AS vs. NLD

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I've had 8 reports as a child indicating NLD and only one as AS. To complicate matters, I am flexible, conscientious, compassionate, empathetic, and have commonsense and have had these traits as young as 5 years old. I don't have an executive functioning deficit fortunately (hyperlexic but organized) but do have difficulties with central coherence and visual processing.

What's the likelihood of misdiagnosis of AS vs. the misdiagnosis of other conditions? If I needed to tell someone what I had, would my difficulties in visual processing more make me a person with NLD than with AS or am I just confusing labels and being adamant as to which one to use?



Thanks for any input. I am wondering what I should do.

Last edited by cool-quick13 on 16 Jul 2009, 2:36 pm, edited 1 time in total.

I'm curious about the distinct differences between AS and NLD as well, as I'm provisionally dx'd AS and my son was dx'd NLD. we have some things very much in common, and I've been reading as much as I can but not coming up with anything that really explains it.

I read something that said that since both are PDD's, they're essentially on the same spectrum and will have many symptoms in common. but, I'm still searching for info.

People with NVLD have troubles with visual spatual stuff.

Info here.

NLDline.com estimates that 1/3 of AS people also have NLD. They can overlap. I have both. NLD can also be caused by traumatic brain injury and some inherited conditions though, leading Dr. Bernard to state that it may not be a part of the autistic spectrum. I still think the inherited form of it is.

My first two diagnoses were NLD. Since then, I've had four diagnostic tests stating I have AS.

http://en.wikipedia.org/wiki/Nonverbal_ ... _syndromes

"Derold Fitzgerald and Corvin have argued that the diagnosis of Asperger's is more useful clinically, and that NLD is "an example of excessive diagnostic splitting"

There is an overlap of symptoms. Since the diagnosis of both conditions is based on behavior there is bound to be some error and ambiguity. This will be so until someone fines a specific neurological difference that can be observed objectively or some specific genetic markers.

ruveyn

Another useful link:

http://www.nldline.com/

Scroll down the left-hand side bar and click "AS vs. NLD" for a number of articles examining the subject being discussed here.

Having read a little about the subject, here's what I found about differences. Naturally, I can't vouch for the accuracy of these statements, as I'm only passing on what's been written by others. Like all generalisations, they're by no means perfect, so please don't feel offended if they don't all seem to describe you properly.

Aspies don't have the same range of emotions as neurotypicals, NLDers do. (I'm not too sold on that idea myself )

Aspies may have greater social problems than NLDers.
An Aspie might be content with one or two friends, i.e. more withdrawn than an NLDer, who more commonly desires strongly to be included in groups.

Aspies have narrowly-focussed interests, NLDers don't.

Aspies do stimming, NLDers don't.

NLDers have big problems with visual & spatial issues, Aspies don't.
(an Aspie might obsessionally put everything back in the "correct places" while an NLDer wouldn't be able to remember where the things came from; Aspies have a better sense of direction than NLDers.

Theory of mind - Aspies would have more trouble than NLDers in realising that others don't experience things like they do.

If an Aspie begins to read a book, they'll probably read it to the end. An NLDer will be more able to abandon it more easily.

Aspies can recognise blindfolded objects placed in their hands; NLDers can't.

I appreciate the input. I feel that I have two AS traits that I have only done (became a self-fulfilling prophecy) only after "knowing" that I had Asperger's. The first one was my passion for investing; it has been a passion since 24. I was bored about it, until I became a conservative, and than I said, that's cool and lets make some money doing it. I've lost only between 13-15% since 2007 so I'll call that a victory (don't know how I'll finish today). Oh, I really want to help people with their portfolios and make a living doing it. While I talk about it a lot now (because I haven't been able to do it), I expect that when I do it full-time, I will want to talk about something else when I went home. I have a lot of investment postings, i.e. maybe 2 or 3 a day for a few years (some days 0-2 and other days 5-6).

When I was 13 (i.e. in 1997), I set up a job shadowing experience at the National Weather Service. I didn't tell my dad (who was homeschooling me) until the day before the event, i.e. keeping it a secret). It was really fun because I got to see all the equipment. I would say I maybe was obsessed for about 1-3 months (when I was 10) and than I just read up and studied it; it never interfered with my work or way of life. I still played soccer (and only quit when it wasn't competitive enough) and basketball (a good long-distance shooter). Individual sports are a nightmare for me, however, because I think of the activity and the adrenaline just isn't there. It really is mind over matter.

I am wondering whether stimming is out of enjoyment or necessity. Can it be an action that a 5 year old might do (immaturity), is it something that is unique to a person with AS, or could it be a combination of both? I got a lot of detentions so I stopped doing it, but in college the policy was a little more lax so I started doing it again and than I learned it wasn't professional so now I don't do it anymore.

I have vestibular sensitivity and some light sensitivity. I have always had trouble with eye-tracking devices and 3-D images, but have done well with 2-D images, math, and directions. I couldn't tell you what something was if I was blindfolded.

I did well in college, especially during the summer terms. Did anyone else have that predicament? I felt having too few was very boring, 2-3 was ideal in a 5 and 7 week time frame, respectively and that 4 in a 14 week time period was a stretch. While I was good at long-term memory, I found 4 or more to be a real pain in the butt and that I could read much quicker when I could focus on 2-3. When I had one, I also didn't do well because I lost interest.

I seem to have traded some AS strengths that I don't have for some AS weaknesses that I don't have.

Last edited by cool-quick13 on 16 Jul 2009, 2:37 pm, edited 1 time in total.

thanks for this short list, this will be a good reference point to start from.

I agree about the range of emotions. my son and I were agreeing about how annoying it is to be asked how we feel about something because we usually don't know and we have to stop and think about it, which can really throw us off. we're both getting better about spontaneously identifying our emotions though. he's had a lot of social coaching at school and I just think a lot

another difference I noticed is he really needs to have friends and go places, although he gets to a point of sensory overload and has to go home.

he went through a head-banging stage when his teachers were hassling him and his dad was putting a lot of pressure on him, but I don't know if it was stimming or random self-destruction due to intense depression.

he also has had no interests that last beyond a couple of months until I put him in drum lessons. I was feeling despair over him not having a "thing" that he likes and is good at because it sucks to fail and/or get kicked out of everything, then we tried drum lessons and for some reason he's really into it, which makes me extremely happy. he usually talks about his friends and gaming, though, so he doesn't seem obsessively AS to me

the blindfold test sounds interesting. I might try it out on him.

I think on this is a generalization, and on an individual basis this does not end up being true and the two are extremely similar when it gets down to it. If you read the literature on girls with AS and girls with NLD, you begin to realize it can go either way in almost every case, especially in long term studies. In fact I am prone to believe that NLD and AS is different manifestations of the same thing, and most individuals with either will more often then not over the long term demonstrate aspects of both.

As far as the person with NLD getting frustrated with a book more often than not they have shown people with NLD to be more avid readers then those with AS...there is a tendancy to overlearn with NLD, but usually in areas where there are streangths. The thing is this is only with occupational therapy, but usually the visual tracking issue is taken care of.

By the way when I say they are different manifestations of the same thing, I mean they are both related to abnormal development in the right hemesphere. They are both considered non-verbal communication disorders.

I would also want to make clear that I don't think AS is a more severe version of NLD, I think they run along a similar spectrum and can be as bad as each other.

I think AS fits me better but I can relate to a lot of things that NLD describes-- particularly the reading/words/spelling part.

By the way I like the graph in the article on the NLD site, the one called "AS and NLD: Descriptions, Differences, and Similarities"

It shows a symptom and then if it correlates with AS or NLD more. There are many similarities and few differences.

I first noticed NLD a couple of weeks before getting diagnosed with AS, and at the time I just thought "oh no, not another complication!" - I was relieved to find that some workers consider NLD to be a case of excessive diagnostic splitting, and I threw the issue out and went back to focussing on AS. But now I think I might be wise to give the NLD brigade the benefit of the doubt and take fresh look, just in case I've got NLD all the time and have been mis-labelled. Admittedly there's so little difference between the two conditions that it's hard to imagine any great trouble coming from being in the wrong box, but I'm curious anyway. So I thought I'd look at how I fitted into those differences I'd dug out of the literature:

Range of emotions - It's hard for me to say, as I've spent my entire life thinking that I had the same emotions as anybody else, and still can't see how anybody would know that Aspies don't have the whole range - sure, they might not be able to communicate them, or even be aware of them, but my jury's still out on this one. What emotions would I expect not to have?

Content with a very few friends - I'm Aspie in that respect. I once lived in a room next to the front door of a shared house full of friendly hippies and dropouts in a district of similar people, and towards the end of my stay there I felt that I had too many friends, and that they were playing havoc with my need for solitude and my personal special interests. What had happened was that I'd put my special interests on hold and taken up "socialising" as an obsession, and although that worked out very well for some time, with a constant stream of non-judgemental folks knocking on the door, in the end I had to limit my human contact, and I moved out of the area. I'd be mortified if I were ever to become completely without friends, and when that scenario has looked imminent I've been very lonely and depressed, but I've learned that just one or two suits me best. I've thrown out my ambition to prove myself as "life and soul of the party," and I now realise that I only ever had that ambition because I was trying to disprove the notion that I was a sad, lonely introvert.

Narrowly-focussed interests - Aspie again. I have little interest outside whatever obsession I'm into, I'm very tunnel-visioned and preoccupied with the tasks I take on, e.g. if I'm looking for something I need for a hobby in a catalogue, everything else therein just gets in the way and annoys me. All the time when I'm reading, I'm thinking "for God's sake cut the crap and just give me the answer I'm looking for!"

Stimming - Aspie. I do stimming.

Visual and spacial issues Aspie. I get upset if my stuff isn't where I left it. I do have problems with directions and getting lost in new environments, but once I focus on the problem, I fix it.

Theory of mind - Aspie. Once I've worked something out, it never ceases to amaze and frustrate me that there are others who haven't yet got there. I still can't fathom why so many people seem to take the world of work in their stride when it upsets me every day. Religious belief is a complete black box to me. Right-wingers must have been (metaphorically) touched by Satan. Intellectually I know the theory about why people love competitive sport, but I can't get into their shoes, they still seem like maniacs to me.

Reading books - Aspie. It's all-or-nothing when I read a book. Same as when I do pretty much anything. Even when I hate a book, once I've begun, it would take an immense effort to just give up and move on to something more worthwhile.

Recognising objects in my hand while my eyes are closed - Aspie. At night, I've often distinguished between two watches I keep by my bedside, just by the feel of them.

Also, it's interesting to look at this article, which has a description of a set of adult twins, one with AS and the other with NLD. As far as I can see, the article doesn't tell you which has AS and which has NLD, but by the time I'd read it, I was pretty sure of the answer to that. I can see myself in one of those guys, but not in the other:
http://www.thelighthouseproject.com/Dif ... d%20AS.htm
I won't spoil it and post the name here, but if you're curious, go to my blog where you'll find my answer. I presume I've got it right?

In a sense, the whole NLD vs. AS thing is a matter of perspective. AS was first described by psychiatrists and other medical doctors, and is considered therefore to be a psychiatric disorder within DSM-IV. Therefore, the emphasis is more on odd behaviors and social interaction problems. NLD, on the other hand, was first described by special education people and is considered to be a learning disability. Therefore, the emphasis is more on academically-relevant problems, such as visual processing and the odd profile of IQ scores (good with reading and vocabulary, bad with math and non-verbal tasks). You could compare this debate to the frontal lobe syndrome (emotional dysregulation, socially inept) vs. dysexecutive syndrome controversy: both are aspects of some people with traumatic brain injury, but seen from different perspectives (psychiatric and neuropsychological, respectively).

Don't forget that you can have BOTH. The diagnostic criteria for NLD does not contain the differences provided by people on the site. All that is required is visual-spatial difficulty to have NLD.