ASD & AS High Functioning is there a differnce?????

[manicmum]

Hi everyone

 

My son was diagnosed last year they said it was ASD i have now received a letter from my sons paditrician to go towards his statement at school and it say it AS high functioning and just wonder if there was any diffence between this and ASD??? Does it mean he is the more able end of the spectrum?? Did look on the interent but was getting so confused so thought would be eaiser to ask on here

[Tally]

ASD includes all kinds of autism, including Asperger's and "classic" autism.

 

The difference between HFA and Asperger's is to do with early childhood development.

If there has been significant speech delay, then the diagnosis would be HFA.

If there has been no speech delay, or only minor speech delay, then the diagnosis would be Asperger's.

It's very difficult to tell the difference once speech does develop. Both Asperger's and HFA would be considered more able types of autism, but people with either diagnosis can still have significant difficulties.

 

There is no such diagnosis as high functioning Asperger's, but it is sometimes used as a descriptive term.

[smiley1590]

this came up in conversation the other day .....my pyschologist said she worked with both groups H.F.A and A.S and only real difference hard to recognise unless know individual case and situation behind closed doors is that H.F.A have LD's attached too and they not bothered if they have NO friends don't socialise where as A.S wants friends but finds it extremely hard and difficult task to achieve successfully!due to social anxiety lies beneath the surface it is easy mistake to make classify both the same condition as i know some do .... not well explained the difference between the two conditions as so simliar affected and high functioning autistic conditions people assume it has to be the same diagnosis!

[Mumble]

H.F.A have LD's attached too

This is not correct. The only difference between HFA and AS is, as Tally has said, in terms of early speech development. HFA and LD cannot go together because HFA requires an average or above IQ and LD requires a below average IQ - although both HFA and AS could also have a co-morbid SpLD which has nothing to do with IQ.

[chris54]

On my sons diagnosis it says "High Functioning Autism presenting as Asperger's Syndrome".

This has led to the two terms being used almost interchangeable by the professionals involved with him.

 

By LD do you mean Learning Disabilities. This is to do with IQ.

 

Learning Difficulties has nothing to do with IQ. My son has a high IQ but is also described as having Moderate Learning Difficulty.

 

But of course now things like Dyslexia is being described more and more as a Learning Disability which would makes the statements that both I and Mumble's made about IQ incorrect as there are many people who have AS who are also dyslexic.

[JsMum]

This is not correct. The only difference between HFA and AS is, as Tally has said, in terms of early speech development. HFA and LD cannot go together because HFA requires an average or above IQ and LD requires a below average IQ - although both HFA and AS could also have a co-morbid SpLD which has nothing to do with IQ.

 

 

Learning Disability doesnt always mean a low IQ either, a learning Disability requires an impairment that can be in different sections of a disability, you can have a Learning Disability and still have a normal IQ.

 

My son has a learning disability because though he has an average IQ he can not apply his intelligence to everyday tasks and has considerble impairments in other parts of his development.

 

This is interesting information here.

 

 

 

http://www.learningdisabilities.org.uk/information/learning-disabilities-introduction/?locale=en

 

http://www.bild.org.uk/pdfs/05faqs/ld.pdf

 

JsMumx

Edited October 29, 2010 by JsMum

[Sally44]

It can all get very confusing.

My understanding is that it is as Tally says. The different diagnosis of HFA or AS relates to the acquisition of language. There is a close link between difficulties acquiring language and learning difficulties.

 

Learning difficulties for those with an ASD (which includes HFA and AS) usually means they have a "spiky profile". That means that in assessments their abilities can vary a great deal. My own sons range from percentiles of less than 1 (where 99 children out of 100 would perform better than him) to 92nd (where only 8 children out of 100 would perform better than him). This variance in abilities can be due to cognitive/sensory processing integration or delays, difficulties with concepts or abstract information, problems with sequencing information, working memory or memory retrieval etc etc - the list is quite long).

 

Spiky profiles are typical of ASDs.

 

On top of that the child can have a specific learning difficulty such as dyslexia.

 

I have recently wrote to the Developmental Paediatrician because in her letter to me some months ago she listed ASD, SID and Learning Difficulties as my son's diagnoses. He has now been diagnosed with Dyslexia and she has added that to the list and has kept "learning Difficulties"

 

My feelings are that he has a cluster of abilities that are just below, average and above average. Then he has specific abilities that are severely affected and other areas or special ability. So i've asked her for some 'clarification' as to what learning difficulties mean - especially when he has so many 'average' results.

 

To further confuse the issue, there can also be language impairments and disorder. My son also has disordered speech, which again causes difficulties with language/learning. Eg. he said today "Have you seen the remote where I put?" He meant to say "Have you seen where I put the (TV) remote?"

[AutisticMillionaire]

ASD = Autistic Spectrum Disorder, all forms of autism come under this

 

Asperger's and High Functioning Autism = for all practical intents and purposes, they are the exact same thing, and will be merged in 2013

[manicmum]

Thanks for your feedback guys

[Hortus]

So does that mean that Asperger's will now be a type of HFA or just another flavour of ASD?

 

My GP currently thinks I have HFA [and what I've read about it, makes it sound pretty likely] but there was apparently no delay in my speech as a child.

[baddad]

Hi manicmum -

 

this came up yesterday too... There isn't officially a diagnosis of 'High Functioning AS...' The AS diagnosis implies an IQ of 'average or above' with no upper limit on the 'above' which could be 'genius'. So, as 'high functioning' in ASD's relates to IQ, 'High Functioning AS', despite its increasing use as a catch-all phrase, is actually a contradition in terms.

 

heres a link to yesterdays thread on the subject:

 

http://www.asd-forum.org.uk/forum/Index.php?/topic/25648-tired-and-falling-apart/page__view__findpost__p__299130

 

hope that's helpful

 

L&P

 

BD

[Mumble]

My GP currently thinks I have HFA [and what I've read about it, makes it sound pretty likely] but there was apparently no delay in my speech as a child.

If there was no delay in speech then you cannot have HFA as that is one of the essential diagnostic criteria.

[Hortus]

I'm very confused now.....

 

conflating the last few posts.... are we saying that;

 

AS is High IQ Autism with no speech delay

HFA is simply 'mild' Autism with speech delay

 

and that HFAS is a tautology as by definition AS is High IQ ASD ?

 

and that in 2013 'mild autism' will be grouped with AS?

[RainbowsButterflies]

I'm very confused now.....

 

conflating the last few posts.... are we saying that;

 

AS is High IQ Autism with no speech delay

HFA is simply 'mild' Autism with speech delay

 

and that HFAS is a tautology as by definition AS is High IQ ASD ?

 

and that in 2013 'mild autism' will be grouped with AS?

There is no such thing as 'mild' autism. If I remember correctly from the post the other day, Autism means an IQ of less than 70, High Functioning Autism means an IQ greater than 70 with speech delay, Aspergers Syndrome means an IQ greater than 70 with no speech delay.

[Hortus]

'There is no such thing as 'mild' autism'

 

 

I understood Autism is a 'spectrum disorder' and could therefore go from very mild to very severe. Or have I misunderstood 'spectrum'?

[Bluesbreaker]

Is it me or do all these different 'categories' I shall say, cause confusion at the time of diagnosis? and as well, can it be argued that we don't technically need HFA and just classify them under AS????

[Hortus]

'There is no such thing as 'mild' autism'

 

 

I understood Autism is a 'spectrum disorder' and could therefore go from very mild to very severe. Or have I misunderstood 'spectrum'?

[Hortus]

[apologies for repeat posting- connection is a bit ###### here]

[Mumble]

There is no such thing as 'mild' autism. If I remember correctly from the post the other day, Autism means an IQ of less than 70, High Functioning Autism means an IQ greater than 70 with speech delay, Aspergers Syndrome means an IQ greater than 70 with no speech delay.

This is correct. Actually, to be really pedantic, it's 70 or above, otherwise those with an IQ of 70 do not fit in.

 

I understood Autism is a 'spectrum disorder' and could therefore go from very mild to very severe. Or have I misunderstood 'spectrum'?

Spectrum can be very misleading and leads to labels such as mild and 'a little bit' - these are all very damaging. In my view, it's often not so much the Autism but the associated learning difficulties and other diagnoses that lead to the appearance of severe (or not severe) difficulties.

 

Spectrum if more to do with individuals being affected in different ways by the triad of impairment, and it's possible to be affected to different extents on each strand, but also for positions to move relative to environment and other factors.

 

Is it me or do all these different 'categories' I shall say, cause confusion at the time of diagnosis? and as well, can it be argued that we don't technically need HFA and just classify them under AS????

The new diagnostic manual will subsume all diagnoses just under Autism.

[RainbowsButterflies]

This is correct. Actually, to be really pedantic, it's 70 or above, otherwise those with an IQ of 70 do not fit in.

I do have to admit that I'm baffled that an IQ of 70 is considered high functioning though...

[Mumble]

I do have to admit that I'm baffled that an IQ of 70 is considered high functioning though...

High functioning refers to an average or above average IQ - nothing to do with functioning at all.

 

An average (mean) IQ is 100. The standard deviation (how spread out the scores are) for IQ is 15 points. Average / normal for any distribution is within 2 standard deviations of the mean, i.e 30 above or below. Approximately 95% of the population will fall within 2 SD, i.e. they have IQs of 70 - 130. However, this is only concerned with the low cutoff, hence saying an average IQ is 70 or above. Those with IQs of >130 are dealt with within 'above average' IQ.

 

But then IQ doesn't actually mean anything anyway...

[Bluesbreaker]

 

The new diagnostic manual will subsume all diagnoses just under Autism.

 

Oh chocolate pancakes! that's no good! I think Autism and Asperger's should exist as boundaries, but just not HFA, because all that basically is is Asperger's with speak delay.

 

Let's put it this way.

 

There is a breed of tropical fish called the Zebra danio, now there was another species called the Leopard danio, However, due to the genetics of these fish (zebra's striped, leopards spotted) they found that the leopard danio was just a zebra with a slightly different coding in the DNA which meant they were technically the same fish, so now the leopard danio is a sub-species..... wait....

 

erm....

 

yeah LOL

[smiley1590]

when assessed at 14 years old my I.Q level was 70 dead on!!! and but like others i'm confused over matter i did have speech and language delay but could this have been due to dyspraxia? but at time didn't know i had A.S? but then shouldn't i have been diagnosed with H.F.A instead of A.S as went to speech and language therapy when younger? anyone make this diagnosis clearer?

 

XKLX

[RainbowsButterflies]

Approximately 95% of the population will fall within 2 SD, i.e. they have IQs of 70 - 130.

 

Ah - I didn't realise that 'average' covered such a large spread. My statistics is (are?) very rusty!

[Boy]

The 'rules' aren't always stuck to when diagnosis is made. I know of people diagnosed with AS who have speech delay, and I know of at least one person diagnosed 'HFA' (or, I suppose, diagnosed with autism considered to be HFA) who had no language delay. Although those are probably exceptions to the 'rule', I think it shows again how that particular criteria doesn't necessarily count for much.

 

All supposed differences between HFA and AS tend to be silly myths, and, if diagnosed as an adult, surely language delay is irrelevant (or at least it definitely can be, if the person has required normal or even better than average language skills by that point). I also think that the term language delay is also quite a 'catch all', and so the difficulties can be caused by completly different things which complicates the issue. What if a child is perfectly capable of 'normal' speech but doesn't use it? What if a child never speaks save for one perfectly formed sentence (that wasn't echolalic in nature, and was in context? I know of a boy who is now 13, has never spoken save for saying, "You look nice, mummy," when his mum got dressed up to go out a good few years ago (this seems to suggest that it's hard to measure the ability). Then there are children who can verbally repeat things perfectly to near perfectly (echolalia), and request things using one word and are easily understandable when they do speak, but rarely even attempt verbal communication. Then you have children who try to communicate verbally on a regular basis but can't form the words correctly and are impossible to understand. And, of course, there are many children who aren't autistic who have some form of language delay. So, whilst I'm not saying that it's not at all relevant to someone's autism, and that it can't be a serious issue (especially if it lasts into adulthood) but I don't see how it can be simplified so much, yet still be seen as a way to separate two diagnosis for what are essentially the same thing.

 

I have struggled to put my view across here as I'm quite tired. Apologies if it doesn't make the sense I'm hoping it does.

[leeds_demon]

This is confusing. I have AS and yet, I'm not bothered whether I socialise or not. I had no delay in speech whatsoever and when doing reading tests at primary school, I performed very well.

 

Ergo, do I have AS or HFA?

[Sally44]

I think this is a very difficult subject for anyone to get their minds around.

I understand the difference between a diagnosis of AS or ASD (of which AS is part of), and that AS means there was near normal language development (however they still have to have language difficulties and social communication difficulties as part of the diagnostic criteria). That is confusing enough.

Then we add in the 'high functioning'.

Does that means regarding academic ability, or social ability or any other ability? What exactly is it that they have that is 'high functioning'? Can it be anything, or only specific things?

And, as already mentioned, what about those children with severe speech disorders, dyspraxia, CAPD, dyslexia etc who are performing badly academically due to those difficulties. If they were assessed on 'typical' assessments they would be below 'average'. But on other assessments they may well be 'above average'.

My own son was assessed as being on the 75th percentile. Yet the LEA EP has dismissed this result as irrelevent!

He also has percentiles which range from <1st percentile to above the 92nd. He has severe dyslexia. He struggles to read and write. He is years behind his peers in literacy, and a couple of years behind in numeracy. But in construction/design/acting and performing etc he is way ahead of his peers.

As those on the spectrum have spiky profiles, I would have thought it was therefore typical of all on the spectrum to perform well, or even brilliantly in some areas, and be pants in others?? I don't think anyone would be 'around average' on all skills. If they were, then surely they would no longer fit the criteria for a diagnosis of AS or ASD as there has to be significant difficulties in certain areas of performance.

So again where is the 'high functioning' coming from? Is it fair to only label 'high functioning' on 'academic skills', or should any areas of excellence mean they come within the 'high functioning' category?

There are some autistic children that cope well in mainstream. Are they high functioning?

When other highly intelligent AS children cannot cope. Are they low functioning?

[Boy]

This is confusing. I have AS and yet, I'm not bothered whether I socialise or not. I had no delay in speech whatsoever and when doing reading tests at primary school, I performed very well.

 

Ergo, do I have AS or HFA?

Desire to socialise or not being a difference between HFA and AS is a myth. There are no measurable differences between the two, other than speech delay. And based on that you have AS.

 

However, personally I'm of the opinion that AS and HFA are exactly the same thing.

 

 

Judgements about how high or low functioning someone is are very subjective, really. Even when comparing people who are generally considered to be low functioning you can find that one is also generally considered higher functioning than another, even if it's based on just one thing (such as one child managing to stay dressed while another insists on stripping off in inappropriate places, or one child using one word requests compared to another being completely mute, or a child who is able to use the toilet compared to a child who has to use nappies). Where it gets more confusing towards the higher functioning end of the spectrum,

 

I personally also find it annoying when the term ASD AND ASPERGER'S is used, because although I can accept that perhaps Asperger's needs to be used as well as 'autism' for clarification (so AUTISM AND ASPERGER'S makes some sense), if there are people who are just as high functioning but diagnosed autistic because of speech delay, then the separation is rendered pointless, and Asperger's is an ASD, rather than a separate thing, so ASD AND ASPERGER'S is pointless.