Are many people misdiagnosed with Asperger's?

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Skills set topic

I have dyspraxia as well as AS which accounts for my problems learning to drive. Hyper-focusing on one thing (in order to understand what I am doing) also hinders the ability to operate a motor vehicle. (I always pass the written exam.)

I had the same problem exactly, but I don't know if I have dyspraxia. Did you know that Daniel Radcliffe from Harry Potter has it?

Yes. Prior to encountering the information via media reports, I strongly suspected his neuro-diversity just from observing him during an interview on a tv show.

Under DSM-IV, a person diagnosed with AS cannot also be diagnosed with ADHD. I fit the DSM criteria for ADHD, except for the part about my symptoms occuring during the course of a PDD.

Under the ICD-10 dual diagnoses are allowed.

And the criteria also says you can't have schizophrenia and AS. So as sarcasm I say, "So what if an aspie got schizophrenia in their early twenties, does that mean they don't have AS anymore?"


The point of that sarcasm just shows how bull the criteria is. It also doesn't state what age the symptoms must be present by. Sure it says criteria not met for another PDD or schizophrenia but it still doesn't state what age the symptoms must be present by. So what if an anorexic met the AS criteria? Doesn't mean she has it. They also get poor social skills because they don't relate to their peers anymore, they are sensitive to touch and hearing, they are clumsy, they are obsessed with their weight and diet and excerising, they focus on their work outs and they do avoid people. It does impair how they function in society such as in school, at work, at home because their mind is lacking food so they can't focus right and it impairs their memory and working skills.

No, it does not. AS is not supposed to be diagnosed if one meets the criteria for schizophrenia. That is entirely different from suggesting one should be undiagnosed if schizophrenia becomes diagnosable at a latter date.

I think many people forget that the DSM is not intended for lay people, but rather people who have particular context relevant understandings and knowledge. For instance, if "person A" does not know that PDDs manifest symptoms in childhood, then "person A" is not the intended audience of the DSM and has no business interpreting it in a clinical context.

Without sarcasm ... yes, under the DSM-IV if an aspie gets schizophrenia he/she no longer meets the diagnostic criteria for AS.

The DSM is not used to determine whether you have an underlying neurological condition called AS, it is used to determine whether you have symptoms that have been classified as AS. The DSM classifies mental disorders based on clinically definable symptoms. If your symptoms change, your DSM diagnosis may change (even though you may have the same neurological condition that presented itself as AS).

Many of the DSM classifications are heirarchical, which is necessary to avoid classifying people under a laundry list of disorders. The focus is on the primary cause of the person's distress or disability. Right or wrong, under the DSM delusions/hallucinations trump poor social skills/obsessions. For example, a person with an eating disorder should be diagnosed as having an eating disorder, not every other disorder that their symptoms present.

I have pondered the same questions, more so the second criteria. Many people diagnosed with autism as a child(Classical I think) are upgraded to Aspergers later presumeably because they are highly intelligent. All the comments from people diagnosed with Aspergers who state they are physically disabled, can only read a limited vocabularly and what you said.

I question my own diagnoses regularly because it is all about social impairment, a few issue with not wearing clothes until 3 yrs and sensory issues Looked at NVLD because of my learning difficulties with visual spacial intergration(Reading, abstract concepts and geometry/trigonometry are very difficult), Borderline PD and few others. I can establish a couple of the criteria, but fit the Aspergers mould except I make inappropriate eye contact (Stare)at times, not avoid it.

One more thought that troubles me at times. Moms who post at other asperger/autism web forums who are frustrated with school and medical professionals who state their child has agreat deal autism characteristics, but can't because she makes eye contact, does not flap her arms etc. They appear to be assessing children in relation to autistic disorder and not the variant spectrum disorders such as Aspergers.

Many people in the autism community appear to want to group all autism/autistic spectrum doisrders as one and be referred to as ASD. Personally, I'm not in favourable of this view and believe there should be a distinction and the criteria adhered to by professionals when making a diagnoses of an autism spectrum disorder.

Thanks for the post

There seems to be a very common misunderstanding about eye contact as it pertains to AS.

Firstly, the list criteria states:
1. marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

This criteria is one of 4 (in a particular sub section), only two of which need to be present, so it is not a necessary criteria; people who do not meet this criteria are not necessarily excluded from diagnosis.

Secondly, note that the criteria is "marked impairments in the use of multiple nonverbal behaviors....to regulate social interaction", and this is followed by a description of some possible manifestations of the criteria. Manifesting the listed examples is sufficient but not necessary to meeting the criteria item.

Thirdly, the example referring to eye contact simply states "eye-to-eye gaze". It does not say "eye-to-eye gaze avoidance".
If you are inappropriately staring, then it's not necessarily true that you are unimpaired in using eye-to-eye gaze to regulate social interaction.


The reason for this is because many believe there is no substantive case for keeping Asperger and Kanner type autism separate.

I agree with most of this, i.e. that some people can get too comfortable in the comfort zone. And it is possible to make positive changes and to overcome fears and to be more sociable and more integrated with wider (NT) society.

But I wouldn't necessarily condemn people staying in their comfort zone if they are genuinely happy with their lives that way. But if their lives are restricted in a way that hinders their progress in work or relationships, I think it's only really negative if that's making them unhappy and then changes should be encouraged and facilitated to help people achieve their potential.

I agree with both of these.

Sometimes there's a misdiagnosis like a genuine misdiagnosis, for example Aspie males have previously been more likely to be misdiagnosed as schizotypal disorder, and Aspie females have previously been more likely to be diagnosed with borderline personality disorder.

In other instances, it's possible there's not so much a misdiagnosis, but a diagnosis of a co-morbid, such as OCD, or depression, or ADHD, and the AS has been overlooked and not picked up on, it's less of a misdiagnosis and more of an omission.

Which, if you read further, it says they can coexist as long as the Schizophrenia was of a later onset than AS.

Sora has it right with the meaning behind the DSM-IV-TR; it's early developmental milestones compared to Autistic Disorder. Once someone hits school age, that criterion no longer applies.

To the dude with Mona Lisa smoking as an avatar:

HFA is Kanner's Autism, but with an IQ equal to or greater than 70; around 1/4 to 1/3 have HFA, the others have LFA. It's been a known disorder since Kanner's first paper. Think, Rain Man or Simon from Mercury Rising.

You don't grow out of Asperger's. You may learn NT behavior through observation and/or therapy, but part 2 of the DSM-IV diagnosis doesn't change:

Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(D) persistent preoccupation with parts of objects

When Aspies get older, they still have the urge to obsess over random things, have a set routine, or stim, they just don't make it obvious to strangers or casual acquaintances.

The symptoms that you consider to be major parts of your life...which symptoms are they? If it's a little awkwardness and unease in social situations, you could just have social anxiety. But if it's a significant deficit in social skills, who knows, maybe it is AS. But that's only if you meet the other criteria.

The criteria become more puzzling the more I read about them

I asked the psychologist who evaluated me about why I have AS and not HFA. He said because as a child I hade no significant speech delay and I had normal adaptive behaviour (I'm assuming he means things like potty-training, using a fork, dressing myself etc).

Why would you think you're HFA?

league girl:

I say I have AS because that's my diagnosis and because if I ever tell anyone outside family, I think they won't believe me if I say autism. But in reality, I think I have autism, not AS or HFA or LFA. I have autism, with certain specific traits that I can't distinguish from my personality and because of that I can't define myself any more narrowly than that. To be honest I also think those definitions are rather arbitrary.

If I had to choose a term though, I'd prefer HFA. I don't think calling the better adapted individuals on the spectrum by a completely different name, such as Asperger's, does anyone any good, it makes it sound like it's a completely unrelated condition. It makes AS-problems smaller than they are and makes it more difficult for NT's to realize that autistic people are not some exotic species or a particular brand of hopeless people, but rather fellow men and women who are on a sliding scale of varying degrees of impairments in three key areas.

Sorry, rant alert again.