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When "Social Demands exceed Capacity"

I recently attended an educational meeting where one of the speakers did a brief but very informative presentation on the recent changes to the Diagnostic and Statistic Manual V (DSM-V) in relation to Autism Spectrum Disorder.  In the DSM-IV, Asperger’s Syndrome was recognised as a sub-category of Autism Spectrum Disorder.  In the DSM-V, all sub-categories have been removed, and are now just “Autism Spectrum Disorder”.

I’ll leave it to our ASPIA educators to make any further comment about the DSM-V, although if you’d like to read for yourself, go to the website of the American Psychiatric Association http://www.psychiatry.org/dsm5 and click on the fact sheet for “Autism Spectrum Disorder”.

What I want to mention here though is a phrase in the diagnostic manual that caught my attention rather profoundly and got me thinking, as I tend to do.

It says “This criteria change encourages earlier diagnosis of ASD but also allows people whose symptoms may not be fully recognized until social demands exceed their capacity to receive the diagnosis.

How often do we talk about not really recognizing our partner’s AS traits or the significance of those traits earlier on, particularly before marriage?  And we wonder how they managed so well before they got married, particularly those who have friends, a “social set” and have survived uni, etc.

I’ve often mentioned to partners  that the individual with AS may manage in a relationship ok until the first child is born, after which more and more difficulties begin to emerge as they can no longer cope in a situation that includes more than one other person.  Add subsequent children and the challenges are multiplied, add a change in jobs, moving house, etc and the situation is way beyond their capacity and the non-Asperger partner finds herself/himself absorbing more and more responsibility within the family.

This sentence in the DSM-V says to me that individuals with AS do have capacity up to a point, and that at some point social demands exceed that capacity.  After that their symptoms become more recognizable.  This adds another reason why it is only us, the partners, who make this observation and why others find it so hard to believe us, even our partner’s family members.

This says to me that the traits may have only emerged in a significant way as the demands of adult life have increased, which of course is the context that we share with them.

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