U (2003) Autism Explaining the Enigma.
  Oxford Blackwell Publishing
• Ghaziuddin, M (2005) Mental Health Aspects of
  Autism and Asperger Syndrome. London Jessica
  Kingsley
• Hartup, W. Stevens, N. (1997) Friendships and
  Adaptation in the Life Course. Psychological
  Bulletin, 121(3), 355-370.

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References

• Katz, L. G., McClellan, D. E. (1997). Fostering
  children's social competence The teacher's role.
  Washington, DC National Association for the
  Education of Young Children. ED 413 073.
• Larson, R. , Mannell, R. Zuzanek, J. (1986).
  Daily Well-Being of Older Adults With Friends and
  Family. Psychology and Aging, 1(2), 117-126.
• Malikiosi-Loizos, M. Anderson, L. R. (1999).
  Accessible Friendships, Inclusive Friendships,
  Reciprocated Friendships As Related to Social and
  Emotional Loneliness in Greece and the USA.
  European Psychologist, 4(3), 165-178
• Pahl, R. (2000) On Friendship, Polity Press,
  Oxford.
• Selman, R. L. (1980). The growth of interpersonal
  understanding. Developmental and clinical
  analyses. New York Academic Press.
• Stoddart, K. P. (Ed.). (2005). Children, Youth
  and Adults with Asperger Syndrome Integrating
  Multiple Perspectives. London Jessica Kingsley.