Is there a difference between HFA and AS?

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MeshGearFox
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17 Dec 2007, 2:10 am

Danielismyname wrote:
Those at Attwood's told me that the difference in adults with autism and Asperger's is the ability to communicate verbally, those with autism have great difficulty with verbal communication, even though most can do it. The other difference is the motor mannerisms, they said they're far more frequent in autism compared to Asperger's. Those with Asperger's can communicate adequately in a social setting compared to those with autism; communicate adequately in actually being able to initiate and sustain a conversation, no matter how..."odd", "weird" and/or "eccentric" it is.


Excellent description. This question has been on my mind. Daniel, I see it as related to your non-response thread. I'm always amazed at the stories of aspies getting fired or causing disruption for talking too much. Conversation is exremely difficult for me. Some days, I have no desire to talk at all. My supervisor loves to talk, and it is a great source of conflict. Even if we're talking shop -- the only kind of conversation I can sustain with my co-workers -- if the conversation drags on too long, I need to stop it in its tracks or my brain will explode.

My difficulties often do not revolve around being "weird" in terms of socialization; it's my silence and wish to stay to myself due to a low threshold for meltdowns. Some see this as hostility; some think it's aloofness. For me, it's a matter of survival. I think HFA is a better description of me, but switching labels obviously doesn't make any real or practical difference.



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17 Dec 2007, 3:11 am

MeshGearFox wrote:
Danielismyname wrote:
Those at Attwood's told me that the difference in adults with autism and Asperger's is the ability to communicate verbally, those with autism have great difficulty with verbal communication, even though most can do it. The other difference is the motor mannerisms, they said they're far more frequent in autism compared to Asperger's. Those with Asperger's can communicate adequately in a social setting compared to those with autism; communicate adequately in actually being able to initiate and sustain a conversation, no matter how..."odd", "weird" and/or "eccentric" it is.


Excellent description. This question has been on my mind. Daniel, I see it as related to your non-response thread. I'm always amazed at the stories of aspies getting fired or causing disruption for talking too much. Conversation is exremely difficult for me. Some days, I have no desire to talk at all. My supervisor loves to talk, and it is a great source of conflict. Even if we're talking shop -- the only kind of conversation I can sustain with my co-workers -- if the conversation drags on too long, I need to stop it in its tracks or my brain will explode.

My difficulties often do not revolve around being "weird" in terms of socialization; it's my silence and wish to stay to myself due to a low threshold for meltdowns. Some see this as hostility; some think it's aloofness. For me, it's a matter of survival. I think HFA is a better description of me, but switching labels obviously doesn't make any real or practical difference.


Good posts guys. Thanks.
I identify as I prefer less social contact. I don't seem to need to talk although I can initiate conversation and keep it going. Conversation is very tiring and almost impossible if I am overwhelmed or overstimulated and I also have a low threshhold for meltdown. I have developed some conversational strategies to help protect myself from meltdown - I figure if I control the conversation - especially by getting the other participants to talk more - then I can blend in more easily. People are usually keen to talk about themselves and aren't that fussed to find someone who doesn't talk much, especially if you are able to say just enough that they don't notice that you aren't saying much.

Social interactions are so exhausting and can even take a couple of days to recover from. I DO socialise but only because I think I should. I force myself to participate at a level that many people still consider me to be aloof or socially reserved.


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Danielismyname
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17 Dec 2007, 3:35 am

Here's the DSM on the differences of communication between Asperger's and autism (as well as a bit on selective mutism to show another phrase pointing to "verbose"):

Quote:
In Autistic Disorder, typical social interaction patterns are marked by self-isolation or markedly rigid social approaches, whereas in Asperger's Disorder there may appear to be motivation for approaching others even though this is then done in a highly eccentric, one-sided, verbose, and insensitive manner.

In Selective Mutism, the child usually exhibits appropriate communication skills in certain contexts and does not have the severe impairment in social interaction and the restricted patterns of behavior associated with Asperger's Disorder. Conversely, individuals with Asperger's Disorder are typically verbose.


Those with verifiable Asperger's that I've seen have indeed been verbose, just as talkative as any "normal" person; "weird" compared to "normal" people (as well as a complete lack of non-verbal communication). It's said that people with Asperger's withdraw and become aloof due to constant failure at socializing, it makes sense; people with autism withdraw and are aloof because they cannot do it at all (receptive language is possible in autism). People with autism have trouble with talking in a social context, some also have trouble in a mechanical context; one thing with me, I've never started a conversation in my life, social or mechanical out there and in person.



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17 Dec 2007, 9:29 am

1of5 wrote:
I think there is a differance. I am HFA. There are 5 in my family with an ASD two with Aperger's three with HFA. Some of the presentation seems to be the same, but I'd say the main differantiating feature is that, for the most part the major lack of wanting socialazation is the main differance. Those that I know that are Aspies want to socialize, but those of us with HFA don't really have that, and it seems to be physicaly and emotionaly draining for us. I have also found, that in our family, those that are Aspies don't have the need for order that those with HFA seem to need. Atleast these are the things that I have observed in my family and with those I know and am aquainted with.


The actual only official difference is that people with AS don't have a language delay, or (supposedly, these are more contested) don't have delays in self-help or other cognitive delays besides social skills. People who do have those things (and meet the other criteria) are classified as autistic (whether "HF" or "LF", and whether those two terms have any meaning or not). And of course, as some people have otherwise said, AS is generally considered one form of autism (the form without language delay, although of course some of Asperger's patients had language delay and some of Kanner's patients didn't).

I've known a lot of people with diagnoses of Asperger's and diagnoses of autism. I've seen just about every way to differentiate them tried online, in both directions. It's actually kind of funny, because I've heard the way you describe, and I've heard the exact opposite of the way you describe, and I've heard a bunch of other ways too, used to differentiate. In practice they never seem to work because among any group of people there may be trends in either direction, but among another group of people there's always trends in the opposite direction.


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anbuend
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17 Dec 2007, 9:36 am

Danielismyname wrote:
AliceinOz wrote:
Would it be reasonable to say that there are a number of different dimensions on which to measure ASD? IQ (low or high), sociability (aloof, passive, active but odd) - anything else?


"Officially", they measure severity of ASD in how it affects the triad of impairments: social, vocational and/or educational.


Wow, is that what they've changed the "triad of impairments" to now?

I wonder if they're just trying to come up with three random areas autistic people are impaired in, or something, just so they can keep the name "triad of impairments".

It used to be social, communication, and imagination. Then when that didn't work it became social, communication, and "social imagination" (with them trying, falsely, to say that's what "imagination" meant all along), and then also social, communication, and repetitive behavior or interests.

I wasn't aware they'd come up with another one. That really does not make sense to me, I doubt that autistic people's range of difficulties really fall into only three areas, it sounds like they're really just trying to come up with three so that they can keep saying "triad".


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17 Dec 2007, 9:37 am

This is an old news item but it highlights some of the political issues in differentiating between AS/HFA. I imagine this will only increase as DSMV approaches.

http://www.uq.edu.au/news/?article=5816

From article -

Quote:
Fiona Lewis, a postgraduate student at UQ's School of Health and Rehabilitation Sciences (Speech Pathology), said the issue of Asperger Syndrome and High Functioning Autism was contentious, with some researchers arguing there was little difference between the two.

Both conditions are included on the spectrum of autistic disorders, and both must present with a cluster of symptoms such as impaired social interaction and relationships, abnormal communication, and rigid and limited imagination and play.

Ms Lewis said the distinction between Asperger Syndrome and High Functioning Autism lay in their developmental language histories.

“But, at the moment many researchers in the field of autism are pushing for the removal of Asperger Syndrome as a distinct diagnosis, due to the lack of solid evidence to suggest that Asperger Syndrome is a different presentation to High Functioning Autism” she said.

One of the aims of the research is to determine whether a language and communication assessment, done at a time when mature language use has emerged, can differentiate the two disorders.

Ms Lewis said there was also a lack of information about whether girls with symptoms suggestive of an autistic disorder are overlooked in the diagnostic process.

She said this could be due to their possible better language skills and general compliance in the classroom.

“However, at present no-one knows if females and males present differently. This is particularly important if girls presenting with symptoms of Asperger Syndrome are to be correctly diagnosed and helped,” Ms Lewis said.

Ms Lewis aims to compare the language and communication skills of females and males with the diagnosis.

The incidence of Asperger Syndrome/High Functioning Autism is in the range of 24 to 48 per 10000, with many people arguing the incidence is increasing. Boys outnumber girls with Asperger Syndrome/High Functioning Autism, with the sex ratio ranging from 4:1 to 18:1.


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17 Dec 2007, 10:21 am

Danielismyname wrote:
AliceinOz wrote:
Danielismyname wrote:
(most don't have friends in both categories).


what do you mean?


Most people with Asperger's and autism have no friends. It's the sad truth.

Except that many with AS and autism DO have friends.


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17 Dec 2007, 10:25 am

anbuend, it's actually the triad of functioning [in society], my mistake sorry; I get my triads mixed up. They're the big "three" in the medical circles for how they define the outcomes of individuals with Asperger's/autism.

I agree that the aforementioned three aren't the only areas that individuals will experience difficulty in.

beau99, of course people with AS/AD have friends; when they're taken as separate and complete entities (AS or AD), most don't.



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17 Dec 2007, 10:30 am

Danielismyname wrote:

The social aspect of the two disorders is similar in severity, they just manifest differently: autism is usually aloof, Asperger's is usually active and odd (most don't have friends in both categories).


huh?

Seriously you are going to have to explain this like I am 4.

I have read all of your responses and I think you are saying:

Auties can't verbally socialize well, Don't want friends and are aloof.

Aspies try to socialize, want friends and are active.

Is that right? I'm just confused I guess.

Because I don't particularly want friends, I'm very aloof, although I can socialize well. Does that lead me in an AS direction or a HFA direction?



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17 Dec 2007, 10:59 am

Okay, to answer someone's question (sorry to not remember your name). According to Lorna Wing (although there may not be a lot of science behind this), there are four main social interaction styles among autistic people:

Aloof (actively avoiding social contact, or appearing not to even notice social contact when it's initiated).
Passive (allowing social contact if someone else initiates it, but not initiating).
Active-but-odd (initiating social contact, but doing it in a way that most people wouldn't do it).
Formal (dealing with social contact in a manner that seems too formal for casual occasions, but staying in that formal mode all the time).

One of the main problems is, for instance, that many autistic people categorized as aloof, have been able to say that they want social contact, they're just not able to send the signals of wanting or noticing it. I can remember asking someone at one point why nobody interacted with me, and getting a startled (and startling!) reply of "But you don't want to interact with anyone, and you don't notice when people do interact with you!" or something like that. (The person was actually very stern with me about how much I was supposedly avoiding contact, which was not my intention at all.)

Personally, if I had to categorize myself along those lines, while I've certainly had times where I'd be categorized as what people would call aloof, as well as what people would call "active-but-odd" (i.e., running up to people and saying nonsense in several languages, running up to people and reciting facts, etc)., my main social interaction style would be considered passive, as in I have real trouble initiating, but once someone else initiates, I will go along with it.

Of course, that's true for me not only for social interaction, but for all things requiring action at all, and they've found that, while autism and AS and LFA/HFA and any other classification within the autistic "spectrum" did not seem to correlate to the kind of movement disorder I have, social passivity did, making them think that social passivity is sort of one of the subtle early elements of a movement disorder that becomes really obvious much later and makes it hard for a person to initiate all movement. In my case, I have to have environmental things set up so that I will be able to do assorted required movements, and also set up so that I don't do movements that are not required. And I also have trouble initiating thought, memory, etc., on my own as well. Something always has to trigger them, and when comparing deliberate vs. triggered on just about any aspect of my life, triggered is always far superior to deliberate. (And deliberate movement has been shown on me to be stressful enough to show up on a measure of galvanic skin response -- most people's movement doesn't show up on it at all even when moving vigorously, whereas automatic movement (such as rocking) or triggered movement (such as keyboarding) does not show up at all on mine. So wiggling my toe is more physiologically stressful to me than touch-typing, since the presence of a keyboard triggers the ability to type.)

Also I know some autistic people who don't like the designation "active but odd" because it implies there's some sort of disparity between "active" and "odd", and prefer "actively odd" :)

Online, my passive conversational style can make me seem somewhat argumentative at times, because often it's seeing something I consider inaccurate that triggers me into responding. Although seeing something I agree with and want to elaborate on can trigger a response too.

Also, sometimes I wonder a couple things. Whether "aloof" (when it means, actively avoiding contact on purpose) and "active but odd" (meaning actively seeking out contact) are actually the same thing but with different preferences (both of them the opposite of passive), or the same thing but with different overload thresholds (that way explaining why, for instance my brother went from "aloof" to "active but odd" seamlessly throughout different points of his development, but never being "passive").

And whether some kinds of "aloof" are actually forms of "passive" where instead of another person's approach triggering interaction, another person's approach triggers avoidance or expressions of overload or other such things (such as when I was small and screamed when other children tried to interact with me).

And whether some kinds of aloof are other forms of passive where a person is so passive that it takes far more than an approach to trigger a kind of interaction that most people would recognize. (Such as some people who may only be triggered into action by being touched, or other things besides mere social approaches. This is similar to other times I've been considered "aloof", and still easy to come by if I get exhausted enough.)

And whether scientists have bothered to look at this (although from what I've heard, many scientists don't take the aloof/active-but-odd/passive/etc system too seriously, since it wasn't arrived at by science as much as observation and subjective categorization).

Also whether scientists have bothered to look into social passivity to see if it correlates to other things being triggerable by aspects of the environment other than social aspects. (Since that is how I experience things, and many other people I know who are classifiable as "passive" see things similarly.)

I'm also curious why it is that sometimes a person's presence triggers my ability to do things (including interact), and why other times a person's presence makes me less able to do those things.

Er... enough thread-hijacking, I guess. :)


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17 Dec 2007, 12:41 pm

anbuend wrote:
Okay, to answer someone's question (sorry to not remember your name). According to Lorna Wing (although there may not be a lot of science behind this), there are four main social interaction styles among autistic people:

Aloof (actively avoiding social contact, or appearing not to even notice social contact when it's initiated).
Passive (allowing social contact if someone else initiates it, but not initiating).
Active-but-odd (initiating social contact, but doing it in a way that most people wouldn't do it).
Formal (dealing with social contact in a manner that seems too formal for casual occasions, but staying in that formal mode all the time).


That's a really useful way of looking at all of this. I'd say I'm mostly "passive" with a little bit of "aloof" mixed in. I think I've been more socially successful than a lot of aspies, and I think my "passive" interaction style may be a large part of why. To me these kinds of distinctions are much more useful than HFA/AS/PDD-NOS, all of which pretty much mean the same thing IMO.



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17 Dec 2007, 1:16 pm

Although be careful with PDD-NOS, it doesn't always mean what most people call 'high functioning'. I have known people who were diagnosed with PDD-NOS because they were so unable to do most things (whether because of cerebral palsy or something else), that they could not do the things that people are required to do in order to get an autism diagnosis. (I also am not sure the HF/LF dichotomy works that well, but that's a whole 'nother subject.)


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17 Dec 2007, 1:48 pm

1of5 wrote:
. Those that I know that are Aspies want to socialize, but those of us with HFA don't really have that, and it seems to be physicaly and emotionaly draining for us. I have also found, that in our family, those that are Aspies don't have the need for order that those with HFA seem to need. Atleast these are the things that I have observed in my family and with those I know and am aquainted with.


I agree with u on that one, I don't have any care in the world to socialize, growing up, had no interest at all for people, rather be in my room disappearing in my own world.

I think the main difference is language delay though. I wasn't just delayed i was non-verbal for awhile. Some people say Aspergers is a mild form of autism, but sometimes that isnt the case either, i think its a high functioning form of autism, and HFA is classic autism, and either your high functioning enough to live in this world, or functioning enough or low functioning.


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17 Dec 2007, 2:18 pm

The req for a PDD-NOS dx is displaying autistic behaviors and not meeting the criteria for another PDD. This lack of meeting can come from many things, like inability to take the tests ( as stated above), severity of behaviors not meeting criteria guidelines, or late onset.

More on the last one. Forms of autism, like CDD and Rett's, are late onset by nature. What I mean by late onset above is that the onset is later then CDD/RTT criteria allow ( 7+ typically although there have been some cases of CDD in children as old as 9)

Okay, this post was kinda off topic but just thought i'd give some info.



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17 Dec 2007, 2:22 pm

Age1600 wrote:

I agree with u on that one, I don't have any care in the world to socialize, growing up, had no interest at all for people, rather be in my room disappearing in my own world.



You are HFA right?
I really don't know the difference between the two. Other than what was said here.
I'm just like you. I want to be alone, don't mind it. People ask If I get lonely, I tell them no, they think it is strange.



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17 Dec 2007, 3:03 pm

busy91 wrote:
People ask If I get lonely, I tell them no, they think it is strange.


Same here. Most people think it very strange that I do not get lonely spending most of my time alone.


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