Why don't we all see neurologists?

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Am I correct in believing that AS is a neurological disorder? Because that would mean that your brain is either wired differently, or it's not. In that case, how is it possible to have a mild case of AS? And why do we see psychologists who assess our traits, when a neurologist could detect AS in our brains, right?

I'm not trying to prove a point here, I'm really trying to figure it out. Also, how is it that some people have AS traits and then give birth to full-blown Aspies? It's personality in one generation, then neurological in the next...???

Of course, you have to understand that I'm not a science person and don't know much about genetics, so don't worry about seeming condescending if you want to tell me how that works on a basic level - just don't BE condescending...

Some people see neurologists, some see neuropsychologists, others see psychologist/psychiatrists as those are the ones trained in making the diagnosis and aiding the person with adapting socially and all. Many of us see psychologists and all for co-morbid issues like depression and anxiety.

How does a person with some AS traits create a full blown Aspie... at times things do skip generations and all. My father may have some odd AS-like quirks but he's more NT than anything, just like my mother, yet I have Asperger's... my partner is NT, we have one son that has Autism and one that is non-autistic and gifted. Not everyone gets a "full dose" of genes and all for everything.

And some people with some traits on the spectrum can be diagnosed with PDD-NOS which is the proper term for having some traits but not enough for AS or Autism, but it still means they are on the spectrum.

AS affects many things, it affects neurological due to it's affects on communication and social as well as sensory.

Yes just like Autism, AS is a spectrum in itself, you'll find some very mildly affected and better able to adapt than others. A lot of it depends on comorbid conditions that can happen with it, like depression, anxiety, ADHD and all.

"Am I correct in believing that AS is a neurological disorder? Because that would mean that your brain is either wired differently, or it's not. In that case, how is it possible to have a mild case of AS? And why do we see psychologists who assess our traits, when a neurologist could detect AS in our brains, right? "

Well, "What is mind? No matter. What is matter? Never mind."

Adrie, yours is a very perceptive question. To answer it fully is beyond the space of a reply here, but in a nutshell, it goes back centuries to the idea of what the mind is. Psychology grew from an acorn of religion into a science when Freud medicalized what were considered previously problems that were in the realm of religion. To this day, there is an uneasy tension between psychology and neurology. Today, on one extreme, you have the people who want to throw drugs at every psychology problem, whether caused by living or chemicals. At the other end, you have Anti-psychiatrists like R.D. Laing, Scientologists, and (despite his protests) Thomas Szasz, who say that mental illness is a "myth", or as Szasz says, a metaphor. This often involves a denial of the body/mind connection. Without arguing who is right, those are the key ideas to answer your question of why it is the way it is. Sadly, there is no clear-cut answer as of yet that I can answer about whether AS/Autism is brain or psychologically based. My armchair theory is that if your brain is structured one way, it will affect perception and/or conception, i.e., how you interpret incoming sensations and perceptions. I actually am considering college to study these issues first hand instead of second and third handedly from the armchair! So maybe someday I can answer.


(Side note: Szasz, unlike others in his orbit, does not deny the existence of neurological problems, and would say that autism is neurological. His better arguments involve keeping the state out of determining who is mentally ill, usually because the state and others use "mental diseases" to keep down undesirable dissenters! Very dangerous stuff.)

It's widely accepted now that AS has genetic causes. Very few human traits or conditions are caused by just one gene. For example, in the absence of poor nutrition or growth-stunting disease, height is mostly hereditary. However, many genes are involved in determining height; so height, like autism conditions, is a spectrum. This is just a conjecture on my part, but I think that AS is probably controlled by many genes, just like height. Some people are clearly much shorter than the average, and some people clearly have AS. I'm 5' 1" and a Caucasian female. That's short enough that many people remark on my small stature, but not short enough to be considered abnormal. A mild case of AS is the same - people can tell that the person with mild AS is different, but they aren't sure if its different enough to be abnormal or not.



I think it's because there isn't enough research to conclusively identify the specific brain differences that exist in AS at this time.



If my multiple gene theory above is true, then it would be just like height - my parents are both close to the average height for their gender, but I'm significantly below it. Also, since there is no neurological test for AS at current, we have no way to determine the severity of any case of AS except by its symptoms. Many adults with AS have developed extensive coping mechanisms to appear more neurotypical. The parent who only seems to have AS traits at age 35 might have qualified for a diagnosis of "full-blown" AS at age 5.

Hope that helped! As I said above, I don't have any actual genetic evidence for my theory of multiple genes causing AS, but I think it's fairly reasonable, and fits with current understandings of genetics.

The science can't really answer it yet, the tools aren't high resolution enough, they can really only give vague generalities, not anything really specific (yet). That research will take a while!!

I'd love to see a neurologist. But I have to jump through hoops to get to one. I needed my GP to refer me to a psychologist, to refer me to a specialist, and then and only then, will I have the chance to see a neurologist. And it's unlikely.

my daughter saw a well known child neurologist in Toronto. He decided her behaviours were more characteristic of OCD and ruled Autism out. That was when she was 5. 4 years later, after a bunch of cbt, ssri's and what we feel was a misdiagnosis, she was finally seen by an Asperger's Specialist and diagnosed with AS.

I am so angry that we bothered with the neurologist!

My psychiatrist is a neuroscientist. I didn't realize people went to psychologists for asperger's... I don't recommend going to doctors who don't specialize in psychopharmacology / neuropsychiatry for Asperger's. It is a neurological thing.

It's all an artifact of our university inspired degreeing process. Bucky didn't have medicine in mind, but his quote fits pretty well.

Why do some people with psoriasis go to a dermatologist? The disease is most apparent on the skin. Why do some go to a rheumatologist? There is an autoimmune component. Why do some only go to their family doctor? Personal preference, or an administrative system that decided that they aren't worth the cost of a specialist.

Last edited by monty on 27 Sep 2007, 11:47 am, edited 1 time in total.

Unfortunately, no. At this point, AS can only be diagnosed through behavior and cognition, not neurology. There is no "AS marker" that we've found in the brain yet.

It's a neurological thing, but it's currently diagnosed based on behavior and patient report because we don't know enough about the neurology of AS yet. In fact, psychiatrists often don't have much of a background in AS, since they're trained to diagnosis and then prescribe medication, and there's no special test that neurologists can perform to test for AS. So most people's best bet is to see a psychologist with a specialty in ASD. For NLD, you can see a neuropsychologist because of the specific tests that can be performed.

I think in England it's a test. I went to my GP saying I thought I had AS, and she tried to refer me to the specialist directly, but they don't accept referrals from GPs. What she had to do was refer me to a psychologist to most probably rule out any other disorders or psychiatric illnesses, and then for THEM to refer me to the Autism specialist.

All personality is neurological. Actually, everything that the mental health professions deal with (neurology, psychiatry, psychology) is all neurology, because it's all the brain. Even trauma has a physical effect on the brain. Even LEARNING has a physical effect. The best thing is to not worry what the professional is called but how much experience they have with ASCs and how well they work with you. That's the more important thing.

As for heredity, ASCs aren't personality versus disorder. ASC traits, despite a minority, aren't uncommon in the human population. For example, you might put a female aspie and a male aspie together and they have an autistic disorder kid. It's potentially an additive effect. It could also be a continual replication of a portion of the gene with each continued generation: the father has 40 copies of such and such gene, the next generation it is naturally increased to 120, and the next generation, 150. There are genes which may be programmed to increase in number simply through sexual replication (Huntington's is one such, where each successive generation gets it earlier and more severe.)

Genes are also activated by the environment, so one generation may have the genes and be "aspieish" but there isn't the proper trigger for the remainder of those genes to bring out full-blown autism. So environment does play a role. And this includes the outer environment, or could also be something which is triggered by the internal body environment, such as being sex-linked. It is possible that female aspies may present with less severe phenotypes because some of those ASC might be androgen-activated and females tend to have fewer androgens than males. Or it could have genes located on the X chromosome which are integral to the development of a more severe version so that a male always receives the X from his mother and if she is a carrier, he won't have another X chromosome to battle for dominance. So females may end up being subtler phenotypes but with the same genetic type as her male counterpart.

There are many possibilities. But autism doesn't just stop at the cut-off point of some label. It ranges into a much broader phenotype. The labels are there to help humans-- like psychologist, neurologists, psychiatrists-- to categorize those who are having the most trouble in life due to their phenotype and thus to plan some sort of treatment if possible (well, that's the ideal though not always how it works out).

I see doctors who know about AS and work with people with it. Mine specializes in autism. I think thats why my clinic put me with her because she works with autism, depresssion, and eating disorders. She works with other things too because she said she has worked with people who have NVLD and I defenitly don't have that. That was good to hear to that means I don't have to worry about it and can cross it off my list of what I might have. I figured I probably didn't have it anyway because it doesn't take me two years to remember where places are or even a few months.

I don't think that I have the money to afford it.

Does your country have programs for people who can't afford doctors and other health stuff?


Here in the USA we do, we have Medicare and Medicade. In my state we have a prgram called Care Oregon and its for people who are under 65 I believe but unfortunitly you have to be on SSI to have it. If you don't have any disabilities that make you qualify for SSI and you don't make enough money to see a doctor, to be on meds, see a dentist, etc. you're deadbeat. I suppose those people have to go to places where they don't charge them if they have low income or they borrow money from their family or beg for money in the streets.