Why is Aspergers on the spectrum?

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What you're observing is probably the phenomenon known as the "broader autism phenotype". Family members of autistic people often have strong autistic traits themselves, though they may not be diagnosable because they do not have impairment related to those traits. As you know, autism is genetic; and there is no one gene for autism--it's almost certainly many genes, possibly even hundreds, interacting to create autism; plus, any given case of autism has different genes responsible for it. So maybe your family members who have autistic traits have half or a quarter of your genes, and happened to get some of the ones that are involved in your autism.

The description you're giving (regression, CP-esque movements, epilepsy, respiratory problems, limited lifespan) actually only fits Rett's; it doesn't fit classic autism or CDD. (CDD and autistic disorder are both commonly found together with epilepsy, but so is Asperger's. CDD is the only one in that group to involve regression.) Rett's is being considered for being taken off the spectrum entirely because it has a known genetic cause (the MECP2 gene, mutations of which areresponsible for most cases of Rett's). If anything, Rett's is to autism what Down Syndrome is to mental retardation: A genetic syndrome, one of the traits of which is autism, just as DS is a genetic syndrome with one of its traits being MR.

You're also saying that Asperger's and HFA don't sound "serious or limiting". First, don't discount the very real disability experienced by people with autism even without developmental delay. It's not some kind of mild thing you can just shrug off and ignore. Coming along with "good things" is irrelevant. Second, just because there's a wide range of severity within a given diagnosis doesn't mean that the diagnosis isn't the same thing along that range. CP can mean no voluntary movements or it can mean a tendency to walk slowly and tire quickly. Diabetes can mean sensible dietary adjustments, or it can mean an insulin pump and constant danger of diabetic coma. A broken bone can be a hairline fracture requiring only time to heal, or it can be such a severe break that a bone graft has to be used to replace the pulverized bone. Autism, like most things that can be diagnosed by a doctor, has a wide range of expression, from barely-there to extreme.

Aspergers, HFA , and LFA all have a similiar neural roadmap of an abundance of thick, dense, near to connectivity within the brain, and comparativily thinner and fewer, long distance connections.

It's my understanding that Aspergers/NLD correspond to left hemisphere dominance. While HFA is a more right hemisphere dominant type of autism

It's just different styles of autism, with the same general type of neural wiring.

KissOfMarmaladeSky,

Focusing on the positives may be a great way of making us feel better about ourselves and HFA and AS certainly does give us a few special abilities (which I call my "autistic super powers"), but overall, the higher-functioning end of the spectrum is quite debilitating. It nearly destoyed my life, creating so many barriers that I wanted to die everyday. Just the anxiety and depression caused by the inability to properly interact creates problems in employment, relationships, physical health, etc.

After my diagnosis, I was able to get the right support and life has been much easier, but one of the most difficult aspects is that there are many people who look at me and say, "You seem perfectly fine. There's nothing wrong with you" and they then find no reason not to over-burden me with responsibilities (when they don't flat-out bully me and take advantage of me), which take me right back to square one. Support is necessary for those with high-functioning autism and Asperger's syndrome, lest we lose them to homelessness and mental illness or worse yet, to suicide.

That's believed to be true, but they're not even sure of this. Apparently impairments which are typically associated with one side can sometimes appear in the other side.

Given all of the variables, the unknowns, and the fairly arbitrary, unrepeatable criteria for each, it makes sense to stick them all together. The last thing you want is to deny someone who is autistic a service they need because they have the wrong label.

My doubt is if, in childhood and adolescence, you can really diferentiate between BAP and mild ASD. For two reasons:

- In adults, if you choose to go to a doctor, it is a clear evidence that you have an impairment (you don't go see a doctor if you feel happy with yourself); however, children and teenagers can be sento to shrink, not by them free will, but by parents, teachers, educators, etc.; then, it is not easy do differentiate if they have an impairment or if they are simply "excentrics" who are thought by their carers as having in impairment.

- One (the main?) typical problem faced by "strange" children is the bullying at the school; but bullying is a transitory problem - in the "real world", strange people are usually simply ignored, not "bully-ed"; talking in a more general way, school life has a component of forced socialization and regimentation that you don't find in real life (where you can chose your friends, your profession, etc.); then a person that you will be only "strange" as an adult can be severly "impaired" as a children.

Being ignored can have as devastating impact on adult life as bullies in school. Success in most every field requires someone else to recognize your assets and contributions.

Because AS and HFA are the same thing basicaly. My offical diagnosis isn't AS, but HFA. I was born LFA.

Good points except actually about half of all AD children have a history of regression, it's just that Childhood Disintegrative Disorder is only diagnosed instead when there is a loss of at least two skills after no signs of autism for the first two years of life. Most regression in autism happens before the age of two and there were always some signs of autism before the skills were lost, but it's developmental regression nonetheless. I saw a study once looking at autistic people who had a history of regression and those who didn't, and it found differences in the levels of anxiety and sensory integration issues between the two groups, can't remember more specific findings than that but it - along with the discovery of Rett's Syndrome's distinct cause and just common sense - makes me agree with Temple Grandin that regressive autism needs to be studied separately just as high and low functioning autism currently are.

I read somewhere that the "regression" in autism is usually a kind of "optical illusion" - because in the first years (or months) the child seems to be developing at normal level and after some time the development becomes unusual, the parents had the impression that he was "normal" and then "regressed".

That implies that there is a real, objective difference between the two, but I still haven't seen anything clearly articulating what that difference would be?

I agree with that. In many cases, the child seems to be developing typically or even be precocious, until development in the areas of weakness is expected--speech, socialization, and self-regulation, usually. Those demands cause a great deal of stress, and the child begins to use autistic-style coping methods more often--stimming, zoning out, looking away. The actual loss of skills is different from the problem of hitting an age where developmental milestones are expected but cannot be produced, and the toddler's response of "looking more autistic" to try to keep their sanity intact.

True regressive autism does get diagnosed as classic autism, and I think it's odd that it's only diagnosed as CDD if the regression happens later in early childhood because often times, regressive autism involves multiple regressions, all through life--losing skills when they can't be maintained anymore, and having to learn them back later on, rather than just losing access as the person with regular autism (or AS) would do. If it were up to me, though, I wouldn't call it 'regressive' autism; that gives the impression of developing backward, as though the person in question had been on the typical development schedule to begin with! I don't know what I would call it, but the myth of "this child is developing typically until they suddenly start to lose skills"... I think that simply doesn't happen. The kid was atypical to begin with; why else would he start to lose skills at some point? It just wasn't atypical enough for the parents to get worried enough to take their child to a doctor.

Increased autistic behaviour is not classed as regression, though. Regression as observed by researchers and diagnosing clinicians refers strictly to the loss of skills that had been there previously, such as language or bowel control. Failing to obtain a skill as expected in the first place is not what researchers have been reporting as regression in these children, they've observed children losing the ability to speak completely after initially speaking ahead of time, losing bowel control after making normal progress with it, losing motor coordination, quite drastic and obvious changes really. The only feature that might represent a coping mechanism rather than a lost skill is eye contact, because it's possible that being under stress or feeling self-conscious would make a child start making eye contact less often, but mostly the regression refers to really quite drastic changes in specific abilities.

Another thing they ought to study separately is the non-verbal group who don't understand language, and the non-verbal group who can communicate electronically and appear to have some kind of apraxia preventing speech. There's clearly something very different happening with these people than with the people who either learn to speak with language therapy or who are unable to use words in any form.

Is this off-topic? Sorry, I think I'm referring to the fact that AS vs. AD has already been studied as has been pointed out, and I don't think there's much left to say about it. There are other differences on the spectrum that are more worthy of separate study and conceptualisation, I think, because AS vs. AD doesn't seem to be telling us anything we didn't already know: some people with autism have additional verbal communication and/or intellectual delays or deficits, and others don't, and the ones that do have additional neurological differences.

Last edited by roseblood on 06 Oct 2010, 4:04 pm, edited 1 time in total.

What I really wanted to say was:

"many (probably most) people diagnosed with AS don't match the DSM-IV criteria for AS but the DSM-IV criteria for HFA instead"

Ok, thanks. yeah, I wasn't trying to be annoying, I was just confused. Yeah, I think it was Tony Attwood who said that HFA is supposed to take precedence over AS even in the absence of a speech delay, but that in practice most clinicians do the opposite.

i would just like to point out something that seems to me is not often enough examined: by employing the LINEAR concept of "low"--"high" we are obviating the palpable impact of circumstances & surroundings--indeed, i believe these are greater determinants of response than one's place on the "spectrum".

when my wife & i are with people i don't know, i notice she apologizes for me not saying much (or anything) & says, "he does talk"; when i am with people i trust & know well i can be actually quite verbose. likewise for spaces that are comfortable (close, familiar, not intensely loud or bright)--things i know about & can to some degree compensate for, but it takes an effort (occasionally an extreme effort) to overcome--versus, say, WalMart, an amusement park, or airports.

having a clear purpose, like a thread in the labyrinth.

and the whole sequence is important also. if i have had to drive in heavy traffic for an hour, even reaching a comfortable destination doesn't do me much good at first, & for some time thereafter.
i learned to travel early to the site of job interviews, & wait leisurely at a separate location to calm down. or the thought of having to leave on a similar journey, at a preordained time: this also jangles.

so you see that tests performed in a "lab" environment, travelled to from home, in themselves create a distortion-effect that is not considered part of the result.

i believe most people with whatever degree of aut-spectrum impairment could function in a society that granted them the possibility of secure spaces wherever they went, & peaceful transit thereto; even those whose are practically nonverbal.

but this is too utopian. it would be enough, just to take away the BLAME.

m.

Part of me thinks that Asperger's is being overdiagnosed and is like an extreme form of the INTJ or INTP personality. I also wonder if, in milder cases, a diagnosis is beneficial. I don't see the point of seeking a dianosis for myself at this point, for instance, since a lot of my social difficulties have lessened over the years. (I'm in my late 30s).

On the other hand, I look at my 6-year-old, who talks and is doing pretty well in a regular class, and I think, what if I hadn't spent all that money on products (specialized books, flashcards, videos, computer programs) for him? What if I hadn't made all those flashcards, books, DVDs, etc., for him? The other kids with autism at the school are doing poorly, and I'm not sure that my son started out ahead of them.

My son attends a public elementary school that does not have a autism expert on site, staff has been very uncooperative, and the district pretty much fails to meet special education No Child Left Behind Standards every year. A big part of me wonders how many LFA kids could be HFA kids but for poverty or inadequate education.