EILEEN HOPKINS: Can I ask you who you are and what role you play in the world of autism?

TONY ATTWOOD: Well, I’m Tony Attwood and I’m a Clinical Psychologist, the role I play is a mixture of roles. I work as a clinician but I’m also involved in supervising research and giving presentations at conferences and so on. So I work in a whole variety of areas on the whole of autism spectrum.

And you obviously write a great deal and we read with interest what you’ve written.

So do I.

Right, one of the things I’m interested in are your special interests, and in particular Asperger syndrome you’ve written widely about it and you’ve obviously taken great interest in this particular area, so I’d be interested to hear about some of the particular issues around this group of people and this diagnosis.

To talk about the issues is a huge topic and I suppose I’m interested in all aspects of Asperger. From how to identify characteristics in the kids, but new areas on how to diagnose characteristics in adults, how to support such people at school and home, what I call the social curriculum plus dealing with some of their particular issues in relation to managing their moods and feelings and the development of cognitive behavior therapy for this population. So, I’m interested in all aspects of Asperger Syndrome.

What do you think were the real pertinent, social issues? What can people do to gather a widening knowledge really about the sort of spin off, if you like, of living with Asperger syndrome? You mentioned the social support that people need, obviously we’re getting formulized daycare, we’re getting education to people, we’re getting a variety of career opportunities, what seems to be missed in all of this is the very narrow social lives that people with Asperger syndrome have, do you want to comment on that?

Yes, I think one of the major issues is encouraging friendship skills, starting at school because friendship skills are the basis of teamwork skills as an adult. The better you are in friendship skills the better you are in managing conflict. In many ways developing a relationship that may become a partner and finally when we look at the major reasons for depression and agitation that goes with Asperger Syndrome. It’s because of their confusion in the social world, so it’s a very good antidote to potential depression, anxiety and anger later in life.

And so you’d recommend the development of informal group supports for people with Asperger’s syndrome, or are you saying you need to teach them how to proactively seek friendship because one of the things that I’m aware of is that sometimes people are given social skills training in how to initiate friendships but because the person they then approach is not aware of the issues around Asperger Syndrome it can fail and obviously failure isn’t good. So are we talking about friendship skills including recruiting people to be friends, if you like?

The friendship starts from day one, how to find a friend, what to say, and what to do, but also how to maintain friendship, but also how to recognize those who are not friends.

Exactly.

Because my concern with Asperger Syndrome is that they are very vulnerable to not only bullying, teasing as children, but also being taken advantage of as an adult, so their friendship and relationship skills really need support and monitoring probably most, if not all of their lives.

Right, there’s been a great deal spoken over the last 2-3 years about the widening of the spectrum to include those people with Asperger Syndrome, who maybe functioning reasonably well in society, but we now draw into the spectrum of people with autistic spectrum disorders, do you consider this useful? Why, and why not?

OK, I think it’s very useful to identify those people who may need assistance; obviously if they don’t want assistance that’s their choice and that may be the case but they need assistance in a variety of areas so that it maybe when it comes to employment it’s looking at the profile of abilities in Asperger Syndrome to really make good career choices, so that their abilities are used to best advantage. But then if their weaknesses are in certain areas the strategy is to accommodate that, so I think that the support goes through in many different areas.

Can you comment, on some of the issues for people that enter relationships with people with Asperger Syndrome. The partners with people with Asperger syndrome and some of the difficulties they encounter?

I have great admiration of partners of people with Asperger syndrome. They are remarkable, usually ladies but not exclusively, who have shown a degree of compassion, loyalty and understanding that’s absolutely incredible, and I’m delighted with what they do, but what happens is that clearly they also need their own emotional support because they are faced with all sorts of personal challenges with a partner with Asperger Syndrome in both their personal life, in family dynamics as the ability of the person with Asperger’s Syndrome to relate to their children and other aspects of their work situation, so I strongly support a good network for partners of people with Asperger’s Syndrome.

And what would you say; they fall into two categories because they’re quite a different group of people who knowingly marry someone who has Asperger Syndrome and there’s another group of people who through difficulties that emerge in the relationship discover their marriage is to someone or they’re living in partnership with someone with Asperger’s Syndrome.

I would say that the partnerships split into three groups. One is marrying someone with very similar interests so they may be both entomologists or they are both fascinated by a shared interest, but they live together as platonic friends which is formalized in a marriage and they may have similar aspirations to be successful.  The other group tend to be partners who are very empathic, very socially skilled and extremely maternal individuals who recognize that their partners have difficulties and are kind and supportive of them but realize that it is not an equal relationship. The third group is that some people with Asperger’s Syndrome can be what I would call arrogant and find a partner who is by nature a very submissive individual and that’s the third group and that third group find a partner from another culture where the relationship suits both financially and socially but it is a unusual relationship.

Very complex relationships, and complex for both of the two people involved to manage and also for other people to support and I know there is a growing network for partners certainly in the UK and I would be interested to know if this group of people are a growing network worldwide.

There is a growing network worldwide. Fortunately the UK are the  forefront of this but certainly in the United States there is a realization that the marital support is a crucial support not only for both partners but also for their children as well.  So I think this is only just starting. The Internet has been remarkable in allowing partners to contact each other but there are now workshops being proposed specifically to support partners.

I suppose it becomes even more complex because some of those people involved will also be parents of people with autism.

Yes, indeed it is a complicated area and needs remarkable diplomacy and tact in situations but also clear support, and I think as a group they have the ability to support each other with tactical ideas which aren’t in any text books but they found by their own personal experiences.

An event such as this will give them the opportunity to explore those support systems.

Indeed, that is why I support it so much.

Next and really of interest to people who may be listening is what would you view as the key events over the period you have been involved with autism, which I guess goes back 25 years?

My involvement, began in July 1971, with the key events were the first two children I met with autism who looked like any other kids but totally challenged me both intellectually and emotionally [so] that I decided to pursue a career in this area.  I suppose the key events in many ways are key people.  Key people have been Uta Frith, who was my PhD supervisor, for her intellect, her remarkable insight into this but also with Lorna Wing, with her compassion and understanding and also a colleague, Carol Gray, [for] her practical ideas. So there are key people but also I suppose in a way it’s every person I meet on the autistic spectrum, it’s the ingenious way that they have accommodated autism or Asperger’s Syndrome so I have learnt more I suppose from people with autism and Asperger Syndrome than from any text book or lecture.

And what do you think the next big breakthrough might be?  This is a question we have asked a number of people and we have had very interesting answers.

OK, right when you say breakthrough I think there are areas where we have not covered that must be covered in the new millennium.  First of all the repetitive behavior is of special interest. We recognized it from day one but we have no idea why and how.  Secondly the sensory perception, the hyperacusis, the tactile defence system which really does impact on the lives of such individuals and yet we do not know physiologically what is going on; we are very much in the dark to what to do. I also suspect the next big breakthrough will be in movement disorders in the autistic spectrum, from Tourette’s disorder to catatonia and we will recognize that some of these kids do have recognizable movement disorder. Finally, I think the new neuroimaging techniques which show which areas of the brain are switched off may well lead to medication which eventually switches them on.  I think that is extremely promising.

And on that very positive note, Tony, I would like to say thank you very much.