Question re: DSM V and Aspergers diagnosis

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I agree that Rain Man seems more HFA than LFA. He may require full-time supervision, but that doesn't not mean that he can't carry out his daily activities as part of his routine as long as someone is there to keep him on track. Requiring only supervision is actually very high-functioning. For instance, at the hospital I work at, the FIM ratings (Functional Independence Measure) run this way:

7- independent
6- modified independent (if you need extra time or external aids like hearing aids or visual cues)
5- supervision (assistance with set-up, needs cueing mainly for initiation and to keep on track, no physical contact necessary)
4- minimal assistance (performs at least 75% of task)
3- moderate assistance (performs 50-74% of task)
2 maximal assistance (performs 25-49% of task)
1- total dependence (performs less than 25% of task)

Note that these are ratings for *basic* tasks- for example, communicating basic needs and wants, and eating food that is put in front of you, not for complex activities like balancing a checkbook or cooking a meal.

Individuals characterized as LFA would tend to be in the 1-3 range for their daily activities (probably mainly 1-2)- i.e. tons of prompting and probably lots of physical assistance necessary to complete tasks like getting dressed, eating, brushing their teeth. "Rain Man" is more like supervision, or possibly occasionally minimal assistance. Rain Man may seem low-functioning from the standpoint of Asperger's, but honestly, given the range of the spectrum, he definitely seems high-functioning (I worked at a school for autistic kids and have seen quite a wide range of abilities).

You work with kids, though, not adults... if it's a school I doubt you've got anyone there older than 21... Most HFA will be in mainstream classrooms or regular special ed, not a segregated school.

I hope everybody realizes that they are talking and comparing a 'fictional' rainman from the movie and the observatiuons have nothing to do with reality. Have we gone so far that we can't tell the difference between the two even on this forum?

There are no fixed definitions for HFA/MFA/LFA, though. You would have to make those definitions first, agree on them, and then use them.

If by HFA you mean "able to live independently without support", that's a lot different from what you'd mean if you said HFA was "able to perform basic self-care without prompting".

And then there's the complication that HFA is still considered to be "lower functioning" than Asperger's, under the usual definition; and that "high-functioning" is also used to describe developmentally delayed individuals who don't need help with basic ADLs, at the same time as it's used to describe people with normal IQs who do need help with those things. It depends on what criterion you use and it's confusing because other people use fifty other different criteria, including things like whether or not you "look ret*d". (No kidding.)

This is why I like GAF, if anything at all has to be applied. At least it's concrete (or as concrete as anything gets in psychology); and it's been acknowledged that it can change throughout one's lifetime.

Callista you are right on this one for sure.

I don't think "high-functioning" has ever been defined as living independently, except in unofficial circles. Autism with a normal mental age and Asperger's Disorder (the same autism as prior without the marked problems with semantics in early childhood, generally speaking), are both seen as high-functioning forms of autism, and they both always have been, no matter the outcome in regards to vocational pursuits and academia.

I was reading the other day that the GAF is a poor tool for adults with a high-functioning form of autism, due to the subjectivity of the results as the professional administers it, and that it wasn't made for autism to begin with (and not to mention that no one with such scored over 70, and it was the mildest of cases that tended to be close to 70. Most were around 40, which is quite severe when one compares it to mental illnesses).

I just read up on the GAF, and I would fall pretty short of what I am actually capable of if tested, just because of some of the catches... It is the hygeine that would screw me. I would be somewhere between 20 and 60...

EDIT: corrected number...

I think this is an absolutely terrible idea for the DSM-V! First of all, I'm a proponent of AS being a form of Nonverbal Learning Disorder, not autism, so I was hoping they'd revise the classification of AS into being a division of NVLD. However, that isn't what I'm upset about. I don't like how they're only going to have HFA, MFA, and LFA classifications. That does not tell enough about what the person's individual disorder is like. For example, two people could be diagnosed with "LFA," but one has true Kanner's autism and the other has PDD-NOS. Likewise, two other people could be diagnosed "HFA," but one has true HFA with a speech delay and the other has Asperger's with no speech delay. In my opinion, decreasing the amount of diagnostic classes is only going to make research on these conditions even worse than it already is. The neuroscience field is already rife with studies that lump together those with AS and those with HFA diagnoses. We need to figure out the differences between these conditions, so we can understand how they differ neurologically. At any rate, even if the term "Asperger's Syndrome/Disorder" disappears from the DSM-V, I will continue to say that I have Asperger's. I never will say that I have High-Functioning Autism, because I do not believe that I am autistic. I also think that it's a travesty to get rid of Hans Asperger's syndrome, since he worked so hard in defining what makes an Aspie an Aspie. He didn't get a syndrome named after him until 1981, almost 40 years after he published his work on AS, and it wasn't recognized in the DSM until 1994. I don't think it's right that Dr. Asperger only will receive 18 years' recognition in the clinical DSM setting...
-OddDuckNash99-

AS and HFA are so similar that it dosen't really matter anyway.