A REAL difference between HFA and Asperger's

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GoldTails95
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02 Apr 2015, 2:42 pm

It is a common debate in the medical community. But however, there is scientific proof in reality based on MRI that HFA is different from Aspergers. In HFA, Many see them as different in the prime difference, early development: Aspergers don't not have speech or cognitive delays, in fact they develop them ahead of their peers according to Hans Asperger's 1944 report. There are also some other differences that might be quite obvious particullary in socioemotinal functioning. Though both score normal to above normal in traditional IQ tests, people with HFA typically have more severe immature sensory behavior than those with Aspergers Syndrome. Some professionals agree that as the teenage years fade off, so do the differences between Aspergers and HFA. In other words, as adults, some professionals say that if you put someone with Aspergers and someone with HFA in the same room, they would be almost no difference. But Hans Asperger disagreed and said that his condition and HFA are two different terms.
I've heard that many with HFA, who have histories and tendancies different from Aspergers often get misdiagnosed as Aspergers. That has happened to me, when I was 6 my nuerologist diagnosed me as Aspergers. Despite this, through extensive research on Hans Asperger's studies, I found out that I did not have Aspergers Syndrome. In fact, in my early history, I grew up just about like a nuerotypical until I was like 2 1/2 years old. At that point, I had a dramatic regression into autism losing speech and functioning. Because of this I actually fit the criteria for either Classic Autism or Childhood Disintegrative Disorder, even though I am right now high functioning. What I said in the last sentence along with the fact that I have imagination perception that is very strange but good comapred to even an Aspie, a strong knowledge in different subjects, a disorganized language where I even make up my own words, and severe immature sensory reactions/behaviors all make me different from someone with Asperger's Syndrome. What do you think is the difference between Aspergers and HFA?


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02 Apr 2015, 4:17 pm

I just talked about the same subject today in a different topic on here. It was in response to someone talking about how the United States is going to begin using the international ICD-10, which I wasn't familiar with. I'll post my reply below in quotation marks. I didn't know there was any debate between HFA and Asperger's; I just thought everyone considered them the same thing. The differences you describe fit me pretty well.

people with HFA typically have more severe immature sensory behavior than those with Aspergers Syndrome.

Does that mean like covering your ears and screaming in response to sensory overload? That type of immature sensory behavior? That's me.

Makes me wonder if HFA is a more appropriate diagnosis for me. But, as I said in my earlier post (below), it doesn't matter if it doesn't help me function now, today.

"I've been looking over the ICD-10 criteria for autism and Asperger's. It looks like there is no diagnostic criteria for diagnosing autism in adults. There is only childhood criteria; I guess they feel that if you make it to adulthood undiagnosed, you can be an Aspie but not an Autie? I dunno.

I'd have to double check with my mother, but it sounds like I, as a child, would have met the criteria for standard autism according to the ICD-10; the only difference I can see between that and Asperger's is that in Asperger's there is normal vocal development by the age of 3. Not for me, there wasn't. I'm vocal now, but I wasn't then. My parents told me I babbled on in what they called 'James language,' sounds without meaning to anyone but me. I did that until I was around 4, I think. Then once I started talking, I didn't shut up. I was well into grade school before I learned that conversations are supposed to be where both people talk.
I can see how I fell through the cracks, diagnosis-wise; we were poor and didn't visit the doctor much, I went to a very tiny private school for all of my education. Had I gone to public school, someone may have noticed my oddities (and I would have had a MUCH more difficult time). As it was, I only ever saw my family and people from my church.
But none of that matters; it only matters how a person is NOW and how well they are currently able to function.
Which all goes to illustrate, in my opinion, how Asperger's and autism should be grouped together under ASD.
But also, the ICD-10 was adopted by the WHO in 1990; I think they're about due for another edition, and hopefully, they will take the DSM-V into consideration with this one.

ICD-10 childhood autism diagnostic criteria
ICD-10 Asperger's diagnostic criteria

I know this isn't relevant, but I'm realizing how fantastic my tiny private school was for someone with ASD. I had only one teacher and one classroom; all school work was self-taught at the student's pace, and it was all written, not verbal (unless you needed the teacher's help); there were no reports or presentations that had to be given in front of the class; most of the day was spent working in silence, alone, in a little cubicle that cut off nearly all sensory input; there was a "six-inch rule" where touching was not allowed and everyone had to stay at least six inches away from each other (a rule I fastidiously enforced); there was a uniform that allowed me to wear the same thing every day (navy blue or black pants and white or light blue button-up shirt) but also allowed me to keep the collar open enough so it never touched my neck; noise was minimal; socialization was minimal, since there were so few students and there was never a situation where I was forced to interact with anyone; break times were ten minutes every hour, which was short enough that nothing had time to build up to the meltdown point; there was no gym class. I guess it was kinda awesome."


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02 Apr 2015, 6:19 pm

The problem isn't that no one can find a difference between AS and HFA. It's that no one can agree on what that difference is, so one person's idea of AS bears no resemblance to another person's. When someone lists multiple traits, as you just did, we run into another problem - most autistics identified as AS or HFA have a mix of so-called AS and so-called HFA traits.

Also, can you give a citation for Hans Asperger saying AS and HFA are different? Several cases in his 1944 article had language delays, and they're essentially no different from the upper end of Kanner's cases.



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02 Apr 2015, 9:26 pm

I do NOT fit Hans Asperger's criteria for early speech than typical. In fact, according to the end of Leo Kanner's 1943 paper, I would not even meet the criteria for his condition because what he said on the end. And what he said was "dementia infantilis", which is another name for Childhood Disintegrative Disorder, constitutes of at least 2 years of normal or near normal development before regression. I developed normally until the age of 2 1/2 and then had a regression into autism that was quite dramatic. So all because of that, I fit the criteria for Childhood Disintegrative Disorder, which is usually considered a low functioning type of autism even tough I am now a high functioning individual. Leo Kanner said all of his 11 patients had their condition from birth or were babies. Childhood Disintegrative Disorder is similar to classic autism so much, it has became part of the autism spectrum. Plus, I still fit the ICD10 criteria for dementia infantilis/CDD with the fact that tough it resembles dementia later in adult life, it is a severe psychosis into the patients very own autistic world instead of losing memory and intelligence like true dementia. This is the reason why it is considered a PDD and an autism spectrum disorder instead of a type of true dementia like Alziehmers. So being that CDD is considered an autism spectrum disorder, I would still be called HFA if the term is used to refer to anyone on the autism spectrum that is higher functioning. Also, based on my experience and knowledge since HFA is very similar to Aspergers in symptonalogy, it seems possible that all the disorders, Aspergers, PDD(NOS), Childhood Disintegrative Disorder, and Classic Autism are all wraped up into a single syndrome just like the DSM V criteria for ASD.
But that still does not convince me that all other froms of HFA are the same as Aspergers. For example, someone might have little to no speech even when grown up and yet have well adaptive behaviors and be aware of rules of the real world arounf him. Plus, in that prespective considering that I fit the criteria for CDD (Aspergers does NOT come from a regression) along with the fact I have better and more sophisticated visual spartial imagination than those with Aspergers, i would still not be considered an aspie.


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02 Apr 2015, 10:05 pm

I really don't see a difference between HFA, Asperger's, or Classic Autism. I see it how it's being treated currently, a wide spectrum. Up until the last thirty years or so the psychological community has had to rely on grouping symptoms together to form "clusters" to categorize various mental disorders. The problem with relying on symptoms alone to make diagnosis is fraught with errors, chief among them being that several disorders have overlapping symptoms and it's up to the psychologist to determine which disorder is being presented. This introduces human error on a case by case basis. With modern technology we have CT and MRI scans to actually see how the brain is operating, and all forms of autism have different brain circuitry compared to neurotypical brain circuitry. With that evidence I would conclude that it is all the same "disorder" (I hate that term), just different wiring schemes create different forms of autism. Under that philosophy autism merely describes different brain wiring, each sub category (classic, HFA, Asperger's, PDD-NOS, etc) could be used to describe the various non-typical wiring schemes the human brain facilitates. Therefore, I don't think there is a true underlying difference, only the SYMPTOMS appear differently.



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03 Apr 2015, 3:00 am

From what I understand, aspies do not have a speech or language delay. They reach their milestones, they do not lack curiosity in childhood environment. They are normal except in social skills and the autistic criteria mentions how there is lack of imagination and pretend play and spoken language and back and forth conversations but in AS criteria, that is absent so that meant an aspie isn't supposed to have any of these difficulties. From what I had been taught as a kid, autism and AS are two different things, it's like having a cold but you don't have the flu. That is the analogy my mom uses for AS and autism and how they are different. But as early as the year 2000 I was seeing aspies calling themselves autistic and it would always confuse me because AS is a form of autism so how could they be autistic and have AS if autistic is worse than AS, more severe.

I think lot of doctors don't really follow the DSM IV criteria which is why they got rid of AS and made it all level 1 level 2 and level 3.


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03 Apr 2015, 4:14 am

Hmm. Don't most people with hfa have good visuo-spatial skills than aspies? I know an aspie in rl and he gets lost easily and isn't so good at drawing things to scale buy I've been diagnosed with hfa and i can draw to scale.

That might seem odd but is that a difference? Also I had a speech delay as a child so that's why I have the diagnosis I have.


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03 Apr 2015, 4:41 am

Hey guys. I just found this:

'Relative to HFA, people with AS have deficits in nonverbal skills such as visual-spatial problem solving and visual-motor coordination. People with HFA have language delays in childhood while people with AS have stronger verbal abilities, but both groups are likely to be of average or above average intelligence.'

From the website:
http://www.icare4autism.org/news/2012/0 ... -syndrome/
I think this might be true. :)


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03 Apr 2015, 5:53 am

Hmm, since there is so much debate between professionals on this subject, I tend to agree with Aristophanes (not for the first time) that separation made by symptomology is fruitless. How many times have we read or said ourselves that ASD presents with any combination of a rather large set of symptoms, which is partly why it is so difficult to diagnose unless the professional has specific specialized training in the area.

It would be wonderful if a physical test such as CT scans or MRIs could definitively lead a diagnosis of one type or another, and it is good that autism et al. can be seen physically.

Without having done enough research to earn a PHD on the subject, it appears to me that, as of right now, there isn't enough concrete evidence of reliable, across-the-board symptomatic differences to warrant making a distinction between Asperger's and HFA or any other ASD in which the individual is able to function with a certain amount of relative independence (such that would classify them as 'high functioning'). This becomes especially true as a person reaches adulthood; the specifics of diagnosis, once under the umbrella of ASD, become less relevant unless they are needed for assistance or help. All that matters is helping the person to have what they need to operate successfully in life.

If the distinction between Asperger's and HFA means the difference between getting assistance or being denied it, I would tend to agree that the term 'Asperger's' should be thrown out and all forms of HFA grouped together into ASD, similarly to the way the DSM-V did it, so that anyone with an autism spectrum disorder who needs help can get it. I understand that there are some bureaucratic offices that makes this distinction; if you are autistic at a high-functioning level, we will give you help, but if you 'just have Asperger's,' then you don't need our help. That isn't right; many people who mostly function well still need help of some kind, and they should be able to get it.


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03 Apr 2015, 6:07 am

Not that it matters, but since we're discussing symptoms, I find it interesting that I had the verbal delays that are indicative of HFA but I also have spatial deficiency that is indicative of Asperger's.

I still have verbal difficulties that are much less strong when I write; as is common, I think of things in concepts without having a name for them and I often forget what things are supposed to be called. It's like English is a second language to me, only I never had a first. English is all I can speak; I tried learning Spanish and was a miserable failure with it. When I'm talking, I often say a word that is similar, but quite right, to the thing I want to say. Like, if I'm referring to a gallon of milk, I should call the container a 'jug,' but I might call it a 'cup' or a 'bottle' or a 'jar.'

As for spatial deficiency, I have a hard time knowing how close or far away something is, or estimating volumes of things.


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03 Apr 2015, 8:11 am

But Classic Autism, exculding High Functioning cases, are indeed different from Aspergers. Futhermore there can be HFA people who still have little to no speech and yet still have very good adaptive behavior. So comparing Classic Autism to Aspergers is for real comparing a flu to a cold. Also, in 1971, Hans Asperger, after reading Leo Kanner's 1943 paper, said that there is indeed a difference between his syndrome and autism(Classic Autism and HFA). So HFA is not all exactly the same as Aspergers. Every person with HFA is different. Just about all who would have HFA would, early in life, have a speech/cognitive/self help delay and even a minority like me, would develop normally or near nomally from birth until they regress (lose functioning and skills) at any point between the ages of like 15 months and 3 years. Meanwhile, Aspies according to In Hans Asperger speak before they walk and gain large vocabulary in little time along with intellectual obsessions.
As for MRI and EEG, in HFA, there is unusal functioning in the left lobe and discombloberated, while in Aspergers there is disfunction on the right side but there is more order and a longer focus. This clearly explains how different the behavior and presentation, particullary in terms of cognition. People with HFA have lower verbal abilities and higher visual presepctive imagination. This means their IQ is scored lower on traditional tests, tough it is still normal to above normal. Their nonverbal IQ is much higher than even Aspergers. A pattern in traditional and vebal IQ, similar to HFA, has also been reported (in much lower scores in both scales) in Classic Autism, Angelman Syndrome, Rett Syndrome,and some cases of CP. In Aspergers it is the opposite (lower visual nonverbal IQ but much higher traditional vocabulary IQ) and that has also been reported in William's Syndrome (same pattern but with much lower scores on both scales).
Also, do note that even tough many with HFA look like fully verbal, they are actually not fully verbal and instead partially verbal and disorganized in their vocabulary.This is because repeating like a parrot masks their actual disorganized verbal capabilities in HFA. From my own expereince, i have a string history of repeating words ike a parrot. My vocabulary is also very disorganized. And I might have learned social skills like an NT, BUT I struggle on what to say and sometimes stumble and correct my sentences in the middle of speaking. Also, that teamed with my visual imagination which is as wierd as is strong also makes me make up vocabulary that is strange even to someone with Aspergers, like "Sweedoulhaore" and "Scouwelonderstroublronobourneone" for example. How does this word sound Aspies?
In Aspergers, yeah they still struggle with social skills and communicating the proper way with others. But their vocabulary is strong and very organized. And super sophisticated too so they speak like Mr. Spock all the time.


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03 Apr 2015, 10:11 am

GoldTails95 wrote:
But Classic Autism, exculding High Functioning cases, are indeed different from Aspergers. Futhermore there can be HFA people who still have little to no speech and yet still have very good adaptive behavior. So comparing Classic Autism to Aspergers is for real comparing a flu to a cold. Also, in 1971, Hans Asperger, after reading Leo Kanner's 1943 paper, said that there is indeed a difference between his syndrome and autism(Classic Autism and HFA). So HFA is not all exactly the same as Aspergers. Every person with HFA is different. Just about all who would have HFA would, early in life, have a speech/cognitive/self help delay and even a minority like me, would develop normally or near nomally from birth until they regress (lose functioning and skills) at any point between the ages of like 15 months and 3 years. Meanwhile, Aspies according to In Hans Asperger speak before they walk and gain large vocabulary in little time along with intellectual obsessions.
As for MRI and EEG, in HFA, there is unusal functioning in the left lobe and discombloberated, while in Aspergers there is disfunction on the right side but there is more order and a longer focus. This clearly explains how different the behavior and presentation, particullary in terms of cognition. People with HFA have lower verbal abilities and higher visual presepctive imagination. This means their IQ is scored lower on traditional tests, tough it is still normal to above normal. Their nonverbal IQ is much higher than even Aspergers. A pattern in traditional and vebal IQ, similar to HFA, has also been reported (in much lower scores in both scales) in Classic Autism, Angelman Syndrome, Rett Syndrome,and some cases of CP. In Aspergers it is the opposite (lower visual nonverbal IQ but much higher traditional vocabulary IQ) and that has also been reported in William's Syndrome (same pattern but with much lower scores on both scales).
Also, do note that even tough many with HFA look like fully verbal, they are actually not fully verbal and instead partially verbal and disorganized in their vocabulary.This is because repeating like a parrot masks their actual disorganized verbal capabilities in HFA. From my own expereince, i have a string history of repeating words ike a parrot. My vocabulary is also very disorganized. And I might have learned social skills like an NT, BUT I struggle on what to say and sometimes stumble and correct my sentences in the middle of speaking. Also, that teamed with my visual imagination which is as wierd as is strong also makes me make up vocabulary that is strange even to someone with Aspergers, like "Sweedoulhaore" and "Scouwelonderstroublronobourneone" for example. How does this word sound Aspies?
In Aspergers, yeah they still struggle with social skills and communicating the proper way with others. But their vocabulary is strong and very organized. And super sophisticated too so they speak like Mr. Spock all the time.


Don't get too hung up on the words. Yes, there may be different wiring schemes among HFA, Classic, Aspergers, PDD-NOS, etc.

Autism, in it's current understanding, is just a word used to describe someone that doesn't have typical brain wiring-- hence the reason at it's core we are the same: we do not share the same brain wiring as ~98% of the rest of the population. Currently that's all autism really means. Each subcategory may be different in that different wiring, but there are overlaps in that wiring, sometimes minor, sometimes major.

Think of it like a tree-- at the trunk we're all human, then the trunk splits into two big main branches, one is NT the other is autism. Go further up the autism branch and it splits again and now we have multiple branches coming off, say one for HFA, one for Classic, etc. That branch also splits and you can see multiple different branches that represent say classical autism in different forms: those with extreme sensory issues, those with extreme motor coordination deficits, those that exhibit multiple or all symptoms. At the end of the branch is a leaf-- that's you, the individual with all of your unique brain wiring. Since you, the leaf, is connected to all those branches your individual make up can show signs of any branch your leaf is connected to. Will they be exactly like another branch? No, we're all individuals, just as every leaf on a tree is different, but that doesn't mean there's no overlap (shared symptoms), because we're all connected to the same main branch: autism.

This is the reason it's so hard to diagnose a sub-category of Autism, there are lots of overlap and some features that aren't shared at all. I'm like you, I have very good visual-spatial abilities, I sometimes think in objects not words. This used to be considered HFA, not Asperger's, yet I had no delay as a child and I also have a strong sense of words as well, a sign of Asperger's. My mind varies between how it thinks between highly visual and highly verbal- a function of both forms. So if we have strict categories that demand all aspects fit to be considered part of that category, I wouldn't fit into either-- I'd be an NT, even with my meltdowns, auditory/visual sensory overloads, low social functioning, etc. This is why I accept the current "spectrum" concept-- I am stuck between two forms. Also it should be noted there are examples of autistics that straddle the border between classic and high functioning, what of those autistics? If we start over categorizing things, we cut out those that are in between as if they don't even exist.



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03 Apr 2015, 10:21 am

I don't think there really is one, Aspergers is not a seperate disorder from Autism...The idea of it being a spectrum makes the most sense.


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03 Apr 2015, 10:26 am

League_Girl wrote:
From what I understand, aspies do not have a speech or language delay. They reach their milestones, they do not lack curiosity in childhood environment. They are normal except in social skills and the autistic criteria mentions how there is lack of imagination and pretend play and spoken language and back and forth conversations but in AS criteria, that is absent so that meant an aspie isn't supposed to have any of these difficulties. From what I had been taught as a kid, autism and AS are two different things, it's like having a cold but you don't have the flu. That is the analogy my mom uses for AS and autism and how they are different. But as early as the year 2000 I was seeing aspies calling themselves autistic and it would always confuse me because AS is a form of autism so how could they be autistic and have AS if autistic is worse than AS, more severe.

I think lot of doctors don't really follow the DSM IV criteria which is why they got rid of AS and made it all level 1 level 2 and level 3.


AS is a form of Autism, meaning if you have AS you have autism....the misconception that autism is worse than aspergers is probably more likely part of the reason Aspergers was merged with Autism in the DSM and now its just a spectrum with different levels of severity....Your mom is misinformed sorry to say.


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03 Apr 2015, 10:30 am

starfox wrote:
Hmm. Don't most people with hfa have good visuo-spatial skills than aspies? I know an aspie in rl and he gets lost easily and isn't so good at drawing things to scale buy I've been diagnosed with hfa and i can draw to scale.

That might seem odd but is that a difference? Also I had a speech delay as a child so that's why I have the diagnosis I have.


I am diagnosed specifically as Aspergers, did that right before they dropped the term....and I don't really get lost easily, though it is a little hard to draw to scale, not impossible though but enough hassle if i am drawing I usually don't bother but I know how to if I want.

I had not speech delay as a child, and in fact was reading by the age of 5.


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03 Apr 2015, 10:48 am

Aristophanes wrote:
I really don't see a difference between HFA, Asperger's, or Classic Autism. I see it how it's being treated currently, a wide spectrum. Up until the last thirty years or so the psychological community has had to rely on grouping symptoms together to form "clusters" to categorize various mental disorders. The problem with relying on symptoms alone to make diagnosis is fraught with errors, chief among them being that several disorders have overlapping symptoms and it's up to the psychologist to determine which disorder is being presented. This introduces human error on a case by case basis. With modern technology we have CT and MRI scans to actually see how the brain is operating, and all forms of autism have different brain circuitry compared to neurotypical brain circuitry. With that evidence I would conclude that it is all the same "disorder" (I hate that term), just different wiring schemes create different forms of autism. Under that philosophy autism merely describes different brain wiring, each sub category (classic, HFA, Asperger's, PDD-NOS, etc) could be used to describe the various non-typical wiring schemes the human brain facilitates. Therefore, I don't think there is a true underlying difference, only the SYMPTOMS appear differently.



First off, show me some evidence that classic autism, HFA, and Asperger syndrome are indistinguishable from the standpoint of diagnostic neuroimaging. CAT scans do not show brain activity, they only show tissue density. It is
functional MRI and PET scanning that can show brain activity through blood flow. PET scans are particularly useful because it can use radiolabeled neurotransmitters and drugs and allow the observation of where there neurotransmitters are being uptaken.



Are you KIDDING me?

There are puh-lent-y of differences between Autism and Asperger Syndrome. People with classic Autism are truly solitary creatures: They really have no desire to interact or even live with other humans which is why classically autistic children often wander off. Language is very much a form of interaction and classic autists are non-verbal despite having the ability to speak and understand spoken words because talking to people is a form of social interaction which they have zero interest in. Classic autism is a highly specialized intelligence: A brain that is wired to one task and do it extremely well but cannot manage to do anything else.

Aspies on the other hand, often want to interact with and connect to other people, they're just very bad at it because our brains aren't capable of picking up on social information that isn't conveyed verbally. Some of us are savants but many are not even though there are things we're good at.

I strongly believe that Autism and Asperger Syndrome should be clinically distinguished because autists and aspies have very different needs and abilities.