The Difference : Asperger's and High Functioning Autism

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I was just wondering if anyone could clarify the essential difference between an adult with High Functioning Autism and an adult with Asperger's.
I read on a forum somewhere (I think a posting by Donna Wiliams) that an adult with Asperger's has more verbal and physical stiltedness with a tendency for mathematical/scientific talents where as an adult with autism has better social communication skills but severe sensory problems, they are apparently more gifted artistically than with computers and stuff. Not sure any viewpoints are most welcome!

I don't know that there's any official answer to that question; there are about six different definitions for them both; some people think they're the same thing; others think they're completely different.

IMO the difference between Asperger's and autism is that Asperger's does not involve a language delay. An Aspie child will often speak early and with good grammar and large vocabulary and may learn to read very young (hyperlexia), though tone of voice, figures of speech and other subtleties will lag behind his peers. S/he is likely to use precocious speech to talk about special interests rather than communicate emotion, desire, etc.; reciprocity in conversation and other bits of polite social convention will probably need to be consciously learned.

A child with autism will have a language delay; he may not speak until about age four or so, or may speak only to repeat things he has heard. Sometimes an autistic child learns to read and write before s/he learns to speak; writing is often a preferred method of communication (as it is with Aspies, who are often overloaded trying to process all the nonverbal communication). Communicative speech, when it appears, is often cobbled together from stock phrases; and as the cihld grows into an adult, the phrases become more flexible and varied.

When it comes to strengths, autism tends towards the visual, and Asperger's towards the logical... an autistic person can often clearly see an image in his/her mind, while an Aspie can mentally plan out a logical sequence (programming, problem solving, mathematics, etc.). However, autistic people are often good with numbers, able to visualize them easily; and I bet there are quite a few Aspie artists out there... not to mention that there are things like flowcharts, Venn diagrams, and graphs that are visual representations of logical ideas.

The sensory processing might be different; Auties could be completely confused by some bit of input (and withdraw), while Aspies will be anoyed and overstimulated (and have a meltdown)... but that's the other way round a good part of the time, so I don't know whether it's a good indicator.

There's not all that much difference in skills and sensory processing, really; it's mostly in the use of language, I think.

--HFA might be a diagnosis given to someone who used to be low-functioning, but has overcome a lot of the barriers between him and the world--communication, sensory processing, etc.
--Possibly, a psychiatrist/psychologist/whatever will see "high functioning autism" as more severe than "Asperger Syndrome" though, once the child has overcome the speech problems, they can look identical...
--Some people with HFA (who had speech delays) are "upgraded" to a diagnosis of Asperger Syndrome as they get older; others are told they are HFA despite functioning the same as an Aspie because of their history.

Nearly every time I hear this sort of thing, it ends up being, people (including Donna Williams) start differentiating between stereotypes based on particular people they have known, or based on bits of logic that don't really make a lot of sense, and you end up with twenty definitions that all contradict each other.

I haven't seen -- personally -- a consistent difference between AS and autism without huge amounts of counterexamples to it. I have seen various different sorts of autistic people, but the differences I find important are not necessarily going to be the differences someone else finds important, and I'm not going to privilege my preferred important-differences over others the way some people do.

The only person I know who's arrived at their separate definitions through science rather than through some combination of knowing people and stereotyping them or making up their own definitions, says that, first off, the question of "difference between AS and HFA" is a false one, because there's not serious evidence in cognitive science for an HFA/LFA distinction within autism (and if you combined AS/HFA under that idea, then LFA would be some totally different category unto itself -- she says there's no evidence for that, either). She says that there is, however, evidence for a difference between AS and autism, and it has to do with where their peaks of ability are in different testable areas.

The idea that "autistic people withdraw, AS people melt down," doesn't even make any sense to me based on sheer personal experience. Has nobody seen a non-speaking autie have a meltdown before? I've sure seen it, easily dozens of times. That's the kind of thing that happens when people start extrapolating from small numbers of people, or else imagining things based on assumptions about how people work (like possibly that AS people are going to be more extraverted and auties will be more introverted, which also isn't true but is frequently trotted around as a difference -- as, by the way, is its exact polar opposite, which is why I don't do this sort of thing).

Here's a more recent thread on the topic.

My answers are in there.

Yeah what if a person had ADHD and OCD that could look very much like ASD. My
thoughts are it is beyond pointless to worry about some precise DX. Its like they just
said in the news Pluto is no longer a planet. Well its still a planet as far as Im concern.

You treat your issues in mental health not a condtion. If you have social skills problems
you build skills. If you have social fear you can try a combo of meds and exposure therpy.

If you can not stay focus take stimulants.

Etc

While it can be comforting to stick labels on things - there are times when things are not so black and white. I know this can be frustrating to an Aspie, but in these areas there is a whole raft of conditions which seem to overlap. Sometimes it seems to depend on which so called expert you are listening to as to what label you end up with.
The point made about delayed speech development is, I think, a key issue. I have 5 children with a wide age span. For myself(age 58) and my oldest son(age 30) Aspergers is the correct diagnosis. We both were early talkers with vocabulary and grammar well ahead of our age norms. We have both had success academically - in science subjects - both have achieved university degrees and PhD's. For my youngest two sons(age 4 and nearly 3) they have both been diagnosed with severe Autistic Specrum disorder. Neither are yet talking, although my 4 year old, with a lot of input, is beginning to use one or two words. It is early days to say how far the two little ones will develop in terms of their level of functioning, but for now the most important thing is that they are very happy children.

Well, that makes me a little less confused. Since I'm middle aged and have no formal diagnosis except for LDs and most of the comorbids of AS and some of the ones for HFA, I have to go on what I read. I'm hoping it will be easier for the younger ones like my daughter and granddaughter, since now there seems to be some help available.
I go back and forth sometimes wondering if I have AS or Autism, but I don't feel like fighting for a diagnosis at my age with no insurance to pay for it. It's been too much of a battle just getting this far, and now I just want to help my younger family members who take after me.

Ive always thought of the three different labels as simply indicating what area of the spectrum the person is on.. take normal on one end of a scale, completely non-functional on the other and divide it into three even portions with starting at NT you go through AS then HFA then LFA where the lines between them are drawn is fuzzy though and ultimately pretty irrelevant.

Generally I think the differentiation is if you can hold a job where you have to interact with people you have AS if you can communicate verbally fairly well but shouldnt live alone without assistance of some kind thats HFA if you can barely communicate verbally at all its LFA.

But as others have pointed out theres a thousand different definitions and criteria for each depending on who you ask I just feel this is the most reliable of the classification schemes.

I don't know if one can actually clarify a difference. It depends I guess. For example you could take one aspie and a person with HFA and there be a significant difference between the two people. On the other hand you could do the same again, but only this time there appears to be no significant difference at all, all part and parcel of being on a spectrum I guess.....

Lots of replies - each with own valid pointers. An easier but more crude way of distinguishing is the theory that aspies high verbal/low performance IQ & HFAs the reverese.

I read recently there is a British definition of Asperger Syndrome (the model I think they adopt in my country Australia and other English speaking countries like the US) which does not exclude slow to very slow childhood language development, would that be right? This would imply the line between HFA and AS in the UK, US and Aus would be much fuzzier than in Europe.

I've been wondering about this too because I had no language delay, have excellent grammar and use of words when writing or feeling very well, but I also tend to mix up words, grammar and pronouns as often. Usually I use sentences that don't differ from teenie-speech at all. From expierence in school I seem to be almost unable to explain more complex things to others. At home I seldomly speak and use correct sentences or complex sentences. I prefer writing way more to speaking, because even when I'm unable to to speak, I can always write the words.

That much for the "speech/communication" criteria thing. It's so confusing! I'm not yet diagnosed though, the appointment is tomorrow morning. I suppose I'll tell if the the doctor says anything about this.

HFA/LFA are traditionally divided by IQ, but since IQ has been called into question in several ways anyway, and in autistic people has even among people who believe in IQ tests been called into question (several "low functioning" people suddenly outperformed the vast majority of non-autistic people when an IQ test unbiased by language was given to them, and many others rose about 30 percentile points -- not IQ points, but percentile points, which would mean any of them with an IQ anywhere under 70, the cutoff point for LFA/HFA, would suddenly have one of at least 90).

Plus, there's no evidence for particular difference in the kind of cognitive functioning between so-called LFA and HFA, or even the degree in the areas that autistic people are strong at, it's a matter of which areas of expertise are focused on and whether they happen to correspond to areas valued by certain people.

From what I've seen, how a person divides LFA and HFA tells you more about what the person values than about the people so labeled. For instance, I have seen people divide it around presence or absence of expressive spoken language, presence or absence of expressive spoken or written language, presence or absence of various kinds of receptive language (which the person assumes they know about other people, usually), IQ score, overall appearance (level of eye contact, standard vs. autistic body language, etc), level of violence and/or self-injury, level of cooperativeness with professionals (whether voluntary or involuntary), and ability to carry out various tasks of daily living.

Then some people grade it on whether a person actually is able to apply various stuff or not. Last year I got a score of 46 (where lowest score is 40, highest is 130) on a test (rated by someone else) of 'adaptive functioning' in various areas, and so was rated as 'low-functioning'. Of course, they did not bother testing anything I'm good at. (Nor did the people who declared me 'low-functioning' ten years ago, but they were relying more on some of the other qualities I described.)

At any rate, when getting into cognitive science at least there may be evidence for an autism/AS split (in which AS is not considered "mild" by the way) but is not necessarily evidence for an HFA/LFA split.

I've had a difficult time trying to figure out if I had any speech delays or not. My mom was a 17 year old west Texas farm girl when I was born and rather unsophisticated and somewhat uneducated as you can imagine. Her memories (now 51 years old) of that time are quite fuzzy.

I've been told that I had read every book in the house before I started school. My dad was the big reader at first and he had Zane Grey and Louie L'Amour westerns and when he wanted some serious reading it was Sir Arthur Connan Doyle. So shoot 'em ups and Sherlock is all I had read. I doubt that helped me much in school.

It may be impossible for a psych to ever determine for certain if we need to know about speech delays, but if hyperlexia is a telling component I had that by the load. Most of my problems are sensory dysfunctions and confusions, like too much smell, no taste, and no clear line between sights and sounds. Tactile sense that comes and goes is most disturbing of all and any help in that region is where I would want to focus.

If I go looking for specific labels I would want those issues to take the forefront, since I have learned to socialize all I ever want to and the depression I experienced in youth is mostly gone after stopping alcohol and learning about autism in general.

Do us older people really need specific diagnoses to be happy?

According to the DSM for autism, there doesn't necessarily have to be a language delay. Section B says "B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play." (And even that says 'social' communication, not general communication.)
To get a dx of HFA/LFA instead of AS you do have to meet one of the communication criteria in section A 2 but there's a few possibilities -
"(2) qualitative impairments in communication as manifested by at least one of the following:
(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
(c) stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level"

All the other criteria between autism and AS are the same, the stuff I just posted is the only difference. I saw a study one time where they said that almost all people on the spectrum have at least one of the language criteria even if there's no actual language delay, so they were questioning whether AS even exists because autism has to be ruled out first before an AS dx can be given (if you go by the dsm literally the way it's written).