Might my correct diagnosis be autism rather than Asperger's?

Post Reply New Topic

Okay, just to clear up whether Kanner's original subjects would be considered LFA or HFA, I actually have his original paper saved to my computer. Here we go:

Case 1: Could sing accurate before one year old. Before age 2, unusual memory for faces and names. Learned and recited short poems. "His enunciation was clear."
Conclusion: Likely would be labeled HFA or AS today.

Case 2: Said two words before two years of age ("Daddy" and "Dora"). Began singing around 2.5 years of age- sang about 20 or 30 songs.
Conclusion: Likely would be labeled HFA today.

Case 3: Was not talking or responding to questions at 3 years of age. "...seems quite intelligent." Obeyed spoken commands. First intelligible words at just under 5 years- "good night." Bear in mind this kid had no speech therapy.
Conclusion: Probably more likely HFA than LFA, especially if he had been given speech therapy.

Case 4: "At 3 years, knew the words of not less than thirty-seven songs and various and sundry nursery rhymes." "His enunciation was clear and he had a good vocabulary," but did not use the first-person pronoun.
Conclusion: Likely would be labeled HFA.

Case 5: "Ordinary vocabulary at 2 years, but always slow at putting words into sentences. Phenomenal ability to spell, read, and a good writer, but still has difficulty with verbal expression."
Conclusion: Likely would be labeled HFA.

Case 6: "She pays no attention to what is said to her but quickly comprehends whatever is expected. Her performance reflects discrimination, care and precision." Tested with an IQ of 94 (note: 94 is in the average range).
Conclusion: Likely would be labeled HFA.

Case 7: "He did not respond to being called or to any other words addressed to him. He sometimes uttered inarticulate sounds in a monotonous singsong manner." "...remarkably intelligent physiognomy and good motor coordination."
Conclusion: More likely to be labeled LFA rather than HFA.

Case 8: "He has gradually shown a marked tendency toward developing one special interest which will completely dominate his day’s activities. He talks of little else while the interest exists, he frets when he is not able to indulge in it..." Slow to develop language.
Conclusions: Likely to be labeled either HFA or AS.

Case 9: "His enjoyment and appreciation of music encouraged me to play records. When he was 1½ years old, he could discriminate between eighteen symphonies. He recognized the composer as soon as the first movement started. He would say 'Beethoven.'" Speech consisting of a large library of learned rote phrases.
Conclusions: Likely to be labeled HFA.

Case 10: Echolalic language at age 2 years, though he developed more language in the next few years. "There was endless repetition of sentences. He had an excellent rote memory and could recite many prayers, nursery rhymes, and songs 'in different languages...'"
Conclusion: Likely to be labeled HFA.

Case 11: "She could say four words at the end of her first year but made no progress in linguistic development for the following four years." Began to speak more at age 5 years, but use of pragmatic language was disturbed. Used verbs well, but not pronouns. Excellent vocabulary.
Conclusion: Likely to be labeled HFA.


So of the 11 children originally described by Kanner, all but one would likely be labeled as HFA today, especially if they actually had access to speech therapy. Bear in mind- these kids had *no* therapy at all. Asperger certainly described high-functioning children. So since these were the earliest descriptions of the developmental disorder of autism, where is the idea coming from that "classic autism" means low-functioning autism?

This one is the closest match to my daughter. She also "seemed quite intelligent" until the testers gave her an IQ test, which she scored pretty low on. From then on she no longer "seemed quite intelligent" to the medical community, although she remained so to the people who actually spend time with her (family, teachers, therapists). Nevertheless, that IQ test is the apparent divider in the medical community between HFA and LFA. Technically there isn't a term for Moderate/Medium Functioning Autism (that I've seen) but I use it anyway. Because she really isn't that unique. I don't think there really is an inverse Bell Curve where most autistic people fall at either end and not enough people in the middle to warrant a term.

So I will waffle between using the term MFA (even if nobody else will) and embracing both anbuend's and Callista's more sensible observation that this supposed linearity is just a fiction that gets used for the sake of brevity and pigeon-holing. It does take a long time to describe everybody's different areas of ability and the fluctions those areas have. But it's a lot more accurate. The problem with LFA/HFA (or LFA/MFA/HFA even though I use that myself) is that it props up the illusion of linearity. Then somebody like my daughter...or the OP who started this whole conversation....! !! ! comes along and shatters that illusion and people are left scrambling (for 3 pages now) trying to re-assemble the illusion and get everybody back in their boxes.

So am I

There are (or used to be?) a few people on here who have Kanner's, classic, low-functioning autism, are mostly, if not fully, non-verbal, and require assisted living. Reading their lengthy, articulate, well-thought-out posts on this board always makes me wonder how anyone can associate the "low functioning" label with low IQ...it makes you stop and think what low functioning even means.

from what I have noticed about the LFA and HFA posters, they have been very articulate, interesting writers.

Hold on! Thanks to ColdBlooded's tireless PM's and a few other posters here on this thread, I've reread Asperger's introduction to his original paper in a new light, as well as some skipping around further in Uta Frith's book.

It may come as no surprise to those of you who have been trying like the dickens to convince me that "Classic Autism" isn't what I thought it was, but may surprise some of you who agreed with me.

The bottom line it, THEY'RE RIGHT! It's NOT what I thought it was!

The biggest question I kept asking myself is "Why is WP the only place I ever hear that Classic Autism can and does include High Functioning Autism? Why do I keep reading all over the place, and hearing from face to face interactions with professionals and others that Classic Autism only applies to low functioning Autism?"

And the answer is, "Ding! Ding! Ding!"



"Preconceived ideas probably influenced by taking in too much information from the Media, including, but not limited to the Internet..."

Not just my own preconceived ideas, but those I based on too damned many things written by others with preconceived ideas!

How I came to this conclusion is a topic for another thread, if and when I can find the time.

Suffice to say here that they are absolutely CORRECT. Classic Autism DOES NOT necessarily mean "low functioning."

Thanks to every one of you who piped in, and especially to ColdBlooded, who refused to give up in spite of what may have appeared to be stubbornness on my part (it wasn't stubbornness, else I wouldn't have bothered trying to verify anything he and others have been trying to get through to me on this thread).

Nice job guys! Thanks a heap for not giving up!

As you can see from my post just above, I now realize I was wrong. Man this whole thing can be a confusing issue. There is just WAY too much misinformation about it out there!

To the OP: Sorry for inadvertently "hijacking" this thread. It wasn't my intention. I am now "bowing out" of this thread as far as this question is concerned.

Asperger's, autism, tomato, tomata...

Actually, the confusion over Asperger's vs. Autism has become great enough that the 2013 update for the "Diagnostic and Statistical Manual of Mental Disorders" is going to get rid of Asperger's and have both conditions be Autism, precisely because the difference is so subjective. Even if there was a difference, I would still guess that you have classic Autism.

Actually, the confusion over Asperger's vs. Autism has become great enough that the 2013 update for the "Diagnostic and Statistical Manual of Mental Disorders" is going to get rid of Asperger's and have both conditions be Autism, precisely because the difference is so subjective. Even if there was a difference, I would still guess that you have classic Autism.

I find your verbal communication problems somewhat puzzling, because online you converse quite coherently, and intelligently. I too have problems with verbal communication, but mine are because of word recall problems. I will start to say something, but the word I intended to use will vanish before I get the rest of the sentence out. Maybe your problems somewhat like mine except much much worse. I don't know. When you are writing, there is no timing issue if you cannot think of words quickly enough, or whatever. Its just curious.

And there we have one of the most important parts of science: Figuring out where your preconceived ideas are, testing them, and being willing to throw them out if they don't match! The public idea of what autism is, is of "low-functioning" with all those stereotypes that Autism Speaks and its kind put into their scare-tactic "awareness" ads; but the fact is that this hasn't got much to do with what autism actually is. Nobody is a stereotype; even people who fit the "doesn't talk, rocks all the time, won't make eye contact" definition have much more to them than that, and much more to their minds and personalities.

Yes, many of the new diagnoses that increased the numbers of autistic people are among those who have milder symptoms and would not have been diagnosed in the past. But many more are among the group who would, before the 1990s, simply have been given a diagnosis of "Mental Retardation". Now, they have a dual diagnosis of Mental Retardation and Autistic Disorder (or PPD-NOS). What Asperger and Kanner both found so fascinating about their patients is not that they had these delays in speech and socialization combined with their unusual focus on objects or subjects of interest; it was actually that these signs were present in children where they could not simply be put down to a Mental Retardation diagnosis.

That's where we found and defined autism for the first time: In people who had plain autism, without other complicating factors, who seemed they should be intelligent enough to learn to speak, learn to socialize, etc., but who had some condition that had prevented them from learning, while at the same time giving them unusual focus and often unusual ability in other areas.

They called it "autism" because that was the name of a symptom often used for those with schizophrenia: Someone who was self-focused, whose world didn't really include other people, or who had a great deal of difficulty bridging the communication gap between his own mind and his own world and the world of others. The lacking or clumsy social interaction of those early patients probably caused the original researchers to use the term "autistic"; and from there it was differentiated from schizophrenia and discovered to be a unique neurological condition.

The numbers of autistic people expanded for more than just one reason. Yes, there were newly diagnosed people who had fallen through the cracks before. But there were also a great many who had, before, had some other diagnosis; and one of those other diagnoses was "mental retardation", which as a diagnosis decreased in number as the rates of Autism diagnosis went up. Autism today includes a much, much wider range of needs than it used to; it used to be a pretty narrow range that included only the most obvious, uncomplicated cases, not the subtle ones or the ones that involved some other diagnosis as well.

Thanks everybody for answering!

I know. It is puzzling. I have always had these problems with verbal communication.
I just feel uncomfortable while talking. I get stressed by the obtrusively eye-contact and body language.

Makes sense to me. Writing is a lot easier for me than speaking, and that's true of quite a few autistics. There are even people who can't get a single useful word out verbally, who are quite fluent using typing. Sometimes the grammar's unusual; sometimes it's better writing than the average person could do. Even for me (with an Asperger's or PDD-NOS diagnosis depending on the doctor), typing is easier than speaking, and much more likely not to result in my messing up my ideas or using automatic scripted responses instead of what I meant to say.

As far as AS and classic autism go--quite a few people diagnosed with AS or PDD-NOS should really be diagnosed with classic autism instead, but because of the stereotype of autism as always being very severe, they're diagnosed AS or PDD-NOS instead. Doesn't matter that much, though, because the categories basically suck to begin with, and while doctors are quite good at telling apart autistic and non-autistic, there's not very much agreement at all over which specific category to put people in.