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How would you define High Functioning ASD/Low Functioning ASD?

39 replies

ghoulsforgodot · 07/11/2010 15:35

Just curious really.
Are there certain criteria?

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LucindaCarlisle · 07/11/2010 20:36

Purple, I am not convinced that people with Aspergers realise that they are different from other people. People with Aspergers may simply think that they are eccentric. Many people with Aspergers have not been correctly diagnosed and if they HAVE been diagnosed the DX has not been communicated to them.

Twowillbefine · 07/11/2010 20:50

I find this interesting as we have received no indication from our various HCPs as to what DS1 would be. I have sort of assumed that this is because he is still so young. He's nearly 4, non-verbal (although beginning to have a go Grin), and still in nappies. We've only been told ASD and significant speech delay - when have others been given a more specific diagnosis?

Marne · 07/11/2010 20:58

Twowillbe- dd2 is 4 and has a dx of ASD, the pead said it was too early to say where on the spectrum she is but she suspected it would be HFA. Dd1 was diagnosed with AS when she was 4.5 but i guess it was easier with her as she was very verbal (when tested by SALT she scored at the level of a 12 year old). Apparently they don't like to give a full dx until they have been at school for a while as they can change so much in the first year.

Dd1 knows she is different from others and knows she has Aspergers but doesn't understand why others don't want to be friends with her.

genieinabottle · 07/11/2010 22:26

DS who was dx 4 months ago at age 4.7 was given the dx of autism (and speech and language disorder).
We were verbally told by his comm.paed that DS presented as 'mild' and HF. So was expecting a dx to reflect that.

But the team who dx DS did not want to write anything about where he is on the spectrum, on the dx report his dx is autism because of his ADOS score which was 12 meaning it's in the range for autism.
But they explained in details about his strenghs and weaknesses and if you read between the lines a lot indicate he is HF imo.

purplepidjin · 07/11/2010 22:39

Purplepidjin-thats interesting. So you reckon its an inability to conform really esp with functional living?

I have worked at two different schools with children (mostly teenagers) who have been diagnosed as being both ends of the autistic spectrum.

One school was for children dx with Asperger Syndrome or High Functioning Autism. It is a specialist school, and all the students were aware of why they were there. That's where I noticed the difference in thinking between those considered to have AS and those dx with HFA.

I then moved to a school for children with Autism and Severe Learning Difficulties. Those students displayed very little interest in the world outside their own, even the very verbal ones. They required constant 1:1 supervision to keep them safe, support with toiletting, dressing, eating and playing, and had no awareness that other people might have an opinion of them.

Marne, that echoes what students have said to me about it :)

Lucinda, I think we might mean the same thing although I might not have typed it well :) The children I have met who have Asperger's don't understand why they are different to the world. Those with Autism don't understand why the world is different to them.

The Autistic Spectrum covers many things. All children are different, and those with ASD possibly more so!

tiredmummyoftwo · 08/11/2010 06:24

DS was diagnosed at 2.5 with childhood/Classic autism. At the time of diagnosis he was verbal with few words, knew his colours/numbers and just started to copy words said to him. He was nearly toilet trained at the time and fully toilet trained by 2.8. He scored very low on his ADOS test ( I think that is what they used) on everything, he did not give them any eye contact and I think within few minutes of meeting him, the team at CDC decided he had classic autism. Although I heard the word autism, it did not mean anything to me at the time, so it did not occur to me to ask any questions about the diagnosis. I think DH was too shell shocked to ask any questions. Now I still wonder why DS got a diagnosis of classic autism? Reading this thread making me understand a bit of it. DS has no understanding that he is different in any way from other kids, he is quite oblivious to any kids looking at him differently. He wants to play with other kids, but only his games, not their games, so he will quite happily carry on playing his game alongside them without paying any attention to what the other kids doing.

ArthurPewty · 08/11/2010 06:55

This reply has been deleted

Message withdrawn at poster's request.

mum2twoboyz · 09/11/2010 13:06

read this thread with interest, altho my ds2 seems so different from every other child ive read about!!

he was dx with asd at just over 3 (nearly 2 yrs ago) and had very little speech and in nappies, along with the usual tiptoeing and arm flapping etc...

now, ppl say hes a social autistic, as he is happy at school and around others, yet he has very little language to communicate, and is happy just to run around..... his language is improving, but no way is he like a nt 5 year old. hes still in nappies, and very often wont feed himself.....

everything i read is confusing, as he seems to be happy around ppl, but doesnt appear to be fussed bout friends (but we arent sure due to no language to explain) he has limited language, and colours & numbers are still beyond him! i honestly wish i knew which 'box' he fitted into.....

it honestly does show that every child is different, just like every nt child, but that doesn tmake it any easier for us does it???

amberlight · 09/11/2010 14:02

The international (DSM V-led) plan for 2013 so far that autism is going to be diagnosed?

  1. If the person is socially very ?clumsy?
  2. And can?t work out how to communicate socially without causing offence
  3. And can?t make relationships work properly, compared to the average person.
  4. And shows two out of three of these:(repetitive movements or sounds and/or sensory processing difficulties; huge need for routine or ritual; very specialised interests
  5. And these things have to be true for our whole lives.

The experts will still be able to say whether someone?s autism is mildly, moderate or severe. But there will be no need for labels like ?Asperger syndrome? any more. It?s all going to be autism. Many leading charities are planning the switch to this, because it makes far more sense. There is little or no evidence that the brain is different in Asperger syndrome than it is in autism, so far. Speech difficulties are thought to be a separate disability and not really related to the level of autism.

The experts will also be able to say whether there are additional things such as a low IQ or language difficulties or dyspraxia, epilepsy, ADHD etc. It should mean that people have a more accurate diagnosis and their teams can put in place better support.

Measuring quality of life includes the following:

? Basic safety and hygiene
? Appropriate food and drink
? Being able to access good healthcare
? Being able to make good choices in life, freely (within the law).
? Being included and accepted in society
? Being able to contribute to society in a respected way
? Having enough money to enjoy a normal quality of life
? Having the freedom to decide where to live (safely) and who with
? Being able to safely express feelings
? Being able to express and enjoy any spiritual needs
? Having friends and safe relationships
? Being able to vote and have a say in how society operates
? Being able to travel with freedom and security
? Being able to enjoy hobbies and interests

There are nearly always major barriers to these for someone on the autism spectrum, no matter whether mild, moderate or severe. Sensory, routine and comprehension difficulties, combined with social isolation and bullying, mean that even the most ?able? of adults can have huge problems accessing everyday things. We may be living in a state of constant fear and anxiety about the smallest details of everyday life,and struggling to feel any sense of self-worth and achieve the most simple friendship.

?Neurodiversity, Quality of Life, and Autistic Adults: Shifting Research and Professional Focuses onto Real-Life Challenges? by Scott Michael Robertson says more about these. (Disability Studies Quarterly, Vol 30, No 1 (2010))

The National Autistic Society writes, ?Asperger syndrome is not a 'mild' form of autism. It is a serious disability?

www.autism.org.uk/about-autism/research/information-for-pupils-and-students/families-the-impact-of-autism.aspx

Certainly if you have autism and a low IQ and lack of speech, that's worse than just autism.

If you have autism and dyspraxia and sensory processing difficulties and arthritis and hearing loss, that's worse than just autism too.

So, hopefully we'll move to a system that says if you have each type of disability, mildly, moderately or severely...and guides teams on what to do about them separately and combined.

amberlight · 09/11/2010 14:04

ooo, I wonder how it got a sad face in the middle of that? Blush

SantasMooningArse · 09/11/2010 14:23

mum2 he sounds a lot like my ds3, who is a sociable child with autism.

He does display autistic criteria but coming at it from a different angle- instead of his inappropriate social skills being withdrawal, theya re through non discrimination between people, being in your face all teh time, having absolutely no social nouse IYKWIM.

Now, he is seven and school agrees that as he ages he becomes more obviously autistic- more spells of withdrawal for example. But he is still sociable (the reverse of my AS ten year old) and every time he accesses support someone asks to take him home LOL!

He also attends a school where every child has Sn but not ASD yet fits well with the ASD children; we was diagnosed at 6.

According to all teh definitions I have, it's a simple criteria- AS = triad with no language delays ; HFA = triad, language delays (technically at age 3) but IQ above 65; LFA = triad, language delays at age three, IQ below 65

BUT

In many children like my ds3 there also needs to be an awareness of functional ability- ds3 does have a high IQ but will never achieve independence even of the basic level of a self managed shopping trip becuase of his withdrawn times, innocence and complete inability to pay attention to more than one thing- he just doesn't have a seconds stream of attention to give. The high IQ is great- it emans he can read, play PC games, etc- but won;t make the difference between independence and dependence.

There's also ds1, whose AS can be undetectable in small timespans, has a decent IQ but when he loses it goes so badly that as a pre-teen he needs 1-1 adult supervision at all times or people get hurt.

The more I experience their growing development, the more I relaise that IQ etc is mroe significant to soem than toehrs: if for example you ahve extremely poor social skills but an IQ that allows you to access a very specialised work or academic area then it buys you much; otoh if a high IQ fails to be backed up by functional ability then it is as nothing in the reality of things.

And the same for L:FA children: for the very lowest functioning then very little else will get in a look edgemways and tbh many APeds would see a dx of LD before the ASD co-morbid; however, a child at the higher end of LFA may well have prospects oif they have otehr comorbid skills- I worked in a unit whrere the people meetiong that deascription wpould make money for themselves cleaning buses at the depot; these days those people would have more independence probably being in supported accomodation rather than a unit.

And yes- wrt to the use of autistics: not something I like. PArtly for the simple phraseology but also becuase it reads as a denial of their humanity. The mroe we head down the avenue of gentic explanations for ASD the mroe the freaks* creep out of the cupboards with comments about genetic differences equate to non humanity; keeping the people in the terms we use matters.

*Whilst nto a word I often use, am happy to utilise freaks for anyone wishing to deny my boy's humanity.

purplepidjin · 09/11/2010 17:51

"And yes- wrt to the use of autistics: not something I like. PArtly for the simple phraseology but also becuase it reads as a denial of their humanity. The mroe we head down the avenue of gentic explanations for ASD the mroe the freaks* creep out of the cupboards with comments about genetic differences equate to non humanity; keeping the people in the terms we use matters.

*Whilst nto a word I often use, am happy to utilise freaks for anyone wishing to deny my boy's humanity."

I've always thought of it like this:

Someone with cancer is not a Cancer.

Someone who plays music is a Musician

Someone on the autistic spectrum is not an Autistic.

It's a medical/neurological condition, not a career choice!

Eloise73 · 09/11/2010 20:52

When we first got DDs diagnoses of autism we wanted to know if she was high functioning, for some reason we felt that meant she would be ok, no idea why we thought this.

We are now 3 months post diagnosis - and we have no clue if dd is high functioning and i'm not too fussed as long as she gets the help she needs.

She loves being around kids but on her terms and isn't that keen on being touched. She goes up to them and you can see she wants to join in but doesn't know how. She can count to 100 and knows her alphabet, colours etc but cannot answer basic yes and no questions. She has no sense of self and i'm still not sure that she understands that I am her mummy (she calls me mummy but she may think that's my name). She gets insanely jealous when my husband and I kiss (daddy is HERS lol!) and laughs hysterically at slapstick humour like You've Been Framed. Yet is you just simply smile at her that will usually not evoke any reaction.

She gives kisses if you ask her too, never spontaneously, can feed herself well, loves her food yet is completely oblivious to bowel movements. She loves to sing, knows dozens of songs yet if you ask her what her name is or what she'd like for breakfast she will greet you with a blank look.

So...is that high functioning? No bloody idea. But she's happy and improving and we're hopeful that we can bring her very low communication up to a level where it will help/compliment her obvious ability in other areas.

The way I see it our job is to find their strengths and weaknesses and help them and guide them towards their strengths. Reading Temple Grandin has inspired, taught and changed me and my views on my beautiful funny daughter. Being high functioning or not I guess will always be subjective. She functions pretty darned good to me Grin

ghoulsforgodot · 09/11/2010 21:09

Eloise-thats lovely!

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