What Determines Level of ASD?

[sammythemummy]

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]

why do you ask?

fwiw, i hate the HF label

[sammythemummy]

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

[UnChartered]

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]

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.

[StarlightMcKenzie]

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]

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

[UnChartered]

that's another good point Star

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

[BeeMom]

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...

[inappropriatelyemployed]

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]

please inappropriate

that would be really interesting and helpful to me personally

[inappropriatelyemployed]

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.

[ApplePippa]

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 ) but is not "classified" as hf, for which I am actually grateful.

[someoneoutthere]

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]

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]

all received and thank you very much inappropriate

[inappropriatelyemployed]

See

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]

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

[YoniOneWayOfLife]

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

[tabulahrasa]

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]

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]

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

it's used to dismiss and minimalise

she is achieving academically

OP, have you run off

[ouryve]

Our paed never made any distinction when diagnosing the boys. Both have a diagnosis of "autism". The qualifier on DS1's was "with associated hyperactivity" which has since been further investigated.

I've never had much truck with the "high functioning" label. DS1 might be bright and articulate, but he's just as disabled as DS2. Perhaps more, because the world will tilt its head and make more allowances for a cute boy who can't talk than for a bolshy one who will tell you exactly what he's thinking.