True or false?
1. When Leo Kanner first described “autistic pathology” in 1943, he focused on the most severe cases of autism. This is why “classical” or “Kanner’s” autism refers to severe autism today.
2. The simplest, most effective way to communicate the most information about a person with autism is to assign them a functioning level.
3. PDD-NOS is not really autism.
4. Asperger’s disorder is named after Hans Asperger, who described a handful of boys who presented with social isolation, unusual language, and gross motor issues. He named the syndrome after himself.
5. Asperger’s disorder is a high-functioning form of autism.
K, ready for the answers?
1. FALSE! Kanner described somewhere in the realm of a dozen or more patients. While all of them had speech or language issues as young children, about half resolved by the time of evaluation and were verbally fluent. I do believe that none were completely nonverbal. Also, not a single one of his patients fit the stereotype of autism in which the affected person is sitting in a corner, rocking. Most, if not all, of Kanner’s patients, were, albeit oddly, quite engaged with their surroundings. Kanner described what would be termed “HFA” or “mild autism” today, on the whole.
2. Emphatically FALSE! Let me tell you a little story to set you straight about functioning labels. Say you have a patient who can use worse like antepenultimate and sentience, but can’t carry on a conversation and is, at times, nonverbal. This person can drive a car (though not on highways, across bridges, or in tunnels, which leaves her rather stranded in Pittsburgh!), but she can’t cross the street by herself. She has a college degree, but she can’t read beyond a 5th or 6th grade level in terms of fiction books, and sometimes not even that. She has a thorough understanding of all things nutrition, but she can’t cook without help, not least because she tends to leave the stove on and lay towels across the turned-on burners. She lives alone, but she requires nearly full-time staff.
So, do you take all the upsides and call her high-functioning? Or all the down-sides and call her low-functioning? Neither is true. Or, you could take the average and say she’s mid-functioning, but that ignores both her skills and her deficits. You’re not doing her any favors with the label. So, too, is this fact true for the majority of people on the spectrum. We are humans, not textbooks; therefore, we require more than one word to sum up our ability and disability.
And even if you’re not with me on that, consider this: HFA and LFA are not defined. That’s right. No definition, or rather, many. Some say HFA means a high IQ; some say it means verbally fluent; others say it means independent; still others say it means able to perform basic self-care. With everyone using different definitions, we can’t possibly learn anything from such a label when, in fact, we don’t know what we mean!
3. FALSE! PDD-NOS is as much “autism” as autistic disorder and Asperger’s disorder are! There is an umbrella, and under that umbrella fall five conditions: autistic disorder, Asperger’s disorder, PDD-NOS, Rett’s, and CDD. This umbrella, called pervasive developmental disorders, the autism spectrum, or just “autism” for short. So, no, PDD-NOS is not autistic disorder, just as Aspeger’s disorder is not, but they are all, equally, autism.
4. Almost true, but still FALSE! Asperger described “autistic pathology,” just like Kanner did, at the same time that Kanner did. It was not until the 1980s when Lorna Wing came into the picture that there came to be an “Asperger’s syndrome,” called Asperger’s disorder in the DSM-IV.
5. FALSE! If you took 100 people with Asperger’s and 100 people with autistic disorder, and if you set out a very specific detailing of criteria, and assigned them all a number, with 1 being the most affected by autistic symptoms and 10 being the least, then overall, the AS group would score closer to 10 than the AD group.
However! There are plenty of people with Asperger’s who are, in fact, more affected by their symptoms than a person with autistic disorder might be. Just because a person does not have specified delays before age 3 does not say squat about their ability to function as an adult!
Okay, I hope you learned something. Nothing worse than people passing around incorrect information, after all. Just call me Hermione, eh?
11 Aug 2011, 8:01 pm
