DSM V changes.. How do you feel?

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Yep. They both discovered autism separately; Asperger's work didn't receive much attention, though, and Kanner syndrome came to mean much more severe than the original patients Kanner actually examined. What we learned from Kanner's work was that autism was not the same thing as mental retardation; all of his patients were children who were quite intelligent, but who had problems connecting with the rest of the world (language, conversations, etc.).

However, after a while, autism was only diagnosed in extreme, severe cases. When we rediscovered Asperger's work, we also rediscovered the less-severe forms of autism. Asperger's and Kanner's original patients are pretty obviously part of the same group; most of both groups would today be called classic autism; and some from each would be called Asperger's.

Just some stuff I found to be helpful here.

http://www.dsm5.org/ProposedRevisions/P ... spx?rid=94

The original basis of Kanner's work consisted of patients who had severe speech delays and intellectual impairments. Those who Hans Asperger observed did not have these issues.

Several of Kanner's original patients did not actually have speech delays - that was the point of linking said blog post, to point that out. Most of them did not have intellectual impairments, which is also pointed out in that post.

Here's his full paper: http://neurodiversity.com/library_kanner_1943.pdf

just posting so i can find this discussion again if it disappears. sorry to disrupt it.

Interesting link on the history of autism..

http://www.bestbehaviour.ca/briefhistory.htm

I guess I should add that historically, many who would today be described as "low-functioning autistic" in the time during and after Kanner's research were typically diagnosed with childhood schizophrenia. I don't recall when autism was expanded to include children who were nonverbal and perceived to be intellectually impaired (I have found other research that shows that this assessment of intellectual impairment has never been empirically validated - I really need to find it again), but apparently it caused some consternation and debate.

And then we come back around and Lorna Wing writes her paper on Asperger's Syndrome to include people with similar presentations to some of Kanner's patients who are not perceived as autistic, because the dominant diagnostic and cultural paradigm says that autism = nonverbal child rocking in a corner, thus Kanner's research = nonverbal child rocking in a corner. Hardly anyone even looks at the source anymore, it's just assumption built on assumption built on assumption until you have people pointing back to their immediate predecessors or peers to support their assumptions without ever realizing that the original source is completely buried.

When I was a kid, in 80's, they tried to diagnose me with childhood schizophrenia...they really tried. I kept getting asked if I heard voices in my head...I kept saying no. They really even tried pinning it on me even without the halucinations. one doctor thought I had a degenerative brain disease and ordered a spinal tap...that was THE worst medical procedure of my life. I screamed and fought them for 3 hours until my mom came back on the floor and made them stop. It was very very painful. i was only 9 years old. Nowdays, spinal taps are illegal for children. The even thought I had an organic personality disorder, oppositional defiant, and for a short time thought I had borderline personality disorder, even though I dont really meet the critera for them, well maybe the oppisitional defiant disorder when I was a teen because I was grounded constantly and felt like that if I was going stay punished, I might as well do what I want. It wasnt until I went to an autism specialist did I get diagnosed properly...but it was kept from me until I found out myself. My mom did not know that PDD was on the spectrum until I found out myself. No one told her, and that was long before the internet.

My mother was blamed for being a "refrigerator mom" when she has tried more than any mother I have seen, and I never doubted that she loved me. We have disagreements in how I was raised, but easy access autism awareness was nada back in the 80's and early 90's. She appologized to once for all that she didn't know raising me, but I dont blame her, how could she have known.

Ugh, how horrible that must've been for your mom... trying to help you and then being called a "refrigerator mom" on top of everything. How frustrating.

I was diagnosed with ODD myself. Reading back over the criteria, I'm pretty sure that I didn't fit them--I was probably having my first episode of depression; that, plus autism, made me hard to handle. Mistaking meltdowns and eccentricity for defiance probably caused it.

I've been diagnosed with: depression, mood disorder-NOS, borderline personality disorder, OCD, generalized anxiety disorder, Tourette's, panic disorder, different eating disorders, and once or twice "early-onset schizophrenia" or "she'll eventually develop psychosis" was brought up. Some of these diagnoses are true (the anxiety spectrum ones, and I had anorexia), some are half-truths (I have traits of borderline and Tourette's, but not enough for a diagnosis), and some are just completely nuts (mood disorders and anything schizophrenia/psychosis-related).

The ASD diagnoses began in 2009, and now it's "obvious" to everyone, apparently. Don't ask me why no one was smart enough to figure it out before that, and when it was figured out, my best friend wrote a letter to the doctor saying, "Look, she's autistic, she has this and that and this symptoms..." and he was like, of course you are! Obviously! Gah.

Donald had what would be then, and is still considered a speech delay because he did not use speech in it's proper context. He also displays a delay in what they would call curiosity about his environment. He would have not scored highly on an IQ test despite whatever his actual intelligence may have been because he could not understand things in the proper context needed to answer the questions.

Fredrick also displays what would be called a delay in curiosity about his environment, as well as adaptive behavior deficits. He also had what would be considered to be a speech delay. Again, his deficits would have resulted in scoring less than average on an IQ test.

Richard displayed speech delays as well, and what would be called a delay in curiosity about his environment. It was noted that he had an intelligent look, but again, he would not have been able to complete an IQ test.

Paul is noted to have had what was thought to be a severe intellectual deficit. He also had a speech delay and what would be called a delay in curiosity about his environment.

I could continue but I see no reason to. Kanner states "Eight of the eleven children acquired the ability to speak either at the usual age or after some delay. Three (Richard, Herbert, Virginia) have so far remained "mute". In none of the eight "speaking" children, has language over a period of years served to convey meaning to others.

These types of language delays, the delay or absence of curiosity about ones environment, other adaptive delays and so on, mean these children meet the criteria for ASD and NOT AS.

The medical and psychiatric communities in Kanner and Asperger's time may have had some absurd philosophical ideas as to cause and effect but there is one thing they were far superior in doing as compared to those communities today, and that's observing patients in depth and writing detailed case studies.

ya she tried sooo hard. The pyscholoigist that said that to her, promptly got a box of tissue chunked at her and that "refrigerator mom" was boiling hot, screaming obsenties at her as well. She later applogized when she saw how much my mom tried with me. Freud was the big thing in psychology at the time...which explains how flawed the psychological logic was at the time.

I was a hard kid to raise because of my life threating seizures and the autism that nobody seemed to understand which was going on, plus I was raised in a time there were very little info about high functioing autism.

An interesting article and I see the point in it. Given that information, I don't see why AS should be the same as HFA. In my mind, those differences are rather clear and testable: any problems are then related to bad diagnostics or the Sorites paradox: it is difficult to place the exact border where it stops being HFA and starts being AS. However, I don't think that's enough reason to abandon the AS diagnosis. The boxes we put ourselves in may be vague, and we may put some people in the wrong box, but I don't think the boxes themselves are useless. I think an average person diagnosed with AS is going to have some significant differences with an average person diagnosed with HFA. This means that therapies should be different for the two groups.

As far as the "lumped in" debate goes: I do not object to being put in the same box as people with LFA because I feel they are somehow different or less than me. I object because I feel the different groups should be helped in different ways. I personally feel that Auties generally have a harsher time at it and deserve to be accommodated more than Aspies. Also, though I realise this is kind of sad and selfish, AS has a "good" reputation, especially in scientific circles, so disclosure becomes easier when you're talking about Asperger's.

If you still talk about AS as defined by Asperger, the children he discusses in his paper do not all/do not quite meet the current definition of AS either.

Might be interesting to more people! Chronos post just got me curious about this.


I had to go through the papers and take notes. I should get myself a cookie or something for such a good job haha

Fritz had delayed self-help and adaptive skills. Asperger's also describes him as displaying an abnormal disinterest in people and things which equates to "lack of curiosity about the environment" in that while he reacts, his reacts are highly abnormal/inappropriate in nature. The AS criteria of today demand normality in this. Furthermore, he has difficulties to initiate a conversation, keep it going and often does not react to someone's questions or verbal instructions. Marked inability to initiate or sustain conversation is a criterion of classical autism today. He is described as displaying echolalia sometimes, either partial, complete or he answered with a rigid standard phrase.

Harro is described as less severe as Fitz, but displays a similar inconsistency to react to his environment or react to it in an appropriate way. Though it's hard to say just based on what Asperger reported how much of this was because the boy plainly did not want to take part. Similar, he showed an unusually good independence/adaptive skills for his age, but had difficulties with other simpler self-help skills necessary in everyday life. Asperger points out that some of these delays are at least partly because of his motor clumsiness.

Ernst did not have speech delay by today's definition, but is described as delayed by Asperger for speaking single words at 1 1/2 years and displayed speech issues(?) well after that for some time. He is described as having very delayed self-help skills (forgets, gets confused, is clumsy), needs to be dressed (at 7) and he has only recently learnt to eat by himself though he still doesn't do it right.

Oh, Asperger mentions he's actively distracted instead of only passively and that he seems to have ADHD too.

(So much for AD(H)D not possible in people with PDDs for the moment as according to DSM-IV-TR and ICD-10.)

Hellmuth had delayed speech that would rate as a speech delay today too. He is described as displaying severe clumsiness in most everyday activities, thus interfering with some of his self-help and adaptive skills. His strong insistence on routines and sameness is something I find noteworthy, because the severity of it is thought of as fitting classical autism more than AS by some specialists today.


But besides that all, Asperger's general definition of AS is partly different to AS of today. (So who was as creative as to come up with the DSM/ICD criteria?:

AS traits are consistent from age 2 onwards.

(He adds that they're consistent throughout life, though intellectual abilities and character traits (experience?) influence how they present to the eye with age. They may seemingly become milder or more severe, but the essence keeps being there.)

Those with AS may have delayed speech.

(For some reason, both a "normal delay" before age 2 which isn't considered a delay today usually, as well as the delay after age 2.)

Infants/toddlers with AS display difficulties in mastering self-help and/or adaptive skills at an age appropriate time (= delayed)

The curiosity about the environment thing is a term that just doesn't appear in Asperger's papers. Hard to say, really.

Instead, he talks about that the children's (and adults') gaze does not linger normally on both people and objects. Social delays while of course a delay in curiosity about the environment are allowed in DSM (and ICD? can't remember).

But as we know, looking at something doesn't necessarily equate attention in autistic people, as does not looking at something not mean an autistic person doesn't acknowledge and/or pays attention to a person or an object. I don't feel that answers the question.

Edit: About cognitive delays or below average IQ (or just getting a lower score than one could achieve).

This is interesting, I think.

All the children's IQ testing was done under circumstances suited to these children to learn of their true intellectual potential.

Asperger frequently mentions that a normal test setting (as it should be) or a normal testing procedure yields "wrong" (=low) results for the children ignore tasks/questions, are unwilling to answer/solve, display language/speech difficulties that prevent them from answering (until prompted again, for example) or they get fixated on something they are interested in/their "special interest" and start to talk about that.

Obviously, that's not how IQ testing it administered today usually. It isn't usually taken into consideration whether you get distracted, answer with an echolalic phrase (but would get it right on the second try), know it, but would rather/can only write it down or show it than say it.


Sooo, that's it.

I'm not motivated to re-read even more about social deficits and peculiarities nor the paragraph about abnormalities in sexual drive.

Yup. Basically, Asperger discovered autism independently of Kanner. They should've been given joint credit for it; but instead, Kanner's came to mean more severe and Asperger's milder, when in reality they were both talking about the same thing.

I can't say for certain....I really won't know until it actually happens, and then I can get a better gage with my perception

I was diagnosed with PDD-NOS when I was 3, but have made substansial strides. I know some people don't want it to be lumped in because it's a 'catch-all' diagnosis, but If I still have Autistic Symptoms (which I do), what makes me that much different from somebody who has AS, or HFA, or Classic Autism? Other than the severity/mildness of it? Isn't that why its known as a 'Spectrum' Disorder?

I was under the impression that Atypical Autism was PDD-NOS, and HFA was Asperger's, someone correct me if I'm wrong....