Is there a difference between As and HFA?

[WellKnownMemorablePeachyClair]

Sorry, all the questions I didn't think to ask earlier! I expected the AS DX, so the HFA one I need to investigate. Paed (lovely woman with an even lovelier registrar) said we could make an appointment to ask her any questions in two weeks, stupidly I said no and said October would be fine. Wasn't thinking straight I guess.

Depends a bit on who is dx, but I would say that HFA children are usually obviously autistic (odd speech etc for example) whilst children with AS can pass as normal superficially (and therefore their problems get completely ignored - and the depth of them is misunderstood). Looking at children I know with these different dx that is how they seem to divide. Having said that some children who have been given HFA dx when little, switch to AS when older......

There are official diagnostic differences as well, but can't remember what they arew!

I asked the specialist who dx,d DS this question and he said that in his opinion they overlap, ie DS may appear NT one day and that would be seen as evidence of AS and then another day he could be more "autistic" if he is having an anxious day and he would appear HFA, but he also said that they can tell also by using psychometric tests.

That sounds confusing, i dont know how else to say it, HTH

That's a question that I've pondered over the last few years as although my ds was diagnosed with complex ASD at 3, he has been referred as AS on a few occasions since.

Now your Sam has been diagnosed with ASD, I wouldn't be surprised over time if he's not described as having AS, there seems to be a big overlap.

When my ds was diagnosed with ASD at 3 years old, I asked the Clinical psychologist if it might be AS, he answered that unfortunately after doing the relevant tests, he wasn't deemed as being intelligent enough You can't believe how hurtful those words were. But when I got his report from that particular meeting, he described ds as having elements of both, confused me even more!! SALT said that as he couldn't talk at 3, he wouldn't be diagnosed as AS, apparently AS children have normal development of speech, although can sound a bit odd. SALT described ds a few months ago [now 6 years] as AS because his expressive language is near to normal, even though he has a severe social communication problem. Paed still labels him as ASD.

Has that confused you even more

OOOps Sorry I now know you asked for a difference between HFA and AS, AS is a part of ASD, HFA can be AS and ASD, autism is ASD and HFA and AS but to varying degrees, confusing??????

My psych textbook says:

HFA: A sub area of the autistic spectrum, characterised by less severe symptoms and/or higher intellectual level.

AS: A sub-type of ASD similar or identical to HFA. Clinicians disagree about whether it involves language difficulties, and how far it is qualitatively distinct from other ASD.

According to the American psychological association, the criteria regarding impairment in social interaction and repetitive/stereotyped behaviour patterns are the same, but for AS:

-there is no clinically significant delay in language development

-there is no clinically significant cognitive development, normal everyday skills (except social ones) or in curiosity about the environment.

Does that make any sense?!

Oops!

there is no clinically significant DELAY IN cognitive development, normal everyday skills (except social ones) or in curiosity about the environment.

Sorry!

That all made perfect sense to me last night after a few glasses of wine

Now im confused because i thought AS was dx,d if the person had higher intellectual levels but becky,s book says that HFA is?

AS DX can only be given if no speech delay,if speech delay then autism DX, i know many children who have DX asd but progress to being very able but cos of speech delay they would be DX HFA.

Ds1 & 2's Paeds both use HFA and AS interchangeably. Ds1's written dx is HFA and ds2's is AS. Both have good verbal language skills but both speak as though English is their 2nd language - if that's not too much of a contradiction! Ds1 will sometimes say odd things like "the key of the door" instead of "door-key" yet at the same time his general vocabulary is better than a lot of children of his age.

Both boys followed a similar pattern of development and are both very bright. Probably the main differences between them is that ds1 started to use language at about 3yrs whereas ds2 was 2yrs old (ds2 had much earlier intervention), and ds2 has slightly better social skills.

It's all very confusing.

She said Sam has SPD, so that may be the key, also his problems at school. I havr to try and explain this at school later- !!!!! lol

From reading more of the book, it also says that the exclusion of communication difficulties from the diagnostic criteria for AS is controversial. It seems even the experts don't agree!!

I went to a talk recently by Gilly Baird. I am sure she said in response to this question that there is no longer considered to be a difference between HFA and AS. She said that children who formerly were not given a DS of AS because of speech depay, then went on to devlop in the same way as those who had the AS diagnosis. In later years the children with AS and HFA could not be distinguished.

or even speech DELAY!

yes our psych said the same, he lectures up and down the country with people like Lorna Wing and Paul shattock and he says that AS and HFA are one and the same, that a person can be HFA one day if their autism is more evident and AS another day if its not.

Now that makes sense- Sam was having a ver HFA day yesterday then, sat in a corner staring at a computer toy and refused to interact.

I get it now then.

Message withdrawn

Now, Sam could speak pretty fluently at 12 months so it's not the speech delay, maybe its just speech dysfunction (delay or SPD, which he has?)

Haven't been posting for a while - busy doing a degree ... but thought I'd add my twopennorth to this

I think the main difference is the degree of anxiety/fretting ...

My son has HFA and frets very little - my friend's son is very similar to mine in many many ways but he 'worries' about all sort and his diagnosis is AS.

Since developing my 'theory' it seems to fit many children and adults that I've encountered - but it is just my view!

My dd who was recently dx could fit under the criteria for AS using the Gillberg's diagnostic criteria which includes a language delay.
The cp has changed it to HF asd as this will keep doors open for dd with regards to her secondary school (crazy I know).
I feel she is probably more AS tbh although her language is very pedantic and "odd" still.

Now as a baby/toddler i was development delayed, delayed in walking and talking but i have been dx as AS, ok i am in my thirties but the psych who dx,d me took all this into account but still said AS and not HFA.

To me i am glad to be AS and not HFA, i dont know why but i just feel happier with a dx of AS.