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To the Editor:
Across the nation and around the world, we are all deeply troubled by the tragic events in Newtown, Conn . As a neurologist who has dedicated my career to working with children with neurodevelopmental disorders, I was also dismayed by the fact that the individual who committed these acts was quickly labeled by the media as being diagnosed with Asperger’s Syndrome (AS), before it looked more closely into what will almost certainly prove to be his complex and multi-dimensional mental state. This quick and unfortunate diagnosis provided the first, keenly awaited glimpse into this young man’s psychological background and couldn't have been more misguided.
Yes, Adam Lanza may have had AS, but that is absolutely not why he committed these acts. As a practitioner working daily with children with AS, I experience that these children are very bright, kind, empathetic, and caring. On the other hand, they are socially awkward and unable to process non-verbal information efficiently due to an imbalance in development between different parts of the brain.
A recent CBS News piece on the removal of AS as a specific diagnosis in the American Psychiatric Association Manual summarized, “people with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills.”
This characterization, which clearly lacks any reference to violent or psychopathic tendencies, has been recognized for over three-quarters of a century: in 1944 a Viennese physician named Hans Asperger published a paper in which he described several of his young male patients who exhibited normal intelligence and language development but also demonstrated challenges in social and communication skills.
As differently as individuals diagnosed with AS can present, common threads in affected children are reduced self-awareness, difficulties with transitions, and obsessive routines. Another common characteristic is an inability to read and interpret non-verbal cues such as body language, facial expressions, prosody or inflections in voice. These together are known as non-verbal communication skills and are controlled by the right side (hemisphere) of the brain. It is believed that as much as 50% to 80% of the meaning of a conversation between individuals is understood through non-verbal communication. This deficiency on the part of AS children makes it extremely difficult for them to fit in and as a result of this imbalance, these children have trouble making and keeping friends, often leading to secondary self- esteem issues.
An increasingly broad body of research shows that the symptoms associated with various neurobehavioral disorders of childhood including AS are the result of a brain under-connectivity, also known as functional disconnection in the brain, a condition where the two halves of the brain – the right and left hemispheres – do not develop at the same rate and are not communicating with each other in a typical manner. This functional disconnection affects normal development and flow of communication across and between different areas of the brain. One half of the brain is significantly slower than the other, so it cannot compare and share information accurately with the other half of the brain. This communication is critical for an individual to experience the world around him in an efficient way. Simply stated, if you tried to connect a new computer with an older, DOS-based computer, the two could not share information because they would be processing at different speeds. AS most always involves a lack of development in and under-activation of the right side of the brain. This results in a lack of coherence or synchronicity between the hemispheres (think of an orchestra where many of the musicians were playing out of tune or not in rhythm with the rest of the instruments).
As a bright note, there are today certain types of therapies that focus on correcting hemispheric imbalances, frequently with much success. My colleagues and I have seen many children improve their ability to interact with peers, calm their perseverations and become more aware of their environments and contexts. In the coming weeks, it is likely that the full extent of the Newtown killer’s mental dysfunction will be brought to light, and once it is, we will see that there was a much darker and more severe illness than can be attributed to the all too common disorder described above.
I would not want the label of AS to in any way hurt these beautiful children or to place a stigma on them, causing others including the parents of these kids to think that they are dangerous or that the events in Newtown, Conn., could be a result of this imbalance.
Mark Goldenberg DC, DABCN, FACFN
Fellow of the American College of Functional Neurology Executive Director, Brain Balance Achievement Center of Fairfield County
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