Can Asperger Syndrome be mild?

Post Reply New Topic

My son was finally correctly diagnosed in late August 2010, at the age of 14.5. It's always been a struggle for him, primarily due to being misdiagnosed and treated for Severe ADHD for approximately 10 years, as well as being the recipient of a lot of bullying. My current dilemma, even aside from the Aspergers, has been to obtain psychological supports -- as mental health care in our area is severely lacking -- and even if a child is suicidal, etc. they are put on a lengthy waiting list for help. Now that my son has the Asperger diagnosis, there are funds I can apply for, which are specifically for psychological support; BUT, I was told yesterday that the doctor's diagnosis has to be "SEVERE" Aspergers; otherwise, he does not qualify. I only just joined the community, and did not want to make a duplicate forum topic ... and I'm not sure yet how to query and find out if there are posts about how the determination is made, as to whether an individual has "mild", "moderate" or "severe" Aspergers. The letter the specialist issued, which took over a month to obtain, only specifies his diagnosis of Aspergers. And, when speaking with the organization that approves a certain number of sessions with a psychologist, for children with a "SEVERE" diagnosis of their disability, they insisted this did not apply to the "impact" the disability has on the child's well-being or ability to function, the "SEVERE" reference soley is only accepted when the doctor places this term in the actual diagnostic criteria. We can't get into the psychiatrist until Nov 18, to even request the letter, and my son has been going through months of difficulty. I would appreciate anyone's recommendations, as we've already been at the hospital's emergency dept. three times since the first week of June, and he's been suicidal and has been physically assaulted (to the point it brought on vocal ticks). The problem in our area is a lack of services in relation to the need. Thanks.

I think you are getting to my point. I am wondering if people with "mild" AS have a harder time than others because we are more aware of our issues with the world. I don't honestly know if people with classic Autism are aware of their condition and know that there is a great deal of stuff in life that they are missing or finding confusing. If they are totally unaware then perhaps it is better to have severe autism than mild aspergers. (from the point of view of the sufferer anyway)

Honest to gosh, you might be better off just with a good general practitioner (these days, more commonly called a family practitioner) or an internist, who basically has some horse sense, and is willing to go through a series of anti-depressants to find one that works. As I understand it, it generally takes 2-4 weeks to tell if an anti-depressant is going to work. And I think (I AM NOT A DOCTOR) that you sometimes have to be careful coming off the anti-depressant even if it didn't work. In this, as in some many areas, it's so valuable to find a doctor you can halfway talk with.

Okay, about the bullying, I recommend
Tight, defensive boxing to a draw. One week.
http://www.wrongplanet.net/postt134616.html
The difficulty, it's a little bit awkward for you as the mother to recommend boxing. And I don't want to oversell it, the most you can do is fight someone your own size to a draw and that's all you're trying to do, for you specifically are not trying to humiliate someone. Maybe his Dad could productively advise boxing. (And importantly, you don't want your son to take a bunch of blows to the head because that stuff about post-concussion syndrome is real. And just like a football helmet doesn't really protect, presumably boxing headgear doesn't really protect either. Just tell the instructor straight up, 'I don't want my son to take a bunch of blows to the head.')

Another thing, if your son could get positive things going non-school related, that would give him venues of success not bogged down by all the bad stuff going on at school. And social nonacceptance and exclusion, that all by itself independent of the bullying, from my own experience, I fully count that as 'bad stuff.'

Who are these "people"? because I have seen two psychiatrists and three therapists, one of whom specializes in autism spectrum disorders, since my diagnosis and they have all stated that you either have it or not... There are no levels. One may feel less affected by Asperger's because of his or her individual personality and lifestyle, but but there must be an impairment and all critera must be met. Asperger's is part of the spectrum, but it is not a spectrum on its own. If there is no impairment that affects social functioning, then you just don't have it. Also "heavy" is not a medical term. The word they use is "severe."

Good point, but why is that: 'people with "milder" autism often seem to have more distress and a higher rate of comorbid depression'? Is it because they have more insight into their condition than the severe cases so they realise how different they are and this is depressing?

I myself ought to be considered a mild case, I think, as I do have a job and am married. But then I realise that it is unlikely that the average boss would like to keep me and that I would fit in an ordinary workplace like a square peg in a round pole. Thanks God I'm not generally interested in relationships or I am sure I'd have significant trouble if I had to start dating again, should my current relationship fail. So what's mild AS then? The kind in which people don't notice right away that's something's odd about me but causes significant impairment in all important areas of life? I think I should be better off with the theory that all Aspergians are different and there is no gradation in severity.

Last edited by Severus on 20 Oct 2010, 6:08 pm, edited 1 time in total.

No, speaking personally, I think it's because you more feel your exclusion. And you more see how unnecessary it is, and really how unfair it is. And that we could have a more open society, but apparently that takes quite a while

Who are these psychiatrists and counselors? Well, they tend to be people who have issues of their own, and they tend to be "be righters." That is, to them, it is more important that they "be right" about a diagnosis than it is that your life go well. And it is remarkable and shocking to see this in practice.

We're going to have to do most of it on our own. That is, we're going to have to form our own groups and advocate on our own. "Professionals" can help out, but we cannot allow them to run the show.

For example, the current article at the top of our opening page "Acceptance: If It Doesn't Mean Giving Up: What Does It Mean?" by Psychologist Dr. Robert Naseef. Well, I'm sure the guy means well and it might even have good stuff in the article, but what a crapola title. I wouldn't dream of giving up (other than passing depressive times). But damn, I don't need to have this guy preach at me.

And it's not even about parents leading a movement. It is primarily about us as people on the spectrum advocating for expanding our own civil and human rights, and we definitely have things to contribute.

Yes, at times, I am painfully aware of being excluded.

That was what I actually meant, but you said it much better. It is the feeling of being excluded indeed.

Of course you can be mild. I know some Aspergians who can go about life pretty much like everyone else, and others who can't even go out without sensory overload.

i've mild asperger syndrome too, although i find it hard understanding social situations and cues to the extent of a 4 yr old understanding the conversation of several 30 yr olds but i am still able to get on with regulare stuff like buying my own clothes, getting ready for college/going out by myself, and although i am able to get the bus easily enough by myself it did take me a while to get used to knowing where to go, what to ask for, etc

i am diagnosed mild high functioning aspergers syndrome

It seems to be more a matter of expectations and prejudice. Someone who is obviously disabled is not expected to act like a typical person; people will make allowances for him that allow him to be himself to a greater extent. Someone whose disability is subtle or invisible will be expected to act like a typical person, and rejected when he does not do so, often by people who have no idea he is disabled at all. As a result he often responds by attempting to imitate normal and either expend a great deal of effort, or else never feel free to act in the way he actually prefers to act, and his self-esteem suffers. The stress level of someone who is disabled and trying to pass for typical is often very high, to the point of causing depression and anxiety disorders.

I first encountered this phenomenon in a study of quality of life in kids with cerebral palsy; the kids who were less disabled tended to have lower self-esteem, fewer friends, and less acceptance from others than those who were more disabled. While the overall quality of life (which included things like autonomy and self-care) was lower for the kids with the severe disabilities, all the subjective, emotional factors were equal or better than the kids with the milder impairments. Similarly, SCI quadriplegics and other people who acquire what's considered to be severe physical disabilities seem to adjust relatively well, with a rate of psychological problems similar to the general population. Conversely, people who are not disabled at all, merely different, such as homosexuals, tend to have a higher rate of depression and suicide. (I am still looking for data on racial minorities.)

It's not a hard and fast rule, by any means; the numbers only show more of a general trend than an obvious difference, and in most cases I've seen, people with mild vs. severe disability tend to be roughly equivalent; but when they aren't equivalent, I see a great many more where the severe cases are paradoxically more emotionally stable, socially accepted, and confident. I don't think, though, that this has to do with the disability; I think it has a great deal to do with how people see the disability and how kids are encouraged to think of it when they are little. Who tells them what disability is, and what to think of it? What messages are they getting from their parents, teachers, and doctors? What is the media telling them? In general, the message for severe disabilities tends to be a mixed bag, but includes some strong messages of acceptance; whereas for mild disabilities the messages are more along the lines of ridicule, insistence that the disability is "not real", and exhortation to try harder in order to make the disability vanish. People with severe disabilities don't have it all that great, either; they get a lot of messages about "you will never..." limitations and incompetence; but they also don't get so many accusations, and are less likely to be judged by typical standards.

I don't know what it is about the difference that really causes this effect. I think it needs a great deal more research, and what I'm doing here is really a lot of speculation. I do know a psychologist who is very much into disability culture and sociology, though, and I think I'll ask her and see if she can't give me some pointers and/or useful resources so I can study it further.

This is a great thread with great responses! Great post, Callista!

As I have said in other posts, the mild that people seem to refer to is at the level of apparent symptoms rather than the actual neurology of Asperger's/ASD/BAP, etc.

First of all, Asperger's really IS what it is. From what I've learned, it comes in so many forms and presents itself with so many variances in symptoms and levels of apparent symptoms that it is difficults to say what is mild vs. severe. BUT from the perspective of someone who MIGHT have it, a mild level of apparent symptoms does NOT equal mild effects in interacting with others. If what I have actually IS Asperger's or ASD, my apparent symptoms might APPEAR to be mild, but the EFFECT that symptom has on my interaction with others is severe.

We have many, many FINE examples of this on WP, but I'll rattle of a few personal examples for this thread:

Situation: I may walk into a room and just start talking or asking a question...I wake up and don't say anything to others in the house. It doesn't occur to me to say, "Hi, how are YOU today?" or "Good MORning!"

Effect: People yell at me that I'm rude. They then spread malicious gossip about me and make every effort to make me feel like an outcast.

I am not aware of the importance to others and am so often caught up in my own thoughts about what I need to be doing at that moment to the point of being oblivious.

Situation: A co-worker wants to hug as a greeting. I say NO because I'm not comfortable with that and I do not believe that is appropriate for the workplace.

Effect: I am labeled as anti-social (or worse).

I have a need for personal space (perhaps extreme) and only ask that people respect it whereas people think it is okay to invade my personal space.

Where Callista said, "Someone whose disability is subtle or invisible will be expected to act like a typical person, and rejected when he does not do so, often by people who have no idea he is disabled at all" I would totally agree. For those of us who are in the process of discovery, this is completely devastating - especially when you are unprepared for that type of reaction. Having WP as a safety net and a place of knowledge and understanding softens the blow so that one doesn't have to allow oneself to suffer and build up further stress.

On the surface, I do not appear to have a "disAbility" be it physical or mental. But when I run into one of the aforementioned types of situations, I get all manner of labels. I also get ostracized and mistreated by others for thinking/feeling the way I do because people mistake my intentions.

That is unskilled on their part! What they could do is 1), gently coach you along, say 'Good Morning' and then you'll probably say 'Good Morning' in return, or 2) just accept the fact that you're quieter in the morning.

It's been one of my great discoveries that "normal" people can have glaring deficients in their social skills.

REALLY good post! From my Twelve Step experience, I highly praise this type of outlook! For this issue, though, it IS necessary to take it a step farther and advocate for civil and human rights. In the Twelve Traditions, it states that the group should remain "forever non-professional" so that no one person becomes more important than the next - that we can benefit from the experience of others regardless of their station in life. With Asperger's a person who is considered "higher functioning" can benefit from someone who is "more severe" in their level of apparent symptoms even if it's by observance.