A couple weeks ago I found out I'm a mix of aspie and an NT!

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The thing I remember learning about criteria for diagnoses that had symptom counts such as syndromes, was this:

In order to qualify for the diagnosis, the patient issupposed to have:

1. The required number of symptoms/behaviors
2. The symptoms need to be severe enough to be "impairing" the patient's functioning at home, work, or school

As an example, when my son was diagnosed ADHD, he had almost all of the behaviors, and his symptoms were impairing his learning and his relations with others. I've sufferred with anxiety for most of my life, and in early adulthood sought pyschotherapy for it. A pschodynamic approach helped with insight about my childhood, but when I was undergoing the evaluation process with my son, I realized the source of my "anxiety" was actually a life-long, mild case of ADHD that was never picked up on because:

1. In the 60's and 70's there was no ADHD dx, and it was rare for girls to be dx'd with hyperactivity
2. I was an excellent student, and had lots of friends- as an adult, I was living a "normal", productive life according to one what expect for a college graduate and a "non-mentally- ill" adult.

Dealing with an ADHD child, plus having another baby at home as well was taxing me and I couldn't compensate in the ways I'd become used to doing, unconsciously. I asked the Dr. if I could try stimulants. He said that even though I didn't meet diagnostic criteria for ADHD, he believed that the symptoms I were having could possibly be explained by the same brain mechanisms that cause a full-blown case. The stimulants helped me- it calmed my mind, helped filter out the distractions, and I could cope better. Eventually I switched to Wellbutrin.

Of course, it seems that there is some overlap between ADHD and Asperger's symptomology. I wouldn't be surprised if somewhere down the road we see ADHD/combined type reclassified as an autism spectrum disorder.

An excellent book about milder, often missed versions of certain syndromes, disorders, etc and how they present in real life- ones that often get misdiagnosed as depression, anxiety,ocd, personality disorders, et al is Shadow Syndromes by John J. Ratey, M.D. The chapters about "shadow autism" is called Autistic Echos", and he gives three case studies of men who came in for specific symptoms and he figured out they were mildly autistic.

I also think that when we're talking about syndromes, which are clusters of behaviors, that exist on a spectrum, almost all, if not all humans are going to be somewhere on the spectrum in terms of symptom count and/or severity. I think what's important is knowing whenever possible, the etiology of the symptom.

For example... some kids with ADHD are described has a having poor social skills. Is the etiology of this the same as an autistci child's, or is because they're impulsive and distractible? Can they in fact "read" the other person when their paying attention, or is it a core deficit? What about interest? What about people who can "read"others just fine, but feel they are way above them, due to high intelligence?

Does anyone know how "severe" "severe" is? I've often wondered just how bad symptoms have to be before it's "clinically significant".

eg., totally unable to function in society, unable to hold long-term friends, unable to easily bond to new people, general social awkwardness, etc. Where is the line typically drawn?

I disagree. If your brain is "hard wired" so as to be autistic, but your environment is such that you don't have "significant social impairment", you would not get a Dx only because of your environment when the same person in a different environment would not function and be clearly Dx'd.

Its a fuzzy BS set of criteria which looks only at the outcomes within a particular environment, not how a person processes their environment.

I suppose in the the various fields that diagnose, there is a comparison with behaviors considered "within the normal range" for specific age groups and under certain circumsatnces. There is going to be a certain amount of subjectivity and variance from clinician to clinician.

Another would be patient reported discomfort. Good clinicians should listen carefully to their patients and want to help them ease their suffering no matter what diagnosostic criteria they may or may not "meet".

Unfortunately, "mild" versions of certain disorders often look like something else completely. "Mild" depression can look like "irritability' as opposed to sadness. For a long time, "mild" autism was not recognized at all, or people were diagnosed as other things.

One of the problems with the diagnosing of a "mild" case of AS is that it may be considered a "mild" form of autism. So then what would a "mild" form of a "mild" form of something else be? Within the range of "normal" behavior?

Eventually, as brain imaging and physical diagnostic testing gets perfected and comonplace, a diagnosis will be made by what your brain is doing or not doing, and hopefully most of the subjectivity and guess work will be taken out of it.




A good thorough assessment should take into account a through history of the patient and how he behaves in different enviornments and under different circumstances, from several sourcesas well as patients complaints.

I would say I'm mixed I remember one day coming out of a Meltdown looking around looking down at me looking at my hands and then shouting I haven't got AS anymore. Then I started saying things like 'Who am I' 'What am I going to be like now' 'I could be this I could be that' there were more as well.

I just re-did the AQ test (I'd forgotten my last score). I got 26, which is apparently half-way between the average NT score and the average AS score. Argh!

another consideration.... what makes a person "more" Aspie, or ADD, or whatever...


....having most of the symptoms, mildly (meaning you can relate to the traits, tend toward them, but are living a life that could be considered normal- you're just considered a little "quirky"), or having a few of the traits BIG time... enough that they are impairng you and make it obvious to others you have some "syndrome"?

I really, really recomend that book, Shadow Syndromes.

Why couldn't it come out equal?

Also- given that the idea of disability is environmentally defined- environment is obviously going to be a major variable in how much two cases are "disabled."

Melantha is beautiful.

another BS theory

Autism is a spectrum ...true


BUt you are either on this spectrum or not ...there's no inbetween.

but isn't the concept of a spectrum a graduation of varying degrees. Its not "black and white" but different shades of grey. The starting point would be difficult to determine with any precision.

But m'darlin' lad, my spectrum is red and orange and yellow and green and blue and purple and blinding white! not a speck of black on it at all!

m