difference between Asperger's and high functioning autism

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For what it's worth (whatever that is), I fit the OP's definition of AS much better than HFA.

We're looking at a lot of theoretical stuff here, but if you subscribe to the idea that "A theory is only valid to the point that it can be applied to or observed in the world around us", then it becomes simpler.

Given:
1. Any dividing line between AS and HFA would leave, on both sides of that line, people who had very different educational styles, support requirements, and skills.

2. The difference between those two groups is small enough that one cannot predict, with any degree of confidence, the exact characteristics of someone based on the label they are given. One can only make predictions about general tendencies among people in each group.

3. However, the conclusions one can make about someone based on their being in either the AS or the HFA group would be valid for anyone in that group, by definition: That is, he would meet certain diagnostic criteria defining the overall category of "autism without profound disability".

Then:
1. In the real world, people with AS and people with HFA, however well they could be categorized, would need similar diagnostic tools. Each person would need to have his or her own particular cognitive style taken into account in order to have individualized education or therapy.

2. Even if differences could be found that split AS from HFA, these differences would have no impact on the handling of any specific case of either AS or HFA.

Therefore:
AS/HFA is a distinction that is purely theoretical. Since it cannot be applied to the real world, the distinction between AS and HFA should be left to the researchers, since it is not relevant to the psychologists, teachers, and therapists who come in contact with people in this diagnostic category.

There is a pyramid of people with autism spectrum disorders. This is not a hierarchy but a reflection of the probable statistical distribution of the population and the fact that each group is in some ways a subset of the layer it rests on.

At the first, and most populous, level is Kanner-type autism, in which people do not possess savant skills and are completely noncommunicative, even if they do verbalize.

At the second level is autistic savantism, in which a noncommunicative person displays savant skills.

At the third level is high-functioning autism, in which the person can communicate but is more or less "OK" with not sharing their world and life.

The litmus test of whether someone is at the fourth level of Asperger's Syndrome is if when you ask them whether they would like to have the regular and rewarding companionship of their fellow human beings, they answer "yes." It might not be solid clinical definition as the behaviorists define it, but if you would like people to belong to a group and/or a close relationship or friendship with another human being and you struggle with it in ways that are typical of people with high-functioning autism, then you embody the Aspie state of mind. Let me know what you think, folks. I'm 20, at home from college with my mother, and she is acting like I have to have a P.Hd. like her to have a philosophical discussion about this, so I hope you'll be more understanding.

No idea where you got your numbers, but your pyramid is upside down.

PDD-NOS is actually the most common category of autism. Another name for it is "atypical autism". It means "autistic traits" that don't fit into any other category--for example, if it looks like AS but you had a speech delay; if you have two of three for classic autism but not the third, or if there are too few traits to fit into even the Asperger's diagnosis.

That PDDNOS is the most common type really points to a defect in the categorization system; the "NOS" (not otherwise specified) category is supposed to be the smallest, because it's basically a miscellaneous category for cases that don't fit other diagnosis; but it's the largest in many places.

Savant skills can happen in people who either do or don't have speech. It doesn't have much to do with what kind of autism you have.

Asperger's is less common than PDD-NOS in most places, but a lot more commonly diagnosed than classic autism. The problem with this is that many Asperger's diagnoses should actually be classic autism diagnoses because of the way the criteria are written.

Classic autism is the most rarely diagnosed of the common autistic disorders, but actually more prevalent than Asperger's by the diagnostic criteria. So if you go by what's actually being diagnosed, you get Asperger's being more prevalent; if you go by diagnostic criteria, then classic autism is more prevalent. PDD-NOS still makes up more than half of autism spectrum disorders.

Childhood disintegrative disorder and Rett Syndrome are very rare; both are characterized by loss of skills and Rett's has a distinctive mutation associated with it.

People who are non-verbal can and usually do desire meaningful relationships; and people who are extremely competent and independent, with full use of speech, can be almost completely nonsocial. The degree of introversion or extroversion is only loosely linked to the strength of autistic traits.

Yeah. I think there are even some NTs that have no desire to be part of a group or have friends, despite having all the inborn skills to do so. It seems like that would be more of an individual thing than an indicator of the level of autism a person has. I'm pretty sure there are a lot of relatively lower-functioning kids with autism who seem very attached to their parents.... And that indicates wanting companionship, their inborn social skills just aren't up to the level that they can even communicate that they want it without a whole lot of difficulty. I think there could easily be a very severely autistic person who wants companionship and also someone with very mild AS who doesn't. There are too many factors involved to make that some big dividing line, i think.

If more people are actually being diagnosed with AS than autistic disorder, then it would certainly suggest many diagnosticians are ignoring the criteria. Do you know of a reference to the actual figures? Prevalence studies give the rate of AS diagnosis as lower than that of autistic disorder, which makes sense because the studies apply the DSM-IV criteria correctly.

One example: Chakrabarti & Fombonne (2001) find rates per 10,000: 16.8 for autistic disorder; 8.4 for AS; and 36.1 for PDD-NOS.

[Chakrabarti, S., & Fombonne, E. (2001). Pervasive developmental disorders in preschool children. Journal of the American Medical Association, 285, 3093–3099.]

Prevalence is all over the place depending on many factors.

When AS equates to more than AD, it's because the people include PDD-NOS, HFA, and AS into the "AS" grouping. But, when it's based purely on the DSM-IV-TR/ICD-10##, it goes AS as being the rarest, then AD, and then PDD-NOS as the most prevalent.

PDD-NOS is the most prevalent due to it encompassing such a large and broad category of impairment in social ability and communication difficulties or repetitive behaviours that are far more diverse than either AD and AS in manifestation. Some can be close to AS or AD, whereas others are nothing like either.

hmm

4. Inability to understand metaphorical language
While the concrete thought process is there, ability to interpret metaphors and abstract language varies.



i dont think that's true, i'm a diagnosed aspy, and have quite a few heavy traits, but i study metaphysics...and i quite enjoy deep metaphors.

Yes, prevalence studies do have autism > Asperger's. When reported by school systems, though, you often end up with Asperger's > Autism... but that's complicated because a lot of the time, they get reported as the same code anyway. Plus, many AS children remain undiagnosed because they talk on time.

They are both autism which is why it would be easier to not have diagnostic names such as "HFA" or "Asperger's Syndrome", instead, why not call all the disorders "autism" and list the criteria each individual meets. That would personalize the diagnosis more, no more competing for diagnosis because one seems better than the other.


I walked and talked on time. I was walking at ten months so this rings true.


Maybe. It depends on the mood. I sought to share enjoyment but it wasn't that simple. More accurately, I sought interaction but it wasn't a positive experience and was often a source of distress when it should have been one of comfort.


Just about everything is easier for non ASDs, on a sensory level than for me (except driving a car). They can handle a lot more time away from the safety of home than I can without feeling stressed out.


I disagree with this. AS can make it difficult to learn in a conventional classroom and from other people.


I don't know if being autistic means you are an unimaginative concrete thinker.


Not sure about this. Having AS doesn't make everyone a super genius.


Maybe. Maybe not.

Not sure about this. I definitely understand "personal space" because, usually it's far greater between me and another person than appropriate. I have the opposite problem.


AS can be really difficult. AS is easy to diagnose if people are aware and know what to look for. Awareness is the key.

I don't think HFA has it's own criteria. In fact, I don't think there's any real difference between AS and HFA as I have a diagnosis of AS but my symptoms mostly matched your criteria for HFA. That's just my opinion, of course.

I know that most proffesionals debate this as well.

Which is the same organization that included homosexuality as a psychological disorder in the DSM, which definition underwent several transitions until finally being eliminated in the DSM-IV.

The DSM-V is likely not to include all the current ASD labels -- Asperger's, PDD-NOS, and so on -- but contain instead simply Autism Spectrum Disorder, with a severity scale. (See this report from the Working Group.) So the APA appears to be recognizing HFA and Asperger's as two names for roughly the same part of the spectrum.

If dominance of any indication, then those without a specific dominance... might they either have it super mildly or have both disorders if they're not as mild? Because then I would have both. How depressing!

You have now i didnt walk until age 18 months. i didnt crawl at all but one day stood up and walked.

Selectively silent type aspies (which i know a few of) dont seek to share enjoyment. As for autistic children using social interaction to communicate wants and needs i agree with you.

That comment has severely offended me , ive had severe sensory issues since i was a child and im an aspie. There is no way to know for sure that this applies to all aspies/auties.

Not true of me either, i have to have concrete examples and dont recognise examples that arent black and white.

Except when under stress then i become more like a MFA (medium functioning autistic) than an aspie.

You have now as i have been pc literate since age 3. My last IQ score was 130.

Please clarify this point for me.

i still have problems with this and it didnt stop until i was given the "stand approximately a metre away from the person" rule.

i am just like her and my diagnosis is Asperger syndrome. i have found auties to be less likely to want to fit in. i know 2 auties that dont wish to have friends and no aspies who wish to remain without friends. i rarely see this in aspies.

They all have this, its a requirement for a diagnosis. The criterion is "non functional routines" which applies to repetitive interests or the way they do their daily living tasks.

That's not what the term means and i also have many different topics of interest. Watching star trek 3 times a day or quiz shows 3 times a day even when on "holiday", that is my repetitive focus of interests or my need for routines.

This is not a necessary criteria for diagnosis just an additional problem we can have.

It doesn't say that in DSM-IV, just that we have problems with metaphors and abstract language.

Who told you this? i dont remember that being in the diagnostic criterion either.

Something else not in diagnostic criterion.

i would like to meet these aspies that arent distracted by details or have problems with the bigger picture.

Also it mentions difficulty with not inability to which are different things.

Wondering where that idea came from? Faceblindness is a different condition to autism/aspergers but is more common in the autistics/aspie population.

That we don't have empathy with others, i do.

That we dont make allowances for others i can do that as well.

Alexis

PS wondering where you got your myths about aspergers from, i havent seen them in the autism literature.

orwell wrote

I had a slight speech delay, and spent years in speech therapy overcoming assorted speech impediments, and I am diagnosed with Asperger's.

treksters reply

Same here, i had 6 months of intensive speech therapy age 3 and read in my medical notes "she has over formal use of language", but my autism/AS was missed until 13 years later!

Alexis

That sure placed me between AS and HFA as my psychiatrist put it when I was 12.

I had a speech delay due to my hearing loss and I had to improve my motor skills so my mom had do pottery and I didn't understand personal space growing up. I loved hugging people and wouldn't understand why they didn't like it. I loved licking and kissing people I liked and I always stood close to someone in line. So some people on the spectrum are affectionate because they invade your personal space by grabbing your and getting on you and licking you or kissing you because they like you.


I have also read Pretending to Be Normal and I believe most of her problems were due to sensory issues so it made it look like her AS was bad. I am sure it was mild but the sensory issues seemed to put her in the moderate range. I can relate to copying people and I was told at Autism Speaks many typical kids develope by copying other kids. Okay so I guess us copying people isn't faking then and we are doing it the normal way but I think the difference is kids know what to copy and what not to copy and they know what is appropriate and what isn't appropriate but some can still choose to do that behavior even if they know better while aspies don't know any better because they don't understand. I was copying kids of all ages, even toddlers and I get confused when I get punished for my behavior because I didn't understand the difference in ages and what behavior is acceptable for what age level. My mom always had to explain to me about the behavior so I learned "oh that's three year old behavior." I never knew how to act my age as a kid growing up so I got sometimes "grow up" "you're acting like a (insert younger age here)" "Oh stop crying like a two year old" "Oh stop screaming like a two year old" and I remember how hard it was to have young emotions, it made my mom mad at me more often when I get upset. Back then I didn't even know what was going on and I thought I had to try harder to not get upset and not cry but I couldn't help it. Then I learned eventually to hold it all in.


I was also very literal and I did not understand jokes. People could play games with me and say "I'm joking" and I'd still be upset because I wouldn't grasp the concept they were joking and they weren't really going to do it. People could tell me a joke and I wouldn't laugh or find it funny.


What you said about the difference between AS and HFA is a bit inaccurate because it's a spectrum. Someone can have autism and prefer to be alone and someone can have AS and try and seek friends. An aspie can also be very literal and concrete like I am. I can still understand idioms and learn them. It's just memorization and the definition never changes and it means the same thing always when an idiom is used.