Criteria for Asperger Syndrome

[waitingforgodot]

Have just been reading a Tony Attwood book and he mentions the criteria for AS is "speech and language problems and non-verbal communication problems".
I thought speech probs=ASD and non speech probs=AS
Have I misunderstood?

Speech delay = ASD but it is accepted many with as will have isues- usually along the SPD end.

They're reviewing it anyway for the new dx manuals tomake it clearer

I believe the criteria for defining different areas of the spectrum is in the process of being changed - the regular posters on here prob know more about that that I do. I kind of see the definitions as having blurry edges - can't you be AS inclining a tad towards ASD in a cartain aspect like language? There are no clear boundries as every person is individual.
Just my thoughts having not long ago read the Attwood book before sending it on to my AS father.

Kissing, AS is part of ASD- its a progressive spectrum. In fact research (which I can link to) suggests that the only qualitative difference between autism and as is langauge- bearing in mind though that the other aspects can manifest very differently in individuals anyway, so you can very mild asd or severely affected AS just without language difficulties. Obviously severely affected asd with language issues is the most severe of all, no disputing that.

The DSm and ICD criteria are both up for review atm and being published in a few years, and the NICE guidelins are also being produced atm.I have met someone on the NICE committe who says language and sensory is being looked at but thats all I know.

Peachy-
I knew you would know and nearly put FAO PEachy in the subject line!
What does SPD mean?

Kissingfrogs-when are they introducing the new criteria?

What are the main differences between the 2? How do they differentiate? (i know this is prob a complex process but thought I would ask anyway. )

I think with AS you can have good language but it is the way that it is used which is considered unusual - which I guess would be called a speech and language problem?

Semantic pragmatic disorder,ds1 has it.

giveme a sec and I will get the different diagnostic criterias- I have links to both handy.

And yes whilst I have finished the MA dxmiodule now LOL there areloads know more than me,I am a dunce with a certificate is all

icd-10

DSM-IV

PCTs can choose exactly which to go by apaprently,DSm is primarily American,ICD is WHO and popular in mainlnad Europe

SPD

I wrote a list of possible signs and issues related to AS for my school, very simple, but this bit might be what Eveiebaby was meaning?

Difficulties with communication.
May speak fluently but take little notice of reactions, may monologue, may not be aware of audience's feelings or reactions.
May be over-precise, formal or literal in speech. Jokes, metaphors, sayings, figurative language may cause total confusion, stress, meltdowns etc.

So if a teacher says 'Would you like to come and see me after school?' my son probably won't show unless he wants to.
'Come and see me after school' and he will comply.

yes peachy you're quite right, AS is part of the spectrum, I should have expressed that better. I've been interested in this subject(still learning!) for quite a few reasons. My father has AS, my DD2 presents some but not all symptoms of ASD/AS (with langauge problems) and last week I began 1 to 1 support for a lovely girl in mainstream who has an informal diagnosis of HFA.

I remember reading recently about the proposed changes to diagnostics (this/next year?). As I an a serial lurker on this board, I probably read it on here.

cross-posting. Thanks for links Peachy

This is a subject close to my heart as DS2 has been diagnosed AS but I really feel he is more generally just on the spectrum. We are not in the UK and the DSM not always used.

Our Paed used 'Gilberg' as a reference who clearly says that speech delays are part of the criteria for AS, and DS has them in spades.

But reading Tony Attwoods book doesn't ring true for my DS. I await with interest to see any changes in criteria.

Tony Attwood didn't ring any bells with me either. DS1 has too many comprehension difficulties and no overwhelming interests. His diagnosis is HFA.

AFAIK, in the DSM-V, AS is going to disappear as the differences between AS and HFA are too subtle to be of much use.

Goblin...that's what my NT DC is like!! He is so pedantic he could win an award for it. At 4.9yo, I had him with me while I was seeing my DD's teacher. He was reading the number line (1-100) out loud, and the teacher told him to 'be quieter'. So he was. QuietER !! What the teacher meant was 'shut up'. He then proceeded to argue with her that she hadn't said 'be silent', rather that as she had said be quietER, he was whispering, hence being quietER. AARRGGHH!! We have occurences like that with him on a daily basis. He's 7.9yo, and I am getting 'more concerned' about certain aspects of his behaviour. He's working on Y6 work in Y3, is losing friends at a rate of knots (he will ONLY talk about either club penguin, computer games, chemistry or physics), he is err pedantic/argumentative to the max, and has never slept for more than 7hrs/night...Putting any worried thoughts out of my head as 2 asd DC's is enough.

Kissing- your DD, did you read the link for SPD? Always wotrth considering imo

Oh and the DSM

AS / HFA is rumoured to be vanishing but AFAIK nobody knows for sure tey; I hope soa s once we have a broad spectrum dx wecan start to look at kids individually rather than attaching labels that don't necessarily have much relevance to their needs. However, there is opposition,some from the non-ASD research community (that I have encountrered anyway) who don'tseemmuch bothered about services but want thier subjects groups pre-referenced (grudge? moi? )

The most inportant thing in the pipeline i think will be the sensory stuff if that happens,becuase it is so important and woulod force OT involvement for ASD. But certainly language is a primary focus and I hope broad spectrum DX.

2012 isn't it that verything com4es out (DSM, ICD and NICE?)- Tutor has mentiond that we might need to relearrn a fair amount in the last few months

Goblinchild - yes - thanks for elaborating that's exactly what I meant

Peachy-
I am fighting for OT as you prob know and was told by my PCT that the OTs are not trained to deal with any sensory issues, nor do they plan to train them.
Starlight and I think we should train as OTs with a focus on sensory issues and ONLY see kids with ASD-care to join us haha!

Joking aside, there is a huge gap here for anyone looking to change careers

WFG the lady leading my MA is an OT with a big interest in sensory issues, she is really interesting on it.Wewwerelucky to see someone from OT with ds3 though can't say she was gifted at fulfilling her promises IYKWIM.

Presumably though if it becomes standard they will have toaddress it?

Now, should the world magically provide me with childdcare in 18 months when ds4 is ready for nursery (is that a flying pig I see....) I amoff to do my SW conversion, just another of the many depts that need to be staffed with people who get it LOL, but should I win alottery I willgladly fund yourtraining.

My best mate actually was doing her OT training- she was also caring for her MH Sister, elderly Dad and Mum with Alzheimers. they kept sending her from Exeter to Staffordshire or wherever for placements making it completely unmanageable. Much like here they say they are begging for SW's but if you need a part time course, a promise of localplacements of just any support they tell you where to go.

Peachy-go for it!!

Yup, I've never met someone with an ASC who used 'language' normally (and by language I mean the whole range - words, tone of voice, content of sentences, linking that content to what others are saying in useful and appropriate ways, reading body language, their tone of voice, their eye contact, using appropriate body language themselves, etc etc. We just can't do it. We might get some of it right for X amount of time, but to the amazing minds of NT people it mostly comes across as clumsy, rude, boring, obsessive or all four things at once, and leads to us getting less and less of the things we need.

The range on the spectrum means you can have anything from no speech at all right up to incredible use-of-words-but-in-nearly-all-the-wrong-ways. It's always a communication disability though.

Jobs, friendships, relationships, help, housing...the social skills required to 'buy into' those things are so often beyond almost everyone on the autism spectrum unless there's help and training and understanding.

For example, X, has a degree in science and in theory could be anywhere in the world earning a small fortune in his very specialised area of it. He has Asperger syndrome. Intead, he's unemployed, has no friends, no partner, lives in hellish accommodation where his stress levels are through the roof, gets no help or support, can't do even the simplest of everyday things without getting himself into a total state. A specialist could easily write "high functioning - excellent use of language". But what does that mean for X and his life outcomes? Not a thing. Just a life filled with loneliness and fear and poverty because he has speech and a high IQ, therefore needs nothing, according to the services on offer.

Funnily enough my friend wastelling me her son has a suggested DX of HFA but no language delay. I told her if it were me I would refuse the dx,as not only would it barr him from the AS comp but doesn't sounsd right. ASD every time I say

Ive just receive a paper from NAS 'HFA and Aspergers - what is the difference?' (as we seem to be getting close to a dx and different experts, have different views)

I have just moved borough and the SALT therapist in my old borough told me autism because of speech delay. Paed in new borough is saying Aspergers because of IQ!

Anyhow the differences in the paper:-

Level of cognitive functioning - The view that Aspergers is autism without any learning disability is helpful from the dx point of view as it is fairly easy to make a distinction. However, Asperger himself said that there might be unusual circumstances where a person could present the symptoms of Aspergers with additional learning disability. It is widely recognised that HFA will also have difficulties in these areas. HFA cannot occur in someone with an IQ below 65-70.

Language development - This is the area that causes the greatest controversy. Both ICD10 and DSM IV state For a dx of Asperger then spoken language development must be normal. Children with HFA may have had significant language delay. However Aspergers original descriptions of the condition stated that speech and language peculiarities are a key feature of Aspergers. Often dx's of Aspergers are made when a child is quite old and they or their parents may have difficulty remembering the details of their language development.

I got given a dx of Aspergers rather than HFA because I was saying words like Supercalagragalisticexplialidocious at age 2, by repeating it off the tele, randomly. Couldn't use language very usefully until my late teens, though: I could think of some phrases but it might take me ten minutes or more to come out with one, or I'd jumble up the words, or get the context wrong. Just epeating stuff fairly randomly should not count as good language skills, perhaps.