November 8, 2006 by Kristina Chew, PhD
Filed under Health
Is it autism? Asperger’s? How to tell the difference is the title of a short article in today’s RecordOnline.com (Times Herald-Record). I understand autism and Asperger’s, and PDD-NOS, as all part of the autism spectrum.
What do you think?
[...] Grinker’s sixth chapter, “Autism by the Book,” further notes “how murky the diagnostic waters of autism have become” (p. 141)—-and this seems to be the case for more than a few child psychiatric disorders as well as for autism. A recent discussion on Autism Vox about whether autism and Asperger’s are the same or different is further testament to those “murky diagnostic waters.” [...]
 | Click here to subscribe to Blisstree, or enter your email address and we'll send updates straight to your inbox. |
I think that they are two disorders that have some strong similarities but also some significant differences as well.
The only difference I really know about is that with Asperger’s there isn’t a delay with speech, whereas with Autism there is. I’m probably completely wrong, and there is probably more to it than that, but as a kid that was the only difference I noticed.
I firmly believe that Aspergers is on the autism spectrum & is just one way of looking at the many ways that autism can manifest. I refer to my son as both autistic & as having Aspergers, interchangeably (& so does he). My understanding is that the similarities among the spectrum disorders are greater than the differences, & I am also dismayed by the “ghettoisation” of those deemed “lower-functioning” as autistics, while the “higher-functioning” people get the Aspergers designation. I prefer to show solidarity with all autistics by recognising my son as autistic, rather than continue to promote artificial divisions between people by exclusively identifying him as having AS.
Well it is possible to have both AS and autism (so long as you disregard the criteria of AS that states that you can’t be speech delayed), but it would be going too far to say that all people with AS have autism because many of them simply do not meet the developmental criterion that is required for a diagnosis of autism (and quite a few professionals would agree with me there). You are entitled to your opinion, but this is what I firmly believe.
I totally agree with Lisa/Jedi. Asperger’s is often glossed as “high functioning” but I don’t know anyone who really knows what high and low functioning mean. I know two men in their 40s with autism. One has a diagnosis of Asperger’s and cannot work. He has too much trouble socially, but is highly intelligent and very verbal. I know another person with autism who is definitely not Asperger’s — more “classic” autism — and has mild MR, but he holds a job — and has had the job now for several years (at Home Depot). So which one would be “high functioning” and which one would be “low?” It all depends what your criteria are, I guess, and that makes high and low pretty meaningless terms.
More and more, I have been realizing that I have known more than a few persons who might now (if they were children) have received an AS diagnosis. These individuals had no speech delays of the sort that my son Charlie does and yet they did have certain struggles with speech. I have noted this in their writing and in their repeated use of certain phrases, sentences, and whole paragraphs that recall to me my son’s way of plugging certain words (or sounds, or parts of words, or tones of his voice) into many situations, whether or not the context requires it.
And yes, holding down a job has not been easy for some of these (not necessarily diagnosed) AS persons.
It’s all different flavors of autism, as I understand it. Changing it all to “autistic spectrum D(wordofchoice)” would make the most sense for the DSM V, because breaking it way down only makes sense as a prognostic indicator, and even THEN is only accurrate-ish for classical Rett and for CDD (which some “regressive autism” may be, but thats a whole other bag of worms).
So just calling it all autism unless a further distinction is required to make sense to someone whod knows what is being talked about just makes SENSE.
I personally feel that people believe in the Spectrum Theory because they want to think that autism is simpler than it actually is.
Or, the notion of the spectrum suggests that autism is more complicated, more varied, than it might seem.
Autism is way too complicated to pin down with “autism” “aspergers” “pddnos” “cdd” and “rett”.
Using those labels divides a whole lot of people who have more in common INTERNALLY, but EXTERNALLY look very different. When you get a bag of gummy bears or whatever, they come in a whole zillions of colors, but theyre all gummy bears.
And unless you want to call a WHOLE LOT of people NOS, or make a WHOLE LOT of new categories-something that I dont think the scientific world is up to, and that defeats the purpose of the NOS designation, nonrespectively, using ‘autism’ for the big tent of ASD is, well….
I’m looking for a metaphor and all I see is the exhibit hall at a conference and it’s sorta working and sorta not. Metaphors aren’t my strongest.
But I don’t think autism is simple. If it was, people wouldnt somehow have 3 or more of the PDD labels assigned to them at different points in their lives, would they?
Now we don’t have any evidence to suggest that all people with autism and AS (and other disorders) are interconnected somehow; it is still very much just a popular theory. To say that autism and AS is “all the same” when there are very little facts to support such a claim just comes off as fishy pseudoscience, to me. And I know that I’m not alone in feeling that way.
I’m not trying to be mean; I’m not trying to be cruel. I’m just letting anyone who reads this article know that opinions of the “autistic” online population are not unanimous in regards to the theories which concern the true nature of autism.
Someone, who are others with your view?
Someone: I get the impression that the spectrum concept is useful inasmuch as it allows people to identify individuals who might share certain characteristics, thereby allowing more appropriate forms of education and addressing of issues. I understand your concern that it might end up becoming some media-hyped overdiagnosis thing, but I think if that was going to happen, it would have already happened. There seemed to be a surge of media attention after Wired published that “AQ” article, but that surge seems to be leveling off now, and only the people for whom the subject actually matters are sticking around to keep discussing and exploring it.
Though autistic people have likely existed for as long as humans have existed, the identification of people by the term “autistic” is relatively recent. Hence, different people and groups seem to be vying for “ownership” of the term (something that bothers me somewhat), and I doubt this is something that’s going to be resolved anytime soon.
I also don’t think that the “true nature of autism” is anything so simple as to be easily described in a single page or paragraph. Brains are too complicated for that.
Go sit in a room with 20+ adults diagnosed AS, HFA, PDDNOS, if you can find some CDD and speech preserved Rett put them in there too. All at roughly the same language level. Have them all communicate in the same or similar ways, so as to not make things obvious (hence speech preserved variant and not just any old girl with Rett).
Then figure out who’s who.
It’s no 2D spectrum, but even the “highest functioning” Aspegerian Aspie Supremicist has way more in common with the kid who may never master more than 50 words or showering unsupervised than they may want to admit.
It’s funny, I never hear people labeled as autistic try to dissociate themselves from the rest of the spectrum but I have heard many aspies do it, and I was informed by one guy dx’d PDDNOS (and who got very upset if referred to as autistic, he had PDD, you see) that stimming and sensory issues are for “bottom of the barrel” autistics.
Guess that’s where all the good deep pressure is…
“I understand your concern that it might end up becoming some media-hyped overdiagnosis thing, but I think if that was going to happen, it would have already happened.”
Uh, I’m sorry to say this, but it already has. And I also wasn’t trying to describe the true nature of autism in a paragraph; sorry if it came across that way.
Also Dr. Chew to answer your question I have met online other autistic people who have felt alienated by others on the “spectrum” and (perhaps as a direct result) do not have great faith in the theory. I would name them, but that would be kind of rude and inappropriate to do because having anti-spectrum thoughts and believes are extremely unpopular amongst the autistic (both real and not) population, and thus I wouldn’t want to single them out. Also I’ve heard a rumour that Dr. Lorna Wing herself (the person who I think came up with the theory) no longer supports it, but I have yet to verify that. So yeah, that’s it for now.
Thanks for the clarifications—is there a particular article or book of Dr. Wing’s that you are referring to?
No. Again, it’s only a rumour; who knows if it is true or not. I’d ask her herself, but I don’t have her contact information.
Well Someone I’d like to know who you are.
I have written and made a DVD which deals with this question and for what it is worth I have communicated with Lorna Wing about these issues. At the time of my making the DVD she concurred with my opinions, having given her an early draft of the script.