Wednesday, March 21, 2012

What's The Difference

Through the past three-plus years I’ve been really confused about many things with Konner, but the one thing that has really puzzled me is his diagnosis. I’ve heard Asperger’s Syndrome and High Functioning Autism thrown back and forth. While trying to research both I’ve seen PDD-NOS, Rett’s Disorder, Tourette’s’s, etc. The problem is that Autism is a spectrum disorder. That spectrum is wide and includes many symptoms.

So how do tell each of these spectrum disorders apart? Most parents are not experts when they learn about Autism. I had heard about Autism, but honestly couldn’t tell you what it was prior to Konner’s diagnosis. Asperger’s Syndrome was just a funny sounding name (I realize now how cool and unusual it is).

For a long time I thought Konner was diagnosed with Asperger’s Syndrome. However, upon our last evaluation I learned that it was really High Functioning Autism. This was confusing to me, so I asked the doctor what the difference was. I had tried to read about it, but sometimes the confusing lingo you find on websites and in books written by “experts” can get to technical and and you end up more baffled than before.

I hope that this column can help distinguish the differences of these, and other disorders, better.

Let’s start with the run-down. This information comes from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. The manual says that Pervasive Developmental Disorder (PDD) is an umbrella term that all of these following disorders fall under.

Autism or Autistic Disorder: Classic autism appears before the age of three and is characterized by three distinct traits: (1) poor social interaction, (2) lack of communication, both verbal and nonverbal, and (3) odd and repetitive behavior and fixed interests. Four times more common in boys than girls. The disorder develops along two distinct paths. Either symptom occurs early in life or a child develops normally then regresses, losing language and social skills.

Asperger’s Disorder: Unlike Autism, children with Asperger’s disorder shows no obvious delay in language or cognitive development. In fact, they can be verbally precocious. Defining characteristics include social cluelessness, isolated or excessive interest in a topic or object; awkward body movements; sensory issues; and inflexibility. Average age of diagnosis: seven years old.

Atypical Autism or PDD-NOS: Pervasive Developmental Disorder-Not Otherwise Specified is a diagnosis given to children who do not quite meet the diagnostic definition for autism but who still have impairments in the three areas indicated by Classic Autism, though intellectual impairment is rarer.

Childhood Disintegrative Disorder: This extremely rare Autism Spectrum Disorder is also known as Regressive Autism. Only 100 cases have been reported since 1908. Children develop normally for three to four years before they experience a pronounced and extensive loss in skills- motor, language, and social- and bodily functions. This is often misdiagnosed as Autism.

Rett’s Disorder: This is another rare but severe spectrum disorder that primarily strikes girls between six and eighteen months. Early signs include loss of speech and motor skills. Hand wringing is a common trait. Unlike most of the other Autism Spectrum Disorders, it is caused by mutations in a single gene.

As for other parts of the spectrum, including High Functioning and Classic Autism; according to the eHow Health page:

The key issues that differentiate one end of the spectrum from the other are language and intelligence. Children diagnosed with what is often called "classic" autism fall at the "low functioning" end with severe deficits in verbal and nonverbal communication. They may have an average IQ but many have low IQs. On the opposite end of the spectrum, high functioning autism describes individuals whose language develops normally and who have average to above average IQs. HFA is often used interchangeably with Asperger's Syndrome (AS), but professionals disagree about whether the two are the same. Some differentiate HFA by saying that these children have an early language delay while those with AS hit all the developmental milestones.

Tourette’s Syndrome has most recently been linked with Autism as well. This disorder According to is an inherited neurological disorder with onset in childhood, characterized by the presence of multiple physical (motor) tics and at least one vocal tic; these tics characteristically wax and wane. It is a co-morbid disorder with Autism Spectrum Disorders such as autism and Asperger’s syndrome.

American Idol fans will recognize these characteristics through this year’s contestant James Durbin. Durbin has Tourette’s’s and Asperger’s Syndromes. This explains the facial twitches be shows on stage and during interviews. He has said that this becomes more present when he is nervous.

You can see with a spectrum disorder that things can get very complicated and overlap. Many of your psychiatric professionals are becoming better at determining the differences. However, many are still disagreeing on some aspects. This is why it is so confusing to understand. The only thing you can do is research the diagnosis given to you and try to find the best way to advocate your child.

Disclaimer: I am in no way claiming to be an expert. I’m just a father who is trying to learn as much about Autism as I can to help my child. I hope that you all can learn from me, and I from you. I ask anyone who has questions or comments about something I have written, or autism, please contact me at I will try to answer questions as I have time, and if I find it interesting enough I may touch on it in my column.

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