Death of the Syndrome

Post Reply New Topic

Yes. They couldn't give me a conclusive answer when I had my assessment - they said I fit both. I didn't have a classical speech delay - it was delayed for AS but not for HFA. So I was left to my own devices to choose. I picked AS because I had heard more about it and my attempts at research didn't yield much about HFA. But the difference between where the motor abnormalities origin from is kind of significant - especially if HFA and AS show different motor abnormalities as I then could compare it to what mine are. Are there any difference?

The lab tasks are usually very specific, like measuring postural reflex in response to some visual illusion, so I don't think that you could tell whether you had AS or HFA from real world behaviors. As far as I know, there is not list of motor characteristics for AS and another for HFA, and you could see which list you fit bester.

Were you the one who didnt' speak until 2, then spoke complete sentences? My cousin was like that, and I think that he didn't speak until 3. Then, there was my other cousin who didn't like to speak and was shy. Then, there was me who didn't speak and never thought of speaking. And we were all around the same age, so there were three non-speaking children running around in grandparents' house being weird.

Yep, that's me.
You must have had fun!
I guess this is the thing with the approach they are talking about, all of us are different from each other in some small ways. I guess I should relax about that as I know so many others are in the same position if they really thought about it. It's just some small anxiety left from not getting a diagnosis on paper right away then (and who knows, other psychiatrists might have said differently - they said it's barely any difference at all between AS and HFA) that actually feels even better already.

Some studies seem to suggest that HFA and AS are the same condition and as many seem to indicate that they indeed are different conditions. I personally find it interesting that most of the studies suggesting that they are the same condition are focusing on behavioral clusters, whereas most of the studies suggesting differences are neurological. For example a study by Lotspeich et al. (2004) suggests neuroanatomical differences: Exploratory assessments of brain-IQ relationships reveal differences between HFA and ASP, indicating that these conditions may be neurodevelopmentally different when patterns of multiple measures are examined. In a study by Enticott et al. (2009) results support basal ganglia, thalamus, and supplementary motor area involvement as a likely source of motor dysfunction in autism, and provide further evidence for the neurobiological separateness of autism and Asperger syndrome.

I found also several neuropsychological studies indicating differences, e.g. Klin (2006): The groups differed significantly in 11 neuropsychological areas. The profile obtained for individuals with AS coincided closely with a cluster of neuropsychological assets and deficits captured by the term nonverbal learning disabilities, suggesting an empirical distinction from HFA. Some studies focused on individual aspects as separators, e.g. Sahyon et al. (2009) found out that HFA participants appeared to favor visuospatial over linguistic mediation. The results support the use of linguistic versus visuospatial tasks for characterizing subtypes on the autism spectrum. Ghaziuddin et al. (2004) found out that pedantic speech is common in AS and may help differentiate AS and HFA.

These studies were so plenty, that I only picked up some from the first pages that Google Scholar offered, so these might not be the most relevant ones but in relation to my query. But I hope this helps, Anomiel and others.

In that case I agree with your views. However this is also a matter of perception more than scientific constructs. Parents of HFA kids want their children to catch up with their AS peers and start to use language in an independent manner. Thus they have no problem saying their kids are like AS kids in terms of intellect or IQ. On the other hand parents of AS kids are hurt or insulted if their children are referred to as autistic. I have now met around 10 parents of AS children who refuse to refer to their kids as HFA and will continue to retian the label that their kids have "Aspergers" as if its a completely separate diagnosis to autism. It's also bleedingly obvious that most adults with AS will continue to consider themselves Aspies and not refer to themselves as autistic.

Yes, I agree that a lot of people much prefer the "Aspie" or "Asperger's" label(s) because they're perceived as somehow better than autism.

I think some people genuinely (with good intent and good will) see them as two separate diagnoses as well.

I do get that there's going to be neurological differences when developmental trajectories are different (such as speaking earlier or later or having motor delays or not having motor delays, etc), and it's possible that working from neurological observations that they may be described differently than they are today, but I suspect it won't be a clean break where everyone diagnosed AS will end up in one category and everyone diagnosed HFA will end up in another. I think it's going to cut across a few subdemographics in both groups, along with everyone else diagnosed anywhere on the spectrum.

Attwood and others have presented data that outcomes for HFAs and AS kids in adulthood are similar in both IQ, speech and motor nueron issues. According to Attwood the biggest statistical predictor of success for a HFA child is IQ. The higher the IQ the more likely the child will overcome their speech delay.

Yeah, I know this research, although I am curious - does the link to IQ specifically refer to overcoming speech delay? Other research I've found is that outcome is influenced more by social impairment than IQ.

Sorry I was using speech delay as a proxy for normal/functional development (using the criteria for normal development specified by Attwood). I think there are a suite of fucntional characteristics. I picked speech delay as it's the most prominent setback although there are others. One interesting outcome is the HFA kids born with speech delay who later develop speech are less likely to have motor nueron problems or disgraphia/dislexia etc compared to AS kids.

VisInsita, thanks for the information, it was exactly what I hoped for.
I've done some reading, and it seems what I had was technically a speech delay, and not a language delay.

I don't know if IQ-scores are accurate with autistics (of any kind).
That only means they don't score as high on IQ-tests, and we must remember that those are not made to measure our kind of intelligence correctly, because it seems to be normal to get relatively scattered results. If the IQ-tests were made by us, then it would be the NTs whose scores were scattered and maybe low because they aren't like us.

In most outcome studies, IQ and language acquisition are the two major contributers to outcome. I have always that intellectual ability played a verry merry berry important role in my development, including language acquisition at later age than normal.

I don't know how I feel about this -on the one hand the DSM is shifting more towards a sliding scale/spectrum (or at least it sounds like that's what they're trying to do) rather than having separate names. But at the same time there's more room for confusion. I worry that your average person isn't going to be able to understand the difference between autism (what was once Asperger's) and autism (a more severe form).

On the other hand at least I won't have to tell people I have Asperger's ('ass-burgers') anymore. I mean, come on, I'm different enough.

This makes it sound like I'm both HFA and AS to a mild degree no matter how you slice it, if that's possible. Aspies and psychologists alike notice my motor symptoms, and I had early language development and a huge vocabulary, plus a tendency to be pedantic; but I also have had incredible visual-spatial ability from a young age. Curiouser and curiouser.

This is normal, I think. At least it's normal for me. Whenever someone presents a "this is HFA and that is AS" list I seem to have traits of both, and it seems like many others here are similar.

ThetaIn3D, These studies are not how you “slice” a diagnosis. A diagnosis is based on a completely different set of parameters.

ThetaIn3D and Verdandi, If a diagnosis would focus on individual characteristics everyone could be placed into the autism spectrum or to any other behavioral or psychological diagnosis for that matter, for most people have at least some feature(s) in some diagnostic manual or in some study linked to a certain syndrome or “illness”. Many people have incredible visuospatial skills, but they aren’t diagnostically autistic or even close to those arbitrary and extremely fuzzy borders that surround a categorization called the autism spectrum. The real fuzziness is actually in that wide grey area, where typicality gradually becomes a syndrome – and in the case of autism this happens more and more frequently and nearer and nearer to the so called typical behaviors.

These studies highlight the diversity of views and ways to see – scientifically even. All information – conflicting even – can be bended to obey personal or popular agendas, but as long as there are studies and personal experiences suggesting something else, this diversity should be at least acknowledged and accepted.

This is a slippery slope argument and has no relationship to what I posted. I don't know how one could conclude from what I or ThetaIn3D posted that everyone could be diagnosed with anything, or that anyone claimed that those traits were exclusively autistic.

My point was that people like to list traits as "this is what HFA is like" and "this is what AS is like" and that these lists don't line up neatly with real people. These are both the informal lists of traits people produce here and elsewhere as well as the more formal lists produced by professionals.



I do not see anyone denying any diversity. I have expressed the opinion in this thread that autism presentations are likely far more diverse than people realize, especially when they're focused on identifying and defining two groups that are not all that easy to separate into two clear groups.

The studies you mention are interesting, but having read studies involving brain scans where researchers produce statistical tendencies involving two or more populations, I have found that the overlap among such populations tends to be fairly significant. Which is to say that while you can point to statistical trends, that does not mean that any given individual will fall neatly into one of these trends, because everyone is different and not a statistic. Or as some like to say, "if you've met one autistic person, you've met one autistic person."