AS and HFA? Spectrum?

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I've been here for a while, but there's something I never quite understood. HFA stands for high functioning Autism. Autism is a spectrum. How does this spectrum measured? Level of how noticable it is? Severity? What is the order? LFA,AS,HFA? or LFA,HFA,AS? I'll be leaving for a week, so there's plenty of time to think about it. Bye for a week everybody!

Have a good holiday Sarcas-mo!

Autism is not the Autistic Spectrum. Its a part of the spectrum, like AS is. The LFA/HFA division is a nonofficial subdivision of Autism, which is supposed to sit on the more severe end of the spectrum. AS is considered a higher functioning version of autism, so its considered at the lighter end of the spectrum.
The differentiating factor is really the amount of impairment it has in your level of functioning. AS is not supposed to have delays in development. Autism does.

<---------Autistic Spectrum--------->
<----Autism----><---AS--><-PDD->
<-LFA-><-HFA->

Kind of like that.

This is a very broad generalization of the levels of severity on the Autistic Spectrum. It is not wholly accurate for everyone because the disorders overlap on the line of severity. It is a generalization only.

Severe:
-Low-Functioning Autisitc Disorder (LFA)
-Rett's Disorder
-Childhood Disintegrative Disorder

Moderate:
-Moderate-Functioning Autistic Disorder (MFA)

Mild:
-High-Functioning Autistic Disorder (HFA)
-Asperger's Syndrome

PDD-NOS I believe can be all over the place. It depends at what age the diagnosis still remains PDD-NOS or whether the person has been rediagnosed as something else. It's just the lovely catchall category.

Hope that helps.

First of all, psychiatrists use two different standards to diagnose mental disorders: the American Psychiatric Association's (APA's) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, (DSM-IV-TR, published in 2000; DSM-IV published in 1994) and Chapter V of the United Nations (UN) World Health Organizations' (WHO's) International Classification of Diseases, Tenth Revision, Second Edition, (ICD-10-2, published in 2003; ICD-10 published in 1990).

In the DSM-IV-TR, the autistic spectrum is classified under Axis I, Clinical Disorders; Other Conditions That May Be a Focus of Clinical Attention, subcategorized as Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence. The DSM-IV-TR calls the autistic-like conditions found here the pervasive developmental disorders (PDD).

• Autistic Disorder - 299.00
• Asperger's Disorder - 299.80
• Childhood Disintegrative Disorder - 299.10
• Rett's Disorder - 299.80
• Pervasive Developmental Disorder (Including Atypical Autism) - Not Otherwise Specified (NOS) - 299.80
  

In the ICD-10-2, the pervasive developmental disorders are in Chapter V, Mental and Behavioral Disorders, where F80-F89 are disorders of psychological development. The pervasive developmental disorders are coded as F84.

• Childhood Autism - F84.0
• Atypical Autism - F84.1
• Rett's Syndrome - F84.2
• Other Childhood Disintegrative Disorder - F84.3
• Overactive Disorder Associated with Mental Retardation and Stereotyped Movements - F84.4
• Asperger's Syndrome - F84.5
• Other Pervasive Developmental Disorders - F84.8
• Pervasive Developmental Disorder, Unspecified - F84.9
  

Rett's syndrome is rare and occurs almost exclusively in women. Loss of muscle and autistic-like behavior eventually develop. In childhood disintegrative disorder, normal development occurs for at least two years followed by a loss of previously acquired skills and the development of autistic-like behavior; after the detioration of psychological development, the child is usually profoundly mentally ret*d. Atypical autism is atypical in regard to age of onset or fulfillment of all three sets of diagnostic criteria. ICD-10 diagnosis F84.9 is used "when a lack of adequate information, or contradictory findings, means that the criteria of the other F84 codes cannot be met" (ICD-10, 1990). F84.8 is the code reserved for PDDs unknown at the time of the ICD-10's publishing or otherwise unlisted.


When an autistic person is also mentally ret*d (IQ < 70 by most standards), the diagnosis is Autistic Disorder (or possibly PDD-NOS) in the DSM-IV-TR or Childhood Autism (or possibly Atypical Autism) in the ICD-10-2. Asperger's syndrome is ruled out by definition because, "E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood" (DSM-IV-TR, 2000). In either the case of Autistic Disorder/Childhood Autism or PDD-NOS/Atypical Autism with mental retardation, researchers consider this to be low-functioning autism. If Autistic Disorder/Childhood Autism or PDD-NOS/Atypical Autism is diagnosed but the person is not mentally ret*d, that person is considered to have high-functioning autism.

Asperger's syndrome goes a few steps beyond this in terms of psychological development: Normal to above-normal intelligence is required (IQ > 84 by most standards). In addition, "D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)" and the criteria for Autistic Disorder or another pervasive developmental disorder are not met. With the normal to superior intelligence and normal language acquisition, people with Asperger's syndrome often have a higher verbal IQ than performance IQ whereas autistic people more frequently have the inverse. Another common characteristic of AS is motor clumsiness whereas people with autism often have relatively superior motor coordination.

If you want some sort of severity scale of the pervasive developmental disorders, here's my attempt at it:

• Rett's Syndrome
• Childhood Disintegrative Disorder
• Low-Functioning Autism
• High-Functioning Autism
• Asperger's Syndrome
• (PDD-NOS and Atypical Autism run the gamut.)
  

I would also like to bring to WrongPlanet.net's attention the difference between the autistic syndrome and the autistic genotype. The pervasive developmental disorders are currently diagnosed on the basis of observable clinical signs and reported symptoms rather than a neurological or genetic test. This means children with autism and Asperger's syndrome could manifest these signs with different etiologies. Various brain lesions and other diseases can cause autistic-like behavior. The child, especially if the damage is done before or very near birth, could still be diagnosed with autism or even Asperger's syndrome legitimately. On the other hand, genetically, they may not share the underlying genes that cause autistic traits to manifest themselves without brain or neural trauma. In fact, the ICD-10 specifies that in the case of "other childhood disintegrative disorder," the neurological cause should be diagnosed in addition if it is known.

Also, Rett's syndrome almost certainly has a different genetic basis from autism, atypical autism, and Asperger's syndrome. The autistic spectrum properly should not be synonymous with pervasive developmental disorders but rather should be restricted to conditions with related etimologies and diagnostic signs. Properly, the autistic spectrum should, in my opinion, refer to the set of syndromes resulting from the genes and other factors that cause autism. Realistically, this limits the so-called autistic spectrum to low-functioning autism, high-functioning autism, and Asperger's syndrome; but have hope! The relationship of autism with other disorders is being researched (notably, obsessive-compulsive disorder, schizoid personality disorder, anxiety disorders, and attention-deficit/hyperactivity disorder). Also, autism's relation to other developmental and learning disorders is being researched (hyperlexia, multiplex developmental disorder, pathological demand avoidance syndrome, and more).

The greater autistic spectrum could have ADHD/hyperkinetic disorder on one end, obsessive-compulsive disorder in the middle, and low-functioning autism on the other end. Imagine that! Add to that multiple dimensions of autism because of different autistic traits being possessed independently and what you have is not a spectrum but rather a veritable matrix of autism!

• Social impairment: Shyness, Social Phobia, Avoidant Personality Disorder, Asperger's Syndrome, Autism
• Perseveration and Obsessional Thinking: Perseverance, Obsessive-Compulsive Disorder, Major Depressive Disorder, Asperger's Syndrome, Autism
• Executive Function and Self-Control: Spontaneity, ADHD, Asperger's Syndrome, Autism
• Sensory Integration: Sensitivity, ADHD, Asperger's Syndrome, Autism
• Introversion: Introversion, Schizoid Personality Disorder, Asperger's Syndrome, Autism, Schizophrenia
• Anxiety: Worrywart, Generalized Anxiety Disorder, Avoidant Personality Disorder, Asperger's Syndrome, Autism
  

Not exactly, PDD is a wider term, which ASDs are under. Rhetts and CDD are often classed under PDD and not ASD, from what i have read.

Though, this catagorizing is confusing, since some places consider PDD the same as ASD, but others have it as 2 separate ones, with PDD being broader. More ofter I have heard it as being 2 separate things.

I think you may be confusing PDD with PDD-NOS.

PDD-NOS is a diagnosis.

PDD is a term used to group all servere and pervasive devolmental disorders were multiple functions are affected.

Developmental dysphasia is a SDD(specific developmental disorder) while infintile autism is a PDD.

It has been reported that a dx of PDD-NOS is more common than either AS or Autism in children refered to the Yale Child Study Center.

My son Hunter was dx PDD-NOS because he shows many signs of AS but has severe language disabilties. He also shows imaginative play which knocked him out of the Classic autism DX.

IT's a weird place to be...There are many people researching Autism and AS but their are very few looking at those stuck in PDD limbo.

No. I know what Pdd-Nos is. But I have been told to that ASDs were under Pervasive Develemental Disorders and that PDD was broader so that CDD and Rhetts and such fell under it, but not under the Autism Spectrum Disorder, which I have been told by some is a subcatagory of PDD. Then again, I have recently seen others that list them as the same. So there is confusion, which is perhaps, part of the overall uncertainty prevelent in the field that I have come across. There is no universal agreement on what ASD, AS, Kanners, PDD-Nos, PDD, are.

I never heard of spectrum for anything but colors. Autism is like rainman isn't it? I don't think I'm anything like him!

This is why the idea of a 'spectrum' has evolved. Although 'Rainman' was innovative for its time - it brought the issue of Autism to the big screen, and into people's thoughts - it relied very much on atypical and stereotyped behaviour to get the message across.

One of the persistent problems is that if it is mentioned it in so-called 'polite' company, sometimes people will give a reaction of shock and even horror. Such a representation does not give an accurate reflection of the fact that there are people of widely varying ability within that, which is one reason why it is possible for somebody to say:

This graph confuses me....

My understanding was that Aspergers WAS a form of Autism in the High Functioning Autism area or zone. Is this incorrect??

Aspergers is at the high-functioning end of the Autistic Spectrum. But it is considered separate to Autistic Disorder. That may soon change, though, so we'll see.