The Difference : Asperger's and High Functioning Autism

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neongrl
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26 Sep 2006, 9:14 am

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).



anbuend
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26 Sep 2006, 1:18 pm

Yeah, that's why researchers tend to use other criteria if they're going to distinguish AS and autism -- because in the DSM there's very few people who'd be diagnosed with AS and not autism as well.

It's not just language delay though -- they also use specific things like echolalia, pronoun reversal, and some other very specific linguistic weirdness, in determining where people fall in that stuff.


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neongrl
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27 Sep 2006, 10:08 am

anbuend wrote:
It's not just language delay though -- they also use specific things like echolalia, pronoun reversal, and some other very specific linguistic weirdness, in determining where people fall in that stuff.


Yeah, that would be part C in the language section - "stereotyped and repetitive use of language or idiosyncratic language", wouldn't it? In the study I saw, they found that almost all verbal aspies (dx'd AS) had either that one or they had B - "in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others". That's the one I have, definitely with social communication and even with other communication at times. Everyone had something from the language section, and the dsm for AS says that autism has to be ruled out first before AS can be considered. I wish I could find that study but I can't. Back when I read it I started a thread on one of these forums asking how many people have at least one of the language criteria (regardless of a delay) and judging from the many responses it appears that the study was right.

(Personally I do think there are other differences that seem to divide people on the spectrum into at least two groups, but the dsm doesn't even begin to address that stuff. It would all have to be rewritten. And maybe it's just a coincidence based on the people I've met and doesn't reflect the broader population?)



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27 Sep 2006, 12:36 pm

No the DSM is new and was written by people who had only the most vague of ideas of what AS is so as usual with most new diagnosis the criteria needs to be adjusted as they get more information (and we point out whats wrong with their "guesses").


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