"Theory of autism"--why Asperger's had to go

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Let me preface this by saying, yes, I know I'm making a lot of assumptions here. I welcome all criticism, feedback, refinement, tweaking, etc.

Asperger's generally describes significant dysfunction, disorder, or abnormality (hereafter referred to as "DDA") of the right hemisphere.

What I will call "classic" autism generally describes significant DDA of the left hemisphere (or both hemispheres).

Autism, in a general sense represented by the "autism spectrum", unites Asperger's and "classic" autism, describing significant dysfunction, disorder, or abnormality of the brain, period.

The headlines read: Asperger's no longer a valid diagnosis--but the truth of the matter is, the notion of "classic" autism has also been abandoned--both have been absorbed into the broader notion of autism, although the abandoning of the concept of "classic" autism has been virtually imperceptible, because the term "autism" itself has not been abandoned. Rather, it is now meant to be used in the broader sense only.

The reason that the diagnoses of Asperger's and "classic" autism had to go is that, while they are generally representative of (and are generally understood to represent) DDA in the right and left hemispheres respectively, they are not universally representative--mainly due to the fact that Asperger's, "classic" autism, and autism in the general sense are diagnosed from a behavioral perspective. The brain, and specifically the roles and interaction of the two hemispheres, are so complicated and vary so much between individuals that DDA in the left hemisphere (or both hemispheres) can result in behavior typical of Asperger's, while DDA in the right hemisphere can result in behavior typical of "classic" autism. Further complicating the issue is the fact that any "flavor" of autism can be associated with DDA in the connectivity between hemispheres. Further complicating the issue is the fact that DDA in either hemisphere can exist without the typical behavioral manifestations.

So, while the concepts of Asperger's and "classic" autism are useful, they lose effectiveness and even relevance when applied to individuals as diagnoses--when a doctor diagnoses his patient with Asperger's, all he's really saying is, "Your behavior is consistent with the general clinical picture of DDA in the right hemisphere." In reality, the patient could very well have DDA elsewhere in their brain. So the diagnosis of Asperger's is useless, except that it indicates DDA somewhere in the brain. Likewise, the diagnosis of "classic" autism is useless, except that it indicates DDA somewhere in the brain. Because these two diagnoses share a common utility beyond which they have no real function, it only makes sense to fold them both into the general concept of autism represented by the "autism spectrum"--DDA of the brain, period. That's all you can say about DDA of the brain when assessing it from a purely behavioral point of view--you can only say that DDA is present somewhere in the brain. You cannot say with absolute certainty which area or areas of the brain is/are involved.

This is why the association between Asperger's and DDA of the right hemisphere tends to be acknowledged tacitly and even downplayed. It's just not sufficiently reliable on a case-by-case basis.

Think about Nonverbal Learning Disorder. It is much more readily and openly associated with DDA of the right hemisphere, but that is only so because NLD is NOT diagnosed from the relatively narrow, purely behavioral point of view that autism is. Simply put, the diagnosis of NLD involves a bit more "detective work" in regards to ascertaining the physical location of DDA in the brain.

Of course, this whole matter of correlating specific behaviors with DDA in a specific part of the brain is complicated endlessly by the fact that autism is diagnosed in some individuals whose brains, after a CAT scan (or something similar) is performed, are found to be physically rather normal-looking. This fact highlights our still rather crude understanding of neural functionality. In these cases, it is assumed that we simply can't recognize the DDA, not that it isn't there.

Am I on to something here, or is this all just a misguided product of my brain DDA?

PS) Depending on your philosophical point of view, you may feel free to replace "DDA" with the term of your choice.

Autism affects the left hemisphere and AS affects the right hemisphere of the brain.

Right vs. left brain thinking is often used to justify many self-help books and homeopathic therapies that provide people with false hope. In general, many people do not take it seriously for the way that the original study (back in the 80's) has been misused and abused. Either way, I found your post confusing, but just saying, some people may not take you serious and you should really provide some sources when you attempt to make profound statements.

If there was no such thing as a spectrum then there would be 30000 members on WP who display more or less the same behavioral and psychological symptoms yet with varying differences and severities so they would all have different "disorders" because without a spectrum there is rigid categories. This would be ridiculous. "Science" does not even know what the primary symptom of AS is to explain behavior - is it sensory, a lack of innate social skills, a global/local processing disorder, right vs. left thinking, rigid thinking, an inability to read non-verbal communication, a lack of expressive capacity, a lack of empathy? There have been numerous studies on what the difference between AS and HFA (and they can be summed up with one word) and what disorders should be on the spectrum (like rhett's, fragile x - which is probably what you should be looking at due to the genetic/chromosomal nature of both).

Just one additional thought.

This discussion focuses on behavioural versus neurological differences between (classic) autism and Asperger's syndrome. But what about the genetic aspect? Simon Baron-Cohen expressed his dissatisfaction with merging AS and autism into a single ASD partly on the ground that they may turn out to have different genetic bases.

http://www.lookingupautism.org/Articles ... ignal.html

I'm not sure what that has to do with this thread.

I don't really mean to be a jerk, but posting a link to a google search doesn't really demonstrate extensive research. It does look like there are some reasonable forms of evidence that AS is associated with right hemisphere abnormalities, but I'm not seeing any indication that classic autism is strongly associated with the left. Try searching "autism left hemisphere". You absolutely do not find the kinds of results that you get for "asperger right hemisphere". Instead you find people talking about asymmetry across hemispheres, or dysfunction of cross-hemisphere communication, both of which might also be present in AS (indeed, right hemisphere abnormality would imply asymmetry). Indeed, some classically autistic students I know (those whose language skills were delayed, and even still impaired into their teens) display excellent math abilities relative to their overall functionality, which tends to be associated with left brain intelligence.

I respect Baron-Cohen's work, and it's great that he's helping the world find out about autistic gifts. However, I am at present inclined to disagree with him about the etiology of AS and other ASDs. They appear very strongly to be different expressions of the same or a similar genotype, and their behavioral effects are nearly identical. I'd really much rather he were right on this one, because then I wouldn't have to worry about having LFA children, but until someone can demonstrate a single significant and generally applicable difference at either the neurological or genetic level, I have to assume that it's a possibility.