Those diagnosed with AS are "higher functioning" (need less special assistance) than those diagnosed with "high-functioning autism". But I do not think that means anything for diagnostic purposes. It's not that "having AS causes you to be higher functioning," but more like, "being higher functioning causes you to be diagnosed with AS". There is no clear line between AS/HFA. The groups are basically created by the history of how we discovered autism and defined it for the first time, then enhanced by the stereotype of AS as high-functioning.
If the only reason Asperger's tends to be more independent than classic autism is that psychologists diagnose the people with AS/HFA who are more independent as Asperger's, then the distinction is purely an artifact of the way psychologists see those two categories. It's not a distinction that would be obvious to people looking at the overall group of AS/Autism while unaware of the two categories. This unaware observer would see a single, diverse group.
Popular ways of saying, "This is AS and this is Autism" include:
1. Speech delay. This is the big one everyone points to. But what is a speech delay? DSM-IV says, single words used by age 2 years, communicative phrases used by age 3 years. Seems simple enough, right? But what about the kid who uses single words at 12 months, doesn't get sentences until four, and in the meantime repeats canned phrases to request things? What about the kid who goes straight to full sentences at age 3, without the usual stages in between? What about the kid who speaks on time, answers questions if prompted, but doesn't get the idea that one can spontaneously communicate one's own feelings, desires, and observations? What about the kid who uses functional echolalia? Not so clear a distinction anymore now, is it?
2. IQ. Well, I'm not going over it again, but IQ is pretty worthless to describe what autistic people can do in the first place, but even that stereotyped criterion vanishes when you try to use it to divide AS/HFA. What about the guy who comes in with an IQ of 60, but speech development and self-help development quite at the same level as an otherwise neurotypical guy with a 60 IQ? You can't say Asperger's, but if it weren't for that one little criterion he'd be a textbook case! And then, don't ignore the guy who's so strongly autistic that he needs a live-in assistant and uses a communication device... but gets a genius score on the IQ test. He exists, too, just like the guy with the 60 and the mild autistic traits. IQ isn't a clear distinction, either.
3. Self-help skills. This is the other half of developmental delay. If you're slow to learn to dress yourself, feed yourself, take showers, clean your room, drive a car, pay your bills, or find and keep a job, you have a delay in self-help skills. What's the problem here? Well, it's pretty simple: Both AS and Autism have, more often than not, significant delays in self-help skills. I have "only" Asperger's, and while I quickly managed to learn dressing and eating, I was slow to do all the other things on that list. The real distinction seems to be that if you learn on time the self-help skills you are supposed to learn in your toddler years, then you can be diagnosed with Asperger's--even if you are years behind the NTs by the time you hit puberty. And, of course, there are those diagnosed with Autism when they are toddlers, thanks in part to self-help skill delays, who as adults are independent, maybe holding high-level jobs and having families. We already know that it's a little silly to try to predict an adult situation based on what you see in a three-year-old. Yup, you got it--more fuzzy lines and continuums. No clear dividing line here.
"But you don't need a clear distinction!" some people say. "It's obvious this guy over here, with the PECS, the untestably low IQ, and the ceiling fan obsession, is Autistic, and this guy over here, with the monotone voice, the genius IQ, and the baseball statistics, is Asperger's!"
Well, yes, it would be obvious--if Autism and Asperger's fell entirely into two categories more-or-less along the lines of cases like the above. But the fact is, it doesn't. There are many, many cases that fall on the dividing line--as many as fall neatly into one or the other category. And when there's no clear line, just a list of symptoms that everybody has, you can't call it two different things. You call it one thing with a lot of variability.
It would be like turning mild dyslexia into a completely different disorder, and then arbitrarily saying, "If you learned to read somewhat without special help, you're Disorder X, not dyslexia," even though, just like people with more obvious dyslexia, you still have trouble decoding written words. Or saying that people who have low hearing, but can still use hearing aids, or who are good at lip-reading, don't have "hearing loss" like profoundly deaf people do, but something else altogether--related, maybe, but not at all like those poor people who have to resort to (oh horrors!) sign language!
I am getting more than a little tired of people saying, "Yeah, but I'm Asperger's! Asperger's means being unique and intelligent! It's not a disability, like Autism is!" Get it through your heads, people: There is no clear line between Asperger's and Autism. It's a continuum, and whether you like it or not, you're on the same continuum with the unemployable, diaper-wearing, PECS-using, ceiling-fan-staring guy you so want to disassociate yourself from.
If the only reason Asperger's tends to be more independent than classic autism is that psychologists diagnose the people with AS/HFA who are more independent as Asperger's, then the distinction is purely an artifact of the way psychologists see those two categories. It's not a distinction that would be obvious to people looking at the overall group of AS/Autism while unaware of the two categories. This unaware observer would see a single, diverse group.
Popular ways of saying, "This is AS and this is Autism" include:
1. Speech delay. This is the big one everyone points to. But what is a speech delay? DSM-IV says, single words used by age 2 years, communicative phrases used by age 3 years. Seems simple enough, right? But what about the kid who uses single words at 12 months, doesn't get sentences until four, and in the meantime repeats canned phrases to request things? What about the kid who goes straight to full sentences at age 3, without the usual stages in between? What about the kid who speaks on time, answers questions if prompted, but doesn't get the idea that one can spontaneously communicate one's own feelings, desires, and observations? What about the kid who uses functional echolalia? Not so clear a distinction anymore now, is it?
2. IQ. Well, I'm not going over it again, but IQ is pretty worthless to describe what autistic people can do in the first place, but even that stereotyped criterion vanishes when you try to use it to divide AS/HFA. What about the guy who comes in with an IQ of 60, but speech development and self-help development quite at the same level as an otherwise neurotypical guy with a 60 IQ? You can't say Asperger's, but if it weren't for that one little criterion he'd be a textbook case! And then, don't ignore the guy who's so strongly autistic that he needs a live-in assistant and uses a communication device... but gets a genius score on the IQ test. He exists, too, just like the guy with the 60 and the mild autistic traits. IQ isn't a clear distinction, either.
3. Self-help skills. This is the other half of developmental delay. If you're slow to learn to dress yourself, feed yourself, take showers, clean your room, drive a car, pay your bills, or find and keep a job, you have a delay in self-help skills. What's the problem here? Well, it's pretty simple: Both AS and Autism have, more often than not, significant delays in self-help skills. I have "only" Asperger's, and while I quickly managed to learn dressing and eating, I was slow to do all the other things on that list. The real distinction seems to be that if you learn on time the self-help skills you are supposed to learn in your toddler years, then you can be diagnosed with Asperger's--even if you are years behind the NTs by the time you hit puberty. And, of course, there are those diagnosed with Autism when they are toddlers, thanks in part to self-help skill delays, who as adults are independent, maybe holding high-level jobs and having families. We already know that it's a little silly to try to predict an adult situation based on what you see in a three-year-old. Yup, you got it--more fuzzy lines and continuums. No clear dividing line here.
"But you don't need a clear distinction!" some people say. "It's obvious this guy over here, with the PECS, the untestably low IQ, and the ceiling fan obsession, is Autistic, and this guy over here, with the monotone voice, the genius IQ, and the baseball statistics, is Asperger's!"
Well, yes, it would be obvious--if Autism and Asperger's fell entirely into two categories more-or-less along the lines of cases like the above. But the fact is, it doesn't. There are many, many cases that fall on the dividing line--as many as fall neatly into one or the other category. And when there's no clear line, just a list of symptoms that everybody has, you can't call it two different things. You call it one thing with a lot of variability.
It would be like turning mild dyslexia into a completely different disorder, and then arbitrarily saying, "If you learned to read somewhat without special help, you're Disorder X, not dyslexia," even though, just like people with more obvious dyslexia, you still have trouble decoding written words. Or saying that people who have low hearing, but can still use hearing aids, or who are good at lip-reading, don't have "hearing loss" like profoundly deaf people do, but something else altogether--related, maybe, but not at all like those poor people who have to resort to (oh horrors!) sign language!
I am getting more than a little tired of people saying, "Yeah, but I'm Asperger's! Asperger's means being unique and intelligent! It's not a disability, like Autism is!" Get it through your heads, people: There is no clear line between Asperger's and Autism. It's a continuum, and whether you like it or not, you're on the same continuum with the unemployable, diaper-wearing, PECS-using, ceiling-fan-staring guy you so want to disassociate yourself from.