Asperger's vs Autism: the diagnosis and label debate

Submitted by KentPotter on Fri, 02/19/2010 - 17:34.

There has been a lot of debate in the media whether Asperger's Syndrome should remain under the Autism diagnosis. If you are not familiar with Asperger's Syndrome here is a very quick (no techno babble) explanation....Asperger's Syndrome is very often what people refer to as high functioning Autism when it comes to the Autism Spectrum of Disorders. Asperger's is a diagnosis in and of itself. Sometimes a child, teen, or adult will be diagnosed with Asperger's Syndrome and later learn it is part of the Autism Spectrum of disorders. The purpose of the Asperger's Syndrome diagnosis is to identify very specific (often obvious) differences from the diagnosis of Autism or Classic Autism. Given there is a need to distinguish between Asperger's and "typical" Autism why don't we do the obvious? Separate the diagnosis of Autism and Asperger's Syndrome.

Books will tell you that someone with Asperger's Syndrome may never have "lost speech" or "digressed"....it may even tell you that someone with Asperger's has very "formal" or "adult" speech at a young age. The general public likes to perseverate on this one tiny item. But, not all people with Asperger's had "formal" or "adult" like speech at a young age. This is another typical myth in the Autism Community and one that the general public likes to reference. Let's set the record straight.......you did not have to have "adult" like speech as a child to be diagnosed with Asperger's Syndrome. People in the Autism Community are just as bad about stereotyping and labeling as everyone else.

Once the CNN article hit the airwaves regarding this matter all the message boards fired up. People with children who have been diagnosed with moderate or severe Autism quickly began knocking the Asperger's diagnosis. Some of the statements were.... these are the "problem behavior kids", these are the kids who grow up to be "jerks" or "pains in the a#%", these are the kids that grow up and "can't hold a job for a consistent period of time", these are the kids who are "more likely to go to jail", these are the kids who "think they know everything", these are the kids that "have no manners and speak back to authority", these are the kids who "will forever be socially awkward and inept", and I could continue to pull from this list of quotes I printed out from the 15 or so message boards I watch but you get the point. (obviously, not everyone with children that are considered more severe feel this way....a few don't speak for everyone) Frankly, this is absolutely ridiculous. Here we have the very core of the Autism Community ridiculing, belittling, and bullying their very own people.

No one wants to think of their child as low functioning. Everyone can understand that. A diagnosis doesn't define anyone. Reality is important though. There is a significant difference between a person with Autism who has minimal communication skills, limited understanding, can not perform basic daily functions and the person who can speak multiple languages, has multiple college degrees, an outstanding IQ and EQ (emotional quotient) and is sometimes (or often) extremely awkward in social environments (even though that isn't always the case....these skills can be taught and applied). It should also be noted that not every person with Aspeger's is a genius, artistic, good at math, capable of remembering enormous amounts of facts or information. That is also another myth about Asperger's. There is a difference whether some want to admit it or not. I was very disturbed to read a post that said, "I would prefer my child to by more Autistic than Asperger's any day." Seriously? This serves what purpose? This type of thinking is completely nonsensical. You don't get a choice between one or the other. Our children didn't ask to be diagnosed or to face the challenges that they will for a lifetime.

For the record, my son has Asperger's Syndrome. Sam had a significant speech delay, low muscle tone, serious sensory issues, digestive problems, horrific tantrums (at times he still does), was lost in his own world for some time, and showed signs of regression. This is also the same boy who has an extremely high IQ, loves to hug, hasn't ever met a person he doesn't call friend, gifted musically, reads well above his age level, and went through every therapy imaginable. He's a walking dictionary, thesaurus, fact compiler, and avid train enthusiast. Therapy didn't make him any more "Asperger's"....it's simply the category that every specialist and doctor we know says fits him perfectly. Time and again we are told, "Sam is a textbook Asperger's kid."

Early on, we were told Sam had a severe speech delay and low muscle tone. Then we were told Sam was a "Sensory Kid." This meant noise, lights, and various textures were hard for him....which they definitely were. Early intervention helped him overcome many (and most) of these issues. As he has grown, we have a better understanding of what appear to be more long term challenges. For this very reason, the school district diagnosed him with Asperger's Syndrome following their evaluation. Every other doctor and therapist over the years have come to the same conclusion. Was Sam Autistic and then suddenly became Asperger's? Did we do just enough to get him to clear the Autism diagnosis hurdle and qualify into the Asperger's diagnosis? This is ludicrous thinking.

We didn't make Sam Asperger's-ish, therapy didn't cause his "Autism" diagnosis to be diminished and his "Asperger's Syndrome" diagnosis to flourish and grow wings. The same is true for our friends with kids who have more severe Autism. They are not more severe or moderate because they didn't do all the therapies, pray hard enough, or from a lack of trying. People always want to be able to point a finger, place blame on something or someone, and sometimes you simply can not do that. The cliques that exist in the special needs community disgust me. Yes, they disgust me. There are a lot of reasons why I refuse to take part in certain groups, cling to an organization, or join a maniacal tribe of inconsistency. I refuse because of how fake and transparent some are and they don't even know it.

We have done the 110 mile-round-trip-in-one-day for 4 days a week therapy schedule for many years, we feared that Sam would never speak more than 10 words, we were told he would be institutionalized, we did eating therapy for years to try and help Sam eat more than 3 foods, and there will be some therapies that Sam will likely always need. As our kids get older and their skills and abilities change, so will the gap in similarities between our experiences. This does not ever change the fact that all of us are parents of children with special and unique needs. The current umbrella diagnosis of Autism is much to broad and expansive. There is no single form or type of Autism. The misconceptions (right or wrong) and the stereotypes are often highly inaccurate. I do believe our children are all better served when the definition of their diagnosis best resembles their general capabilities. Grouping Asperger's Syndrome and Autism together is complicating things in school districts, faith based organizations and in communities around the world. This doesn't diminish the similarities that those with severe and high functioning Autism share. However, the two diagnosis are common today and they are more accurate when helping someone new understand what it is that your child is dealing with.

There is already enough to deal with as parents of children on the spectrum and our kids face enough challenges as it is. We don't need to add more "issues" to the mix by refusing to face reality. There is a difference between those diagnosed with Autism and those with the diagnosis of Asperger's Syndrome. These differences are exactly why people (every single day) use the two different terms to set expectations and communicate general capabilities. Ignoring it won't make it go away. We need to think about what will be most beneficial for our kids in the long run and generalizations that are extremely broad only fuel confusion and misunderstanding.

Comments

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great blog Kent. Your last statement says it all. What will be the most beneficial for our kids and grandchildren.

one more point...

Kent, I agree with almost everything you say about this issue. I would like to expand, however, on what you say about the autism umbrella being too broad: My feeling is that there is a political side to this. All of our kids are unique individuals and have a unique set of problems. Unfortunately, the health care system is primarily built on catagories, codes, and stereotyping systems. There are enormous political forces at work hammering out "reforms" for health care legeslation in many states concerning autism. Central to this is the concept of "science-based" treatments. The medical bureaucracy and insurance industry uses statistics and percentages to determine what is "science-based," and approval (insurance coverage) is only given to treatments that benefit a huge percentage of a given group.
It is to the insurance lobby's advantage to make the group as large and all-encompassing as possible in order to drive the percentages down. If they can show that a given treatment isn't effective for some percentage of the community, they don't have to pay for its use for anyone.
Those of us who have been denied insurance coverage for years for "unproven" biomedical treatments that are, in reality, working for our kids, know what's going on here. We laugh (in a sad, ironic way) when we hear people saying that kids with Asperger's will get more support and more benefits under the "autism" catagory, because the opposite is obviously true.
Just beneath the surface of all of these issues in the media is a labyrinth of economic and political issues that only we who have been in the trenches for ten years can see.
Best wishes to you, your family, and Sam.
Jim