New Study Says Autism and Aspergers Essentially the Same
Interesting new study in the upcoming issue of Journal of Autism and Developmental Disorders
which examines the historical emergence of the classification of autism
alongside the emergence of the classification of Aspergers. Abstract is:
The
histories of autism and Asperger’s Disorder (AD), based on original
contributions by Kanner and Asperger, are reviewed in relation to DSM-IV diagnostic criteria. Their original articles appear to have influenced the distinction between AD and autism made in the DSM-IV.
Based on up-to-date empirical research, however, it appears that AD and
autism are not qualitatively distinct disorders, but are different
quantitative manifestations of the same disorder. The differences
between AD and autism may be a function of individual variability in
these areas, not the manifestation of qualitatively distinct disorders.
The DSM-IV criteria for AD and autism need to be considered with their historical developments, and based on empirical evidence, the DSM-IV diagnostic criteria may be subject to critical review.
The
whole paper is a fascinating and accessible read but its overall
conclusion is difficult to resist. Despite certain peoples beliefs that
autism (by which I mean classic/severe/whatever) and aspergers (and the
artificial construct of HFA) are very different, there
is, in reality, very little difference between the two and, as the
author argues, are simply slightly differing manifestations of the same
‘thing’.
Sanders (the author) makes the excellent point that
the fact that these are seen as two different things is almost
certainly due to the fact that Aspergers paper was only introduced into
the USA in 1981, one year after the introduction of DSM III. It was further not fully translated into English until 1991. Amazing.
There is apparently talk of separating autism and aspergers in the new revision of the DSM. Based on the contents of this paper I’d say that is very premature.
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Mr Leitch does not define what he means by "the artificial construct of HFA".
HFA is not a separate diagnosis on the PDD or ASD spectrum of disorders. But it is a term that has been used extensively by researchers, including Dr. Laurent Mottron, to describe persons with an autism disorder who share the Aspergers social deficits but not the cognitive deficits and deficits of language comprehension and expression that challenge persons who are more severely affected by autism.
As a common sense, practical description distinguishing conditions which are markedly different in their real life impact there is nothing "artificial" about distinctions between Low Functioning Autism, LFA, and HFA, High Functioning Autism.
Merge HFA and Aspergers? Yes, because there are no substantial real world differences between these conditions.
Separate LFA and HFA/Aspergers? Absolutely. The lack of ability to comprehend the complexities of every day life and lack of ability to understand lanugage and to communicate are clearly important deficits of LFA that are not shared by HFA/Aspergers.
There is also "talk" of separating the various autism spectrum disorders by degrees of severity in the DSM V. Presumably severity will be measured by ability to function in the real world. Cognitiive deficits and lack of understanding of language are very substantial real world deficits and should be used to understand differences in severity of Autism Spectrum Disorders.
My 13 year old son has severe deficits cognitively and in terms of understanding language and ability to communicate. His autism spectrum disorder is much different than that of the persons with HFA/Aspergers that I have met and worked with. He requires 24 hour supervision for his safety and is not capable of appearing in media interviews, posting on the internet , conducting autism research or running an advocacy organization as some persons with HFA/Aspergers do very well.
A distinction in the DSM V between ASD's based on the functioning levels occasioned by cognitive and linguistic differences is not artificial. It is practical and makes good sense. Such a division is long overdue.
True, a distinction based on functioning levels, cognitive differences and linguistic differences is not artificial. It *is* practical and it *does* make sense.
What a spectrum with gradations does give the general public a framework to understand Autism in a more nuanced manner. It facilitates the process of meeting a wide variety of needs and telling all of our stories. I think we sometimes worry about one group getting more attention than our own. As if by one person telling their story there won't be room for our own.
That's just bullshit, plain and simple. Education and awareness are not limited commodities. The world needs to be educated on the realities of autism ...ALL AUTISM. Not just higher functioning individuals. Not just cognitively and linguistically disabled individuals. All of us--and we can build that future more effectively together than we ever could separately.
No one would argue that public awareness to all levels of autism on the spectrum would be a bad thing. If actual, full, egalitarian awareness in the public eye of autism in all its manifestations were possible, that'd be great. But it simply has not happened, and doesn't look to be happening soon.
The public sees HFA and Aspergers AS autism. A high functioning eccentric is the simplistic, non-nuanced way that the public world sees autism. The entire autism community has to come to see this reality, because it is indeed damaging to those who are on the much, much lower functioning side of the autistic spectrum like AutismRealityNB was talking about.
Its easy to see this in how all new treatments and research are oriented towards individuals who have high language and cognitive abilities. Some new books I've looked into expect children to reply to questions, and describe how they feel about some of these therapies. Any parent of a profoundly autistic child laughs at this idea; if their child ever said "Mommy" by age 26 they would be ecstatic.
That side of the autism world DESERVES more awareness simply because it has essentially gotten NONE so far.
As far as media exposure goes, I would argue that extremes get attention. In all of my research I have never heard of middle functioning autism . Only high functioning and low functioning. But more to the point, when we talk about who gets attention we are talking about people crying out for help.*Then* we are talking about money . We are talking about resources to get much-needed services.
I will not argue that lower functioning people and their families aren't often passed over for services and awareness--because they are.(Speaking of which, autistic adults also need services as we grow up--high or low functioning.That doesn't get reported on much either.Only children .)
I will not argue that lower function people and their families don't face significant challenges. What I will say is this: emphasizing high and low functioning perpetuates the paradigm of extremes. There are more than just two sides. High, low, and everywhere in between functioning would be able to meet their needs *much* more effectively if we worked together.
I had actually been told at a conference that the powers that be were actually going to do away with an aspergers diagnosis altogether because of the fact that aspergers perons want social contact. That the psychiatric community cannot get their heads around the fact that autism is not just what they decide it is. They are on the verge of hurting untold numbers of person's because of their lack of humility.
what autism is? I mean, in what sense are you talking about? Whether to class it as a mental illness, what symptoms to list, what to call it...