Asperger's Syndrome: Myth or Reality?

[RedScout]

You can't fully dismiss Happeh's point of view, Autistic/people with Aspergers Syndrome are usually some of the most honest people you can meet. As for the cause for the responses in social situations I think it will be a while before we know for sure. We don't have a concrete classification of Autism and Aspergers because we simply don't know enough about it yet.

 

[zoobyshoe]

You can't fully dismiss Happeh's point of view,

What you mean is that now, since you are all knowing, you will disregard anything that does not fit into your world view.
I would like to offer some advice to people here. It is common for educated people to become blinded by arrogance. They feel if someone does not speak as they do, the person cannot possibly have anything of importance to say. They feel that if the person says something that they have not heard of, the person is a waste of time.
These arrogant individuals commonly express their arrogance by rudely pretending people do not exist and completely ignoring them
Educated people are of the mind that things must have an extremely complex explanation that only someone qualified such as themselves can understand. If the explanation is simple, they refuse to accept it. Anyone can understand simple. How will their ego deal with that situation?

You really want to side with Happeh on anything? His argument isn't pro-honesty, it's anti-education. He resents educated people and believes education fosters arrogance.

Autistic/people with Aspergers Syndrome are usually some of the most honest people you can meet.

Honesty is an excellent quality. The problem is that in Asperger's it isn't moderated by a sense of people's feelings. As I mentioned earlier in this thread, Asperger's people get themselves into trouble all the time by doing things like going up to strangers and saying things like: "I see you're fat. What's it like to be fat?" The diagnosis usually follows a period of being picked on by their classmates at school for posing questions like this. Without meaning to, or understanding why, they socially ostracize themselves. Happeh's notion that they could tell social white lies if they wanted to but choose to be rigorously honest is a complete misunderstanding of what's going on.

 

[RedScout]

I was agreeing with the side of Happeh's argument that people who have Asperger's syndrome, tend not to lie, and usually say what they think. Also, that people who believe they have education sometimes put themselves above the intelligence of other people. Personally I don't believe they are telling white lies either, because they don't have the ability to intrepret other people's feelings from they're point of view.

 

[zoobyshoe]

I was agreeing with the side of Happeh's argument that people who have Asperger's syndrome, tend not to lie, and usually say what they think.

Happeh doesn't believe there is such a thing as Asperger's Syndrome. He thinks it's a way of knocking honest people:

If you read Zooby shoes list of 10 things commonly associated with Aspergers, you see a very obvious thing. If you are able to see the obvious. If you are arrogant and closeminded, and you believe that Aspergers is some problem that people have because an expert told you so, you will never bother to trust your own god given brain and look for the answer yourself.

When I look at Zooby's list, I see the description of an honest person. And somehow, some bozo has convinced people that honesty is a disease and the honest person is sick.

Also, that people who believe they have education sometimes put themselves above the intelligence of other people.

Obviously true, sometimes, but it has nothing to do with Asperger's. Asperger's people are generally academically above average, and especially attracted to math and science. Asperger's people are always in with the "educated" people. They tend to do well in theater and music, too.

Personally I don't believe they are telling white lies either, because they don't have the ability to intrepret other people's feelings from they're point of view.

I don't think you understood the part where I talked about white lies. Here it is again:

"Happeh's notion that they could tell social white lies if they wanted to but choose to be rigorously honest, is a complete misunderstanding of what's going on."

I am agreeing they don't tend to tell any kind of lies, but for a different reason than the one Happeh thinks. You and I agree about that reason. Happeh doesn't.

 

[debeng]

it seems to me that Asperger's syndrome is not a disorder or a disease. if we go on thinking about it, perhaps everyone might end up thinking that they atleast have some aspect of it. those who have it have it for a special reson (it's a gift for them sometimes) and those who don't have their's too. as far as i can track Newton could have it, Einstein did a lot of interations with many physicist and mathematician around.
it is like just sleeping habit. i heard the lesser the medical students sleep, the more they are likely to have success. they do not have to start a new theory, just learn wat has been written and there are many things to learn for them from science to ethics and to be learned perfectly.though their brain reqiure a lot of energy it can last considerably longer. for physicist, wondering about new things is more important that their brain require more energy that won't last long enough. they need more sleep to regain energy for their brain. basically time means more to a medical student, while full brain functioning to physicist i suppose

 

[zoobyshoe]

it seems to me that Asperger's syndrome is not a disorder or a disease.

It really is though. It's a specific set of important problems that all show up together, from which we can deduce they're all caused by the same root neurological problem whatever that may be. Consider an analogy to a physical , medical problem: if a person has a certain kind of thing wrong with their heart it causes a certain set of specific symptoms. If a cardiologist sees that specific set of symptoms all together in one patient, he or she will immediately suspect that particular kind of heart problem, let's say it's a faulty valve, even though he or she hasn't done an ultrasound yet.
Your brain is a physical organ just like any other in your body and things can go wrong with it. You depend on your brain to sort out information from your senses, and it also is responsible for generating the type and quality and strength of the emotions you feel. If you physically change the workings of the brain you can radically change the perceptions and behaviour of the person. Everyone knows this, and everyone has seen it first hand: you see someone drink a six pack of beer, and they're a changed person. A change in their brain chemistry causes unmistakable changes in the person.
So, if a neurologist finds a group of people who all have the same particular problems and specific personality features, as Hans Asperger did, it is a logical conclusion that he's seeing much more than a strong personality trait, but a physical difference in their brains.

if we go on thinking about it, perhaps everyone might end up thinking that they atleast have some aspect of it.

This is a very common reaction to finding out about just about any 'syndrome". Certain parts of it always seem to describe you. Part of the problem is that the language used to describe it can be interpreted too broadly sometimes. If you read that Asperger's people don't pick up on social cues, and don't have a good idea of what's going on in other people's minds, it's very, very easy to think of times when you missed important social cues, and when you were baffled about what was going on in other people's minds.
Chances are, though, that your experiences with that are very different than what happens in Asperger's, and not chronic. Almost none of these descriptions make any real sense until you actually meet someone with the syndrome or problem, and see first hand the exact way it shows itself. That's the way it was with me, anyway. It was a pretty nebulous concept to me until the first time I met a kid diagnosed with it. When you do, you suddenly realize why the description REALLY fits and isn't just describing mild personality traits, and you also see why it causes problems for them with other people.

those who have it have it for a special reson (it's a gift for them sometimes) and those who don't have their's too.

I think it's important not to mistake any kind of mental or neurological problem as a "good thing". The whole reason doctors try to figure these things out and see what can be done to allieviate them is because they create huge problems for the people who have them. If you say there was something wrong with Newton that happened to give him the "gift" of being a good scientist as a byproduct, then I would say I would rather there had been nothing wrong with him and we did without the physics so he could lead a happy life. (In truth, it's doubtful we'd ever have to do without the physics. It might have taken 20 other lesser physicists to piece together what he pieced together by himself, but it would have gotten done.) It is not required that people be tormented and unhappy to do good work. Feynman was a very happy, well adjusted person, and he soared above his peers in Physics.

 

[selfAdjoint]

Zooby, it's not just what we may believe ourselves, but what society seems to believe. There's a meme going around that almost every brilliant quantitative thinker has Asperger's to some degree. And the evidence adduced is that such people are often unsocialized - even is some cases radically so. I am sure you aren't endorsing such pop diagnoses, but we have to be on our guard against this kind of thing.

 

[zoobyshoe]

Zooby, it's not just what we may believe ourselves, but what society seems to believe. There's a meme going around that almost every brilliant quantitative thinker has Asperger's to some degree. And the evidence adduced is that such people are often unsocialized - even is some cases radically so.

One thing I hope that comes out of threads like this is that people get a better handle on what the syndrome really consists of so they can see it doesn't necessarily fit most of these famous people it's being ascribed to.
Having one or two of the traits is pretty meaningless, and it's especially important not to call having one or two of the traits "some degree" of Aspergers. You need to have a substantial block of the traits. Otherwise the resemblence is purely coincidental. Could be there's some kind of a problem, but it's not Asperger's.

I'm realizing, though, that verbal descriptions of symptoms don't always make the point. It would nice to collect a couple hours of interviews of people with Asperger's, put them on a DVD and let people see what the verbal descriptions are referring to.

 

[quotidian1337]

Skepticism Regarding the Alleged Diagnosis of Asperger Syndrome

I really am skeptical about 'Asperger Syndrome'. I really don't think it exists at all. I say this as someone who has studied psychology for years, and who is intimately familiar with it. I may not be a doctor, but one doesn't have to be a medical expert to realize that there are a lot of psychological conditions out there that are over-diagnosed or misdiagnosed. Asperger's, ADHD, and believe it or not, Bipolar Disorder are some of the most commonly misdiagnosed syndromes out there. It is puzzling in this century how there has suddenly emerged an epidemic of Asperger Syndrome and Bipolar. Allow me to debunk a lot of the hype surrounding this sudden surge of diagnoses, and the reason why they are suddenly so numerous.

The first reason is one that very few psychiatrists and professionals would claim to admit to: the fact that a lot of these syndromes are misdiagnosed for the primary reason of increasing the clientele of psychiatrists, as well as the revenues made by increased sales of antidepressant drugs and stimulants for deficits in "concentration". When you look underneath the layers, you can see how obvious it is that this whole thing is rigged. The pharmaceutical companies are reaping in the profits of selling drugs meant to "cure" ADHD and the various cycles of depression experienced by Bipolar patients and those with Asperger Syndrome who happen to have concurrent depression along with their diagnosis.

I have made several observations as someone who has researched this intensely in my tenure as a psychology student at university: The first observation concerns those with bipolar. I have several friends of mine who claim to have the disorder, when in all actuality they do not. Although they may have some of the shifts in mood swings, there is no evidence of them having the entire diagnosis. For one thing, they were not mentally instituted, nor were they classified as 'incurably insane'. Perhaps this means that instead of having Bipolar (which is a mental disorder), they have some high-functioning variant of it. I have heard of something called "Bipolar Affective Disorder", in which patients with it have aspects of the condition (in terms of mood fluctuations, specifically), but are not so strongly effected that they cannot function. In fact, many of them learn to combat the condition through pro-active means: they transfer their frustration and anxieties into their creativity. It is true that many people with bipolar are extremely creative, and the friends whom I knew who were thought by psychiatrists to have had or, or who were misdiagnosed with the condition, developed the ability to channel their frustrations into creative efforts. In fact, many of them excelled brilliantly in what they did, because they had natural talents, and they knew how to convert these into positive endeavors where their brilliance was put to use. The main reason why I am so adamant against the methodologies in use by the psychiatric practice today is that I, myself, had the direct experience of being misdiagnosed with Bipolar II when I was 17, and going through a rough time. I realized that my difficulties at that time were largely situational, and that I was just more intense than most people are used to. Although I have family members with bipolar, they, too, have used techniques to overcome it. And overtime, I had learned to overcome the adversity of my fluctuating chemical imbalances by channeling my frustrations into positive energy. Several years after I had been diagnosed with the condition, I had another assessment done. This one confirmed that I didn't have it, and that much of my strife was due to circumstantial situations and not to the fact that I had a pervasive chemical imbalance. So I am relieved that I did not have the full-blown thing. However, those who do in fact have the diagnosis are not sentenced for life: they can use these same techniques to control their behaviours and to change the way in which the disorder manifests itself. It is only as disabling as you ALLOW it to become, and you are in control of your condition, no matter what condition you allegedly have.

The second and most prominent disagreement I have is with the diagnosis of Asperger Syndrome. I have met so many people with this supposed diagnosis who have no pronounced symptoms of autism whatsoever. Although I have noticed that they have 'traits' that conform with the symptoms of autism, a lot of what I have observed of their mannerisms are merely habitual behaviour patterns. Ergo, a lot of it is psychosomatic. One case in particular stands out in my mind: of a friend of mine who was perfectly well adjusted, and although relatively idiosyncratic in the way in which he chose to phrase things (he often used very lofty, huge words and had an abstract way of expressing his ideas, and a very eloquent way of speaking as well as articulate and "staccato" prosody), he showed no signs of lack of social understanding or lack of pragmatic comprehension when engaged in conversation. He could relate and emphasize intimately with people, and could easily read them and see into their intentions (for the most part). However, after the psychiatrists had diagnosed him with Asperger's, for the fact that he had an unusual knowledge of astronomy (it's all he ever talked about) and because he had rather poor organization (although functioned very well in spite of this), he began to exhibit more and more traits of autisic spectrum disorders. He admitted to me that he thought this was psychosomatic, and I concurred with him that it in all likelihood was. Three years later, when he turned 21, he underwent a reassessment. They found that he in fact did not have AS, but just perceived things on a different level. This really has more to do with his unique mind than it does with some kind of pervasive developmental syndrome. We are all different, and we all have unique conceptions of things. So this does not classify a syndrome. This is the main reason why I think that psychiatry should reform its methodological practices; and that there should be things like MRIs done to test for autism or high functioning autism, as it is much more definitive. Further, I really do believe that people have to have some core autistic traits in order to be dxed with Asperger's. AS should be eliminated from the realm of syndromes, because I think that there has to be some commonalities with autism in order for an autistic-spectrum diagnosis to be confirmed. So Asperger's does not exist, in that it is merely a psychosomatic, behavioral condition. It is strictly behavioral. And any cognitive abnormalities associated with AS are in fact psychosomatic ones. I noticed this because my friend with it started making odd motor movements psychosomatically after he was diagnosed. Asperger's should be eliminated, as a lot of these people who allegedly have it have no symptoms of autism. Thus, only high-functioning autism should be considered, and AS should be eliminated from the Autistic Spectrum Disorders.

 

[355113]

NECRO! OK, I'm reviving this thread.

Anyways, I am diagnosed with Asperger's Syndrome. I'd be glad to answer any questions people have about it if they are interested.

I am not, to my own private satisfaction, convinced that Asperger's is really a form of autism. The resemblences strike me as superficial.

Asperger's is clinically indistinguishable from HFA (high-functioning autism). I recently read a study in which some researchers attempted to discern whether or not DSM-IV Asperger's could be consistently separated from classic (Kanner's) autism, and they concluded that it could not be. Right now, the classification is a bit messy, and the way in which ASDs are diagnosed and labeled is expected to change with the release of the DSM-V.

 

[zoobyshoe]

NECRO! OK, I'm reviving this thread.

Anyways, I am diagnosed with Asperger's Syndrome. I'd be glad to answer any questions people have about it if they are interested.Asperger's is clinically indistinguishable from HFA (high-functioning autism). I recently read a study in which some researchers attempted to discern whether or not DSM-IV Asperger's could be consistently separated from classic (Kanner's) autism, and they concluded that it could not be. Right now, the classification is a bit messy, and the way in which ASDs are diagnosed and labeled is expected to change with the release of the DSM-V.

Yeah, this thread IS old.

In my opinion the confusion is the result of misdiagnosis: people who should be diagnosed as high-functioning autistic have been labeled as Asperger's people by poor diagnosticians, and the difference became muddied. To a large extent shrinks learn their "feel" for a diagnosis by experience with patients who have that diagnosis. Therefore, if they learn what Asperger's is from people who are actually high-functioning autistics, then they will repeat the error. That's my opinion.

An authentic high-functioning autistic person would never have said "NECRO!" They don't much get humor. Asperger's people on the other hand, love humor, especially word play and puns.

Do you have an additional diagnosis? Asperger's commonly, but not always, co-occurs with something else.

 

[355113]

In my opinion the confusion is the result of misdiagnosis: people who should be diagnosed as high-functioning autistic have been labeled as Asperger's people by poor diagnosticians, and the difference became muddied. To a large extent shrinks learn their "feel" for a diagnosis by experience with patients who have that diagnosis. Therefore, if they learn what Asperger's is from people who are actually high-functioning autistics, then they will repeat the error. That's my opinion.

An authentic high-functioning autistic person would never have said "NECRO!" They don't much get humor. Asperger's people on the other hand, love humor, especially word play and puns.

Do you have an additional diagnosis? Asperger's commonly, but not always, co-occurs with something else.

There have been issues caused by misdiagnosis, yes, but remember, HFA is not a formal diagnosis- according to the DSM-IV there's Autistic Disorder and there's Asperger's Disorder, the main difference being that Asperger's precludes mental retardation (which is not a requirement for Autistic Disorder, only a possibility) and Asperger's also precludes the possibility of a speech delay, whereas a speech delay would be present in "classic" autism. These two together mean that a high-functioning individual with a dx of autistic disorder would, in adulthood (after developing speech) be completely indistinguishable from someone with Asperger's. I personally did have a noticeable speech delay, but it is debatable whether it was significant enough to change the dx. In any case, most doctors seem to take Asperger's as "autism with high IQ" which is not quite accurate, but the formal definitions aren't very clear either so they're left with whatever they can come up with on their own. As I mentioned, a team of researchers tried to go strictly off the DSM-IV and weren't able, based on its criteria, to consistently discriminate between the two. I think they actually concluded that the vast majority of Asperger's diagnoses were incorrect, and those people should instead be labeled simply autistic. Anyways, I normally just refer to myself as autistic (harder to mispronounce) and don't worry so much about the exact right characterization, since the whole autistic spectrum will almost certainly be regarded significantly differently with the release of the DSM-V in a couple years.

Don't believe the stereotypes. An "authentic" HFA person may or may not have a good sense of humor, and an AS person may or may not as well. I've been told in the past that I have an odd sense of humor (or that I have no sense of humor when I happen not to find any given joke to be funny) but response to humor is not a defining characteristic of either HFA or AS. I do, as per your stereotype, enjoy word play and puns, but not everyone with AS does. I know a couple people with classic autism who have a great sense of humor.

As far as other diagnoses, I believe I was previously diagnosed with a sensory processing disorder, though that's a bit redundant as I believe almost all autistics have that to some extent. When I was younger, my teachers recommended me for an ADD/HD dx but my doctor withheld a diagnosis on the basis that I did not, in his opinion, need to be medicated for those traits. ADD is far over-dx'ed, and while I match with several of the characteristics of it, I think I am probably at sub-clinical levels for most of them.

 

[zoobyshoe]

There have been issues caused by misdiagnosis, yes, but remember, HFA is not a formal diagnosis- according to the DSM-IV there's Autistic Disorder and there's Asperger's Disorder, the main difference being that Asperger's precludes mental retardation (which is not a requirement for Autistic Disorder, only a possibility) and Asperger's also precludes the possibility of a speech delay, whereas a speech delay would be present in "classic" autism. These two together mean that a high-functioning individual with a dx of autistic disorder would, in adulthood (after developing speech) be completely indistinguishable from someone with Asperger's. I personally did have a noticeable speech delay, but it is debatable whether it was significant enough to change the dx. In any case, most doctors seem to take Asperger's as "autism with high IQ" which is not quite accurate, but the formal definitions aren't very clear either so they're left with whatever they can come up with on their own. As I mentioned, a team of researchers tried to go strictly off the DSM-IV and weren't able, based on its criteria, to consistently discriminate between the two. I think they actually concluded that the vast majority of Asperger's diagnoses were incorrect, and those people should instead be labeled simply autistic. Anyways, I normally just refer to myself as autistic (harder to mispronounce) and don't worry so much about the exact right characterization, since the whole autistic spectrum will almost certainly be regarded significantly differently with the release of the DSM-V in a couple years.

One extremely significant difference which is mentioned in all books about Asperger's but ignored by the DSM is that Asperger's people frequently demonstrate above average academic skills, at least in one area, but possibly more, whereas Autistic people never do, not even savants. (The prodigious memorization and calculation skills of savants do not translate to academic success because they don't understand contexts.) I can tell from your post that your reading comprehension is well above average and your diction is excellent. Your verbal SAT score was almost certainly superior. I'm guessing from the fact you're here you very much enjoy physics and math and probably had above average grades in those subjects despite whatever issues lead to your diagnosis. A high functioning autistic person would not be able to stand out academically. Temple Grandin could never get straight A's.

Don't believe the stereotypes. An "authentic" HFA person may or may not have a good sense of humor

Um...how the hell would YOU know what a good sense of humor is?

... and an AS person may or may not as well. I've been told in the past that I have an odd sense of humor (or that I have no sense of humor when I happen not to find any given joke to be funny) but response to humor is not a defining characteristic of either HFA or AS. I do, as per your stereotype, enjoy word play and puns, but not everyone with AS does. I know a couple people with classic autism who have a great sense of humor.

It's true that autistic people find some things funny and can laugh and be delighted, but what fits their criteria for funny is markedly idiosyncratic, to say the least. Asperger's humor, on the other hand, is obvious to the general population. (However, general population humor is not always obvious to Asperger's People.)

Response to humor is, indeed, not a defining characteristic of either, clinically, but it is brought up so often in books and discussions about the two that it's clear it is significant. The ability to understand why and how something is funny says volumes about the way a person's mind works and also about how much they understand about those around them. In my experience it is not a stereotype any more than any other common feature of either could be dismissed as a stereotype.

Anyway, I think I see two distinct conditions erroneously lumped together as different points on the same spectrum. That's my perception.

The main trouble with the DSM is that diagnosis is arrived at by observation of behavior and is dependent on the skill of the doctor. There are no lab tests or typical EEG's or MRI features associated with any diagnosis in the DSM, to back up a diagnosis. It is revised over and over because the conditions are defined by apparent symptom constellations in the absence of any reference to, or knowledge of, the physiological problems behind the symptoms. Some day when brain scans become sensitive enough, and our understanding of how the parts of the brain interrelate progresses far enough, we will see Asperger's ( and everything else in the DSM, for that matter) defined specifically, with reference to the exact "circuits" and processes that aren't functioning properly, in pretty much the same way we can now follow the trail of endocrine malfunctioning, and its consequences on other systems, that leads to diabetes. As it is now, you go to a weird enough psychiatrist, he might decide your diagnosis should actually be "Delusional Disorder, Erotomanic Type", and that weird opinion is as good as any in the absence of physiological data.

As far as other diagnoses, I believe I was previously diagnosed with a sensory processing disorder, though that's a bit redundant as I believe almost all autistics have that to some extent. When I was younger, my teachers recommended me for an ADD/HD dx but my doctor withheld a diagnosis on the basis that I did not, in his opinion, need to be medicated for those traits. ADD is far over-dx'ed, and while I match with several of the characteristics of it, I think I am probably at sub-clinical levels for most of them.

The book I read which specifically pointed out the frequent co-occurance of a second diagnosis said it frequently co-occured with OCD and seizures. There was another one, too, but I don't remember it (read that book back when I started this thread.)

Regardless, I just looked at the Wikipedia article and it said something interesting I hadn't heard before, which is that 20% of Asperger's kids seem to "outgrow" it. While googling I ran across a quote from an interview with actor/commedian Dan Akroyed, who admitted he had been diagnosed with Asperger's as a kid. Unlike a lot of other conditions, Asperger's may, in fact, allow for nearly unlimited insight into its own liabilities leading to the creation of totally successful compensatory adaptations.

 

[tgt]

Zooby, I myself am not clear on what the distinction is between high-functioning autism and Asperger syndrome. I'm under the impression the latter is a subset of the former, but am not clear what the diagnostic criteria would be to determine it's Asperger syndrome specifically.

No. One difference is that people with Asperger's lack some motor skills but people with high functioning autism do not. Also people with Asperger's may be very adequate in communicating and language skills whereas people with high functioning autism usually do not.

One common feature to both is lack of social skills.

 

[355113]

One extremely significant difference which is mentioned in all books about Asperger's but ignored by the DSM is that Asperger's people frequently demonstrate above average academic skills, at least in one area, but possibly more, whereas Autistic people never do, not even savants. (The prodigious memorization and calculation skills of savants do not translate to academic success because they don't understand contexts.)

This is simply not true. I know at least a couple Kanner's autistics who have been academically successful. It may be that Kanner's autists less commonly succeed academically, but saying that none do is wrong. Remember, all absolute statements are false. And that's why I never make absolute statements.

Um...how the hell would YOU know what a good sense of humor is?

That's actually a pretty good question. I suppose I don't, or at least I don't know what would conventionally be considered a good sense of humor as I find different things funny than others seem to.

It's true that autistic people find some things funny and can laugh and be delighted, but what fits their criteria for funny is markedly idiosyncratic, to say the least. Asperger's humor, on the other hand, is obvious to the general population. (However, general population humor is not always obvious to Asperger's People.)

Hm... I disagree, not all Asperger's humor seems to make sense to the general population. What other explanation could there possibly be for people not laughing at my jokes?

The ability to understand why and how something is funny says volumes about the way a person's mind works and also about how much they understand about those around them.

But basing such perceptions on whether someone finds a joke funny isn't necessarily accurate... there are plenty of jokes that I intellectually understand but just don't consider to be amusing. I know why they are supposed to be funny, I just don't think they've succeeded. Most people on seeing such a reaction will tend to assume that I just didn't get the joke.

Anyway, I think I see two distinct conditions erroneously lumped together as different points on the same spectrum. That's my perception.

And I think they are fundamentally the same thing, or at least on the same spectrum, that are artificially separated by arbitrary markers such as verbal intelligence when in fact they should not be regarded as separate. Indeed, some new evidence seems to indicate that autism itself is not a discrete condition, but merely a collection of certain traits at a certain intensity. http://news.bbc.co.uk/2/hi/health/7841808.stm"

The main trouble with the DSM is that diagnosis is arrived at by observation of behavior and is dependent on the skill of the doctor. There are no lab tests or typical EEG's or MRI features associated with any diagnosis in the DSM, to back up a diagnosis. It is revised over and over because the conditions are defined by apparent symptom constellations in the absence of any reference to, or knowledge of, the physiological problems behind the symptoms.

Well, yes, and that is the nature of psychology. The disease model really does not apply too terribly well to the autistic spectrum. Physiological problems would be difficult or impossible to identify, and then the practice of labeling all autistic traits as "problem" has been vocally opposed by a number of prominent researchers, as well as most people who are themselves autistic.

Some day when brain scans become sensitive enough, and our understanding of how the parts of the brain interrelate progresses far enough, we will see Asperger's ( and everything else in the DSM, for that matter) defined specifically, with reference to the exact "circuits" and processes that aren't functioning properly, in pretty much the same way we can now follow the trail of endocrine malfunctioning, and its consequences on other systems, that leads to diabetes.

It will be interesting to see neurology advance that far someday, but for now that field is still in its infancy and we have to go with the best we currently know.

As it is now, you go to a weird enough psychiatrist, he might decide your diagnosis should actually be "Delusional Disorder, Erotomanic Type", and that weird opinion is as good as any in the absence of physiological data.

Not quite as good as any, since you have to take into account whether the diagnosis makes sense and is consistent. I mean, no psychologist or psychiatrist could realistically diagnose me as schizophrenic, bipolar, or depressed. A crappy psychiatrist might be capable of misdiagnosing me with ADD or even possibly OCD, but it should be readily apparent that neither of those diagnoses would account for all my idiosyncratic behavior or markedly unusual profile of IQ subscores, whereas some variant of autism does.

The book I read which specifically pointed out the frequent co-occurance of a second diagnosis said it frequently co-occured with OCD and seizures. There was another one, too, but I don't remember it (read that book back when I started this thread.)

OCD and epilepsy are more common among AS people, though epilepsy still is not what I would call "common," it is simply less rare than among the general population. I read once that approximately 70% of AS adolescents have comorbid ADD/HD, but that number seems a bit inflated to me.

Regardless, I just looked at the Wikipedia article and it said something interesting I hadn't heard before, which is that 20% of Asperger's kids seem to "outgrow" it. While googling I ran across a quote from an interview with actor/commedian Dan Akroyed, who admitted he had been diagnosed with Asperger's as a kid. Unlike a lot of other conditions, Asperger's may, in fact, allow for nearly unlimited insight into its own liabilities leading to the creation of totally successful compensatory adaptations.

I've heard rumors of people "outgrowing" AS but that does not actually occur; rather, people develop effective coping mechanisms. I'm not quite sure what to make of Ackroyd- I've heard claims that he was kidding when he said he was diagnosed with AS, though that wouldn't make much sense. Anyways, yes, AS does tend to allow for more self-awareness and ability to analyze one's own strengths and weaknesses, and this is helpful in figuring out how to compensate for the weaknesses.

 

[355113]

No. One difference is that people with Asperger's lack some motor skills but people with high functioning autism do not. Also people with Asperger's may be very adequate in communicating and language skills whereas people with high functioning autism usually do not.

One common feature to both is lack of social skills.

I'm not sure where you got this idea. There does seem to be a correlation between Asperger's and motor clumsiness (if you've ever seen me try to catch anything, you'd know why I was never a start athlete) but HFAs also tend to lack motor skills. And there are some Asperger's people who are much more graceful and well-coordinated. With HFA there is generally a delay in developing communication and language skills, but they often simply develop later and end up at the same level as of someone with Asperger's.

The part about lacking social skills is definitely true though.

 

[tgt]

I'm not sure where you got this idea. There does seem to be a correlation between Asperger's and motor clumsiness (if you've ever seen me try to catch anything, you'd know why I was never a start athlete) but HFAs also tend to lack motor skills. And there are some Asperger's people who are much more graceful and well-coordinated. With HFA there is generally a delay in developing communication and language skills, but they often simply develop later and end up at the same level as of someone with Asperger's.

The part about lacking social skills is definitely true though.

Physical clumsiness is one of the key features of AS. In here

http://en.wikipedia.org/wiki/Asperger's

they say "...specific deficits to address poor communication skills, obsessive or repetitive routines, and physical clumsiness."

It wouldn't surprise me if more AS people have motor clumsiness then HFA people.

 

[355113]

Physical clumsiness is one of the key features of AS. In here

http://en.wikipedia.org/wiki/Asperger's

they say "...specific deficits to address poor communication skills, obsessive or repetitive routines, and physical clumsiness."

It wouldn't surprise me if more AS people have motor clumsiness then HFA people.

Yes, clumsiness is very common in AS. You would have difficulty believing just how uncoordinated I could be. But if you're going to point me to Wikipedia (the AS article is worse than it used to be, incidentally) then I will point to

Hans Asperger's initial accounts[1] and other diagnostic schemes[26] include descriptions of physical clumsiness. Children with AS may be delayed in acquiring skills requiring motor dexterity, such as riding a bicycle or opening a jar, and may seem to move awkwardly or feel "uncomfortable in their own skin". They may be poorly coordinated, or have an odd or bouncy gait or posture, poor handwriting, or problems with visual-motor integration.[1][5] They may show problems with proprioception (sensation of body position) on measures of apraxia (motor planning disorder), balance, tandem gait, and finger-thumb apposition. There is no evidence that these motor skills problems differentiate AS from other high-functioning ASDs.[1]

See that last sentence? Other autistics are clumsy too, it's not just us Asperger's people.

 

[tgt]

Yes, clumsiness is very common in AS. You would have difficulty believing just how uncoordinated I could be. But if you're going to point me to Wikipedia (the AS article is worse than it used to be, incidentally) then I will point to
See that last sentence? Other autistics are clumsy too, it's not just us Asperger's people.

All I am suggesting is that the proportion of people with AS having motor difficulties is higher then the proportion of people having motor difficulties with HFA. So much so that more mention of motor difficulties is attributed to AS then people with HFA.

i.e in here

http://autism-types.suite101.com/article.cfm/autism_and_aspergers_syndrome
"It is accepted that physical motor difficulties and poor co-ordination are an inherent part of AS. This is shared by many youngsters with HFA."

In fact my point is clearly demonstrated here

http://en.wikipedia.org/wiki/Diagnosis_of_Asperger_syndrome
"Relative to HFA, people with AS have deficits in nonverbal skills such as visual-spatial problem solving and visual-motor coordination,[29] along with stronger verbal abilities."

Also here

http://wiki.answers.com/Q/Is_high-functioning_autism_the_same_as_Asperger's_Syndrome
"People with AS are more likely to exhibit motor clumsiness. People with HFA are more likely to have average or above average motor skills."

So you have AS. Langauge development in people with HFA is slow and so speech and vocab are not as good as others which results in them being a bad communicator especially in social situations. How is it that AS people develop speech normally and can even have a good vocab and language skills be so bad in social situations and in communicating with people? It doesn't make much sense.

 

[Kurdt]

Langauge an vocabulary aren't all that is required for good social skills. Non-verbal cues such as facial expression and body language are difficult for people with AS to pick up on. There is also a considerable lack of knowledge about how to lead or direct a conversation and so in many cases it tails off or gets mired in the person with AS talking excessively about what they're interested in. The way language is used is also different. People with AS tend to be very literal and can't recognise some of the nuances of social speech which can often lead to confusion over what the other person actually means.

 

[355113]

So you have AS. Langauge development in people with HFA is slow and so speech and vocab are not as good as others which results in them being a bad communicator especially in social situations.

In HFA, language skills often develop to the same level as in AS, just at a later age.

How is it that AS people develop speech normally and can even have a good vocab and language skills be so bad in social situations and in communicating with people? It doesn't make much sense.

Because social interaction is not based purely on verbal comprehension. There is nonverbal communication as well, in addition to a whole slew of arcane social nuances that most with AS don't understand. In addition, language tends to be used idiosyncratically, and often in a more formal manner that would impede social communication which of its nature tends to be more informal.

 

[zoobyshoe]

This is simply not true. I know at least a couple Kanner's autistics who have been academically successful. It may be that Kanner's autists less commonly succeed academically, but saying that none do is wrong. Remember, all absolute statements are false. And that's why I never make absolute statements.

Hehe. OK.

That's actually a pretty good question. I suppose I don't, or at least I don't know what would conventionally be considered a good sense of humor as I find different things funny than others seem to.


Hm... I disagree, not all Asperger's humor seems to make sense to the general population. What other explanation could there possibly be for people not laughing at my jokes?


But basing such perceptions on whether someone finds a joke funny isn't necessarily accurate... there are plenty of jokes that I intellectually understand but just don't consider to be amusing. I know why they are supposed to be funny, I just don't think they've succeeded. Most people on seeing such a reaction will tend to assume that I just didn't get the joke.

Humor is context dependent. There is no such thing as an inherently funny joke or utterance. The success or failure of a remark intended to be funny depends on the humorist's ability to size his audience up then and there; take their pulse, so to speak, and pitch something to their taste, level of perceptiveness, all in the context of the situation at hand. To the extent that what you laugh at, and what you pitch to others to amuse them, is an indicator of how sensitive you are to who you're with and the immediate situation, it has potential as a diagnostic tool.

And I think they are fundamentally the same thing, or at least on the same spectrum, that are artificially separated by arbitrary markers such as verbal intelligence when in fact they should not be regarded as separate. Indeed, some new evidence seems to indicate that autism itself is not a discrete condition, but merely a collection of certain traits at a certain intensity. http://news.bbc.co.uk/2/hi/health/7841808.stm"

Well, yes, and that is the nature of psychology. The disease model really does not apply too terribly well to the autistic spectrum. Physiological problems would be difficult or impossible to identify, and then the practice of labeling all autistic traits as "problem" has been vocally opposed by a number of prominent researchers, as well as most people who are themselves autistic.


It will be interesting to see neurology advance that far someday, but for now that field is still in its infancy and we have to go with the best we currently know.



Not quite as good as any, since you have to take into account whether the diagnosis makes sense and is consistent. I mean, no psychologist or psychiatrist could realistically diagnose me as schizophrenic, bipolar, or depressed. A crappy psychiatrist might be capable of misdiagnosing me with ADD or even possibly OCD, but it should be readily apparent that neither of those diagnoses would account for all my idiosyncratic behavior or markedly unusual profile of IQ subscores, whereas some variant of autism does.

All the same problem again: without physiological data to point to, any diagnosis in the DSM is an arbitrary agreement of experts on what apparent symptom constellations are going to be called what. There is a never ending series of papers proposing causes and mechanisms for the constellation of symptoms called schizophrenia with no conclusions to be drawn. Therefore, it is also often suggested that a large number of rather different neurological problems can manifest with these symptoms.

Contrast this with seizures. Because seizures have long been accepted as purely physiological in origin it was long ago recognized that there is no disease, Epilepsy. Seizures are always a symptom. They always indicate either tissue damage, or any of the myriad "chemical" problems that can trigger neurons to fire this way. "Epilepsy" is a label that simply means the seizures are likely to be chronic, to continue happening unless there is intervention.

In the absence of physiological data what makes sense and seems consistent to a given doctor in arriving at a psychiatric diagnosis is much more open ended. The differences I perceive between Asperger's and Autism that strike me as important are not persuasive to you, and the similarities which strike you as important are not persuasive to me. At this point it has to be considered a difference in value judgement. My "delusional disorder" example was meant to be one you would agree was absurd, simply to mock the fact that all diagnoses are unchecked by "objective" data: lab results, EEG's, brain scans, etc. (They go some distance in ruling out gross physiological problems like brain tumors, thyroid, drug abuse, and so on, but there is no provision for the fine parsing of neurological cause and effect in the absence of know gross causes of psychiatric symptoms.) You are confident that psychiatrists will be guided by good reasoning skills in coming to a diagnosis. I, however, don't think that anyone with good reasoning skills would end up in psychiatry ;) . Of all the medical sciences it is the least scientific. It's a kind of impressionistic medicine, in the way Aristotle's physics was a kind of impressionistic physics. I think both autism and Asperger's are clear neurological conditions and shouldn't be in the DSM at all.

I've heard rumors of people "outgrowing" AS but that does not actually occur; rather, people develop effective coping mechanisms. I'm not quite sure what to make of Ackroyd- I've heard claims that he was kidding when he said he was diagnosed with AS, though that wouldn't make much sense. Anyways, yes, AS does tend to allow for more self-awareness and ability to analyze one's own strengths and weaknesses, and this is helpful in figuring out how to compensate for the weaknesses.

That's what I figure as well: the apparent "outgrowing" actually probably results from successful coping mechanisms.

 

[355113]

The differences I perceive between Asperger's and Autism that strike me as important are not persuasive to you, and the similarities which strike you as important are not persuasive to me. At this point it has to be considered a difference in value judgement.

Well, not only that, but as it currently stands we have no significant means of differentiating the two even if they are separate conditions. As the two are currently defined, there isn't much relevant difference between them. I suppose you could argue that there is something wrong with the classification scheme and there actually are two separate conditions being referred to here, but those two conditions aren't going to neatly and exactly follow the current AS/HFA split. For what it's worth, I would disagree with such an assessment, but then I don't have all the answers on autism.

You are confident that psychiatrists will be guided by good reasoning skills in coming to a diagnosis. I, however, don't think that anyone with good reasoning skills would end up in psychiatry ;) .

Not psychiatrists. Psychiatrists are idiots, more or less universally. Psychologists tend to be better, though that field still has its fair share of quacks.

 

[tgt]

In HFA, language skills often develop to the same level as in AS, just at a later age.Because social interaction is not based purely on verbal comprehension. There is nonverbal communication as well, in addition to a whole slew of arcane social nuances that most with AS don't understand. In addition, language tends to be used idiosyncratically, and often in a more formal manner that would impede social communication which of its nature tends to be more informal.

But people with HFA won't develop their language skills to as well as a skillful neurotypical. Those years missing will show up in some way.

But you are able to use emotional language well? Good at writing essays and even novels?

So it's the informal nature that you can't stand. Like parties? Do you go to them? What happens? Do you have a gf or bf?

What defense mechanisms have you developed over the years?

 

[mgb_phys]

the apparent "outgrowing" actually probably results from successful coping mechanisms.

Or training - men get a lot more 'normal' once married.

 

[355113]

But people with HFA won't develop their language skills to as well as a skillful neurotypical. Those years missing will show up in some way.

Not necessarily true, some people just develop later. I was a late talker, but if you compare that to my current level, I tested at a verbal IQ of 150 a few weeks ago. (WAIS-IV)

But you are able to use emotional language well? Good at writing essays and even novels?

I'm not sure what you are referring to by "emotional language." I'm good with essays, but have never attempted a novel, nor do I intend to.

So it's the informal nature that you can't stand. Like parties? Do you go to them? What happens? Do you have a gf or bf?

Parties are a problem more because of sensory overload- too many people, too much noise, too much going on at once for me. Crowds are my greatest fear. What happens when I go to parties? I am generally uncomfortable, and usually leave at the earliest opportunity. No, I do not have a gf, and would not have a bf given that I am heterosexual.

What defense mechanisms have you developed over the years?

Avoidance of situations that are likely to involve large crowds. Also, to deal with bullying, I've developed a remarkably thick skin- it is close to impossible to actually offend me now. Most of my own issues are either related to sensory or social problems, and I've found that people in college seem to be more accepting than people in high school were. I can easily enough ignore those who aren't accepting, though. The sensory issues are harder to get around.

 

[zoobyshoe]

Well, not only that, but as it currently stands we have no significant means of differentiating the two even if they are separate conditions. As the two are currently defined, there isn't much relevant difference between them. I suppose you could argue that there is something wrong with the classification scheme and there actually are two separate conditions being referred to here, but those two conditions aren't going to neatly and exactly follow the current AS/HFA split. For what it's worth, I would disagree with such an assessment, but then I don't have all the answers on autism.

If I were interested in sharpening up my case for two distinct conditions I think I'd start by going back and reading all the original literature by Kanner and Asperger then see where that lead. At this point I'm just observing that the difference seems clear to me, and that I think the water has been muddied by years of inexperienced shrinks mistaking one for the other.

Not psychiatrists. Psychiatrists are idiots, more or less universally. Psychologists tend to be better, though that field still has its fair share of quacks.

My brother-in-law is an ER Doc. He said that in med school the meme is that the students with the highest grades are shunted into Neurology and those with the lowest grades are shunted into Psychiatry.

----------------------------------------------

I am curious to know if you feel ill at ease looking into people's eyes. If so, have you tried to figure out how to force yourself to do it so that you'll not stand out?

 

[355113]

I am curious to know if you feel ill at ease looking into people's eyes. If so, have you tried to figure out how to force yourself to do it so that you'll not stand out?

Yes, I do. I do so anyways when I want to avoid standing out; many people have to do things they do not enjoy.

 

[zoobyshoe]

Yes, I do. I do so anyways when I want to avoid standing out; many people have to do things they do not enjoy.

Indeed they do. The reason I ask is because, under a lot of circumstances for various reasons, anyone might feel ill at ease looking into someones eyes. However, I have a theory that the reason Asperger's people do not like it is very different than the reasons other people sometimes don't like it.

 

[Kurdt]

What is your theory?

 

[zoobyshoe]

What is your theory?

A statement of the theory might constitute a "leading" influence. It's a good theory: it can be disproved. However, since we're dealing with reported experience, I can only test the theory against descriptions of why this is unpleasant from people with AS who do not know what theory they might be supporting or disproving.

Whether or not someone might be willing to describe something unpleasant depends. They might not mind, or, it might be an imposition to ask them to examine and analyze something they don't want to think about. I'm in kind of a quandary.

 

[355113]

Indeed they do. The reason I ask is because, under a lot of circumstances for various reasons, anyone might feel ill at ease looking into someones eyes. However, I have a theory that the reason Asperger's people do not like it is very different than the reasons other people sometimes don't like it.

Hm. I don't know if I can help you there, in terms of why eye contact makes me feel uneasy. But I would note that not all AS people necessarily are more averse to eye contact. Rather, it is simply another aspect of nonverbal communication that is not understood by AS people. A friend of mine (who is also AS) makes eye contact, but does so idiosyncratically and somewhat inappropriately. (And yes, even though I'm not generally able to make "appropriate" eye contact, I am at least analytical enough to notice when others are or are not making normal eye contact)

 

[tgt]

Or training - men get a lot more 'normal' once married.

what do you mean?

The HFA and AS typically don't get married as their lack of social knowledge makes relationships hard. Its the normal people who usually get married and it isn't surprising that they get more normal after marriage.

 

[tgt]

Crowds are my greatest fear.

Have you ever gone to New Year Eve's fireworks?

Just say you went alone. Would it still bother you if you did not need to do anything social and people may not even notice you since its in the mid of the night?

 

[355113]

Have you ever gone to New Year Eve's fireworks?

Just say you went alone. Would it still bother you if you did not need to do anything social and people may not even notice you since its in the mid of the night?

I've been to fireworks displays before, but I don't think I have specifically for New Year's. Yes, I would still dislike it because of the noise and chaos that comes with a crowd. It's sensory overload in a bad way. Besides that, I don't like fireworks.