Asperger's syndrome with speech delay?

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I was diagnosed with Asperger's syndrome at age 13, but I did have a significant speech delay. According to one record from my early childhood, I didn't start putting words together until age 3-4. In addition, my parents say that as late as age 4, I would often still use nonsense sounds to attempt to communicate. My language ended up developing as normal, but wouldn't such a delay preclude Asperger's?

One explanation may be that I had just moved and my parents may not have brought the old records to the psyche, and the appointment seemed to focus mostly on present issues. Prior to that, I had a diagnosis of PDD (DSM III).

Yes, speech delays tend to prelude Asperger's.

I didn't talk until I was three either.

Same with my four year old brother, who is seriously suspected of having an ASD (The doctors refuse to diagnose him due to him being only 4)

It seems like they updated your diagnosis to AS due to your current trait of speaking normally. PDD is a rather fuzzy diagnosis, so they probably wanted to give you a moar clear specific diagnosis of AS, although the AS diagnosis does preclude speech delay.

Was there a reason why you talked late?

I talked late because I had lot of ear infections so fluid was trapped in my ear so I could only hear sounds. I couldn't hear other things like fog horns or trains. I even stopped babbling over night and I was quiet. Then my mom says I still made sounds but only a little. Then when I got my hearing back, I didn't pick up where I left off. I needed speech therapy and I didn't start talking until I was four. I suspect that part of the aspie criteria was dropped for me because of this and that was the reason why I didn't meet the autistic criteria.

No reason was given by my parents or in the records I saw. The implication seemed to be that I took much longer than most of my peers to develop language. My sister also had some speech issues, requiring speech therapy for her in early elementary school, but nowhere near as severe as mine.

Gillberg's Criteria for Asperger's allows for delays in the acquisition of speech (it's actually a criterion).

Said criteria are just as valid as the DSM and ICD (probably more valid in regards to Hans' paper).

The possibility exists that your diagnosis was updated to AS because there is less stigma to it than some of the other ASD diagnoses. Sometimes doctors will do this to improve the likelihood of the the individual having a normal life. With the speech delay, I think the Dx with speech delay is usually high functioning autism as Asperger's normally has the speech milestone being reached at a normal time as one of it's criteria.

Might be this.

HFA and aspergers are like "redish blue" and "purple"- they kinda amount to the same thing.

The speech delay is why people are lumped under HFA, and those who reach the milestone at the normal time are lumped under aspergers.

Maybe they thought you would get less stigma under aspergers, but then you might also get less aid from the government than an aspie would as well. I dunno how that works.



But maybe they

Technically should still be classic autism, but just so long as their label gets you what you need (at school, at work, at home), I wouldn't worry about it. The diagnostic criteria are pretty messed up as it is. I just identify as "autistic" and let the psychologists have their fun trying to classify me.

(I learned to speak "on time"... but I learned to read simultaneously, spoke in a highly unusual and often echolalic manner, and was a precocious child who should have been speaking early. Try to categorize that one. I sure can't.)

You're just plain autistic. The specific subtype... ehh, who cares? Even the most stereotypical Aspie has enough in common with the auties that there's not much point in insisting on one category over the other. The same things help both groups. Though the people in those groups are wildly different from each other, treatment decisions can't be made based on the sub-category; they have to be done on a case-by-case basis. And when you can't use the subcategory for making any useful decisions, what good is it? None.

I just hope the professionals can get it through their heads that "autism" is one of those many, many diagnoses that come in an extremely wide variety. It's not like they don't have a precedent. For example, I have two friends with CP; one uses a power chair and a communication device, the other walks with a slight limp. Same diagnosis. There are more categories that are broad like that, than narrow, especially when it comes to "syndromes" like autism where there's no specific single cause. Do they really have to insist on sub-categories all the time?

I watched this:

http://www.youtube.com/watch?v=LOlHvazQvGM

Basically, the differences in practice between HFA and Asperger's are:

1.) Desire to socialize in Asperger's vs. lack of desire in HFA
2.) Greater anxiety in Asperger's vs. less anxiety in HFA
3.) Better connection with emotions in Asperger's vs. worse connection in HFA

I think I had a desire to socialize, but when he said that, now I'm not so sure. I wonder how much was due to my parents pushing me to. For example, there have been lots of times in my 20s where my dad would really pressure me to socialize, when in reality I would have rather avoided it and stay home. Now that I think about it, my dad has often pushed me to socialize, which makes me want to socialize to satisfy him, but also makes me more anxious about the whole process, seeing it as something I have to do. In addition, in one of my records from when I was 8 or 9, my "ability to plan [was] demonstrated by [my] acting up on the bus to the point of great concern. In a therapy session, it was learned [I] had decided to purposefully 'be bad' as [I] wanted to get off the highest behavioral plateau to one where [I] would go to a Friday study hall, rather than a concurrent more popular 'fun' activity." I remember often avoiding social activities, preferring quiet places alone. Maybe the desire to socialize is more related to pressure by parents and others, rather than anything necessarily inherent?

As for connection with emotions, I'm not sure how to measure that. When I was a kid, I would have repeated temper tantrums and aggressive behavior, which seem to be associated with more severe autism. I remember specific incidents like biting a teacher on the arm, bolting out of the school onto a busy highway, and having to be wrestled to the floor by my dad, teachers, or others multiple times. As a young adolescent, I spent time in a mental hospital for this. As I understand, these kinds of tantrums and aggressive behavior are associated with an inability to connect with your emotions and needs and to express them to others. I seem to have gotten better, but there are several cases where I feel I've been unable to express what I've intended to express.

So it seems like it's best that the diagnoses are being collapsed into a single ASD, because otherwise this will get confusing.

I do as well. I've found that for some reason I kinda like the term autism better. I guess it's because it lends greater legitimacy to the actual problems I've faced and still have; whereas, it seems with Asperger's, you're expected to be able to get over it with little or no difficulty.

Yeah, you've hit the nail on the head there. I wish it weren't that way. People with Asperger's (even those who are stereotypically Asperger's) have real problems, and "getting over it" doesn't make any sense. It's like people think that Aspies are just a little shy and nerdy, and everything can be solved by a makeover and a lecture about being yourself, like some kind of after-school special.

As someone who is also transgender, being yourself could get yourself beaten up.

I was thinking more about my issues, especially social desire. The context in which I was diagnosed with Asperger's was one in which I had just relocated to a new town, where it seemed like I could get a fresh start as a normal person. No one there would have had to know that I had all these problems, and there I could finally be normal. I think my motivation for this was this persistent broken feeling that I had throughout childhood, like I was a good toy that was broken and so had to be discarded altogether. I think this feeling originated from negativity from my parents over my condition and the various problems I've had. I read about how even severely autistic children can seem to pick up on and be affected by this negativity.

According to that same record as above, my parents "shared that in some of the weekly sessions they [had] dealt with grief and loss related to understanding [my] needs and difficulties." Though my diagnosis was PDD, this seems to also be common all across the autism spectrum for people's parents. I remember when I was in 1st grade wanting to leave my parents to live with my special ed teacher, so I think that my relationship with my parents was somewhat antagonistic, and a lot of the antagonism had to do with my condition. This may have created a desire to be normal, to fix myself, that led to the failed socialization experiment when I moved to a new town and was in 8th grade.

I had basically cut off all the support I had been getting. I did very poorly, having a very difficult time socializing, which prompted my parents to take me back to the psyche in the first place, netting the Asperger's diagnosis. By January of that school year, I remember when I was in the school, it seemed like I couldn't see very clearly, that things weren't very distinct, and I remember a persistent burning feeling while in school that seemed to come out of my shoulders in like a V shape. Looking back, I think I was terrified. After a violent outburst, I was kicked out in such a way that made it clear I couldn't go back. That night, I had another violent outburst with my dad which landed me in the mental hospital.

So maybe a desire to be normal was why I tried to socialize and not because of any inherent desire?

My diagnosis is Asperger's.

1. I don't have a desire to socialize. I have a desire to have a few people I trust. (I caterorize on the HFA side).
2. I have mild anxiety. It is very mild. It's lack of trusting people and not anxiety of social situations. Everything else is issues with overload. I'd probably categorize myself in between the two categories because I don't know what "greater" and "less" effectively mean. I know that I don't have the levels that a lot of people on here talk about. I also know I have trust issues that some people don't have to deal with.
3. I am very alexithymic. (I categorize on the HFA side).

By those differences I'd easily be "HFA" not "Asperger's".

But, its not that clear of a distinction .

The combining them in the DSM-5 is really useful...

(If you look at the four subtypes of autism that Lorna Wing described: I'm not Active-but-odd, which is where most people with Asperger's fall, and have never been Aloof, and most people with classic autism are partially aloof at least when they're young. I'm Passive from birth - which can be categorized as Asperger's, while many passive people started as partially aloof when young and then are passive or aloof/passive combinations as adults, and they have classic autism. So, its really not a clear distinction for people like me. )

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I can't stand how people think that Asperger's is just being shy and nerdy. We have real problems. I disagree with AANE's position on the DSM-5, but really like part of their letter where they were talking about it.

Last edited by Tuttle on 30 Sep 2012, 12:24 pm, edited 1 time in total.

Though my ears were tubed, due to poor drainage, I remember being distracted by many, many other noises (and other sensory stimuli) during the hearing tests. I cannot rationally explain why the blinking clown should seem traumatic, but it was more than I could take.

I still slur words, occasionally, which is taken by my family to mean that I am having sinus trouble, again.

This is repeated to me, insistently, until I have forgotten the original point, or am forced to withdraw in a panic attack.

The stress is compounded, when I am told that I should try and hear better, that I am being impatient, or that I am hurting the speaker's feelings.

I have a question.

I read the whole thread and agreed with most of what people are saying.

My question is, is echolalia considered a speech delay?

I had significant echolalia until I was 12, and I still deal with mild echolalia even today.