Why Asperger's should be separated from Autism

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I hope nobody took offense to my previous post. I realize (as I think I mentioned in my first post) that IQ-tests are often a poor measure, that autism interacts with IQ in a way that makes the results have very low predictive value and as Callista pointed out, MR in itself is a vague term.

The reason I brought it up is because I'm offended to be told I don't have autism because I have cognitive skills that allow me to compensate. I do not claim to be able to distinguish between MR and autism in someone who has LFA and I'm sorry if that's how it came out. However, I don't believe KoS has that ability either and I disagree with the notion that LFA is more "autism" than HFA. It's a different manifestation of autism, POSSIBLY complicated by additional comorbids.

In retrospect I do think I over-generalized, I think the "autism speaks" tone of the OP threw me a little. But for anyone who seriously claims that Asperger's and HFA are not autism, I think it's important to at least consider that LFA may be autism with comorbidities, even though, to an extent, all psychiatric diagnoses arbitrary categories. With that in mind maybe you won't be so careless about calling aspies non-autistic. As far as the HFA/AS distinction goes, I have nothing to add.

For Janissy: as a parent of an autistic child (though HFA) I can relate to your pain. Before his diagnosis was made there were some moments where I feared he might have MR as well, it was just so difficult to tell because his speech was so delayed. And mental retardation does seem to have more stigma attached to it. I guess my question was rhetorical (sometimes I don't give clear signals about those things).

But I am very aware of the advantages of intelligence. Looking back at my life it's really the only thing I've had going for me. I don't mean in the sense of getting the kind of friends who like you when you do their homework for them, but I mean that because I have strong cognitive abilities, I have learned to do what NT's do, and without intelligence I never would have been able to. I don't want to come across as arrogant, but in academic contexts and whenever pure "brains" are key, I'm usually one of the smartest people in the room. But those smarts make me barely pass for normal. At average intelligence I would probably have been in a far worse place than I am now. And I worry about my son, because even though he's at least average, he's gonna need more than average cognitive abilities in order to lead an average life.

In my opinion, that's the main reason to desire intelligence; because it speeds up your learning. As far as human qualities go, intelligence is a useful tool, but I will take compassion, humility and kindness over giftedness any time of the day. I'm aware that many people don't, though. As a child I had a friend who was probably an undiagnosed dyslexic. In addition, she was more of a slow thinker than the yacking, wildly associating child I was. I thought she was great and liked reading with her (we were about 8 and she couldn't really read). I liked it because I liked her and I was happy that she wanted to sit with me. So far so good. What makes me cringe when I think back to that is the fact that teachers would pat my shoulder and tell me and my parents how great and generous I was for putting up with her poor reading skills. I had never thought that someone wouldn't want to be with her because she wasn't bright, but it seems they thought I was doing it for charity.

Why does this discussion always seem to come down to an either/or proposition?

Research into the etiology of autism, the commonalities between what are currently considered autism spectrum disorders (but might, through research be differently classified), the viability of various therapies and supports--these are all worthwhile pursuits.

The simple fact of the matter is that autism affects different people differently. My presentations are largely managable, and where therapies are required, I use the services of a psychologist. Other people's presentations are significantly different, and may require special education supports, and a sheltered workshop environment. Others may require round-the-clock care and supervision.

I do not for one moment suggest that all people on the spectrum require the same services, supports or therapies. That does not mean, however, that our conditions should be classified by our needs. Diagnostic criteria are largely classified by etiology and comparability of effect on anatomical structures. Therapeutic decisions, however, are largely dictated by the nature of the presentation of symptoms.

Take, for example, cancer. Early stage cancers may be effectively addressed through milder, oral chemotherapeutic agents. Later stage cancers may dictate resection, and more aggressive therapies. Both are cancer, but the approach is dictated by a factor beyond the identification of the condition. While cancer is progressive and ASDs are likely not, the same principle applies: An ASD is an ASD is an ASD--but that is only one part of the puzzle. Once you have concluded that it's an ASD then the question becomes where does it lie on the spectrum, and from there a patient can turn attention to the question of how to address the condition.

The fact that my presentation of an ASD does not merit a "cure" does not mean that my condition is not an ASD. But neither does it mean that another person's ASD would not benefit from research into restorative therapies.

Well, I do know that a lot of very disabled autistic people do have more than just autism; but there are those who don't--they have just autism, and if they have a low IQ it's probably because they've got such extreme autistic traits.

I do think that in people labeled "LFA", you are more likely to find other conditions. The kids on the Autism Hub who seem to need the most help are often also the ones who seem to have not just autism, but other issues too. I don't actually have statistics; it could be a false impression; but that's what I'm seeing now. Maybe it's because when an autistic person has some other problem plus their autism, their sensitivity makes it much harder to learn. Maybe it's because there are things that just cause multiple issues, of which autism happens to be one. (Prematurity, for example, predisposes to a great many conditions. Born early with autistic DNA? Wham--autism.)

Either way, that implies that "LFA" is nowhere near one entity--even the people who have nothing but autism and are labeled that way are different from each other; but there usually are several other things going on that make that particular individual's autism different from everybody else's autism. After all, you've only got one brain; it's not like you've got an autistic brain and an epileptic brain and a dyslexic brain and... etc. If anything, that says to me that you ought to make even fewer presuppositions about very disabled autistic people than you would about people who are only a little impaired. The more that's going on, the more complex the case is, the less you can assume...

Oh, and if comorbidities can make you LFA... then guess what, you can move in and out of that category, too.. Seriously, functioning labels do not mean a thing clinically. We ought to drop them. If you want to use anything, use support levels instead--a description of how much help somebody needs is at least useful!

QTF

Yeah I should point out I'm also one of those people who has more than just autism. It's just if you took me on autistic traits alone that'd be sufficient to cause all the things that make people tend to label me low functioning. The scary thing though is occasionally I've realized that even if I took one of my conditions that I experience as milder and/or less pervasive than autism or some of my most severe physical conditions, even some of those ones would put a person out of work and give them a lot of trouble with daily living. So I imagine there's some synergy effects going with everything taken together. I just hate the assumption that if I am autistic and have extreme trouble with self care then it must be anything but autism.

Regarding the musical, I haven't seen it. But I know a kid with a measured IQ of 30 or under who graduated high school at 13 and is now in college and thriving. Not that everyone can be expected to do that but the expectations are clearly not right. (And he still appears "low functioning" although he rejects the term as much as I do.)

Another thing is that the definition of MR has changed over time. My most recent IQ used to be on the edge of some definitions of MR but currently is around the borderline range, so if I'd tested this way before age 18 (which is possible since it was taken age 22) then in the old days I'd have been MR, but now I'm firmly not.

I agree new terms need to be used but I don't like cognitive disability. To me cognitive disability means anything affecting cognition, so MR, autism, learning disabilities, dementia, some parts of MS, brain injury, stroke, some kinds of epilepsy, etc etc etc. So I think that term needs to stay general. Similarly developmental disability is autism, MR, CP, some kinds of epilepsy, childhood onset brain injury/stroke/etc, and lots of obscure things. (In the USA it's basically any childhood onset condition causing impairment in those same sets of adaptive skills as MR but for different reasons as well).

I agree with the op.

I actually did very well on an IQ test aged five, but a lot of that was due to gaining abilities like reading full-formed and early. Then by adulthood those same skills, having changed much less than they change for most people, had me behind the usual on the tested skills. I hate those tests.

IQ tests just measure, at a given moment, how well you do on that test.

IQ tests are a measure of how well you know obscure Chaucer-era words, and how well you can arrange or think of shapes in your mind. I suck at Iq tests.