Here some suggested organisations that offer expert advice on SN.

What Determines Level of ASD?

(64 Posts)
sammythemummy Sun 05-May-13 16:02:33

Is HF determined by how verbal a child is or how social?

Eg:

Child 1 (Lets say they are both 3 yo)
Speaks in 1 or 2 word sentences, has expressive and receptive lang delays but is very sociable, plays well with other kids, has good eye contact with people he knows, no sensory issues and can read people's emotions.

Child 2
No speech delay, speaking may even be above average. Has sensory issues, does not do well in social gathering, has poor interaction, rigid routine.

Which one of these children would be classified as HFA?

UnChartered Sun 05-May-13 16:05:51

why do you ask?

fwiw, i hate the HF label

sammythemummy Sun 05-May-13 16:11:11

I want to know how experts classify children. Why do you hate that label? Im quite inexperienced in this so I don't really know what's offensive and what isn't confused

UnChartered Sun 05-May-13 16:14:44

it's not that i find it offensive, but it is often mis-used to minimise and discount the issues a child with ASD might have

autism is a spectrum, there isn't a one-size fits all definition, it is diagnosed by assessments to see if the person has impairment under this triad

chocjunkie Sun 05-May-13 16:19:15

afaik, the high functioning definition relates to someones IQ (being normal or above average). but it does not refer to mild or severe asd - this depends on how much the autism impacts on someones life as that one can be high functioning but also severly autistic if that makes sense.

The child determines the level of ASD imo, and the parents advocate for that.

I also hate HFA. And actually I do find it mildly offensive. My child is not a robot. He doesn't 'function', though I would argue that he is unable to use many of his skills functionally, though more capable than some other children with ASD.

UnChartered Sun 05-May-13 16:21:07

that makes sense to me, choc

i'm not having a good day with autism today, thank you for explaining that in way i don't feel able to right now thanks

UnChartered Sun 05-May-13 16:24:00

that's another good point Star

if 'HF' is a way to describe how the actual body functions hmm that takes away from the fact that autism is a neurological disability, because neurology is a sort of function after all?

BeeMom Sun 05-May-13 16:37:03

With regard to "HF", I find that it can minimize the degree of seriousness that the child's struggles are attended to.

Of course, the child who has no effective language, becomes easily overwhelmed and strikes out defensively, has ultra-rigid routines and repetitive behaviours will be viewed in a different light as the child with less "obvious" challenges. I wonder whether it is necessary to even attach qualifiers to the dx to point it out.

By calling it HF, it is like saying you have "mild" cancer or "a little bit" of diabetes. Regardless of the severity, it needs attention and treatment - and it is going to be life altering...

PolterGoose Sun 05-May-13 17:16:30

I've come to hate the 'high functioning' definition too. My ds's dx is Aspergers, which, like HFA, seems to be seen by many as some sort of mild autism, which it isn't.

Diagnostically it should be something like this:

ASD (ie the triad of impairments) plus at least average IQ with speech delay equals HFA

ASD plus at least average IQ plus no significant speech delay equals Aspergers

Neither criteria bear any relation to the severity of the ASD itself.

PolterGoose Sun 05-May-13 17:20:55

Returning to the idea of 'function', IQ is a crap way to measure how well any person can cope with 'normal' life. My ds is very academic but cannot cope with social situations without a lot of support, if at all, he cannot recognise his own or others emotions, he has huge anger and anxiety issues, lots of sensory problems and is highly demand avoidant, they have nothing to do with IQ and they do disable him significantly.

inappropriatelyemployed Sun 05-May-13 17:29:52

I went to a really interesting conference a while back which reviewed the recent research into autism. The term 'high' and 'low' functioning were deemed to be complete misnomers - red herrings.

The conclusions drawn from research (brain imaging etc) were that there is autism, as expressed by the original descriptions from Asperger and Kanner, and this may be accompanied by intellectual impairment and/or delays with language development. But autism is autism.

Work done on sensory processing difficulties for example has demonstrated that there is no difference between those considered to be 'high' functioning and those deemed 'classicly autistic'

I can post the names of those writing on this if anyone is interested.

UnChartered Sun 05-May-13 17:33:04

please inappropriate

that would be really interesting and helpful to me personally

thanks

inappropriatelyemployed Sun 05-May-13 17:34:34

If you would like to PM me your email, I can send you the slides from the talk.

Will do the same for anyone else interested too.

PolterGoose Sun 05-May-13 17:36:21

I'd be very interested in that as well. TBH, I mostly now say ds has autism, because when I say he has Aspergers I get ridiculous comments about how lucky I am he is so clever hmm

ApplePippa Sun 05-May-13 17:40:29

Polter, I agree. My DS's official diagnosis is "autism" - just that. He is at pre-school with another boy with a dx of hfa. He is very intelligent little boy and does not have my DS's severity of speech delay, yet his problems are far greater and far more complex.

The IQ thing confuses me anyway. DS certainly falls within average, (described as "a clever little boy" by the EP grin) but is not "classified" as hf, for which I am actually grateful.

someoneoutthere Sun 05-May-13 17:40:34

Appropriately, can I ask a probably duff question? The research on brain images- does it say autistic ( autism brain?) brain images are different? I am curious as DS had a recent MRI, but there was nothing different apparently. It ruled out any brain damage during birth.

inappropriatelyemployed Sun 05-May-13 17:47:24

People like Eric Courchesne are looking at brain imaging and brains and identifying differences in neural connections in the autistic brain. But this is not a diagnostic text.

At present, we are still reliant in behaviours to demonstrate and confirm autism. It is clear that the sensory processing differences are massively significant - this includes the processing of all types of information.

UnChartered Sun 05-May-13 17:52:51

all received and thank you very much inappropriate

inappropriatelyemployed Sun 05-May-13 17:59:09

See here

Also, Sue Leekam in a 2007 paper said there is no difference in sensory issues between those we regard as ‘high-functioning’(Asperger) and those we consider to be ‘low functioning’(classic autism)

inappropriatelyemployed Sun 05-May-13 18:02:05

Sensory processing issues, including how we respond to outside stimuli, arise from the biology of the brain.

YoniOneWayOfLife Sun 05-May-13 18:05:44

I'm struggling with this as DC was dx recently with "ASD" but the clin. psychologist verbally used the term High functioning and said he met the criteria for Asgergers. So I have no idea what to actually say he's been diagnosed with hmm

tabulahrasa Sun 05-May-13 18:11:59

High functioning has nothing to do with day to day functioning, how autism affects an individual or anything else practical or useful to a parent really.

It's just about cognitive functioning - all it tells you is whether there is an issue affecting IQ or not.

inappropriatelyemployed Sun 05-May-13 18:16:34

But this is the problem. intelligence and function aren't the same and the diagnostic criteria have nothing to do with intelligence. There is a move away from using such terms (or there should be) and I think any clinician using them should explain what they think they mean.

UnChartered Sun 05-May-13 18:20:50

we're lucky in that respect, our paed psych has never used the term, DD is DX ASD

it's mainly school who use the term, despite them not having enlisted an expert opinion at all angry

it's used to dismiss and minimalise

she is achieving academically <sighs>

OP, have you run off grin

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