Studies comparing HFA and AS

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I didn't find many studies about the differences and similarities of HFA and AS here on WP. Only discussions between members.

Anyone who knows about more studies, please post.

Studies that found HFA and AS are identical? or very similar:

A comparative study of the spontaneous social interactions of children with high-functioning autism and children with Asperger's disorder

That doesn't quite fit what the DSM-IV-TR writes about AS


DSM-IV-Defined Asperger Syndrome: Cognitive, Behavioral and Early History Differentiation from High-Functioning Autism

and


Neuropsychological profiles of children with Asperger syndrome and autism

and



This one questions the significance of the early speech delay in HFA:

Non-Significance of Early Speech Delay in Children with Autism and Normal Intelligence and Implications for DSM-IV Asperger’s Disorder


That's what a lot of people talk about isn't it.


These found differences in HFA and AS:

Behavioural and Emotional Disturbance in High-Functioning Autism and Asperger Syndrome

That's really interesting I think.

A Deficit in Shifting Attention Present in High-Functioning Autism but not Asperger’s Disorder

Wow, that's really interesting about the possibility of HFA people having more psychopathology than people with AS. It's just one studty, but it's an interesting finding nontheless.

I don't quite fit into it's category, though. With my speech delay I would be under the HFA category. I have a lot of anxiety, though my relationships with people are often not bad.

Wait a second, isn't it the other way around? It says those with AS have higher levels of psychopathology than those with HFA.

You may be interested in this book: Asperger syndrom or high-functioning autism?

Wow, I just logged in in order to discuss the differences between HFA and AS---and someone just put this forum up. When I was diagnosed as an adult, I was told that I could undergo more extensive testing to see if I might be HFA rather than AS. It was noted because I had gotten along well with my independence that I fit AS. Well, I failed to mention something to the expert who diagnosed me (and it is important). All the way through college (I didn't stay on campus but drove from home everyday) my mother would have to lay my clothes out---I just couldn't do it. During the summer through high school, when my parents were at work I would just stay in my pajamas until she came home on her lunch break---then she would find me clothes. I tended to take my bath/shower at night, and the next morning (I had hair that had to be washed in order for it to lay right) my mom would have to wash my hair because I could not do it. This went on not only through college age, but after I got married---my wife had to wash my hair then. And my wife would have to find me clothes too. This went on through most of my 20s. In my 30s, I learned that I could pick my clothes out. I also learned how to wash my own hair. At 44, I still cannot shop for myself well.

So, if anyone knows much about how I would fall on the spectrum in your opinion---I would like to know. I have held a job for 21 years, but have had a lot of lucky breaks in keeping that job. I taught English for 19 years and had severe difficulty. For the past 2 years I have taught the gifted---only 7 students all day long, and no more than 3 students at a time in a class---this is working out very well. I have been married for 19 years and we have 2 sons. I am receiving therapy on leaning how to interact better with my family.

If you have a high enough IQ, and are autistic, you could be diagnosed HFA REGARDLESS of other problems. AS requires that NO clinically significant cognitive or self help problems exist, outside of social. It ALSO requires that you learned to speak by 3yo. The way I read it, that means that, outside of other problems, such as hyper/hypo sensitivities, alergies, physical problems, etc.... that all AS people ought to be able to work.

That IS according to the most liberal official DSM.

If those people claim to compare, it isn't really comparing the two labels, but comparing how the two labels tended to be diagnosed. HECK, there are probably some 100% non verbal people that were diagnosed as AS even though I bet almost everyone here would admit that that would fall short.

I guess ANYONE will do something to save face and/or make a buck.

HFA and AS are clinically indistinguishable. Personally, I'm in favor of combining the two diagnoses into one.

I think I agree with that. In fact my therapist has told me that he sees them as so similar that they should be dealt with the same way. But I am still interested in something that has always been an interest of mine---what does the spectrum look like. I hate saying one is higher level than the other---but it is the easiest way to address it I guess. I tend to see AS as at the top of the spectrum, and classic autism as the most severe. But there is Kanner's---is that the same as classic? And where does HFA fall? In between AS and classic (if one seperates those two conditions)? Then there is PDD-NOS, Rett Syndrome, and childhood disintergrative disorder. Could someone put these in order for me?

I don't know if this is helpful, but I've read in a number of places that there is one measure that can indicate HFA vrs. Asperger's. If your performance IQ (non-verbal) is several points higher than your verbal IQ, that indicates High Functioning Autism. If your verbal IQ is higher, it could indicate Asperger's. It was explained that HFA individuals sometimes have more of a deficit in their left brain hemisphere and Asperger's people have more of a deficit in their right hemisphere.

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Kanner's autism and classic are indeed the same. It is also sometimes called LFA.

The labelling is pretty messy right now, and trying to classify them is difficult. I just say I'm autistic. That's about as specific as I can comfortably be.

Forget about CDD and Rett's when you look at he ASD spectrum. They're PDDs, but not ASDs.

HFA is the same as classical autism/autistic disorder (called so in the DSM-IV-TR). HFA is an autistic disorder diagnosis without the accompanying diagnosis of MR.

Kanner's is no longer in existence and has been replaced by autistic disorder/classical autism/childhood autism/infantile autism (which is all the exact same).

It is noteworthy that the criteria of classical autism have been modified often since Kanner discovered that type of autism.

There are several models of the spectrum.

An older one is that AS is the lightest form of ASDs, with HFA as a form of classical autism following.

It was, still is, common to limit the spectrum to a linar spectrum like this:

AS - HFA - LFA

An alternative:

NT - AS - HFA - MFA - LFA - profound autism

That view's been questioned and reinforced in the past years, both at the same time.

For one, there are those with classical autism/HFA that are more able than those with AS. Or, if you want to put it the other way round: there are those with AS who're more impaired than those with classical autism.

There is also a growing population of those with PDD-NOS diagnoses that got these because they have symptoms that are considered typical for both disorders or have symptoms that vary greatly in severity. That further aids to the confusion of whether HFA and AS should be considered separate or same.

That all doesn't fit into the old linear model either.

Just as that most people with AS who were diagnosed in recent 5 years have A) delayed self-help skills for non-DSM conform reasons just as some have B) language abnormalities or had significant delays. Which the DSM also says isn't allowed in AS.

At the same time, the AS diagnosis has broadened significantly towards normalcy and has by this moved away from classical autism. People who're diagnosed as 'mild AS' today are often significantly milder than people diagnosed in the 90s who were also considered 'mild AS'.

PDD-NOS cannot be integrated into this sort of linear spectrum. Generally, it is the diagnosis those with atypical symptomatology receive. That's what the DSM intended it to be. That can include:

- if a person doesn't meet all criteria required for an AS diagnosis
- if a person doesn't display all symptoms of AS, but neither all of classical autism but a few of both
- a person who doesn't meet the full criteria for classical autism
- cases in which it's unclear whether there are enough ASD symptoms due to severe(?) or profound MR or other conditions

Not sure if I got it all covered. I tried to make it short.

Last edited by Sora on 18 Jan 2009, 1:17 pm, edited 1 time in total.

I recall someone posting about a study that concluded that, if the diagnostic criteria in the current DSM are properly applied, no one qualifies for an Asperger's diagnosis. One of the criteria for Asperger's is not meeting the diagnostic criteria for any other Pervasive Developmental Disorder. And the conclusion was, people who otherwise would meet the diagnostic criteria for Asperger's, would also meet the diagnostic criteria for another PDD (generally autism I assume).

Note that while it's often said that the difference between autism and Asperger's is a language delay or not, the diagnostic criteria for autism do not require a language delay.

Well, the difference between LFA and HFA is supposed to be the IQ. There is NO ceiling for HFA though. AS TECHNICALLY has a floor and it IS above LFA, but certainly not above HFA, since it has no ceiling. I guess they COULD indicate ANOTHER IQ component to discern HFA from AS. Wouldn't that STILL indicate a split that is deserving of a different classification? What is next, rolling ADD and NVLD into it?

Rett Syndrome, and CDD are different. PDD-NOS is basically almost considered like another classification under PDD, besides AS and Autism. PDD-NOS REALLY means they fit the basic criteria for a PDD best, but don't necessarily fit in Autism or AS. CDD is OBVIOUS at a point, so diagnosing wouldn't be difficult. RETT is a known genetic disorder, and can be tested, and is often OBVIOUS by appearance.

Frankly, I think it is stupid that RETT and CDD are considered PDDs. CDD is more a metabolic disorder that might have an environmental component. RETT is a definite genetic disorder. HECK, many autistic people have early macrocephaly, and RETT have microcephaly. And CDD seems to be possibly due to an overpruning, whereas autism may be due to a kind of underpruning and/or mismapping.

And SOME want to DEFINE PDD-NOS as more or less severe. Why don't we stick by the meaning of "Not Otherwise Specified", and realize it could be either?

If AS requires one requires one speaks by 3, then I can't be AS. I did not speak until I was 3 1/2. I did fit the vocabulary criteria even then (my first word was "apostrophe.") I think I had mentioned this to the psychologist when I was evaluated.

I have found what all of you have written so far as very informative---even if there are still some areas that are confusing to all of us. I definitely am getting better educated on this. Thank you.

Now I am wondering if it would be normal for an Aspie to have had his mother wash his hair until he was 25---then have his wife wash it until he was in his late 20s because he couldn't? And the same with clothes---his mother had to lay out his clothes for him until he got married. For example, during the summer when my parents were working, I would stay in my pajamas until my mom came home on her break and got my clothes out (into high school).

Right. I always forget about that one.




and


And all of these can appear in AS are more or less even common in those with AS.



That is true. According to ICD-10 and DSM-IV-TR classical autism can occur with any level of IQ. But, professionals sometimes choose to ignore that and say that high IQ can only be AS.



Yes, the current versions of the 2 biggest diagnostic manuals/codes require that individuals can only be diagnosed if A) single words are spoken by the age of 2 and B) communicative phrases are used by the age of 3.

Professionals sometimes choose to ignore that too if language skills are present and adequate at the time of your evaluation.

There are quite a few people on WP who had varying delays that would exclude them from a diagnosis of AS but who have an official diagnosis of AS nevertheless.





Studies anyone?