"Theory of autism"--why Asperger's had to go

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I didn't say you haven't done research. I said that simply posting a link to a google search is not by itself indicative. When I asked for links to research, I was asking for what you did further down. I could easily have performed the google search myself.





If something is one sort of thing, it very often looks like that sort of thing too. Referring to the perceptual-cognitive process lets people know that you're talking about evidence, rather than grinding an axe.




I understand the point of your thread, and I'm interested in the evidence you're providing links to. Unfortunately, I do not have access to the full articles you're linking, or the time to read them. Are you just going on abstracts here, or have you actually read all those articles? That question isn't meant to insult you; it's meant to solicit information.




I do understand what you have written, and I think that much of it is based in fact and worth considering. However, you seem to be strongly overstating your case, which you seem to feel is obviously correct. This manner of communication tends to ruffle the feathers of other people who are interested in similar areas of study, but who don't immediately agree with your assessments.

EDIT: Fixed a quote box error.

Last edited by cthulukitty on 28 Apr 2010, 11:02 am, edited 1 time in total.

It is way too simplistic, IMO, to ascribe one disorder to one hemisphere and the other to the other hemisphere. The brain isn't that simple. If there are abnormalities, even at the cellular or subcellular levels, which arise in early childhood or prenatally, then other parts of the brain may very well assume some of the functions (google neuronal plasticity) of the parts which do not function well. Plus, I think the idea of classic autism arising from the L hemisphere is predicated on the assumption that the language areas are in the left hemisphere, which is true for the vast majority of right-handed people, but only 50% or so of left-handed people. It might be more reasonable to argue for the speech delays of classic autism arising from the DOMINANT hemisphere, but not left or right.

Interesting thread anyway, though.

~Kate

Indeed, one of the best posts i've read in this forum.

cthulukitty, I will revisit your post when I have enough time to do it properly.

For the time being, I have to emphasize the fact that you folks seem to be missing my point completely. Let me just touch on a few things quickly.

Yes, exactly! That's why Asperger's had to go--even though the concept of Asperger's is generally indicative of DDA of the right hemisphere, the Aspergian behaviors of any given individual can not be absolutely ascribed to DDA in that individual's right hemisphere, because DDA elsewhere in the brain can present as behaviors typical of Asperger's.

It is generally true that Asperger's indicates DDA in the right hemisphere, and it is generally true that "classic" autism indicates DDA in the left hemisphere (or both hemispheres)--but since both conditions are diagnosed behaviorally, and not by any kind of absolute neurological assessment, they do not describe an absolute neurological condition.



Right--and the DOMINANT hemisphere is generally the left hemisphere! But not always! So while the general notion of DDA in the left hemisphere is embodied in "classic" autism, there individuals with "classic" autism whose actual neurological condition might not be best described as DDA of the left (or both) hemispheres.

I am dying for someone to understand what I'm getting at here.



But they are grouped in a "cancer spectrum"--they're all called cancer! Different types of cancer manifest themselves in different ways, but they all share a "core feature", the unchecked and malignant growth of cells.

The "core feature" of autism is DDA of the brain. So, while there are different manifestations of autism--different "flavors" that relate to the location of the DDA in the brain--they both share a "core feature" of DDA of the brain.

Seriously--if anyone out there understands, please help me explain.

At times it sounds like you don't want AS to be lumped in with ASD, because your argument is that the different physiological causes require totally different names for the syndromes.

Yet, the diagnostic methods for determining the syndromes are based on behavioral traits, many of which are shared between them, so while they both may have different physiological origins, they wind up with similar enough impairments to be diagnosed under the same spectrum.

That is why it is called a spectrum, it implies a collection of things which are related overall, but vary in specific ways, with different poles of the spectrum being most varied relative to the other poles, while still possible to form a connection between the various conditions.

Rectal cancer, lung cancer, and brain cancer are all extremely different physiologically, but they manifest very similar effects, and all share enough in common to be called cancer as a whole.

The excessive growth of body tissues in a tumorous fashion, with a general spectrum of health impairment = cancer.


The impaired development of brain connections in certain areas, with a general spectrum of communicative impairment = autism.

Right, but those names/syndromes--"Asperger's" and "classic autism"--are only absolutely useful as general concepts, not individual diagnoses. As I said before, if the concept of Asperger's generally describes DDA of the right hemisphere, so when the doctor diagnoses you with Asperger's, he's merely saying "Your behavior is consistent with the general clinical picture of DDA of the right hemisphere." But for all that doctor knows, the patient is missing a corpus callosum. So what good is the Asperger's diagnosis?

Useful as general concept, but potentially misleading as a diagnosis.

Say there was a treatment for DDA of the right hemisphere specifically, that "cured" the condition, or at least alleviated it. If Asperger's generally describes DDA of the right hemisphere, but can be diagnosed in an individual with DDA elsewhere in their brain... Do you see where this is going? It all comes down to the extreme imprecision with which any diagnosis of any type of autism is made due to the fact that it isn't made in regards to the absolute core feature of autism--DDA of the brain--it's made in regards to the behavioral manifestation of that core feature.

This is very interesting. I'd like to learn a lot more about it. I've got three kids in the spectrum...sort of. My first two have Asperger's. The little guy was diagnosed with PDD-NOS several years ago. He didn't speak, not in any language any other human could understand, until he was 5. In Kindergarten I was able to get him to a good school where he got good speech therapy. He was, by that time, trying to speak English and likely thinking in it. He quickly progressed.

We had a bunch of tests done on him for various reasons this year. He came out as not even close to being in the Spectrum even though the Psychologist was confident he had Asperger's after first meeting him. They did IQ and Achievement tests on him and he had very odd results, highly divergent...in fact divergently divergent. He is applying to The Davidson Institute for profoundly gifted kids and some of his test scores were appropriate for that, but some were not. The psychologist says that he is unique and that his brain clearly functions much differently than other peoples. I'm pretty sure he's got all his lobes but they are clearly functioning in some unique way. His whole language aquisition process is still odd, effective, but odd...but she says he's not in the spectrum it's something different, something unique.

I sure did hit the Jackpot for interesting kids. I'd welcome suggestions of where to go to get a better understanding of neurological psychology for a layperson.

Kiley

Your son is an excellent example of how the traditional diagnoses of Asperger's and "classic" autism often come up short, and furthermore, why the autism spectrum should not be limited to those two diagnoses--he's on the spectrum, he just doesn't fit either of the two great trends in that spectrum.

There's Persuasive Developmental Disorder Not Otherwise Specified (PDD-NOS).

The spectrum is not limited to those.

Those diagnostic classifications themselves contain variations within them.

Not all cases of Asperger's are caused by right hemisphere DDA, but most cases of right hemisphere DDA produce cases which can be diagnosed as Asperger's.

Right hemisphere DDA which produces autistic traits is a smaller category which can fit within the Asperger's category.

Left hemisphere DDA cases producing autism can fit within the Kanner-type classic autism category.

Both Asperger's and classic types can fit within the larger category of autism spectrum disorders, and do not span the entire spectrum, leaving room for other types.

Maybe a comparison to something COMPLETELY unrelated will help illustrate your point Poke. Some of this is my 2c, but I think it’s pretty close to what you were trying to say. For the pleasure of the people who won't even consider something unless someone else wrote a scientific article about it first; I'm gonna pull this outa thin air. I made all of the following up. No link or quotes will be provided.

THIS JUST IN!

The National Weather Service has announced that they are no longer sub categorizing snowflakes. Round snowflakes, square snowflakes, and snowflakes not otherwise specified will all now just be called snowflakes. This is being done because scientists want to place more emphasis on the snowflake than on labeling it's snowflake type. The bottom line is that ALL snowflakes are the result of abnormally cool atmospheric conditions that cause water to freeze into abnormal shapes. Scientists agree that they will get more out of their snowflake research by investigating: the conditions that cause all snowflakes; how to give all snowflakes a better quality of snowflake-life, and ways to help non-snowflakes understand snowflakes; than bickering over what category to place each snowflake in.

And what the heck I mean is…

We all agree that ASD’s are the result to some type of difference in the brain… right? When the brain develops abnormally, it doesn’t happen the exact same way in all persons with abnormally developed brains. Each person is completely unique. Just like….. wait for it…. Wait for it… A SNOW FLAKE. People have a hard enough time understanding the current subcategories under the Autistic Spectrum, and these are still pretty dang vague. Eligibility for services is decided based on these labels in many cases currently. I know some people with AS diagnosis’ that struggle harder with life than people with a HFA diagnosis. The label doesn’t say squat about the severity of disability. Removing the sub categories and focusing on the severity of the impairment seems like a pretty darn good plan to me. It causes the focus to be on the individual and the severity of impairment rather than the label.

The current labels don’t always line up with the region of brain with differences associated with the symptoms. That is a good indication that the labels are not accurate. Should we have a bagillion (I made that word up, don’t bother googling) different labels because there are a bagillion different ways the brain can be different and cause the same symptoms? I vote for no. I think we’re all just snowflakes and any label would be inaccurate unless we all had one unique to each of us. And well… that’s just not realistic.

"Pervasive". But yes.

The crazy scattered skills are very common on the spectrum. Chances are his development won't be anything like typical--and that's common, too.

It's very odd they should even be considering AS in a boy who couldn't speak until age five, though!

It's no wonder that most autism cases are PDD-NOS, because most autism cases don't fit the stereotypes.

Very good, j0sh.

Why do we "diagnose" things? So we may address them. Obviously, autism, as described by the autism spectrum, should be diagnosed/addressed on a case-by-case basis.

Some people are comfortable putting diagnosis in catagories because it helps the mind keep stuff sorted. The label helps when clarifying certain facts. PDD-NOS is helpful for older people seeking diagnosis who might not know if they had a speech delay. As an adult, does it matter as much? Maybe not if you began talking eventually. You could say AS and HFA or indistinguishable in adults but not so in children who experience a speech delay.
People might benefit from an umbrella diagnosis with levels of severity, while others might balk at being put in the same catagory as those who appear lower functioning. That seems to be the complaint from certain Aspies.
It doesn't really matter to me because labels are meaningless in a lot of ways. You can always defy a label no matter who you are so what does it matter?

Another topic that this line of thinking gestures towards is the confluence of neurology and psychology.

Naturally, this is an extremely dicey topic, given the great number of people in the world whose overall outlook on life hinges on the brain and mind not being ultimately equivalent. It is my wish that we do not allow this fact to keep us from reading the writing on the wall.

Think about the ways in which a neurologist and psychologist ascertain DDA of the brain/mind, and how they differ.

You might compare them to two people who are taking part in a marksmanship contest. The first person uses a very old, somewhat crude pistol. The second person uses a newer, more accurate pistol, but they do not face the target and aim at it directly--they stand facing away from the target and shoot over their shoulder, using a mirror to help them aim.

The first shooter is analogous to the neurologist, who addresses the brain/mind on the most concrete level--by examining its physical structure. However, our understanding of the brain/mind in terms of pure physiology is, at this point, somewhat crude.

The second shooter is analogous to the psychologist, who addresses the same concrete brain/mind, but only through the "mirror" of behavior. The psychologist has an advantage, however, in that the medium in which they operate, when used properly, is more precise--this is reflected by the fact that DDA of the brain (autism) is often diagnosed in individuals who, upon neurological assessment, do not show any obvious physical signs.

If what I'm positing in this thread is true--and I am quite sure that it is--think of the implications.

There is no mystery regarding what autism, "classic" autism, and Asperger's syndrome are. There is "mystery" in how DDA of the brain is manifest in any given individual, but that's different.

Autism, as described by the autism spectrum, is significant DDA of the brain.

"Classic" autism represents the general clinical picture of DDA of the left hemisphere (or global DDA of the brain).

Asperger's syndrome represents the general clinical picture of DDA of the right hemisphere.

That's all those terms have ever meant, and all they will ever mean.

My question for you folks is, why isn't this more readily acknowledged?

Here's my guess. Number one: the truth is kinda obvious and kinda boring. People like mystery, and simply do not want to hear an obvious, boring explanation of something they consider mysterious. Number two: we, with the scientific method, have set such a high standard for "proof" that large portions of what we think of as "science" fails to live up to them. Indeed, if autism/"classic" autism/Asperger's are what I have described them to me, it cannot, by definition, be "proven" to the satisfaction of the scientific method in any absolute sense. Number three: as I said before, many people are highly attached to the notion that the mind exists in a way that the brain does not.

Another question: how do you think those three factors interrelate (if at all)?

The puzzle piece doesn't represent autism. The puzzle piece represents the autistic individual. Autism isn't a puzzle. How it becomes manifest in any given individual is.