Monday, October 6, 2008

More on Aspergers versus High Functioning Autism

I was just reading a summary of the (unfortunately pay-per-view) article;

Social Anxiety in High-functioning Children and Adolescents with Autism and Asperger Syndrome published in the Journal of Autism and Developmental Disorders.

on the following blog post;

High Functioning Autism vs. Asperger’s: You say tomato I say tomahto

It had a few interesting things to say - so please, have a read.

What I found particularly interesting
I've stated before on this blog that the only difference between Aspergers and High Functioning Autism is a language delay but I've always had this problem with my youngest child, who is diagnosed with HFA but is doing a lot of speech therapy. You see, he's rapidly gaining language skills to the point where he's now certainly much more able to tell us what went on at preschool than my older (aspie) son did at the same age.

I keep thinking - what happens to the HFA diagnosis when the language delay disappears? My wife correctly surmised that it meant more than a simple "delay" in speech but I still couldn't quite get my head around the problem. Did it mean writing? conversation?

It was this paragraph (from the translating autism blog mentioned above) which really helped me to understand the problem;

In regards to their social interactions, in my clinical experience and interaction we colleagues, we see a difference in their ‘relative’ need for social companionship. In general children with HFA seem to just want to be by themselves without an explicit desire to interact with peers. They interact when necessary and when such interaction is functional, but not for the “intrinsic joy” of having social interactions. On the other hand, children with AS tend to desire close relationships with peers and explicitly talk about wanting more friends, but their social uniqueness make the establishing of such relation more difficult.
This, I think, makes it very clear that the "difference" isn't so much about a "language delay" as an interest in friendship.

An Example
My youngest has certainly made massive gains in his language skills and is a better talker than his older brother was at the same age. He doesn't however have many friends - the few he has are mostly acquaintances.

To illustrate this;

Recently, we had an incident at preschool when my wife was dropping him off. Another boy called out to him and she said - "oh look, that boy knows you - what's his name". My son responded with "I don't know".

Unfortunately, the other boy's mother was standing nearby and she burst into tears saying "How could he not know my son's name? They've been playing together for over a year!".

My wife was able to gloss over things by suggesting that he was just mucking around and that "he always does that" but it was nearly an incident.

Some thoughts on Social Anxiety...
There's one other thing that the post says about aspergers which I'm sure you can already infer from the definitions above.

It suggests that if both HFA and Aspergers children have difficulty with social interactions but that HFA children don't care anyway. Then Aspie children would be expected to have higher stress levels (social anxiety) than HFA children. Their trials however don't bear this out.

In tests of social anxiety with HFA, AS and NT children, both the HFA and AS groups had more or less the same levels while still being considerably more anxious than their neurotypical peers.

What's worse was that;
The anxiety problems tended to decrease with age in typically developing kids, but these problems increased with age in the children with HFA/AS.
In my discussions with teenage and adult aspies, I've seen a high incidence of "lonliness" and other forms of social anxiety related to the inability to make friends. I haven't really noticed this as much in autistic adults. This could be a perception thing on my part or the fact that I talk to many more aspies than HFA's.

I'd really like to see what the results would be if this study were to be redone with adult aspies and high functioning autistics.


Catana said...

What I'd like to see in discussion of and research on "social anxiety" is some attempt to distinguish between introverts and extraverts. Regardless of the diagnosis: HFA or Asperger's temperament has to play some role, and it's very obvious from discussions on autism forums that there's a wide range of attitudes toward social engagement, depending on whether people consider themselves outgoing or reserved.

LizzieK8 said...

Might be a possibility your son did know the kid's name but it wasn't of importance to him so he just blew it off. My teenage son does that kind of thing.... Later when he's not so stressed he'll admit he knew something but wasn't in the mood to deal with the conversation it might create.

As a kid I was very social and wanted friends. However now at 56, I just don't bother. I would love to have friends, but it just never works out and when I need to go into what my autistic friend calls "radio silence" and just not deal with people, they never understand. I'm lonely, but the pain of another friendship being ended by the "friend" is just too much.

Anonymous said...

I can attest to the fact that our social anxiety gets worse as we get older. I am now 32 and am much more nervous about social interaction now than I was at 16.

I believe NT's social anxiety drops as they get older because they gain more social skills and confidence in their abilities with practice. While AS's gain skills, they are more aware of the gap between their skills and the social standards they will be held up to.

Hip said...

I caught a mystery respiratory virus (a sore throat virus), which produced autism-like mental symptoms in me, as well as many other symptoms.

I am wondering if this virus might in part explain the worldwide rise in autism. The virus is easily passed to other people in normal household contact, or in normal social contact, so it could well be one of the causal factors behind the autism epidemic.

For more info on this autism-like virus, see here:

I am posting this, as I wish to help in the process of bringing to light the likely causes of the autism epidemic.

Gavin Bollard said...

The virus induced autism theory has its roots in the misguided belief that Autism was caused by Immunisations. However recent studies have been unable to find any link.

There are plenty of articles on the subject but most carry plenty of bias and are written with quite different objectives in mind. Many also have links to the church of Scientology who are well known for interference in autism research.

While the causes of autism are largely unknown, it is impossible to ignore the genetic components, particularly in Aspergers autism.

John Elder Robison said...

May I suggest another explanation for the differenc ebetween AS and HFA . . . .

I think the difference may be that kids with HFA have AS plus impairment in the speech area. This impairment may not only prevent or delay speech, it also impairs comprehension of other people's speech.

The result: A much greater degree of disengagement.

That does not add up to a DESIRE to be disengaged. It's simply a natural result of an inability to understand.

Gavin Bollard said...

That's a very interesting theory which I'm going to have to follow up. I'll see if I can find any HFA people to talk to.


Angela Felsted said...

I hope you will excuse my ignorance, but I have been looking for an answer to this question and I am confused.

Is there an age where a child is too young to be diagnosed with Aspergers? I ask because most of my reading indicates that children with aspergers aren't usually recognized into they are put into a school envioronment.

Would having a child evaluated young, say at the age of 3 or so, exclude them from an Aspergers diagnosis?

Gavin Bollard said...

The symptoms of aspergers, and other forms of autism often don't present well in under three year olds. As a result a diagnosis at this age is often difficult.

Personally, unless your child has severe difficulties, I'd recommend that you follow normal remedial practices (eg: Speech Therapy) until they at least reach school age.

The exception to this would be when they have a sibling with the condition already. Even then, sometimes it's better not to rush into a diagnosis.

Anonymous said...

I don't think you can reach a conclusion about the difference between HFA and AS based on your small amount of anecdotal experience. My son is HFA and he is extremely social, but has the social issues that AS comes with. He does have friends but it is hard for him to make new ones because he is getting older and his differences are more obvious.But he strongly desires friends, asks for playdates, etc. I don't think there is any basis for your suggestion that HFA kids are more wanting to be alone in any of the research.

Gavin Bollard said...

The suggestion that HFA kids are more wanting to be alone isn't based on my experience but is actually suggested in the linked article however I do take your point. A generalization like this is circumstantial, based on observation rather than direct feedback and as such it's not terribly supportable research in my opinion.

Denise said...

This makes sense to me. My son has HFA and I often wondered why he wasn't diagnosed with AS, as his language is above average, even for a typical child, he started speaking in complete sentences like an adult before two.

Anonymous said...

My son has HFA and is 12 years old. It's interesting to see that his homeroom class is neatly divided (socially) into aspies who are ALL very "big -headed and "superior", and ALL of these kids tend to talk down to with the other group consisting of HFAs who are not defined by the above mentioned characteristics and also seem to be somewhat developmentally more atypical than the aspies.I agree with the comment that HFAs seem to less understand others' spoken language. We often hear about kids on the spectrum being bullied by neurotypical kids... in my observation, kids on the spectrum, (depending on their nature) can bully others they perceive as weaker in some ways.