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Can someone please tell me what HFA is?

14 replies

5inthebed · 14/04/2011 20:46

Or more so, how a child would be classed as having it?

DS2 has autism, and I know he isn't on the high end of the scale, but I also don't think he has HFA. Is there a middle?

TIA

OP posts:
EllenJane1 · 14/04/2011 21:07

As far as I'm aware HFA is defined at ASD with normal IQ.

But I was also told that it also means how disabling the autism is. If you can function well you are high functioning, if your autism is severely disabling, even with a normal IQ, then are you high functioning?

My DS (11) has a HF ASD DX. He is average at school, better at Maths than English but really obviously autistic, lots of stims and a high pitched voice. No conversation except about obsessions, no social skills but also not bothered by friends. Emotions are up, far down or passive. I'd say he is not very high functioning despite his normal IQ.

The child I support as a TA has a lower IQ but still within the 'normal' range. He is hardly noticeable as being ASD to a casual observer, so I'd call him high functioning.

EllenJane1 · 14/04/2011 21:09

Aspergers is a type of high functioning ASD with no speech delay.

zzzzz · 14/04/2011 21:20

This reply has been deleted

Message withdrawn at poster's request.

EllenJane1 · 14/04/2011 21:30

That is the official definition, zzzzz. It's not very helpful, though, would you agree? DC with AS can be really struggling but are still considered HF. It's a strange phrase, functioning, as IQ hasn't much to do with how someone with ASD can function.

Toppy · 14/04/2011 21:37

May I jump in and ask at what age a child's IQ can be assessed ?
We got a dx of plain ASD in Nov just before DS was 3 and I asked if they could tell us where on the spectrum he was and they told us that would happen later down the line.

PS EllenJane1 - not sure how long you have been around on MN but I am really glad you are, esp in light of the recent exodus of top advice givers. You have some truly excellent advice and insights.
(feels a bit shy of being so gushy)

EllenJane1 · 14/04/2011 21:48

Aww shucks, Toppy. Only since late Jan, but am seriously addicted! My DH is not so keen. But I've learnt lots myself since being here.

Agnesdipesto · 14/04/2011 21:50

Yes I understand it to mean IQ as well - often it is used as meaning anyone with an IQ over 70 and therefore not judged as having an additional learning disability (70 often being the cut off for LD schools etc)
However i think it also often gets used as meaning good speech / level of functioning too
IQ can be very misleading in Autism as my DS can score within the average range on many academic or skill tests but his actual everyday level of functioning in terms of speech and practical ability to do things for himself is at least 2 years delayed (he's 4). On the triad he scores as severe even though his IQ is apparently normal.
Also I expect his level of functioning to improve as he gets older and for him to move up the spectrum
This can even relate to Aspergers as you can have young adults at university with very high academic IQ and advanced speech ability but they can be unable to organise themselves, take a shower etc etc
So in my mind academic IQ is a bit pointless if it does not translate into independent practical use of ones IQ. There should be an academic IQ and a functional IQ.

Also we now know from adults with autism who have written books that being non verbal does not mean low IQ - in the past I think it was assumed if you could not speak you were low functioning but then some non verbal adults started writing novels and blogs so that myth was blown apart.

Children with autism often underscore on formal IQ tests for their cognitive ability because so many of the tests are language based. So its known to be very unreliable to assess a child's IQ

Temple Grandin for eg would have scored as severe ASD and LFA as a 4 year old child (no speech) but is now the most famous HFA person. So her level of functioning has changed dramatically over the years. She is often referred to as Aspergers but in fact she had classic autism (with severe speech delay).

Under the new diagnostic criteria DSM V being proposed I think a child may get assessed against the triad so could be severe in one area and mild in another - and they also plan to include sensory problems. I would think (hope) in future you might get a more detailed diagnosis.

If I was allowed to give my DS his dx I would score it as:

Classic autism, with speech delay but no additional learning disability (IQ in average range)
Language deficit - severe
Social deficit - severe
Repetitive behaviours - severe
Sensory issues - mild
Challenging behaviour - mild

And that could change over time eg as he develops language

Its also often missed that classic autism children are delayed and grow up much slower than other children but that does not necessarily mean they will not get there in the end. So many children will start as severe and end up moderate or mild.

At the moment my DS has a moderate autism dx but in my view this is not accurate - he is severe - so in effect his IQ score is cancelling out his autism severity score and meeting in the middle. It would be much better in my view to score each element individually as that would actually reflect the reality.

If you look up the proposed DSM V that can be useful to score your own child.

EllenJane1 · 14/04/2011 21:52

Oh, not sure when they can assess IQ. EPs assess using lots of standard tests which give centile scores. Others on here know more. But my DS was assessed at about 5.

Toppy · 14/04/2011 21:57

Great post Agnes. Very thought provoking and one I am going to bookmark and come back to as DS develops.
I just had a quick look at DSM V and it looks exciting in terms of being bang up to date. Is this used in the UK at all - I am not very au fait with the testing they use in the NHS.

EllenJane1 · 14/04/2011 21:59

Agnes, another great post. I'm building quite a collection of them.

My DS at 4 would have been very similar to yours. Sensory issues are there but as he is mainly hyposensitive they are not too troublesome. He had no language at 3 and no sentences until 4 but still has very little conversation at 11. He has coped well in primary, soon to try the big adventure of secondary.

zzzzz · 14/04/2011 22:48

This reply has been deleted

Message withdrawn at poster's request.

EllenJane1 · 14/04/2011 23:09

So the consensus is, HF ASD is ASD with a normal range to high IQ, 70 and above. It has no connection to how severe the difficulties may be.

Asperger syndrome is a HF ASD with no history of language delay.

Some people can be more severely affected than others with the same DX.

Some clinicians erroneously interpret 'functioning' to describe the severity of language, sensory, social, behavioural (repetitive or challenging) deficits.

Hope that's nice and clear as mud! Grin

EllenJane1 · 14/04/2011 23:56

DSM 5 brings together classic autism, Aspergers, PDD not otherwise specified, childhood degenerative disorder all under one heading of Autism Spectrum Disorder.

It redefines the diagnostic criteria, bringing social and communication under one heading, bringing the triad down to 2 main sub headings.

It classifies 3 levels of severity, mild, moderate or severe to 2 sub headings of social communication, or restricted interests/repetitive behaviours. Nothing to do with IQ at all! Hurrah. Hopefully a DX of HF ASD will no longer be viewed as 'mild' ASD.

Not officially released until 2013. UK clinicians usually follow suit. Some professional criticism of new diagnostic criteria. Especially the removal of Aspergers.

5inthebed · 15/04/2011 10:32

Thank you all so much for your replies. You have answered my question. DS2 deinitely not HFA then as he is 2 years behind his peers education wise.

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