distinguishing between AS and schizoaffective

Post Reply New Topic

I believe you when you say that you have those thoughts, but instead of concluding that the FBI is inserting them into your mind, don't you think it would be a lot more reasonable to conclude that your brain is playing tricks on you?

Yes, my son has sensory issues like not liking loud noises.

As to the person who said he needs positive features for schizoaffective, the pysch said he may have some disorganized thinking. I read everything I can about disorganized thinking and thought disorders and they do NOT sound like my son. He has no clanging, loose associations, word salad or anything like that.

What he does do is slower to answer questions and he does stop sometime when talking. So I was worried about thought blocking. But as the counselor believes that my son is just trying to be very precise with his wording and sort of perfectionist with what he wants to say. The other concern is that in school my son has problem "wrapping his brain" around things. But it really seems more like a processing thing than anything I read with the SD. Any know anything about what disorganized thinking looks like?

We will look into the seizure thing, but I thought those only lasted for seconds. His zoning out can go on for 10 or more minutes.

Also, I think my mom, dad and brother has Aspergerish traits, so family history seems to suppport AS rather than SD.

The problem with 'thought disorders' as a concept, is that it's based entirely on speech, and therefore a person with a speech disorder that goes undiagnosed, who then falls into the hands of a psychiatrist who believes in 'thought disorder', is that the speech disorder will then get presumed to be the result of irrational thinking (or rather, more irrational than usual) rather than the result of difficulty with speech or with language.

Most autistic people have at least one kind of trouble with speech or movement that would be considered a thought disorder if someone only took the speech on the surface and compared it superficially to things they called 'thought disorders' (which is not that scientific an idea anyway, and encompasses a lot of things you'd see, for instance, in expressive or receptive aphasias -- there's no actual proof I've ever even seen offered that these speech problems are the result of 'disordered thinking' at all).

That is one of many reasons why there's supposed to be a rule that you can't diagnose a psychosis in an autistic person unless there's true hallucinations or delusions, and very prominent ones at that. ("Thought disorder" doesn't count, neither does "disorganized thinking.") And even then... again I'd recommend Tony Attwood on everything that could be mistaken for that, because lots of things autistic people do, can.

In fact, I'd suggest that instead of reading everything you can about SD, you'd read everything you can about autism/AS/etc instead. But still you'd have to take it with more of a grain of salt. And spend at least as much time around autistic people to see what our experiences are like, as you do reading 'experts' (who all have their own theories, which sometimes turn out very wrong, and sometimes turn out right).



Some seizures last that long, and some don't but have a period of confusion afterwards that can last that long.

A movement disorder could also cause something that looked similar, if it were freezing. (And that can go along with being autistic.)

And some autistic people need to 'zone out' in order to deal with information in general, some do so when overloaded, and some just look 'zoned out' when we're really very aware of things (but not able to make our bodies do things that most people would take to indicate awareness).

But seriously from everything you've said, I wouldn't even consider any form of psychosis, it just doesn't make sense and could lead to things that are dangerous to your kid.

Does his talking sometime seem like this?

*Son paces back and forth, possibly chewing on his fingernails, wringing his hands, or playing with a blanket wrapped around his shoulders*

mom: what are you doing son?

--short pause--

son: just thinking

mom: what are you thinking about

--short pause--

son: well, its sorta, um....

--short pause--

son: its complicated

*son goes back to pacing*

Because that is a conversation I have had with my mother several times.

The basic source of my problem with words is that I dont think in words, they come to me like a second language. I dont know if your son is the same way, but he seems to be copying me, so he might be in the same boat. Basically, when I hear words, I have to translate them into thoughts before I can process them correctly. This is usually done quickly, mostly because I have alot of practice. But if I am tired, stressed, nervous, etc. then it takes me a little longer then usual to translate what your saying into something I can understand. I then have to think about it, and once I have my answer, translate that back into words. Again, I have some practice at translating my thoughts into words, but its not 100% effective all the time. If I am stressed/nervous then it will take me a while to express my thoughts. Sometimes they will come out wrong simply because I cant find the proper words to fit what I am thinking. And sometimes, when I cant find the words at all I seem to stop mid sentence (usually followed by an um). It's not that my brained stopped working, it's just that I cant find the proper words to use in order to express what I am thinking correctly. And rather then say it incorrectly, I will slow down, and think about what words I should be using, thus resulting in a pause. You should be able to spot this because he will probably be stimming in some way when he stops mid sentence. If you see him bouncing his leg, playing with his hands, biting his lip, etc. Then that means he is just thinking, and he will start talking again once he has worked out what to say in his head. It is certainly nothing to do with incoherent or disorganized thought.

If anything, I wish everybody would do that. If people stopped and thought their words out carefully, instead of just talking and talking, then we might say less words, but they would at least be correct words.

As far as the problem with 'wrapping his brain around something'. That's called being human. Nobody picks up everything they see and understand it completely after only seeing it once. Its just that normal people pretend they understand it so they look smart. When your son sees/hears something he doesnt understand, he will think about it, and try to make sense out of it. And as I said earlier, when he is busy thinking about something, he will often times seem spaced out. Its not as though he sees something new, and his brain stops working. He is just trying to figure it out in his head. It could also be that he doesnt understand what your saying. As I said, words arent natural to me, so I will occasionally have problems understanding other people. If this is the case, then you just need to teach him to ask for clarification. Simply saying the same thing using different words can do alot to help him understand what you mean.

If your son wants to come on the forum and post about his problems himself then he may be able to do a better job describing his difficulties. If you have any questions, feel free to send me a message.

anbuend interesting Parkinsons link, I have tried to connect family dots, sadly my grandmother was treated for schizophrenia, she received treatment I find too hard to type. I truly wish she had lasted a few years longer, just to let her know I understood her. She had Parkinsons and died a rather angry and I fear misunderstood individual. My belief she was Aspergers, is strengthened by cousins with dyslexia, food allergies and other conditions throughout my fathers family. I believe i am the first to be mentioning autism to the wider family and it is interesting to see who else seeks a diagnosis or self manages like me. Although my father said, "Why would you tell anyone? There are services you can access if needed, make discreet enquiries," if he knew and didn't tell me it is even harder to forgive wilful neglegence, nevermind, he has a point.
When I became truly depressed having no answers for my differences, I experienced a rush of thoughts visual images, unjust images, I have mentioned as flashbacks in prior threads, but during this time far greater in intensity, disabling, my speech conflicted, when pressed I could not make a valid point and shutdown under pressure to provide an answer pinpointing the cause of my distress. It was mostly physical and mental exhaustion and medication would undoubtedly have added to the difficulties. In this modern world, phychiatrists should not be allowed to prescribe medication without initially crossing off an autismn spectrum diagnosis, which, if suspected, should mean instant referal to a fully aquainted professional. I dread to think what may have happened to my father and I if we hadn't been born high functioning with enough intelligence to intergrate. To be medicated for the incorrect condition, I surpress the image. The treatment of mental health patients is not at all desirable, and indeed, my mother has come accross several cases in which the Autistic individual has been wrongly medicated for schizophrenia. One man, according to his mother, spends most of his day simply rocking, described as profound regression. Are we living some awful bed time fiction?

And as I said, a lot of the treatment that you get if you're labeled psychotic, is doubly terrifying if you're "truly" psychotic whatever that means. (As in, actually hallucinating, actually have delusions that are different enough from normal delusions to warrant notice, etc.) I mean... I've known enough people who've described it from that vantage point, and it's like... you already think everyone's out to get you, and then you get that sort of treatment, it'd be shocking if you managed to recover from the fear that you got put there for to begin with.

(And I know exactly what you mean by not typing stuff. I'm deliberately staying clear of a lot of details because I don't feel like rubbing my own nose in what I already know is Really Bad Stuff.)

one time a dostor diagnosed me as schitzoeffective then a week later changed their mind so since you describe what is similar to what i do and mine is aspergers then you need to stop seeing the doctor that tries to stay on the schitzo path and find a doctor that really knows about aspergers

Fair point.

Yes that would be truly horrific, people suffering phychosis of any form need support, encouragement and compassion, to trust at least one person is essential to recovery. I read the article concerning the man wrongly diagnosed this afternoon, I had seen him before, oddly disturbing. He's thirty and in and out of the care institutions still; his mother writing furiously to raise awareness, though she's promoting cures. Shame she hasn't yet focused on caring for her son as is, instead of fettering around labels and clinging to this concept of curing her son! I suppose she would though, baring in mind he was medicated for schizophrenia needlessly. Nevermind, it is awareness I suppose, (Sometimes leads to trivialising conditions of being. Win win situation.)

I didn't know Atwood's books covered things that look like it as well, I will look for that,

I don't think it is disorganized thinking, but more like tracker is saying with the pauses. I have never had trouble following his ideas, but I do have to wait for them to get out sometimes. When he is thinking, I can tell with the pacing and such, but the shutdowns are a bit different. But I am getting lots of feedback saying that is AS-like, too.

Thing is we took him to Children's a year ago and the Dr. said she was on the fence and never gave us an Asperger's diagnosis, she said too mild to tell, but come back in a year. Appt. tomorrow. But reading this site, he sounds so much of what I read here.
He really is a neat kid with his ideas outside the box.

We'll see what happens tomorrow, thanks for the insight.

good luck tomorrow, if you would consider a diagnosis of autism luck.

By the way, how old is your son?

P.S. get him some ear plugs, it would be a good birthday gift for him.

A post elsewhere about differential diagnoses reminded me that even the DSM lists as a differential diagnosis for schizophrenia -- "childhood presentations combining disorganized speech (from a Communication Disorder) and disorganized behavior (from Attention-Deficit/ Hyperactivity Disorder)". Which means, essentially that having a communication disorder and unusual behavior can be mistaken for psychosis, especially in children. Which is exactly what I was trying to say but didn't remember they officially noted this.

Psychiatrists shouldn't prescribe medicine, period, until a patient has been seen by a psychologist and a regular medical doctor, given a full workup, and taking into consideration ALL possible mental and physical issues. I cannot count the number of times I sat in a psychiatrist's office and watch them literally dig around in a file drawer or desk drawer and pull out a wad of med samples to give to me, saying, "Try these. Let me know in two weeks if you see any improvement." It's like a craps game and the doctors are 'betting' on whether or not they've guessed the correct diagnosis. I've been given meds that hurt me seriously over the years, to the point where I no longer take them unless I absolutely can't function. I'd say, based on my own personal experience, that most psychiatrists have no CLUE what they're looking at until they've been seeing you for a couple of YEARS (even then they may not get it right).

When it comes to diagnoses of mental health issues, I'm constantly reminded of the story about the 3 blind men and the elephant. Depending on what part of the elephant the blind men are touching, they'll each describe something different. That's why a COMPLETE profile needs to be done on a patient, ruling out this or that. That goes for AS or any possible ASD, any schizotypal/schizoid spectrum disorders and even simple depression. I have an old friend who was 'cured' of her severe bouts of suicidal depression. After years of taking all sorts of heavy antidepressants, she went to a gynecologist and they discovered a tumor in her uterus. After she got hysterectomy, her mood and outlook on life improved almost 100%. Hormones can cause serious problems - mood swings, depression, etc. This sort of thing would have been caught years earlier had ALL her doctors compared notes on her case. It's sad, really. I'm beginning to believe there's no such thing as good health care anymore.

Every time I see a psychatrist I have something different. I'm not even sure what it is, but like your son I zone out alot and pacr when I think and fidget/stim. I've been considering ADHD lately, could that be a possibility?

My mother isn't doing that though, despite a past situation that in many ways resembles his. But then, most people haven't even heard there's another side to it, and I'm safely out of that system and into a system that does provide decent care, so my mother has a lot less to worry about right now. (The things they did to her when I was in the system are another whole level of horrific stuff.)

When I was in junior high and high school, when I would go into shutdown, or stare out and have limited speech, they kept calling it seizures, when I have had seizures before and this was different.

But, they kept calling them seizures, and I didn't know that this could be part of being autistic (when I was diagnosed with Aspergers, the professionals made it out to be that I just had social skills and attention and nonverbal communication difficulties - speech wasn't brought up really).

So I referred to them as seizures, but I read up on lots of different kinds of seizures and went on an epilepsy board. Also the EEGs came up negative, though that doesn't rule out seizures - just means that one didn't occur while testing, and the seizures I had were sporadic.

Seizures are fairly common in autistic people, though, and I've had them and that should be looked into if there's concern about that.

Also, when I was in meltdown, the counselor described my behavior as "bizarre" and I think there was some mention of psychosis, though I had been diagnosed three years earlier.

A person I knew in high school, he would talk in monotone much of the time, and also would draw elaborate designs of machines and space ships and stuff (he's into science fiction). He was diagnosed AS, too.

I don't usually do monotone, though if I'm particularly exhausted, or reciting some information I know a lot about, but that I haven't specifically rehearsed my intonation and inflection and gestures and whatnot, then I'll speak monotone these times.

Also, if I'm tired either mentally or physically (or both), I'm less inclined to move my mouth and face in exaggerated motions that are necessary to create typical facial expressions, and to not speak monotone. I generally move my lips very little when speaking monotone, and often have a fixed stare, even when not specifically shutting down (kind of like closing one's eyes, as opposed to taking a nap).

It's really disappointing that some clinicians do such an extremely poor job of diagnosing people. Flat affect and thought blocking- which is far as I can tell are the only symptoms this person is basing a Schizoaffective diagnosis on- are not enough to give that kind of diagnosis. Not even close.

Schizoaffective is a hybrid thought and mood disorder. People must have psychotic symtpoms in the absence of mood symptoms for a significant length of time. They also must clearly qualify for a bi-polar or major depression diagnosis in addition to any thought-related symptoms. If the psychotic symptoms occur at the same time the mood symtoms are occurring, then the psychosis is probably secondary to the mood symtpoms. If the psychotic symptoms occur on their own, then then there is probably an independent thought component to the disorder.

Schizoaffective is highy cyclical, and some doctors think it should be classified as a form of bi-polar disorder because of that. Patients are usually very, very unstable, and it is a lot more common to see positive symptoms and thought disorder than it is to see negative symtpoms.

Based on what you've said, my guess is that it's the wrong diagnosis for your son. Just FYI, the side conversation about thought insertion is a classic example of psychosis. If you wanted to know what psychosis looks like, that's it.

Anbuend has given you excellent advice. He mentions that antipsychotics made him worse, and I agree with him that you should go find a different doctor. I am not surprised that another professional is disagreeing with the SA diagnosis. There's another reason why I would not allow antipsychotics to be given in your son's case: they usually aren't very effective for negative symptoms, and the "flat affect" would be a negative symptom. (On the other hand, if your son was diagnosed with AS, and was violent, then in that case even though he would not be considered technically psychotic, antipsychotics could help.)