Research Article
Austin J Psychiatry Behav Sci. 2015; 2(3): 1046.
Course of Fascination: Special Interests in Asperger Autism
Roy M* and Dillo W
Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Germany
*Corresponding author: Mandy Roy, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
Received: December 12, 2015; Accepted: December 20, 2015; Published: December 22, 2015
Abstract
Objective: Special interests are one of the core symptoms in autistic disorders. Nevertheless, these interests are a rarely investigated topic and little is known about their course and their presence in adulthood.
Methods: 39 adult individuals with an Asperger autism (19 female, 20 male patients; age range 21-53 years) described their interests in child- and adulthood via questionnaire with regard to the topic, age of onset and duration of the interest as well as to the time they spent with it and the sensed intensity. Data were compared between child- and adulthood and between both genders.
Results: There were no significant differences between child- and adulthood and not between female and male individuals. In average our participants had 4 interests in both life phases and spent on about 5 days between 2 and 3 hours respectively with them. Their mean intensity of interest was “strong”.
Conclusion: Special interests seem to be of great importance for individuals with autism not only in childhood, but also in adulthood. Adults spend time with them in a similar manner and feel same intensity of interests as in childhood. Therefore, special interests appear to be a stable symptom in autistic disorders and could be used as a pleasant resource by the persons concerned.
Keywords: Asperger syndrome; Autism; Adulthood; Special interests
Abbreviations
ASD: Autism Spectrum Disorders; AS: Asperger Syndrome; SD: Standard Deviation
Introduction
The presence of special interests, which are unusual regarding to their content or extent, is one of the core symptoms of Autism Spectrum Disorders (ASD) [1]. Nevertheless, special interests are a rarely investigated topic and little is known about their course in adulthood.
Probably more than 90% of individuals with asperger autism do have a special interest [2]. Kinds of topics are broad. They can be about nature, such as about dinosaurs or desert reptiles. Also technical topics, like data about cars or stages of a railway network, can become a special interest [3]. Even extraordinary objects could be focus of attention, such as toilet brushes [4]. In childhood, technical topics are the most frequent ones [5]. Thereby topics seem to be similar in different cultures [6]. In some cases special interests are rather about facts and data than about the subject itself, like an interest for match scores or details of players of soccer in children with an autism who do not play football by themselves [6].
Compared to interests of non-autistic individuals, special interests of persons with an autism are more often referring to systemizing domains, additionally they are more specific and comprise a greater number of interests overall [7], only about 30% of non-autistic children develop more intense interests [8].
Investigations of children and adolescents with an Asperger autism between 7 and 21 years showed that they are inextricably entwined with their special interests and when they are involved in them, they feel more positive about themselves as well as more enthusiastic, proud and calmed. Additionally they wish to be appreciated for their topic by peers [4,9].
There is also evidence for gender differences. Girls with an autistic disorder often show “typical” interests, like for dolls or horses or social themes [2,4,6].
The importance of special interests for children with autism is further underlined by a greater attention towards the special interest compared to social targets, such as faces in arrangements with visual stimuli [10]. Bodfish hypothesized that special interests are activating the neuronal reward system in individuals with an autism [11], similar to its activation activated by social stimuli in non-autistic persons [12].
The broad expertise in the individual special interest can lead to success in an according profession in adulthood [2].
Reported data emphasize the meaning of special interests for children and adolescents with an autism. But there are few data about special interests in adulthood, if and in which manner they are still existing, how much time adults spend with them - in comparison to childhood and with a special view on the gender. That was why we conducted this study.
Materials and Methods
Subjects
The study was conducted in Germany. We explored 39 adult individuals with an Asperger autism (19 female, 20 male patients; age range 21-53 years; mean age 36.77 years), who sought evaluation in our outpatient clinic to establish a diagnosis of Asperger Syndrome (AS). All included patients had at least a certificate for secondary education and a sufficient linguistic and cognitive level for the study.
Written informed consent was obtained from all participants according to procedures approved by the Institutional Ethics Committees of the Hannover Medical School.
Diagnostic procedure
AS in adulthood was diagnosed using a self-developed, semistructured interview (Diagnostic interview: Asperger syndrome in adulthood) that thoroughly assesses the patients according to DSM-IV criteria [13,14]. After a general section focusing on medical anamnesis (somatic, psychiatric, and social histories, including childhood development), the interview continues with a special section involving AS that includes the following items with regard to childhood and adulthood: social interaction and communication (e.g. friendships with/relationship to/interest in peers, and being a loner and suffering from loneliness); special interests (e.g. spending leisure time, and interest in specific objects/topics); stereotypic behavior (e.g. rituals, and reaction towards disturbances of rituals); and other characteristics (e.g. clumsiness, and sensitivity towards noises/smells/ tactile stimuli). Eye contact, mimicking expressions, speech melody, “mirroring” of affections, and clumsiness were observed during the interview, too. The interview was conducted by the same experienced investigator. Because in some cases individuals with AS have poor insight or may not report events accurately or fully, the diagnosis of AS, if available, was complemented by information from personal/ telephone interviews, or in written form from observers during childhood and/or adulthood, such as partners, friends, parents, or siblings. In some cases, school reports were consulted. The diagnosis of AS was only confirmed if DSM-IV criteria were clearly fulfilled based on clinical judgment and available information during the interview without a delay of cognitive or linguistic development in childhood.
A standardized interview or test for diagnosing AS in adults according to DSM-IV criteria that is based on information obtained from sources other than parents is not available. Even if the parents are available, adults often do not wish them to be consulted.
Assessment of special interests
Every participant received a questionnaire to assess special interests. Kinds of interests, age of onset and end of interest, engaged hours per day and spent days per week as well as intensity of engagement were explored (Figure 1). Participants were instructed to remember and list all special interests across their lifespan.
Description of interest
Age of onset of interest
Age of end of interest
Days of engagement per week
Hours of engagement per day
Intensity of interest:
(tick the most appropriate)
none
little
mode-rate
strong
very strong
1
2
3
4
5
Figure 1: Questionnaire for exploring special interests (translation, original in German language). There was no limitation for listing interests.
Data analysis
All analyses were performed using the software SPSS (Version 23.0 for Windows; IBM SPSS).
Subgroup differences (childhood versus adulthood; female versus male) were analyzed with the Mann-Whitney-U-Test for continuous variables as they were not normally distributed. Statistical significance was defined by a p-value of .05.
Results
Childhood/ adolescence
Concerning childhood and adolescence female individuals described on average 4.2 interests (SD = 2.2) with a mean age of onset of 8.6 years (standard deviation SD = 4.5) and an average duration of 16.7 years (SD = 13.7). They spent averagely 5.4 days per week (SD = 1.9) and 2.7 hours per day (SD = 2.3) with their interests. Mean intensity of interests were described with ‘strong’ (4.2, SD = 0.81). One female person denied the presence of any kind of special interest in child- and adulthood.
Male adults reported to have had 3.5 interests (SD = 1.7) in childhood/adolescence. Mean age of onset of those interests was 8.9 years (SD = 4.0), mean duration was 18.5 years (SD = 12.6). In childhood/adolescence they passed 4.7 days per week (SD = 2.2) and 2.4 hours the day (SD = 1.9) in average with their interests. Mean intensity was reported as ‘strong’ (4.0, SD = 0.8).
There were no significant differences between described parameters of interests between female and male persons with regard to childhood and adolescence.
An overview of quantitative key data of special interests is given in (Table 1); topics are listed in (Table 2).
Childhood
Adulthood
female
number: 4.2
number: 4.3
days: 5.4
days: 5
hours: 2.7
hours: 3.2
intensity: 4.2
intensity: 4.1
male
number: 3.5
number: 4
days: 4.7
days: 4.9
hours: 2.4
hours: 2.2
intensity: 4.1
intensity: 4.1
Table 1: Key data about special interests in our males and females with asperger syndrome.
Childhood
female
male
dogs
cars
stamps
stamps
horses
numbers
guitars
geology
philosophy
vehicles
animals
comics
leaves
programming
piano
Islam
painting
fishes
electronic
insects
plants
electronic
astronomy
chemistry
stones
maps
computer
astronomy
programming
science fiction
medicine
Lego
cooking
lexicon
rabbits
modeling
paragons
computer
films
weapons
musicals
atlases
star trek
dinosaurs
marbles
economy
maps
Roman history
lego
Marx-brothers
photography
surfs
psychology
football
ships
Adulthood
female
male
psychology
painting portraits
autism
electro-techniques
chicken
genealogy
astronomy
Islam
education
cars
dogs
helicopters
arts
radio stations
drums
informatics
dolls
comics
fossils
telephones
dogs
photography
postcards
evolution
photography
beer mats
saxophones
foreign languages
philosophy
psychology
social justice
programming
animals
chemistry
horses
maps
piano
science fiction
painting
astronomy
medicine
modeling
cooking
atlases
computer
electronic
Table 2: Choice of described interests of individuals with an asperger syndrome in child- and adulthood.
Adulthood
Average number of interests in adult females was 4.3 (SD = 1.9). 62.5% of childhood interests were continued in adulthood. Female adults averagely dealt with the interests 5 days in the week (SD = 2.2) and 3.2 hours the day (SD = 3.6). Mean intensity was ‘strong’ (4.1, SD = 1).
In adulthood male individuals with AS had in average 4 interests (SD = 1.9), 77.1% of childhood interests persisted into adulthood. Adult males spent averagely 4.9 days per week (SD = 2.2) and 2.2 therapeutic element, as adults with an AS often suffer from further psychiatric co morbidities and show lower levels of mental health [13,17]. As described by Attwood [2], in few cases of our participants a special interest even became a profession. One female and three male participants with an interest for programming became programmer, one male person studied history due to his fascination for Roman history.
Limitations of the Study
The results of our study are limited by the small number of participants. Additionally we didn’t investigate a non-autistic control group because our focus was set on the course of special interests within a group of individuals with AS, to find out if there are differences between child- and adulthood concerning the exercise of interests with an additional view on the gender. Nevertheless, there exists no concrete definition of a “special interest” in autism with regard to frequency and intensity of practicing it, the given definition with unusualness in content or spending time with it is quite vague. That is why we didn’t exclude any described interest of participants and didn’t define criteria of frequency or intensity on our own. We rather included all described interest to have an objective result concerning the course of spending time with interests from child- to adulthood in our individuals with AS.
Another limitation of this cross-sectional study may be the retrospective data collection with regard to the childhood. Memories of participants could be inexact.
Finally, a general problem is the lack of a gold standard in the diagnosis of AS in adulthood. Various interviews are available, but there exist disadvantages as the interviews are not consistent with DSM-IV of the individuals. Often parents are not available or adults do not wish to involve them. Therefore, the development of a standard for diagnosing autism in adulthood is an important issue for the future. In agreement with Joshi et al. [19], we gave priority to consideration of the DSM-IV criteria via interview and clinical observation. Thus, we can clearly state that all of the adults included in the current study fulfilled the DSM-IV criteria for AS
Conclusion
According to our findings, special interests seem to be a stable symptom in individuals with Asperger autism. Time invests and sensed intensity in adulthood is similar to those in the childhood. Therefore, special interests may be considered as an important part of life of individuals with an AS across their lifespan and should be appreciated and even be used as a kind of motivating resource, despite as being considered under a deficit-orientated view. In few cases a special interest can even become a profession.
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