How do they know aspergers is autism?

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EXPECIALLY
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23 Jan 2012, 4:11 pm

People DXed as HFA who were often non verbal in childhood often grow up to be very similar to people with Asperger's.

You can't tell the difference in many cases.


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23 Jan 2012, 4:13 pm

CaptainTrips222 wrote:
The people I met with HFA, you can tell they have it, and I am absolutely nothing like them. The two guys I met in person with AS don't resemble HFA at all either. I really don't see them being one in the same, just having some of the behaviors you find in autism.

I haven't met any but TBH I've gotten this impression before.

It's been said here the people who appear more intelligent receive the AS diagnosis.

So i just totally contradicte myself, but it's true.

ALSO true that many HFA grow up to be more like Aspies, perhaps these are th eones who had no speech delay.


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23 Jan 2012, 4:31 pm

CaptainTrips222 wrote:
I don't know what to tell you. When I go to autistic get togethers, it's extremely obvious who has AS and who has HFA. The aspies, especially the women, are the only people you can talk to.


I wonder about whether maybe some of those with AS and HFA have the respective diagnoses because of how they appear/because of the impression they make on other people.

To see whether there truly is a difference between those with AS and those with a diagnosis of classical autism/HFA one would first have to make sure both groups are diagnosed according to diagnostic guidelines of the DSM-IV-TR or the ICD-10.

I have met quite "AS"-ish children who did not have AS because of an early speech delay or because they fulfil criteria for classical autism. Some professionals just went ahead and talked of AS anyway because the children did not meet the stereotypes those professionals seemed to associate with classical autism.


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23 Jan 2012, 5:06 pm

I know a 5 yo kid who is selective mute and shows autistic traits besides it. He is quite HF in other regards. Does he have classic autism? I don"t think so. (He doesn't speak in my presence, though we can play board games together.)

HFA can mean different things, there's no such dx officially. You can use it to people with classic autism who have good coping skills and usually normal or above average IQ, and there's the highly disregarded dx of PDD-NOS (I was given this), this also sometimes called HFA (in my case it's specifically stated in the dx). Sometimes AS itself is called HFA.

The diagnostic boundaries are fuzzy between ASD diagnoses to say the least, and vary from diagnostician to diagnostician.

So, regarding all this I wouldn't say there's much difference between HFA and AS.


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23 Jan 2012, 5:20 pm

CaptainTrips222 wrote:
I don't think I've ever read a straight answer as to why aspergers is considered a form of autism. Some of the behaviors resemble autism, and there's sensory issues in some cases, but is that the only reason it's considered a high functioning autistic disorder? Is it just our best guess for now?


Becuase both disorders by definition include a 'triad of impairments'
- Impaired social interaction
- Impaired communications
- Imagation (generally meaning routines and special interests)


By definition it is the same thing. Its the same triad of imparirments.



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23 Jan 2012, 6:26 pm

EXPECIALLY wrote:
People DXed as HFA who were often non verbal in childhood often grow up to be very similar to people with Asperger's.

You can't tell the difference in many cases.

This is very true. And some people with AS may have a physical rigidness in facial features/ body posture and some don't.
Speech delays don't' just exist in autism too I recently found out. I know people with ADHD who spoke much later than me.

I just think doctor's diagnose based on what they think should fit not what is necessarily in the criteria.

I was delayed in skills especially speech, walking, interacting (this was delayed the most) with people and learning new things (also very delayed). Back then I was considered slow, a late bloomer.
I was never very smart or curious, just stuck to my very few interests.
I've never wanted to make friends until I found out I was really different, at 22.
Then one day I decided to teach myself to catch up to my peers at least in general knowledge.
I was also very hyposensitive to pain, the environment and felt pretty damn underwhelmed by most things.
And now I'm hypersensitive which I think is through medication side effects.

I think I could be diagnosed with either Asperger's or classic autism and I think it's Asperger's because I asked to be. I remember my psychologist told me I could be diagnosed with either but it didn't matter because the treatment would be the same.


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23 Jan 2012, 7:39 pm

Wing's original paper on AS (start of the "spectrum"):

Quote:
Early childhood autism

Asperger acknowledged that there were many similarities between his syndrome and Kanner's early infantile autism. Nevertheless, he considered they were different because he regarded autism as a psychotic process, and his own syndrome as a stable personality trait. Since neither psychotic process nor personality trait has been defined empirically, little more can be said about whether they can be distinguished from each other.

Van Krevelen (1971) and Wolff & Barlow (1979) agreed with Asperger that his syndrome should be differentiated from autism. They differ in their accounts of the distinguishing features and the impression gained from their papers is that, although there are some differences, the syndromes are more alike than unalike. The variations could be explained on the basis of the severity of the impairments, though the authors quoted above would not agree with this hypothesis. Thus the autistic child, at least when young, is aloof and indifferent to others, whereas the child with Asperger syndrome is passive or makes inappropriate one-sided approaches. The former is mute or has delayed and abnormal speech, whereas the latter learns to speak with good grammar and vocabulary (though he may, when young, reverse pronouns), but the content of his speech is inappropriate for the social context and he has problems with understanding complex meanings. Non-verbal communication is severely impaired in both conditions. In autism, in the early years, there may be no use of gesture to communicate. In Asperger syndrome there tends to be inappropriate use of gesture to accompany speech. In both conditions, monotonous or peculiar vocal intonation is characteristic. The autistic child develops stereotyped, repetitive routines involving objects or people (for example, arranging toys and household objects in specific abstract patterns, or insisting that everyone in a room should cross the right leg over the left), whereas the person with Asperger syndrome becomes immersed in mathematical abstractions, or amassing facts on his special interests. Abnormal responses to sensory input - including indifference, distress and fascination - are characteristic of early childhood autism and form the basis of the theories of perceptual inconstancy put forward by Ornitz & Ritvo (1968) and of over-selectivity of attention suggested by Lovaas et al (1971). These features are associated with greater severity of handicap, and lower mental age. They are not described as typical of Asperger syndrome, and they are rarely seen in older autistic people with intelligence quotients in the normal range.

The one area in which this type of comparison does not seem to apply is in motor development. Typically, autistic children tend to be good at climbing and balancing when young. Those with Asperger syndrome, on the other hand, are notably il1-co-ordinated in posture, gait and gestures. Even this may not be a particularly useful point of differentiation, since children who have typical autism when young tend to become clumsy in movernent and much less attractive and graceful in appearance by the time of adolescence (see DeMyer, 1976, 1979 for a discussion of motor skills in autism and autistic-like conditions).

Bosch (1962) considered that Asperger syndrome and autism were variants of the same condition. This author pointed out that, although Asperger and Van Krevelen (1971) listed features in the early history which they thought distinguished the two conditions, in practice these did not cluster into two groups often enough to justify the differentiation. The child in Appendix No. 6 illustrates this problem (see also Everard 1980).


More alike than unalike being the key point. It's interesting that she thought sensory sensitivity and a strict adherence to routine being there only in individuals with LFA. These things being commonly associated with AS nowadays.



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23 Jan 2012, 10:39 pm

OddDuckNash99 wrote:
The answer is we DON'T know Asperger's is the same as HFA. Slowly, some researchers are speaking out against it, which makes me happy. It doesn't matter if the SYMPTOMS are the same. We need to understand how the two differ from a neurological standpoint. The fact that AS doesn't have a speech delay means that there is something very different going on during development. Even if treatment and diagnosis don't differ, as a neuroscientist, I feel that it is crucial to understand these differences in order to properly understand more about the brain and its functioning. The point is that the whole VIQ/PIQ debate and the speech delay have not been resolved, nor has the reason why those with AS tend to be clumsy and uncoordinated, something not usually seen in HFA. And if this hasn't been fully resolved neuroscientifically, it is a huge mistake wanting to remove AS from the diagnostic criteria. Throwing HFA and AS diagnoses in the same group for research is why I believe ASD research is filled with confounds and findings that are often inconclusive and contradictory of one another.


Asperger's does not exclude speech delays. It specifically excludes late speech, but autism does not require late speech for a diagnosis. This actually makes the distinction diagnostically ambiguous since many people diagnosed with AS actually can meet the criteria for autism.

I recall seeing research that indicated the VIQ/PIQ dichotomy was not consistent for people diagnosed with autism or AS, although it does seem to be consistent with NVLD. I've also seen research that failed to find strong distinctions between autism and AS with regards to clumsiness and lack of coordination.

There is research showing white matter differences between autistic people who had speech delays and autistic people who did not. While it was described as comparing AS to autistic brains, they included autistic brains with no speech delay in the AS group. Having looked at other neurological research, I've found that these distinctions tend to include a lot of overlap, to the point that it's not actually really that easy to look at a single brain and see the differences that would mark it as NT, autistic, or AS.

Anyway, I do think that the fact that people with AS and autism have the same symptoms is actually quite relevant. I think it's a bit strange that these strong similarities are dismissed for the sake of having a separate label.



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24 Jan 2012, 1:49 am

A while ago, someone posted a thread here asking if autistic traits increase/decrease with stress/happiness. I'm diagnosed with Asperger's and can personally contest to this, as I've been under extreme stress lately.