difference between HFA and Asperger's?

[thisisyesterday]

Can anyone explain the difference/s to me?
ds1 has just had his second appointment with a paediatrician as part of his assessment process. The first paed said likely diagnosis of Asperger's, second one said HFA.

is there a difference or is it just 2 names for the same thing?

Aspergers is a HFA DX with no language delay. The latest diagnostic criteria (DSM 5) is recommending dropping Aspergers as a separate syndrome, but there is a bit of a fight back from some of the Asperger experts. To be honest it makes little difference to how to treat. You could ask if they could give a joint DX of Aspergers/HFA then you could pick and choose who you tell what. Aspergers has a more positive press (sort of) but HFA can sound more serious. Tell the people you want support from, school etc HFA and your family Aspergers, maybe?

ahhh ok, he has no language delay so i expect we may end up with a dx of Asperger's then (which is what we suspected)
i think you're right about HFA sounding more serious!

sadly dx does effect the support you get. We get help forDD1 who has a dx of HFA but know others who had to fight because they had dx of aspergers

Most paeds are going over to DX High Functioning Autism only and not AS due to DSM 5 it seems. AS has for a long while come under the umbrella term of HFA which includes any ASD with average to high 'intelligence', including those with speech delay.

Round here they;re not differentiating and interestingly not dxing AS either atm
IME EllenJane's hit it on the head. Aspies can do a good impression of social awareness, and social 'niceties' or at least fake it well, HFA might not. It's in the subtleties of their communication, and ime in their ability to perceive the more abstract of stuff like where we're going / what we're doing / social memory skills if that makes any sense. Very difficult distinction to explain, even when you know how it affects a person iyswim.

moosemama managed to get an AS/HFA DX for her DS which she says, has been really useful. My DS has HF ASD DX as he had significant speech delay, and tbh, he's quite noticebly odd, but hypo-sensitive, which seems much easier to handle than hypersensitive DC with AS. He is also socially unaware ATM, so not at all worried about friendships, which is also easier for him.

So, yes, I think AS can often be harder to handle than HFA. It is mad. Lots of people prefer an AS DX as they are happier discussing it with people who think of it as 'mild' autism, why not make it a dual DX?

Hi, Mrs Shrek. Crossed posts!

with AS they're more socially aware and know that they're "different" and they see stuff differently, but don't know how to do something about it. DS1 just doesn;t seem to 'get' stuff that a boy of his age and intelligence would be expected to. And is absolutely shiteola at names. At 10yo he knows one friend's name and he's been in a class with these kids since he was 4. It might as well be rocket science (then again.... he'd prefer that)

Sure do, can't think why? [cgrin]

My DS definitely in the 'not really caring that he's different' case. It may change as he goes to secondary later this year, have to wait and see. Right, I'm off to bed now...........

No it doesn't pipinjo. Sorry! The sensory stuff seems to be completely random. It just happens that my DS with HF ASD is hypo, which I think makes life easier to deal with. His 'friend' is hyper and has much more anxiety, but he is also HF ASD. It's just that the AS / HFA DX doesn't necessarily mean less problems with AS.

That other post was rather confusing. Sorry! [cblush]

The latest thinking is that speech and language delay is a completely separate disability/condition. So is having a low IQ. So the DSM V crew want all autism to be called autism. But then have an explanation of how the autism and other disabilities affect them and what support is needed.

Trouble is, at the moment it can get very elitist, with some people with Asperger syndrome saying they don't want to be associated with autism, and some with autism accusing those with Asperger syndrome of having no real needs, etc. Anything that helps people understand that they are all similar (though not the same) should help in the long term, I think. Me, I'm very happy to be described as autistic.

As it is, IQ is irrelevant for us. and our future success. With a high IQ but no social skills, all we can manage to do is be very clever when alone in our room. What possible use is that? If anything it makes us a great big target for people who see it as showing off.

What counts above all things is us learning social skills, the research shows. And we're all bloomin' awful at those until we learn to do them manually.

well that's clear as mud then

at the moment ds1 is only 6, and he's kind of pootling along ok at school etc. lots of social issues, but nothing that the school can't handle right now.
So it's hard to tell how much support he will need in future tbh, a lot of his "symptoms" at the moment are masked by him being a 6 year old boy, but obviously those will get more noticeable as he gets older.

I think I'll talk it through with the paediatrician again and see what her thoughts are on AS vs HFA dx, and I'll ask her what the differences are.
He is waiting on a speech and language assessment at the moment. He speaks in a very grown up way, which I know can be an indicator of AS, but I think they want the assessment to see whether or not he understands what he is saying as well iyswim?

The paed seems very down to earth and sensible though, so I think we'll talk to her about which diagnosis will help him most in the years to come!

DS1's only been dx at 10 because he's pretty good at copying what he 'should' do in social situations, and apart from ordering everyone around he appears to make friends and acquaintances very easily
He's also got two ASD specialist parents - which is both a help and a hinderance. It's a help because we've supported him as asd since he was very small, and made sure his understanding caught up, proped him up with "remembering books", symbols on velcro in lieu of his atrocious memory and so on, we know the 'tricks' as it were. The big disadvantage is that we'd almost lost sight of what is asd and what's NT, so at times thought we were seeing stuff that wasn't there, and it's just because we know stuff about asd that we could see it in him, iyswim
So for well over five years we've had this on/off debate about what his difficulties actually are, and tbh not really owned up that we both thought that he had asd. Then we went on the Holiday From Hell, first time we have taken the dc to Europe - he threw the money away, it was Euros not £ and therefore "the wrong money", we were driving on the "wrong" side of the road so he screamed constantly - ohh the list is as long as your arm, and after an incident where he hid in his bed for over an hour sobbing and saying "I only like same, I don't like different" then it was there staring us and him in the face :(

we went into it thinking it was Asperger's as, on paper at least, he meets so many of the criteria.
Maybe, as others have said, the 2 are becoming so close that some HCP's are treating them basically as one and the same thing, hence the 2 different dx's mentioned by the paeds we saw.

The only reason we have pushed for any kind of assessment/diagnosis is so that we can access help more easily for him as and when it becomes necessary. We're lucky that his school are very accomodating, and he is going to change school in September to a Montessori school, his class teacher there started her training with children with ASD so hopefully we won't have to fight too hard for what he needs.

I think I need to make a list of questions to ask the paediatrician next time we see her though. Will ask what she thinks the differences are between HFA and Aspergers and report back!

I'm interested in your choice of a Montessori school. If it's not too personal, what were your reasons to change. Does your DS have a statement of SEN, what support will a private school provide? My understanding of Montessori schools was that they usually tend to be early years (maybe up to 6) and the philosophy is that the learning is child led and very much learning through play. You obviously feel that your DS will work well in this environment. I'm not sure it would have suited my DS with HF ASD.

no, he doesn't have a statement.
we have chosen the school for several reasons really... the main ones i guess are:

it's much smaller. he'll be in a mixed age class (yrs 2 and 3) of 16 children. This means his teacher will be more able to meet his needs and help him achieve what he wants to achieve. it also means less change, because he won't be moving class/teacher each year, and because the school is so small he will get to "know" it all very well and hopefully then the changes he does go through will be less pronounced

I like their methods of teaching and learning, a lot is very visual, which will definitely help him! there is a lot of outdoors time and learning "through play" i suppose which means less sitting at a desk doing work which he currently struggles with and finds "boring" (his words)

they are allowed time to finish things they enjoy doing. so while they will follow the national curriculum, they are encouraged to continue with a project they are very interested in rather than being made to stop because the rest of the class is moving onto something else. This is a big issue at school at the moment because he gets very involved in things and never gets to complete them

Although the learning is child-led that doesn't mean it's unstructured. there will be various learning opportunities set out and he will be encouraged to use them at his own pace

I am confident that the quieter, smaller environment will be really good for him and that it will help him accept a less structured approach, although we have spoken to his class teacher a few times and she is willing and able to make it more structured if he needs it that way... this is one of the greatest things really, their willingness to adapt things each pupil.

will it live up to my expectations? I really don't know... it's a HUGE leap of faith tbh because the school isn't even open yet. It opens in September and we're the first intake!