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Difference between Asperger's Syndrome and HFAutism

(19 Posts)
Shells Wed 29-Jul-09 03:19:08

Hi. DS2 has just received a diagnosis of Asperger's Syndrome at age 5.3. We are in New Zealand and I'm conscious the system is a little different in the UK, but I'm interested in people's thoughts.

I know there have been some threads on similar topics but I need to unpack it all in my head. The diagnosis was a bit of a surprise as if anything, I was expecting HFA, and because he doesn't neatly tick all the boxes, I wasn't even sure he would get that. Its not bad news because it helps with funding etc. etc.

Here are my questions for those of you with experience:
1. The Paed here uses the Gilberg list of traits rather than the DSM list (although they use the DSM for Autism). The main difference that I can gather is that Gilberg doesn't use lack of speech delay/disorder as a criteria, which is why DS2 got the diagnosis. He has had a severe speech delay and still has a long way to catch up. Does anyone have an AS child who has/had a speech disorder (and I don't mean just quirks, but very delayed/disordered)?

2. He also doesn't have that classic AS thing of obsessions/interests and because of his lack of language he doesn't talk incessantly about his interests. Although he may in the future!
Do any of your AS kids not have these traits?

3. Do any of you have kids that seem to cross over these categories? (It does seem to me that DS2 has more in common with HFA than AS in some ways). Gilberg focuses on the desire to socialise - which DS2 does have. The Paed says this is what puts him in the AS category and not the Autism one.

I'm aware that on lots of levels these things don't really matter as its just a label and it will enable him to get more support. But I'm going back to the Paed with questions in a few weeks and I was wanting to get my head clear before then.


DidEinsteinsMum Wed 29-Jul-09 04:01:19

am watching this with interest. Am trying to get a dx for ds 4 who could be either or neither.

cyberseraphim Wed 29-Jul-09 06:49:20

No idea but my claim to fame is that Prof G. dxd DS1 and he suggested AS as a possibility despite lack of speech at the time (based on receptive understanding and relationship to me) so clearly has different ideas. DS1 has severe speech disorder at 5.5 so not AS by usual UK standards

Shells Wed 29-Jul-09 06:52:55

Oh how exciting! Well, in our little world... What was he like?
So was DS dxd as AS Cyber? Or just suggested. Sorry, I'm a little unclear from what you said.

cyberseraphim Wed 29-Jul-09 06:55:21

Well we did not really get a clear dx other than definitely on autistic spectrum (3.6) and wait and see about the rest of it ! Very nice and interesting man, definitely not Mr or Prof Average ! Very child centred/child friendly too which many professionals are not.

Shells Wed 29-Jul-09 07:34:13

Yes, it seems quite young to be dx with AS to me. But there you go.
I'm trying not to get fixated on what he 'is or isn't', because he's just lovely DS. But its interesting all the same isn't it.
I'm glad Prof G was nice - that makes me feel better - rather ridiculously!

DidEinsteinsMum Wed 29-Jul-09 09:03:21

I can i ask a question? Have you found getting help from the correct people easier since diagnosis? I have magor problems with some aspects of ds' behaviour and cant get any help at mo. should i push for the second opion i wanted?

bubblagirl Wed 29-Jul-09 09:17:33

my ds has HFA and speech delay and have always believed that AS was without speech delay but have met several parents along the way who's children have AS and speech delay i think AS and HFA are so close on the spectrum there is so little setting them apart only who's dx iykwim

i hope your ok and will now receive more help for him with a dx

bubblagirl Wed 29-Jul-09 09:20:36

not sure of any interest

cyberseraphim Wed 29-Jul-09 09:30:14

Link to Podcast by Prof.Gillberg

sadminster Wed 29-Jul-09 13:16:43

This is really interesting. I have two close friends with children with ASDs - both were significantly language delayed at 4 but since neither family accessed services/diagnosis until the children were 6+ they were diagnosed with AS, I wonder if they would've been diagnosed with HFA if they'd been seen at 3?

DidEinsteinsMum Wed 29-Jul-09 14:10:25

Is language delay a pre requesist and ds in language advanced. Could this be part of the problem in his diagnosis - he is not ticking some of the classic boxes.

amberflower Wed 29-Jul-09 20:42:20

My DS was DX'd as 'meeting the criteria for ASD with an Aspergers type presentation' at 4.9. I would agree with bubbla, HFA and Aspergers are probably very similar in many ways and to an extent it might just depend on who DXes. For example I have read posts from mums on here whose DCs are 'probably' aspergers but paeds will not 'formally' diagnose till 6/7 as they feel 4/5 is too early to tell. Inevitably the professionals will differ in their views and approaches.

DidEinsteinsMum I don't think the language thing is a prerequisite. My DS had no speech delay at all and his language is in the normal range. Neither does he do the obsessional interests (or the talking 'at' rather than 'to' people) commonly associated with Aspergers either. However, he definitely has some kind of auditory processing delay - for example will not always respond to a question or instruction first time but generally does once it is repeated and if his name is used in conjunction with the instruction.

He also definitely has the desire to socialise with other adults and children but can be shy with strangers and is very withdrawn at school, showing some ASD traits there, hence why they initiated the DX process.

coppertop Wed 29-Jul-09 21:10:45

1) Ds2 (AS) was dx'ed initially at 2yrs old. Four years later he still sees the SALT for help with his disordered language development. At 4yrs old he was getting scores of 3 or 4 in CELF tests. (A typical score for an NT child would be 10, and a low average score would be 7).

His spoken language has improved a lot since then but he still has difficulty with receptive language.

2) Ds2's talking about his interests increased as his language skills improved.

3)Ds1 has HFA and seems to cross over a lot with AS. After a late start with language he now has very good language skills. He also has the more typical AS obsessions.

There are also times when ds2 definitely seems more HFA than AS.

Both boys have friends but ds1 has more of a take-it-or-leave it approach than his little brother.

macwoozy Wed 29-Jul-09 22:05:41

Ds was diagnosed with ASD at 3 years old. During the multi disciplinary it was evident he was going to be diagnosed with an autistic disorder, so I asked the physcologist if he thought it was Aspergers, he made a commment about ds not being clever enough. Ouch!!! And yet when I read his report he stated that he was showing elements of Asperger syndrome. I would be interested to know what they were and why he said that.

At 3 years he had quite significant language delay.

He has always had very keen interests. He was able to name every car before he could actually communicate, but it's really only been in the last 18 months since his interests have taken over his thoughts and behaviour. He is now 9 and is pokemon mad, talks it to me all the time, and when he is at a park for instance, will shout pokemon names and incorporate it in all his games. I watched him today at a park, another girl tried to play with him but he just confused her with all his pokemon talk. At school I don't think he shows such a strong obsession so I think he must be able to control to some degree.

He is in a language unit and his teachers often refer him to having Aspergers and I would imagine that if he was diagnosed now at 9 he might well be diagnosed with Aspergers.

PipinJo Wed 29-Jul-09 22:42:50

Message withdrawn at poster's request.

lr2224 Wed 29-Jul-09 23:02:15

I was out with someone from an Autism charity the other night (friend of a friend) and she said that the apparent 'official' difference is that HFA diagnosis will be given where there has been a speech delay. If there is no speech delay then an Aspergers disorder will be given.

lr2224 Wed 29-Jul-09 23:03:18

Meant to say though that I think a lot of people interchange the two terms. The reason the question came up was because I have a nephew who was diagnosed as Aspergers but last dr they went to see mentioned HFA.

Shells Wed 29-Jul-09 23:49:57

Thanks everyone. PipinJo and Ir2224, thats what I'd always thought - that the speech delay was the differential between the two. But this new method of diagnosing (Gilberg) says no. So thats where my bafflement began.

I think as Amberflower said, diff Paeds will use diff criteria.
I guess the way that it can manifest itself negatively is that then professionals (and I mainly mean teachers) can have all sorts of misconceptions about what an 'aspergers child' is and what they're capable of.

I've already had a (very experienced) teacher saying 'I've taught lots of AS children, but they're usually very clever'. Hmmm. I wouldn't say that DS has a learning disability - but he has a LOT of difficulty at school because of his speech delay.

And round and round we go...

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