United States: Asperger Syndrome in Military Service

Roger N. Meyer
Copyright © 2005 All Rights Reserved

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 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 three members who are former military personnel. 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, 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. Their experiences are typical of others who reported good experiences in high-skills-valued military occupational specialties in all branches.

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 primarily in non-combat, non-command, support roles.

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 is offered so that parents become effective partners in the intensive early intervention approaches known to be effective for the children on the autistic spectrum with notable 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 considerably 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 activated medical and mental health professionals have brought current 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-activate mature personnel.

With the recent older profile of Reserves and National Guard, 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 have entered active duty. When 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 inividual member reassignment between National Guard and active service unit components.

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 they are autistic, especially if they haven't 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 they are Asperger Syndrome or high functioning autistic (HFA) but has developed comprehensive coping mechanisms and masking behavior to the point that his/her manifestations rarely "leak out" to casual acquaintances -- their 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 perserveration that masks their otherwise noticeable manifestations of Asperger Syndrome.

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.

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 rhistoric 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.

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 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.

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.

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.

At the risk of simplifying matters, it is possible to take the clinical manifestations of Asperger Syndrome as described in the Diagnostic Statistical Manual (DSM-IVTR) and apply them in an uncritical way to a "watch list of symptoms."

This author believes such an approach to be, at best, simple minded, and at its worst, foolhardy. While the world of mental health differential diagnosis is opaque at best, what is needed are some easy touchstone descriptors of features of Asperger Syndrome most likely to be manifest under the high stress conditions of combat found in the military service. The list below is a brief identification of features of Asperger Syndrome of immediate significance to military commanders even before referral of individuals in their command for medical evaluation is indicated. However, if the person demonstrates a good number of these characteristics during periods of relatively low stress as they appear to someone with command or supervisory authority, referral for evaluation is recommended.

No one without medical or clinical license should ever attempt a "field diagnosis" but it would be appropriate to request that competently licensed personnel conduct a formal diagnostic "rule out" for Asperger Syndrome. This is a higher level of request than just a request to "Find out what's the matter with this person."

What is important for persons in command to understand about Asperger Syndrome is that all individuals demonstrate these characteristics from time to time. What applies to AS is that these characteristics appear 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.

• Unusually rigid adherence to routine and schedules
• Out of scale adverse response to announced or sudden changes
• Literal interpretation of orders and directives - "Inability to read between the lines"
• Unpredictable or unexpected behavioral outcomes to routine commands
• Inflexibility in the face of unexpected or sudden change of command or authority
• Inflexible approach to problem-solving "on the spot" when preference for "by the book" protocol is situationally inappropriate
• Consistently poor ability to anticipate the needs of work team members or others not well known
• Constant problem recognizing people after having seen them only a few times, or even once
• Poor appreciation of danger to self or sense of danger to others
• Inability to "read others' minds" when a security or quick decision-making action is called for
• Arriving at answers to a problem which, while correct, could subject others to danger or harm "along the way"
• Consistently arriving at conclusions without being able to articulate the steps to the conclusion
• Sleep problems (interruptions, difficulty in falling asleep) resulting in chronic or unpredictable inattentiveness during waking hours or hours of duty
• Unusual food preferences that may inconvenience meal preparation or require elaborate preparation rituals
• Excessive devotion to ritual behavior of any kind not easily explained by religious or health reasons
• High vigilance to auditory stimuli - hypersensitivity to sound (both a strength and a phenomenon leading to exhaustion)
• Unusual tolerance to or reaction to heat, cold, light, sound, touch, taste, smell, pain
• Adverse, consistently negative response to being interrupted or re-directed
• Unusual difficulty in "finding place" or resuming a task after interruption; preference to "start all over again from scratch"
• Consistently flat affect (unemotional, but to the extreme)
• Consistent distracting attention to detail or demands for more complete explanations than may be necessary in a "tight situation" (Good for military intelligence; bad for immediate combat decisions)
• Unusually avoidant of contact with others when not on duty or accomplishing joint tasks
• Rejection by members of command who ordinarily must depend upon a sense of camaraderie for effective performance of difficult or complex missions
• Consistent, greater than average concentration or attentional lapses
• Unusually slow response to verbal commands or directives (not related to auditory acuity)
• Difficulty responding in own words to request to repeat what was just stated in own words
• Insistence on telling "all the truth" when not warranted by the situation
• Difficulty in accepting correction or modifying approach to completing a task according to directive
• Not understanding when "Enough is Enough"
• Inappropriate perfectionism or attention to detail when "Good Enough" will do
• Difficulty initiating new tasks without being provided step by step instruction, often repeated
• Difficulty generalizing from one specific task to a related one with changed minor details
• Failure to "See the Forest for the Trees" - the individual is transfixed by details, not attending to the whole picture

While one article can't do justice to the complex topic of Asperger Syndrome as it affects the military, the author hopes that this introductory paper can help sensitize individuals at a command and supervisory level to some of the issues attendant to commanding individuals on the autistic spectrum.

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 touched on in this paper. The author's motivation in presenting Asperger Syndrome as he has is to provide decision makers with "bare bones" understanding of some members of their command 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. 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 by 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.

Roger Meyer, a professional disability advocate, is author of Asperger Syndrome Employment Workbook (2001).