Autism ‘v’ Asperger’s
I’m planning a trip to the Far East next year and I’ve been trying to arrange some travel insurance. I know that’s it’s essential to diagnose any medical conditions when applying, so I declared that I had been diagnosed with ‘Autism’. I was then asked if I would be supervised at all times and if my condition made me aggressive. There were no such questions for ‘Asperger’s’.
Often, when I see articles or information pages along the lines of ‘What is the Difference Between Asperger’s and Classic Autism?’, it is stated that an Asperger’s diagnosis is given to those on the spectrum who are of average/above average IQ, with no language or behavioural difficulties. The implication being that a diagnosis of Classic Autism is given to those who are of lower than average IQ and do have language or behavioural difficulties. This is not the case.
If you look at the diagnostic criteria in the diagnostic manuals – the DSM-IV and the ICD-10, it is impossible to get a diagnosis of Asperger’s Syndrome if you had a childhood speech or developmental delay, but this has nothing to do with your current abilities. A diagnosis of Autism can also be given to anyone, regardless of their IQ. You could be a professor of linguistics and have a diagnosis of Classic Autism.
As someone with a diagnosis of ‘Classic Autism’, who does not have a lower than average IQ or any language or behavioural difficulties, I feel intense frustration at continually being told that I am something I’m not. Articles that contain misinformation such as this contribute greatly to the inaccurate public perception of these autism spectrum conditions. I get the distinct impression that many of these articles on autism are at least partly rehashed/plagiarised/borrowed/stolen from others, so the same misinformation gets continually reproduced.
I have heard that a number of clinicians give a diagnosis of Asperger’s Syndrome anyway, in cases such as mine (Tony Attwood, The Complete Guide to Asperger’s Syndrome, 2007 (Chapter 2) and anecdotal evidence), but in my opinion that is inappropriate . The whole point of having official ‘diagnostic criteria’ in the first place is that everyone follows them. If they’re going to make it up as they go along, they may as well diagnose people with ‘Unicorn Syndrome’. It made me laugh when I came across a woman on an online forum who proudly declared that she had Asperger’s rather than Autism and then mentioned that she didn’t speak until she was seven.
In my case, I had a speech delay, but my speech was definitely average or above average by the time I was five years old. I went to mainstream school and was considered academically gifted, I then went on to gain a post-graduate degree and was diagnosed at age 49 with Classic Autism, using the ICD-10, because of my speech delay. Now, over forty-seven years after I learned to speak , I am being asked if I will be supervised at all times and if my condition makes me aggressive.
I’m not at all convinced that Autism and Asperger’s Syndrome are separate conditions, but if they were, it would seem that historical ‘developmental delays’ are not an appropriate way to distinguish between the two. The DSM-V no longer treats them as separate conditions of course, but many parts of the world are still using the ICD-10, so some clinician’s are still distinguishing between Autism (officially called ‘Childhood Autism’ in the ICD-10) and Asperger’s.
There are a number of ‘Aspies’ that are utterly convinced that Asperger’s and Autism are completely separate conditions and should remain that way. They are deeply and emotionally opposed to the changes in the DSM-V (which combines the two conditions into ‘Autism Spectrum Disorder’, albeit with three different levels of support being required).
Although I have heard various attempts to justify this point of view, I have never seen one that I believe to have any validity. It is obvious to me that the real reason that they are deeply opposed to these changes because of their own prejudices against those diagnosed with Classic Autism. They will fight ‘tooth and nail’ to disassociate themselves from the classically autistic, despite the fact that, in my opinion, the evidence that they are separate conditions is simply not there.
Opinions about this subject almost always come with some kind of disclaimer – “we’re not saying we’re better, just different”. That’s like saying “I’m not racist but….” and then coming out with a stream of racists comments. I came across someone the other day who believed that if ASDs could be symbolized as a whole galaxy, then Asperger’s could be said to occupy a separate quadrant. I’m not sure where my quadrant would be, but I suspect that they’re hoping that it’s ‘very far away’.
I used to frequent various ASD, Autism and Asperger’s forums, both before and after my diagnosis and I have seen a large amount of subtle and not so subtle digs at the classically autistic, with many people taking pains to point out “I’ve got Asperger’s NOT Autism”, as if Asperger’s was something to be proud of and Autism some utter horror. It has been stated for example that I (and my fellow classical autistics) are “neurological first cousins” to those with Asperger’s, which made me feel like I was nearly human, but not quite.
In my case, If I hadn’t given my mother’s phone number to the clinicians, I would have a diagnosis of Asperger’s Syndrome using the ICD-10 because they wouldn’t have found out about my childhood speech delay. If I had been diagnosed using the DSM-V, I would have received a diagnosis of ASD – Level 1. This is exactly the same diagnosis that would be given under the DSM-V to the majority of the ‘Aspies’ who were so proudly proclaiming on the forums that they are different to me. When you look at it like this, it shows that this attitude is laughable.
I have heard it stated that the ‘elephant in the room’ is the fact that people are scared to discuss their belief that Asperger’s should be a separate diagnosis in case they are seen as ‘politically incorrect’. For me, the real ‘elephant in the room’ is the fact that human beings seem to have such a propensity for arrogance and prejudice. I genuinely don’t understand why some of us feel such a strong need to distance themselves from other autistic people. It shouldn’t have to be stated that everyone is of equal value. Surely, the neurodiverse community should support each other, instead of getting involved in an unnecessary and ridiculous one-upmanship contest.