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[quote="Trudeau"]The fact is there is no blood test, nothing that is truly supported with scientific results.[/quote]

There is very solid evidence of something.

These who are spectrum know there is something.

Neither have anything to do with the mechanisms to do with medical diagnosis, which is just a toolkit.

Not convinced?
Take a large number of those diagnosed as spectrum and a large number of controls from the general population.

Carry out brain scans, various kinds can be used. The results correctly sort out the two groups.

Why are scans not used for or as part of diagnosis?
I assume for cost and availability reasons. Not particularly nice things to do either.

.m

Last edited by Trudeau on 01 Dec 2008, 12:06 am, edited 1 time in total.

Dr. Attwood said that during the second World War, the Gestapo came for Dr. Asperger, but the Hospital Director pulled some strings because he said his 'work was too important' to be executed for experimenting with autistics. So it almost wasn't.
there would have been more information but after WWII, Dr Asperger's hospital burned down along with all his notes, so what we do have to go on is painfully little.

Merle

I disagree completely. There should be an objective physiological test.

All human behaviour is the result of physiological processes in the body, so why not use a physical test to diagnose AS (in theory)?

Most conditions in medicine are diagnosed using physical sometimes even genetic testing. If the condition is indeed genetic, we would expect that people's physiological processes would be directly controlled by the genetic coding, as genes code for protein synthesis.

All so called "mental conditions" could theoretically be measured in this way if the right tests were devised, even if it is something as simple as putting on a blood-pressure cuff to measure stress levels. I believe that these "mental conditions" are actually extreme adaptations and biological variations, which are not currently in equilibrium with our western modern society, hence the distress that people suffer.

If indeed the brain processes are different in someone with AS, I see no reason why that couldn't be measured by doing a brain scan.

I will never say that I "have" AS until it's proved by some objective means of testing that the physiological processes in my body are consistent with it.

Until the "diagnosis" can be tested in a quantitative, repeatable, objective way it can't be 100% reliable scientifically.

What is needed is a test that requires inexpensive equipment, is repeatable, fair and takes into account the contribution of the body's physiology resulting from the condition.

Last edited by AmberEyes on 01 Dec 2008, 5:23 am, edited 1 time in total.

You are probably the only person who knows what the above means to you.

I have no idea what holes you believe are left blank. I cannot guess your state of erudition in the subject. In short, if you want answers, ask more specific questions. These holes you describe might be a very good place to begin.


No more can I figure out what you do and do not know (ergo no more can I figure out which information might be useful to you, or which information it might seem condescending to supply). You've as much chance guessing the problems anyone here has in their personal life as I have of guessing what these 'holes' you describe are.

Are they? Do you know the numbers on that or is there some intuitive reasoning entailed?
What actually constitutes physical testing anyway? Would X-rays be included? They do not directly test physicality, they simply record an image that is open to subjective interpretation. Looking at someone's tonsils surely cannot be included, nor 'feeling over' a limb with hands or asking about the patient's subjective view of 'where it hurts' 'what kind of pain is it' or whether the patient views their cough as dry or not?
The majority of times I go to the doctor, I get an answer as to what condition is entailed in the symptoms I have presented, but very rarely are physical tests involved, even if subjectively interpreted 'rendered image' observations (such as interpreting X-rays) is included.
Further, a lot of conditions that can sometimes show up when tested for (physically) do not always show up when tested for, for instance epilepsy can be present and EEG readings normal. It is not uncommon for people with completely normal EEG readings to be diagnosed with epilepsy and placed on medication and subject to restrictions accordingly. Do conditions that people get diagnosed with despite physical testing failing to show indicators count?
Are you additionally counting in conditions screened (inconclusively) for by physical tests as ones being diagnosed by physical tests?

We expect the same of the trait 'blue-eyedness' and we even know the pattern of inheritance entailed (recessive autosomal). None the less, we have yet to identify the genes involved. We also know genes are responsible for factors that influence pigmentation, but we have yet to figure out how many are involved.
It's not necessarily true that the potential causal pathways to autism are sufficiently limited and general (rather than idiopathic and specific) for genetic testing to have viability as a wide-spread diagnostic.


Why would the processes measurable by 'brain scans' be those that display observable (to us) signs of anomaly?

"100% reliable scientifically"? That is an astoundingly unrealistic standard to set. Very few if any diagnostics in medicine offer 100% infallibility. And quite what reliable scientifically means, I'm not certain. Science is a methodology, not an absolute proof.


Whether or not that is plausible is difficult to determine at this time, given the lack of certainty as to quite what ASDs are.

The reason why these scans are not used is that they do not exist.

So far, there has been some limited, partial success reported on the use of brain imaging. It is not at all reliable. So far I don't believe any extensive trials have been undertaken - only small (20 or so) numbers of test subjects, with results not far away from pure chance. Plus what results have been obtained are open to different interpretations.

As to cost... well, that's not all that high. A scanner, itself, is quite expensive, but once you have absorbed the capital expenditure, you may as well use it as much as possible. However, all those doctors, interpreting the results, subjectively.... they cost lots of money, in the US.

I don't, offhand, know of any scans that are "not particularly nice things to do". However, I was involved with early "nuclear medicine", which got renamed, because that word "nuclear" frightened people. That did require the injection of radioactive material (hence the scare, but the dosage was tiny - less that natural background radiation in many areas). I.e. if you didn't like injections, it would be "not nice".

I kind of understand where the OP is coming from.

Asperger's IS a socially constructed disorder. Whereas a disease such as cancer is not. We can actually observe a physical tumor in someone's body. But a test for AS is entirely subjective. One psychologist might consider you to be abnormal, based on their own life experiences. Another one might think you're just a variation of normal. You could make just about anything into a "syndrome" based on a few shared characteristics.

Not to say that everyone here is "faking", or has to prove anything, but if the NT population were more comfortable with stimming or unconventional senses of humour, do you think "Asperger's Syndrome" would even exist?

Wrong on all points.

Asperger's is NOT a socially constructed disorder. Although neurology is a science essentially still in its infancy, there are many studies that suggest it will eventually contribute towards understanding autism. Personally, I don't think it will do so either at the cellular level or at the gross level of whole areas of the brain. I am far more of the opinion that the the underlying physical effect is at an intermediate organisational level in the brain.

You cannot 'make just about anything into a "syndrome" based on a few shared characteristics'. To deserve the name "syndrome", a condition really needs to be predictive, as well. I.e. when a few symptoms are seen to be present, a whole raft of other symptoms are inferred, and found to be present (but it does not have to be a 100% match).

And the answer to the final question... yes.

If it doesn't exist, then how come I have it? I think you are a crazy person.

ANd you do not exisst I just see some text that anyone couls put up here. So from this point there is more proof of my aspergers to me then your existence.

well, have you ever considered, you might have something else? It is just a opinion. I do not know you, but it is a possibility you might have something else. Who knows? However, who says, we need a label to define ourselves?

Doctors diagnose many conditions based on symptoms alone, without lab tests.

For example, if I go to the doctor and say I have a bad ear ache, he or she will examine the painful ear, take my temperature, probably examine the lymph nodes in my neck, and proceed to interview me about my symptoms:

- When did it begin?
- Has it gotten progressively worse and if so, how quickly?
- What other signs of poor health have I experienced?
- How severe is the pain on a scale of one to ten?

Psychiatists have the same degree as other doctors: an M.D., and they use similar diagnostic procedures, one of the most common being interviewing the patient while observing them. Psychiatrists know how to recognize physical signs of neurological abnormalities, such as subtle tics, unusual speech patterns, etc. They also administer tests when they determine that it would be informative to the diagniostic process, just like most types of M.D.'s do. These tests have been developed carefully through years, or decades, or thorough research.

So the OP is taking issue with common diagnostic procedures used in medicine in general; he is not exactly attacking AS in particular, despite the way in which the post is worded.

BTW, most doctors (of all specialties) only resort to lab tests when they think it is necessary because these tests tend to be very expensive, even for people with insurance. And it often takes a few days to get the results back, during which time the patient may need treatment to prevent the condition from worsening. Lastly, blood tests are only one of many lab tests used. Cultures are probably used more frequently.

If I had been diagnosed by some school counsellor or something, I might doubt it. But I was diagnosed by the direct partner of Digby Tantum (leading expert in the autistic field in the UK). If she is 100% sure I have it, then I have it. End of.

It is not a psychological disorder, so psychologists/psychiatrists can't diagnose it officially. I've had enough of those trying to find why I'm so odd from my background, and couldn't find a thing. You know why? BECAUSE IT'S NEUROLOGICAL. If I were born into a rich, healthy, supportive family I would've acted exactly the same when I was growing up. There is no other reason for me being this way.

Asperger's Syndrome/High Functioning Autism DOES exist.