Do you think the notion of a spectrum is useful?

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I have a different perspective on the spectrum concept than I have seen anyone else put forth.

When first described in the professional literature, "autism" and "Aspergers" were two separate entities, and then there were all those other things like PDD-NOS, etc. Scientists viewed all as developmental disorders, though, and I think that is correct.

In part because it would help people with Asperger's to get professional assessment and treatment, paid for by insurance, Asperger's was lumped in with autism in DSM-V. I don't think this was any particular conceptual advance, though. I think of this as a stage in the development of fuller understanding. There is still SO MUCH we don't understand about autism!

In my view, 50 years from now (if we survive as a civilization) we will have distinct autism-like diagnoses and they will no longer be viewed as a spectrum. Hopefully, we will also know how to give the optimal child-rearing and education to each diagnosis - not to "cure" or "prevent" autism, but to give each child the fullest chance at a happy and successful life.

I believe the big difference in the newer term Autism Spectrum Disorder is that at some point the psychologists / psychiatrists realised that people with the disorders that are included in ASD all shared the same symptoms and it is the symptoms that cause the distress / disability and incapacity to function in life which includes a persons potential for employment.

In addition, at some point in time one of the health care professionals had the realisation that people generally held the perception that people with old fashioned autism with learning difficulties (IQ's lower than 75) were significantly disabled, where as people with Asperger Syndrome (who had IQs in the normal range or above average) were almost normal and were not disabled and that this perception wasn't always completely accurate, as some people with Asperger Syndrome suffered from severe symptoms which had significant impact on their ability to work and live a normal life, and there were some people with old fashioned Autism who didn't suffer as severe symptoms.

For example.
Imagine 2 cases. The first is of a person with classic Autism but who suffered less symptoms than normal.
No sensory impairment, no chronic anxiety, fairly happy temperament, able to work to their full capacity of the skills/abilities/IQ level. Able to create and maintain relationships and even romantic relationships, without too much distress. This person would be perceived by the world of normal people as disabled and would be treated with respect and helped with his/her disability.

Now, imagine a second case where a person with Asperger syndrome, who has an above average IQ but who has significant sensory impairment, is hypersensitive to sound, visual stimuli, has extremely ridged thinking in terms of morality (so doesn't lie, or get involved in deceit), at times exhibits inappropriate behaviours. has problems with short term memory.

The second guy finds it hard to find and maintain employment, due to sensory impairment, ridged thinking, memory and behavioural issues. This guy, even though his IQ is high, has a hard time in life because people in the normal world do not perceive him as being disabled, and when he has problems, is considered the cause of his problems (being bad) rather than symptoms of his condition or being disabled.

The second case guy's IQ is also higher than average, and because he has ridged moral thinking, often falls out with the NT people because they break the moral code or expect him to break the moral code (this happens often in the work place) or are doing things in a particularly stupid way (which could be improved upon).

People who are up to no good also will perceive someone who holds high moral values as a threat to their misdemeanours, people who are less bright can also see a person with a higher IQ than them as a threat, so the guy will inevitably get victimised in the work place and perhaps even sacked due to suffering from ASD traits, and as NT people are generally highly skilled at manipulation, and in some cases can be very dishonest and devious, and perhaps do not suffer from the same level of anxiety as the former. It does not take that much to get such a person the sack.

So the second case guy ends up unemployed permanently, so has to survive off a low income, continues to have problems with communication, and is left behind by the NT world.

He doesn't fit in with the NT's, but he also doesn't fit in with the people with old school Autism, and although his IQ is high and he looks normal. The symptoms disable him.

Which case is more disabled? 1 or 2?

The level of disability is different to the level of support a person may need.
Some people with Asperger Syndrome, who need no support from support services are still in fact as disabled or more in terms of their ability to function as a normal or NT human being than many of the people who have classic autism.

It is this observation (or similar) that led to the change in way the American Psychiatrists Association diagnose a person for ASD.

Now, the diagnosis is symptom based rather than IQ based.

I think that another reason for the change in diagnostic term being created was so as to increase the awareness of Asperger Syndrome actually being a disability, especially for general medical doctors, psychologists, psychiatrists and other specialist health care professionals, so that people with Asperger Syndrome are no longer suffering from an invisible disorder.

Yes because there is still is a lot of people that have too narrow a view of autism.

Never heard it put this way before, but I have to agree with you on this one. Kind of makes sense to me. If you'll look at the Aspie Quiz results in my signature, that's essentially what I am. One of the comments there says "People with aspergers (like me) are like the avatars, they're the bridge between the spirit/mortal world, we are the bridge between the autistic/normal worlds."



Again, this is something I'll agree with. Last I checked, there are a total of 65 genes known to be strongly tied to autism. Another 200+ are more weakly tied. Even though they all lead to the same behaviour, they likely arrive there via completely different routes. Even if you choose only three out of those 265 where none are repeated, you end up with 3066580 possible outcomes! Choosing 10 genes out of those 265, you'll get 3.9632386242e+17 combinations (wow!!), more than the total number of humans that have ever lived.

Furthermore, things get even more complicated, because genes don't tell the whole story. If any of you understand genetics or have studied it as of late, you might've heard of RNA interference. Read the article to understand the details, but what this means is that even if two people have the same genes, differences in their environment/other factors may affect to what degree these genes are expressed. Over the past 20 or so years, these have been intensiley studied, so much so that they actually do a lab teaching this in 2nd year undergrad at my university.

Combining all those possible genetic combinations with the ability to express each one of them to varying degrees, I believe what BeaArthur is suggesting is completely right. Autism, PDD-NOS, Asperger's, etc. are all developmental disorders with similar symptoms, but their genetics and the degree to which each gene is expressed differs between them.

I like the spectrum, and I do think it's useful. Autism basically is a spectrum, and there's many different kinds, with varying levels of what you could call "severity". Some people might have Asperger's, which is more milder on the spectrum, or something like that. I find the spectrum is much more helpful than just saying someone has autism, because having autism is different than having Asperger's or something like that.

It's useful in terms of relativity.

Labels...never a good thing.

1. They stop people from being seen as individuals
2. Encourage stereotyping and generalisation
3. Have an impact on an individual's self identity
4. Affect behaviour and even personality
5. Affect quality of life (due to social issues such as discrimination, prejudice, bias etc).

I would prefer if it was called a sphere, not a spectrum. The chart that pops up at the end of the aspie quiz is closer for me than a line, but could still have a few more complex layers added to it. There is a central core of what it is to be autistic, but how it presents branches out in different ways for each of us.

I agree.