An article about the supoposed differences between SPD and AS (or the condition currently known as AS)
http://4np.net/~sum1/psyforum/swolff-beyond_as.pdf
Quote:
We realised from the start that our children resembled
Asperger’s cases (Wolff and Chick, 1980). He stressed the
children’s giftedness, the association with maliciousness and
unusual fantasy. He reported the social disability to decrease in
adulthood when, despite continuing difficulties in intimate
relationships, work adjustment was often excellent. This
contrasts with more recent accounts of people with Asperger
syndrome (Tantam, 1988a and b; Tantam, 1991; and Wing,
1992), who were rarely able to lead independent lives or
maintain employment, and hardly ever married. Most of
Tantam’s patients had the triad of impairments typical of
autism in early childhood, although not always beginning
under the age of three, and most also scored highly on a
measure for schizoid/schizotypal personality. This was thought
to be secondary to the developmental disorder.
There are two reasons for preferring the
schizoid/schizotypal label for the children we have studied,
unless the category of Asperger syndrome is specifically
modified.
First, the children do not meet the criteria for Asperger
syndrome of ICD-10 (WHO, 1992; 1993) or DSM-IV (APA,
1994). They do not have the abnormalities of reciprocal social
interaction, nor the restrictive, repetitive, stereotyped patterns
of behaviour "as for autism". Our children’s features resemble
those of autism, but are not the same. ICD-10 criteria include
the absence of clinically significant general delay in spoken or
receptive language or cognitive development; and they include
circumscribed interests or restricted, repetitive, and
stereotyped behaviours. An exclusion criterion is schizotypal
disorder, but the definition includes schizoid disorder of
childhood and autistic psychopathy. DSM-IV criteria also
exclude significant delay of language and cognitive
development; indicate that the disturbance causes clinically
significant impairment in social, occupational or other areas of
functioning; and differentiates the disorder from schizoid
personality.
A few of our children were of below normal intelligence
and some had early language delays, occasionally severe. And
it is now known that severe developmental language disorder
can be associated both with social oddities and impaired
intimate relationships as well as an increased risk of later
paranoid psychosis (Mawhood, 1995).
In ICD-10, the criterion of circumscribed interest
patterns or restricted and stereotyped behaviour does not really
capture the, often sophisticated, special interests of our
schizoid young people. In the most intelligent of the schizoid
men, such interests formed the basis for a successful career
choice: in astrophysics and graphic design. Only in a few of
the less intellectually gifted, could their special interests be
described as restricted and repetitive.
Finally, an unusual fantasy life, occasionally amounting
to pathological lying and the adoption of aliases, was
prominent in some of our cases, as indeed it was in Asperger’s
too, and should be mentioned as a diagnostic feature of
Asperger syndrome, if the schizoid group here described is to
be included within this diagnostic category.
As Klin and Volkmar (1997) indicate, the diagnosis of
Asperger syndrome has been defined in varying ways, and
according to current diagnostic criteria, it cannot
unequivocably be differentiated from high functioning autism.
Prior et al (1998), in a cluster analysis, also found no clear
demarcation between high functioning children diagnosed as
having autism, Asperger’s syndrome or other pervasive
developmental disorders, merely differences in social and
cognitive impairments. In particular, early language delay or
deviance did not differentiate between the groups of children.
Yet none of our children had ever fulfilled the criteria for
autism.
A second reason for not classifying our children within
the pervasive developmental disorders is because different
diagnostic labels should not be used for the same condition
merely because it is recognised in childhood rather than later
life. Yet researchers into schizotypal personality in adult life
do not always read the child psychiatric literature. Olin et al
(1997) for example, overlooking the work of ourselves and of
Nagy and Szatmari (1986), in a study of teacher ratings of
school behaviour in adolescents later diagnosed as having a
schizotypal personality disorder, state that "no study" has yet
reported on the early behaviour of people given this diagnosis.
Their teacher ratings characterising these youngsters included
being lonely; content with isolation; anxious with peers;
having disturbed and inappropriate behaviour; and disciplinary
problems.
In summary, the children we described could be
classified either as having a schizoid/schizotypal personality
disorder whose diagnostic criteria they fulfil, or as having
Asperger’s autistic psychopathy according to Asperger’s
original description. The current diagnostic category of
Asperger syndrome is inappropriate unless its criteria both in
DSM-IV and ICD-10 are modified to omit the exclusion of
significant delays in speech and language and of schizoid and
schizotypal disorders; to specify the less severe social
impairments and more sophisticated all-absorbing interests in
comparison with autism; and to include a criterion for unusual
fantasy.
However, it is very probable that this "difference"could be only a difference of degree.
05 Mar 2011, 5:49 pm
