ASPERGER SYNDROME IN
MILITARY SERVICE
Roger N. Meyer
Copyright © 2005 All
Rights Reserved
Introduction
To the author's
knowledge, Asperger Syndrome (AS) as it affects the military service has not
received any substantial public attention prior to publication of this
paper. A fully annotated version of this document will be available in
early 2005.
This paper addresses
specific aspects of Asperger Syndrome as manifested by personnel in military
service. Background for material contained in this article comes from the
author's own experience in the US Army in the mid to late 1960's, reports of
service veterans later diagnosed with Asperger Syndrome following their
discharge from service as well as individuals currently serving on active
duty as officers, enlisted personnel, and warrant officer personnel with all
US military services, including the US Coast Guard. Information from these
sources has come through postings on Email list servs, personal
correspondence, and personal contact.
*****
There are few
written accounts of what military service is like for individuals later
diagnosed with Asperger Syndrome. Two accounts appear in the writings of
Edgar Schneider. He served in Korea. He first describes military life in
chapter 18 of his book Discovering my Autism (1999). In that chapter
he refers to the singularity of purpose and hyper focus that made him an
effective soldier performing technical tasks. In "Values Manifested during
Military Service," the author describes the best time he had in the service
was time he spent as an enlisted man. Although he later accepted a field
commission, he alludes to the high level of competence he could demonstrate
as an enlisted technician, something denied him in role as an officer. In
his latest book Living the Good Life with Autism (2003) on pages
227-122, Mr. Schneider refers briefly to his dissatisfactory experience as
an officer including suggestions made by his reviewing commander aware of
his command limitations that the warrant officer career ladder would
be more appropriate for individuals with his known challenges. The author
also refers to the confused and mixed feelings he experienced following his
active service as he encountered other former members of the armed services.
In this author's
Portland adult Asperger Support Group, there are six members who are former
military personnel. (There may be more.) One member, now in his early
seventies, was an aircraft mechanic and crewman in a B-29 bomber squadron
during the Korean War. A second member saw duty as an artilleryman in
Vietnam and like many combat personnel during the early phases of that war,
he received an "early out" following his active duty to Vietnam. A third
member is a graduate of the Air Force Academy who served in highly technical
assignments before he left the service. He did have command experience, but
not in a combat setting.
The fourth man
was in the Navy during WWII. He was a "medical washout." He went on to
have two, long-time careers and lives a comfortable retired life. A fifth
man spent four years of a Regular Army enlistment as an intelligence
specialist in Vietnam. A sixth is a Gulf War veteran Marine Corps Gunnery
Sergeant "in for six" in charge of an advance company of 120 men which
forged ahead right after conditions ahead had been softened by artillery and
air attacks.
Except for the
man who "medicaled out,", their experiences are typical of others who
reported good experiences in high-skills-valued military occupational
specialties in all branches. Of the six, two held up well under demanding
combat conditions. The one who "medicaled out" represents the tip of the
iceberg of late and undiagnosed former members of the service who didn't
fit. While some had successful lives following their encounter with the
military; many more did not.
For a sequel to
this paper, this author has begun to collect service and re-entry histories
of adults recently diagnosed with AS. From only a half dozen histories
taken so far, most individuals report successful military careers in which
they chose to remain on active duty for substantial periods of time in a
variety of roles, some command and some support.
Why Knowledge of
Asperger Syndrome is Needed in the Military
Recent Knowledge
of Autistic Spectrum Disorders (ASD) in Military Medicine
Over the past
decade, adult Asperger Syndrome has become better known to career military
medical and psychological specialists for several reasons.
First, the
general media has featured AS prominently in articles about children,
and, more recently, about adults who may either have been diagnosed with
autistic spectrum disorder as children, or recently properly diagnosed as
adults after a succession of earlier diagnostic labels that never quite
seemed to fit. Career military medical and mental health professionals view
the media and read the same journals as their civilian counterparts.
Second, as
military service and affiliated health service clinical professionals
members identify AS children and adolescents of active service members,
best diagnostic practice currently calls for assessment of first order
family members of children for likely indicia of autistic trait behavior.
If not found in the biological parent(s), autistic spectrum disorder has
been shown to be prevalent in parents' immediate and extended family
members. Even in the instance of deceased family members, it is possible to
reconsider their condition from family history and documentation as
connected to or likely "on" the autistic spectrum. Since many ASD-related
behavioral anomalies are quite manifest in the early years, effective early
intervention efforts are markedly improved when ASD-specific parent training
helps spectrum-sitting parents partner with professionals working with their
children's developmental delays and challenging behaviors.
Third, active
military adults, many of whom have been called to full-time duty
recently as a result of heightened DOD dependency upon the Reserves and the
National Guard may, in fact, have been diagnosed with Asperger Syndrome
or considered likely candidates for the diagnostic label by mental health
providers in the civilian healthcare system. Even if not diagnosed, if an
activated military member reports autistic spectrum disorder in his or her
family of origin, the statistical likelihood of the member having trait or
full-blown high functioning autism or Asperger Syndrome, or PDD/NOS, is
significantly higher than with persons reporting no such incidence in their
families.
Another reason
why AS has become better known to the military medical and mental health
system is that recently activated medical and mental health professionals
have bring up-to-date civilian diagnostic practices and perspectives into
military medicine. Questions regarding accommodations for disabilities are
commonly asked of civilian clinical practitioners. It is likely that
informal accommodations long a part of the military culture may be
formalized by more prevalent practice and the "in the records jacket"
written entries of recently re-activated mature personnel.
With the graying
of the Individual Ready Reserves and National Guard, disability
accommodation issues, generally considered of secondary importance in active
duty retention and promotion situations, now have become far more prominent
as individuals with a very broad range of civilian employment skill sets
along with some special needs are recalled to active duty. When disabled
National Guard members arrive with their intact units, it is not possible
for the active career services to impress such persons into other regular
service units for reasons of military convenience due to the fact that
although we may be in a state of war, a full set of draft conditions does
not, in fact, exist that otherwise might allow such individual member
reassignment between National Guard and active service unit components. If
their disabilities make them unfit for combat and If their units' assignment
involves combat theatre deployment, National Guardsmen and women must
currently be separated from the service. While fitness to serve may be a
medical decision, preserving the fighting readiness of an individual
National Guard unit is strictly a command decision, not a medical one.
Guided by advice and recommendations of their medical corps colleagues,
unit commanders make such decisions on a case-by-case basis.
Disclosure is an
Issue
In the case of
persons called to active duty, some HFA/AS individuals may not disclose
their diagnosis or their suspicions even if they have private concerns or
are self-diagnosed, often with peer confirmation. Failure to disclose is
attributable to a number of causes.
First, the
individual may not be sure that he is autistic, especially if he has not
sought a definitive diagnosis by a competent mental health professional
experienced with the condition.
Second,
Individuals can remain undiagnosed due to systemic problems in the mental
health profession. Many civilian mental health professionals remain
woefully ignorant about autistic spectrum disorders, and if the individual
seeking an explanation for personally troubling behavior or life-long
cognitive challenges encounters professional ignorance, or, worse yet,
arrogance, they may still harbor a concern that hasn't been well-handled by
an insensitive mental health professional or a whole string of them.
Medical and
mental health professionals who have virtually no clinical practice, and
only act as consultants to agencies and benefits systems, such as Social
Security and Workmen's Compensation, and, in increasing numbers, to the
medical insurance industry, persist in obsolescent, professionally
indefensible conduct attributable to collegial reluctance to call such
persons to task for their failure to observe current diagnostic practices.
Other mental health specialists corner a niche market and see only what
their particular specialization within the broader field allows them to
see. Unwary individuals seeking and accurate diagnosis soon learn the
"street reputation" of such self-proclaimed experts, and avoid them due to
their proclivity to label everything and everyone who consults them with
their own one-size-fits-all label.
A related
systemic problem is that some professionals altogether reject the notion
that Asperger Syndrome is a legitimate condition, despite the body of
literature differentiating it from other developmental conditions and
near-universal professional acceptance of its special features. Individuals
in the military medical and mental health fields treating only members of
the service rather than their families are less likely to consider Asperger
Syndrome among suspected conditions as it is often associated in their minds
only with child diagnosis and presents differently in mature adults of
either sex.
Third, the
individual may know he is Asperger Syndrome or high functioning autistic
(HFA) but has developed comprehensive coping mechanisms and masking
behavior to the point that his manifestations rarely "leak out" to
casual acquaintances -- employers or others who might otherwise be in
positions to observe eccentric behavior or thinking and either comment or
act on it. While this is a relatively rare phenomenon, in dealing with
highly motivated individuals desiring to serve their country through
military service, the AS individual's single-minded dedication to serve may,
under non-stressful conditions, becomes a preservation that masks
their otherwise noticeable manifestations of Asperger Syndrome.
Asperger
Syndrome and the Failure of Logical Connections
Even among
individuals who acknowledge their Asperger Syndrome, there may be instrumental
reasons why they do not disclose. Some failure to disclose is a
function of the different explanatory and logic systems of people with the
condition.
For example, they
may view serving in the military as such an essential part of their identity
that they fail to consider the consequences of what would happen when stress
and demands for multitasking and instant-judgment problem-solving suddenly
strips away the veneer covering their condition's ordinary invisibility or
characterization as a mere eccentricity. Another example of an
instrumentally related non-disclosure is that the AS individual may not
think that their self-determination is either of interest to others or would
be considered in the same way they consider it. Their own unique
self-oriented, closed-system logic convinces them of this conclusion. Hence
it doesn't occur to them that others have their own reasons for wanting
them to disclose.
Other ASD
individuals may primarily view the Reserves or the National Guard as a
vehicle towards government-subsidized education or a supplemental income
to what otherwise is very low pay in the civilian job market. It is easy
for others to see the connection between disclosing a condition and the
welfare of fellow comrades in arms. Many AS individuals fail to make that
connection, primarily because up to the time of their activation to combat
duty, they haven't thought of the process they're involved in as "weekend
warriors" as relating to much more than fantasy rather than rehearsal for
the real McCoy. Individual incapacity to see the big picture under normal
-- let alone combat stress conditions -- can have tragic consequences.
Many
individuals are unskilled in disclosing their condition.
Contrary to others' expectations arising from the apparent "social
competence" demonstrated by some AS individuals, many individuals with ASD
have only surface-level skills, developed after patient, long-time
rehearsal. Under non-routine, unpredictable conditions, their poor
initiation skills combined with a fear of making social mistakes leaves them
unable -- not unwilling -- to disclose. Many AS individuals are poor
judges of the best conditions supportive of disclosure, or as is more often
the case, suppressing the truth when to them -- but not to others --
"truth must be told." Having learned that their inaction as well as their
poor behavior choices when they have decided to act generates negative
reactions by others, they don't know how to disclose, and so often
they don't.
Denial
A final reason
why individuals with ASD do not disclose their condition to others is
denial. Having received the diagnosis from a competent professional, or
having been clearly informed about ASD by family members, friends or
colleagues, their brittle self-concept and need for absolute control
prevents them from taking in the message. In the past, under the "old
military model" it may have been possible for service personnel to operate
easily within the clearly designated confines of well-outlined military
occupational specialties. Routine was relatively unchanged between one unit
and the next, and while differences in command style have always existed,
the historic inflexibility of the armed services in accepting change and the
documented practices to always fight the last war lent an air of great
predictability and comfort to individuals whose lives depend upon
regularity, "the same routine," and the absence of sudden change.
These are the
individuals who report having completed their terms of active service with a
certain degree of pride about their military career, whether they spent a
single enlistment period or the full hitch.
Those individuals
(men) who were married and had children and wives with them during their
terms of service were characterized by their wives as rigid, unbending
disciplinarians often acting with unrealistic, "wooden" and unreasonably
high expectations towards their children, and uniformly uncomfortable in the
social presence of other personnel. Their wives reported that living with
them, or when they experienced their returns from duty during leaves and
holidays, were times of high tension. In most cases, the marriages were not
described by the wives as emotionally satisfying, nor were parenting
responsibilities, even under conditions of limited expectations,
successfully carried out by these AS husbands.
Not enough is
known about women now diagnosed with Asperger Syndrome to make such
categorical statements about their active service careers, although it is
very likely that a good number of women have done rather well in the
male-values oriented military because of the greater likelihood suggested in
some research that their values align more along the values, behaviors and
attitudes of the stereotypical male role than the role assigned by society
to the "place" and temperament of women in the work force.
Washouts
On the other
side, those who wash out early, sometimes not getting further than an
enlistment center without seeing life in basic training, AIT, or their first
full-duty assignment...these are ASD individuals who recognize the ill-fit
between their needs and that of the service. When this author was in "the
old military" in the mid to late 1960's, he served six months in an armor
branch training battalion as S-1 clerk after having first served for 18
months as an instructor to enlisted clerical personnel at the same
location. In both assignment areas, he experienced the washout phenomenon
first hand, mainly from enlisted personnel caught in the draft or as
entering-phase volunteer recruits. While most of the individuals found
unsuitable for the service were clearly so long before they entered, others
-- a much smaller number, and among them, most likely some individuals on
the autistic spectrum -- learned that their expectations did not meet the
demands of the service, even surrounded as they were with such regimentation
and routine, with no prospect of seeing combat as a consequence of their
advanced training.
They simply
couldn't take the change from the routines and predictable conditions that
had surrounded them up to the time of entry into the service. Realizing at
last that the military wasn't the same place, they did anything and
everything to get out. Looking back now as this author remembers processing
their Article 15's and Summary Courts Martial materials, some of these
washouts may not have craved escape as much as they did an absence of change
and predictability to what otherwise appeared to them to be a chaotic set-up
over which they did not have the appropriate internal tools in place to
exert control over behaviors that now could be perceived as predictable
Asperger Syndrome response to radical change.
There were junior
officers who failed to complete their initial branch advanced training
assignments as well. Along with enlisted personnel separation and discharge
papers, this author processed their papers. A number of well-educated
individuals in this group demonstrated little capacity to think clearly or
appropriately under the slightest amount of stress or under changed
conditions. This author has little doubt that among such individuals were
persons who made excellent paper grades but whose people-skills, as well as
other skills essential to command, were more likely related to possible
Asperger Syndrome coming into contact with the real-life demands of the
complex social and multi-tasking duty world of the officer corps.
Under the old
military, and under military assignments and conditions that are clearly
unlikely to involve the uncertainties built into combat situations, AS
individuals in the past and in the present do "just fine." Many individuals
in Reserves and National Guard Units who never expected to be on the front
line, no matter how far removed from previously well-defined lines of
combat, now find themselves pressed into duty conditions where the lines
aren't clear, and where high vigilance is often the standing order of the
day. For individuals clinically defined as hyper vigilant even under
non-stressful conditions, the implications of placing such persons in combat
conditions couldn't be clearer. Rather than knowing what they will do under
such conditions, it is best for all dependent upon them to expect the
unexpected from them. And they usually get it.
The New Military
Demands Different Skills and Flexibility
Between Vietnam
and Grenada
The all-volunteer
military brought with it a unique set of demands, but also carried forth
many predictable traditional ways of doing business. During this time, it
was possible for individuals to somewhat control the conditions under which
they chose to serve, or to select military occupations less likely to
experience severe disruption, displacement, or change. Our country's much
smaller volunteer defense component was able to weed out individuals who
showed less promise than that required of a new, leaner structure. Marginal
officers who had somehow made it under the radar and had bumbled along
mostly unnoticed or passed on by commanding officers who hoped for the best
but realized the least from their performance now found themselves cast out
of the service. By the time of the Gulf War, the military had gotten so lean
and mean that for the first time, Reserves and the National Guard were
called up in large numbers. Nevertheless, the War was so brief and the
return of Gulf War "extras" was so swift that it's hard, even today, to
untangle the complicated web that spelled "major change" that we now see in
the active service.
Everything has
changed as a consequence of 9/11 and the Iraq War.
One AS Officer's
Story
In the late
nineties, this author recalls having received a call for assistance from the
sister of former Army major, passed over three times, who was a
reduction-in-force cast-off. He remained largely un-noticed as an enlisted
man, and eventually applied to OCS and received his commission. The author
never met him, but was told by his sister and her husband, who became his
full-time providers of employment, bed and board, and entertainment, that
not only did he suffer from obesity, but also a profound lack of
initiative. It is hard to believe that given their description of his
failure to accomplish a minimal level of adult self-sufficiency, even after
having been discharged with a nice cache upon his mustering out, that he
remained in the service as long as he did. He was an inveterate gambler,
and despite the sizeable amount lump sum of money nearly ($50,000.00) given
him upon discharge, he burned through it in less than six months. He was
slovenly and unkempt. He did not drink. He did not use drugs. He didn't
appear depressed, although reports of his conduct indicated massive
maladjustment to independent living. He joined the military right out of
college with no prior work history or attempts at living independently. As
an adult, the military was the only home he knew. When the author last had
contact with his sister, she reported they had to fire him from his
"make-work" job in the family binding business. He had also been finally
asked to leave their home. He was unable to offer them any assistance in
caring for their children and became another child in the house. As far as
his sister knew at our last contact, he was homeless.
The only way the
sister knew her brother was Asperger Syndrome was through knowledge she
gained in having married a successful, high functioning Asperger husband
herself. The fact of AS was brought home when two of her three children
(males) were diagnosed with AS. Having studied up on AS, she saw "AS all
over the place" in her adult brother's history and childhood.
This man had been
able to get by for 17 years in the active military during its non-draft
history following the Vietnam War. He was finally discharged honorably but
for good of the service primarily because his obesity and poor self-care was
one issue that couldn't be overlooked. He was good at what he did; however,
he refused to accept more challenging assignments. He was a perpetual
student, and while in the military, completed his undergraduate degree and
earned three master's degrees. When he dropped from the author's
sight, he was enrolled as a graduate student studying for a fourth master's
degree at a local urban university, this time having started his profile as
a government loan recipient. He was not working. He is never likely to
work.
He didn't know
the meaning of work in a competitive employment setting, nor did he connect
the value of money with what it cost to live. He had no social skills to
speak of. In today's military, as well as in the military from which he was
discharged, he was unacceptable material.
More Coming Home
Means "More In"
In the media,
there have been occasional articles about homeless individuals who are Gulf
War, and now Iraq War veterans. One such article in a Portland Oregon paper
featured the story of a homeless veteran with Asperger Syndrome. He was in
the Army in the late 1980's for two years, then joined the Montana National
Guard and transferred to the Washington State National Guard serving for an
undisclosed period of time. For most of his adult life he has been
homeless, on drugs and alcohol, unable to hold onto work because of what he
now recognizes as a lack of soft or social skills, and, of course, has
lacked such skills all of his life. He has many hard skills, good-job,
high-paying skills, but not many soft skills. He was diagnosed with AS two
years ago. He's now on a rehabilitation track in a number of areas in his
life. The article says it is unknown how many such individuals there are on
the streets at any one time. Tracking individuals reluctant to access the
shelters has given us only a best estimate of their real numbers. Up to
half of such homeless middle-aged men may be veterans. Of course, this
author does not suggest that a sizeable number of them may have undiagnosed
Asperger Syndrome. But some do. With the number of active service
personnel now at a recent historic high mark, there may be many individuals
like him, just waiting their turn for discharge.
Some Common
Characteristics of Asperger
Syndrome Noticeable
under Stressful Military Conditions
Commanders in
combat theatres know that many individuals demonstrate some of the
behaviors listed below. What should concern military commanders is that
manifestations of Asperger Syndrome present more frequently or
constantly, with greater intensity, or "clumped together" for
longer periods of time, and are generally just "more so" than for the
average person, even if the situation is far from ordinary. When an
individual demonstrates a great number of these characteristics during
periods of relatively low stress while in a combat theatre setting,
referral for comprehensive medical evaluation is especially recommended to
prevent disastrous consequences under the highest stress conditions of
combat.
No one without
medical or clinical license should ever attempt a "field diagnosis" but it
is appropriate for commanders to request competently trained mental health
personnel conduct a formal diagnostic "rule out" for Asperger Syndrome.
When commanders use the term rule out, this term prompts mental
health professionals to exercise a far higher level of sophistication in
their evaluations than general requests to "Find out what's the matter with
this person!"
PROBLEMS WITH CHANGE
Summary and
Conclusion
The author hopes
that this introductory paper to Asperger Syndrome in the military service
will sensitize commanders to the existence of Asperger Syndrome in the
active military service who up to the present who have eluded easy
understanding and who, because of the severity of their manifestations, may,
indeed, present substantial risk to themselves and others in combat
settings.
Asperger
Syndrome, just like all of the other autistic spectrum disorders, or ASD's,
is a spectrum condition. This means that for individuals with mild or trace
aspects of Asperger Syndrome, military service can offer an good quality of
life to them as well as provide the armed forces with their special skills
and talents, which haven't been addressed in this paper.
If means can be
arranged within a "ready to fight anytime, anywhere military" for
individuals with the special skills Asperger individuals are known to have
away from a combat setting, they could contribute substantially to the
higher level intellectual culture of the armed services by being allowed to
serve, as indeed many of them now serve with distinction, undisturbed,
undiagnosed, but appreciated.
Even in its
milder forms, Asperger Syndrome may be accompanied by known higher
prevalence of certain health problems and some mental health disorders of a
chronic rather than an episodic or "one time" nature. Because of the still
unresolved relationship between autistic spectrum disorders and these other
conditions, no doctrinaire conclusions can or should be drawn to suggest
that AS is an unacceptable condition in the armed services. Like it or not,
commanders at all levels may have individuals with undiagnosed, mild
Asperger Syndrome in their units. Rather than sweeping the baby out with
the bath water, intelligent, informed deliberation should guide a
commander's decision to pry into the innards of a subordinate's life,
especially when the person appears to be doing well, if not very well,
undisturbed. If an individual in question has served well and with
distinction, this is even less of a reason for knee-jerk, insensitive
response to a commander's increased knowledge of this condition.
Knowledge of
Asperger Syndrome "in" the command provides no excuse for a witch hunt that
could leave the military considerably poorer in having exercised uncritical
judgment in declaring an entire, highly varied class of individuals unfit
for duty without considering, in each person's case, whether the ultimate
decision to retain or seek separation is truly good for the service or the
nation.
About the Author
Roger N. Meyer is
author of Asperger Syndrome Employment Workbook (2001) and is completing a
second book on peer-led adult AS support groups. Diagnosed with Asperger
Syndrome in 1997 at the age of 55, he is an independent disability
consultant, advocate and representative for individuals with cognitive and
developmental challenges. He served his full enlisted term in the US Army,
attaining maximum allowable enlisted rank. He saw duty as an enlisted
instructor, Battalion S-1 clerk, and intelligence specialist during a
special temporary duty assignment to the Pentagon.
He maintains a private
practice as a special education parent/student advocate, social security
claimant representative, ADA advocate, independent mediator and wrap-around
services case manager. He founded and now co-facilitates the Portland AS
(adult) support group, and with a licensed clinical colleague,
co-facilitates a married AS Partners Group in which one or both members of
the committed relationship are on the autistic spectrum. A frequent
presenter at regional and national conferences, Roger has maintained his
interest in adult issues by participating with clinically licensed
colleagues in a multidisciplinary monthly AS study group developing best
counseling practices for children, families and adults. He is active in
Gresham Oregon (Portland suburb) non-disability politics, serving as one of
his city's three commissioners on the Multnomah Housing and Community
Development Commission. He is acting secretary of the Oregon Social Security
Claimants Representatives organization. Roger is president of the Rockwood
Neighborhood Association serving Gresham's poorest and most ethnically
diverse neighborhood, and active in neighborhood and his condominium
association's board leadership.
Contact Information:
Roger N. Meyer
"...of a different mind"
18162 East Burnside
Portland, OR 97233
Phone and FAX:
503-666-2776
Cell: 503-358-6463
Email:
RogerNMeyer@earthlink.net
http://www.rogernmeyer.com
Copyright Matters
This article is
copyright, all rights reserved by the author, Roger N. Meyer. It may be
reproduced in single copy once for personal use, and in no more than ten
copies total for educational purposes. Fair Use is authorized for all
purposes and under conditions established by US Statute and the
International Copyright Convention, to which the United States is a
signatory nation. No person shall publish, distribute, copy, or by other
means make this material available to others for purposes of personal gain
or professional self-aggrandizement. Individuals wishing permission to
exercise other than fair use or limited distribution as outlined above must
contact the author, in writing, and receive explicit written permission from
the author prior to engaging in further use of this material.
