AS/HFA controversy, not sure If I get it.

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Is AS considered less severe than High-Functioning Autism? I'm not sure If I understand the controversy surrounding the debate as to whether AS should be eliminated as a diagnosis and replaced with HFA.

It just seems that if autistic traits fall on a spectrum that HFA and AS are almost the same thing, at least very similar.

I assume I'm missing something, AGAIN.

lol.

The main difference between AS and HFA is early language acquisition. If there is a language delay, it's HFA. If there is no significant language delay, it's AS. There are plenty of other differences between the two, but that's the diagnostic "sword" that cleaves the two categories.

Classic autism ("HFA") also typically is accompanied by a delay in self-help skills, whereas AS does not.

By adulthood, they often (not always!) look very similar, though.

Many people with AS could be diagnosed with classic autism, but clinicians see someone fairly high-functioning and diagnose AS even though the language delay or delay in self-help skills means that it's autism. It should be a science, but they throw a bit of art in there.

And then I will see some parents say things like, "my child was diagnosed PDD or HFA but he got older and developed more and it shifted to AS" as if one can change into another. That doesn't happen, but diagnosticians and parents and professionals who work with spectrum people often behave as if it does. As if an HFA kid who learns to speak really well suddenly becomes an AS adolescent.

There are a lot of differences between the two, including the testing profile that comes up. For AS it's higher verbal, lower performance and for HFA it's lower verbal, higher performance and this trend continues even when the individuals get older and the HFA develop stronger speech skills.

It's going to be confusing to a lot of people to put it all under one category after researchers have discovered so many differences and doctors have been developing ways to work with those differences. I'm reminded of the confusion between type 1, type 2 and type 1.5 diabetes. Many people think that new names should be developed instead of having such very different conditions with very different needs and causes and prognoses all under one name. The same, in my mind, with autism. Yeah, it's all autism. But it's very useful being able to quickly separate it out into different forms with different sets of needs and different general skill patterns. What works for one person doesn't always work for another and more categorization is helpful for honing in more quickly on what is likely to work. Putting everybody into one big grab-bag category may seem more fair at first glance but it will make it take longer and be more expensive to find good ways of working with the differences within the autism spectrum if we spend so much effort on erasing them first. In my opinion, anyway. For whatever it's worth.

It is a bit more complex - according to the DSM, you can't have AS if you have a language delay; but you can have HFA even if you don't have a language delay.

I have AS and I actually started talking a little early. I had about a dozen words at nine months and I was putting sentences together at eighteen months. At first I though that meant autism was out as a possible diagnosis, but I've read that early language this not uncommon for Asperger's babies. I was also finding words in books at three.

I was reading by age three. At three I could read easy chapter books and at age four I could read newspapers and encyclopedias. Apparently, that's usually called hyperlexia and sometimes happens in children without AS but tends to involve social clumsiness similar to AS as well.

That's me right there. Read the Lord of the Rings and the Narnia books in Kindergarten. Repeatedly. Wound up using British spelling for a while because of it.

I am diagnosed with aspergers. That means I am autistic.

Same here with the British spelling. And words. I would say "dotty" because I didn't realize it wasn't a word Americans used.

I read early and at a high level but I often embarrassed myself by not knowing how to pronounce words. I knew very well what they meant but I pronounced them wrong. I remember unearthing a copy of "Much Ado About Nothing" at a church rummage sale when I was little and all the adults were trying to dissuade me from wanting it because they were sure I didn't know what it was. They asked me to read the title and I pronounced "Ado" as "Aydoh" so they laughed at me. Meanwhile I knew that Much Ado meant a big fuss.

Actually the verbal/performance thing does not always go so neatly. There are other trends that go among individual subtests but they are just trends as well. And some of them are rather self-fulfilling prophecy or something (like people without a language delay tend to do better on language testing). But there's no absolute hard rule and some studies show lack of any consistent performance/verbal split among autistic people in general and more of a split in AS. And it goes on and on with studies contradicting each other.

Personally I don't like always hearing about "the difference between AS and HFA" or "the similarity between AS and HFA". Because both ideas seem to separate "AS and HFA" artificially off from "all other purported kinds of autism" (PDDNOS, autism without a functioning level, LFA, all three of which I've been called). And I don't like it when people make that split. Because it's completely artificial and doesn't speak to genuine similarities and differences among autistic people. And because it seems to elevate sone autistic people above the rest of us.

I don't like the names HFA and LFA because of all the assumptions bundled up in the word "functioning". Those then get applied to AS which gets called "a high functioning form of autism" which then gets translated into "mild autism" and I'm here to say that there's nothing "mild" about the hell I've been through because I don't "function" the way others want or expect me to.

There's a half of me that likes the idea of putting us all under one name and a half of me that doesn't like it. I've figured that I'll let "them" do what "they" decide to do and either direction it goes, I'll learn to fit my life into the consequences. Just as I always have.

I got really frustrated with a teenage cousin because someone had told her, "you should get to know your little cousin. Did you know she can read already?" when I was three or four. So the cousin got a tape recorder and said she wanted me to read into it and handed me Dr. Seuss' "Cat in the Hat." The first sentence said, (if I remember correctly) "It was no time for fun." but the letter "I" had been drawn out cartoon-style in red and took up a huge space and then the letter "t" and everything after it was in black type. I didn't have any exprience yet with Medieval illumination or the typeface styles that had descended from it so I didn't recognize the I as a letter or as part of the sentence. So I sat there, trying to figure out how one would pronounce the word "t".

The cousin turned off the tape recorder and said, "it says 'It was no time for fun.'" *THEN* I could see what the giant letter was doing and I was ready to read the book to her but she took it away from me and wouldn't let me and said, "it's okay if you can't read yet. You don't have to lie about it." And I felt patronized and angry for being called a liar. It never occured to me to go find a newspaper or regular book or something and just start reading out of it to her to show her I wasn't a liar. I wish now that I had done that because I'm still angry with her forty years later and I don't even remember what her name is! Just "some cousin of mine who lived in Florida." The woman's probably about sixty by now and has zero recollection of that whole experience but I'm still festering over it and probably wouldn't be if I'd just gone and found something to read to her to prove I wasn't a liar.

Except for nonverbal adults or BAP (the two extremes), you aren't going to see much difference between individuals with any specific label by the time they're adults. Sure, some superficial things might be different, but they're different amongst people with the same acronym all the same.

Everyone with an ASD, well almost everyone, are far closer to one another, then they are those without one in outward behaviour, and that's all people really need to know.

I think that traits differ from person to person, and that it depends on the individual.