Yesterday I listened to a very interesting talk by Catherine Lord, one of the creators of the ADOS test. ADOS is the “gold standard” in the world of autism diagnosis, and she's a leading figure in the world of autism testing and evaluation, so I jumped at the chance to hear her thoughts on where we're headed in that regard.
People who receive an autism diagnosis are told they have one of three conditions: Autism, Asperger's, or PDD-NOS. The big question is, who should be diagnosed with what? Is there a coherent sense of classification, or is it merely arbitrary or random? She reviewed the diagnostic data for several thousand spectrumites in an effort to determine what caused a person to end up in one of those three categories.
To her surprise, after analyzing the data, she found the principal predictive factor had nothing to do with the individual. Looking at records from a number of good university hospitals, she found places who called almost everyone Asperger, and other places where everyone was PDD-NOS. There was no discernible pattern of variation between individuals; they seemed to simply get different diagnoses in different places.
Was there more to the story?
To answer that, she looked at other factors, like IQ. For example, many people call Asperger's "autism lite" or "high IQ autism.". Her review of Asperger diagnoses at one Ivy League school bore that out, with their Asperger kids having average IQ of 123. However, other doctors must see Asperger's differently, because a Midwest clinic in the study has an average Asperger IQ of 85.
She looked at quality of language in older kids and found similar ambiguity. Asperger's is supposed to distinguish autistic kids who don't have trouble speaking or understanding language. That can be true at age three, but what happens when kids get older and talk more? In the final analysis she did not find any consistent measures of the individuals themselves that led to one label or the other being applied.
In my opinion, those findings support the argument that there is no consistent standard that sets the three descriptive terms for autisms apart. A difference at one point becomes invisible at another. For example, you could say four year old Mike does not talk so he's autistic and Jimmy talks up a storm so he's Aspergers. But what happens when both kids are ten and they look and sound the same? Were the differences justified? What purpose might they serve by their difference?
Her findings made one more strong argument for combining all autism diagnoses under the heading of Autism Spectrum Disorder, with a described range of disability or affect.
That's the way things seem to be headed for the next DSM.
At the same time, Dr. Lord expressed concern that many people have a strong personal investment in one diagnostic name or the other, and they should be able to keep using the different terms.
Yesterday I listened to a very interesting talk by Catherine Lord, one of the creators of the ADOS test. ADOS is the “gold standard” in the world of autism diagnosis, and she's a leading figure in the world of autism testing and evaluation, so I jumped at the chance to hear her thoughts on where we're headed in that regard.People who receive an autism diagnosis are told they have one of three conditions: Autism, Asperger's, or PDD-NOS. The big question is, who should be diagnosed with what? Is there a coherent sense of classification, or is it merely arbitrary or random? She reviewed the diagnostic data for several thousand spectrumites in an effort to determine what caused a person to end up in one of those three categories.To her surprise, after analyzing the data, she found the principal predictive factor had nothing to do with the individual. Looking at records from a number of good university hospitals, she found places who called almost everyone Asperger, and other places where everyone was PDD-NOS. There was no discernible pattern of variation between individuals; they seemed to simply get different diagnoses in different places.Was there more to the story?To answer that, she looked at other factors, like IQ. For example, many people call Asperger's "autism lite" or "high IQ autism.". Her review of Asperger diagnoses at one Ivy League school bore that out, with their Asperger kids having average IQ of 123. However, other doctors must see Asperger's differently, because a Midwest clinic in the study has an average Asperger IQ of 85.She looked at quality of language in older kids and found similar ambiguity. Asperger's is supposed to distinguish autistic kids who don't have trouble speaking or understanding language. That can be true at age three, but what happens when kids get older and talk more? In the final analysis she did not find any consistent measures of the individuals themselves that led to one label or the other being applied.In my opinion, those findings support the argument that there is no consistent standard that sets the three descriptive terms for autisms apart. A difference at one point becomes invisible at another. For example, you could say four year old Mike does not talk so he's autistic and Jimmy talks up a storm so he's Aspergers. But what happens when both kids are ten and they look and sound the same? Were the differences justified? What purpose might they serve by their difference?Her findings made one more strong argument for combining all autism diagnoses under the heading of Autism Spectrum Disorder, with a described range of disability or affect.That's the way things seem to be headed for the next DSM.At the same time, Dr. Lord expressed concern that many people have a strong personal investment in one diagnostic name or the other, and they should be able to keep using the different terms.
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Comments (13)
If everyone in America went in for a test to see if they have one of these conditions, I can guarantee that most men would be diagnosed with aspergers.
In 1960 the average IQ in civilised countries was 82. So all people would be diagnosed with aspergers in 1960
. In 2001 the average IQ was 103.
@ Chibi_Son_Gokou, I think your thesis would fit on most countries.
@Chibi_Son_Gokou@xanga - @Keampun@thailandwetter - my thoughts exactly.
Hmm. This article is just a bit confusing since IQ has little to nothing to do with whether or not someone is diagnosed with Autism, Aspergers or PDD-NOS. For the initial diagnosis, many children are toddlers and aren't even given an IQ test. Even if they were, most couldn't perform it unless it was a non-verbal test. If you look at the current DSM, high or low IQ is not a qualifying factor for either of these.
But, it's interesting. Thanks for sharing, Mr. Robison.
Sockitmama.com
@sockitmama - I think they confused IQ in this study with functioning. Many IQ tests require you to be high functioning. If you are more severely autistic or have more symptoms of PDD NOS, your measured IQ will probably go down simply because you don't fully comprehend the test.
OP - Go to your local library or go online and search in the PDD section of the DSM. That'll tell you the difference. It's simply levels of symptomatology.
I'm not sure what PPD-NOS is but from the films I've seen in class, what distinguishes Asperger's is that the child tends to be very vocal and are extremely bright in specific field. The video that I watched was of a little boy who loved and knew way more than I thought was possible (for a child of his age) about dinosaurs. I could be wrong about the distinction though..
@Keampun@thailandwetter - If I remember correctly, I think IQ has been going up but the average is still the same... I remember one of my professors saying that if the average goes up from 100 to 110 then the entire scale is redone so that 100 now = 110 back then. I don't know if that makes sense or not T.T
This is the problem with overly-confident scientists making precise definitions out of fluctuating and arbitrary behavior.
@ldy_cinnamon@xanga - You've got it right. "IQ" is a measure of RELATIVE intelligence. The average IQ at any given time is 100. And someone who had an IQ of 100 in the past might have an IQ of, say, 87 in comparison to today's scale.
OP- I second the suggestion to look in the DSM. You can find it online here.
Well...for us I.Q definitely is making a difference in determining exactly what my son's dx is.yes,he was diagnosed P.D.D-nos,but my husband and I suspect Asperger's.The clincher? his I.Q turned out to be 138...so he is in gifted as well where everyone expects him to be "smart enough to know better" Seriously??!!When his behavior is clearly characteristic of autism....people expect him to control things more due to his high IQ.HFA,is what I answer people who ask what's up.It's ok to say that,isn't it?it's just so confusing!!
@girlfrommass - @girlfrommass - How old is your son? My grandson was diagnosed with Autism at age 2. After 8 months of E.I. a new evaluation resulted in his dianose as PDD-Nos. I don't know why. He is definately so much better and has evolved in the past 8 months - however- given his age - I would imagine any child would. How do they give an 33 month old an IQ test anyway. He is very smart and figure things out - if he wants to. If he's not in the mood at that particular moment - he won't. I have him spelling a few words. He can count up to 20 by himself - if in the mood - 50 with assistance. His IQ - according to them - was 82. It is very confusing. Are there differences in treatment?
Hello I'm a Mother of a beautiful eight year old girl her name is Dani, I've been a parent that has been told all her life from the age three she was autistic at the age of three she was diagnose as high moderate autistic of course the minute she was diagnose was devastating to me her father and 5 other siblings but once we got over the pain of the diagnoses we put her right in school for early intervention my daughter has come so far. She is very smart girl that speak well and she has even been placed in midstream at school. She still seems to get very overwhelmed when there are any changes at home and at school. But I just recently had her tested at the from the child physiologist and he said she is pdd-nos as a parent I'm overwhelm with three diagnoses from high moderate, to mild Autism now pdd-nos when will it ever stop with the medical profession why do they keep jumping around to different names why don't they stop confusing parents and just stick to Autistic spectrum it would be much easier for the parents and families! Concern Parent.......Gayle Badalamenti
Hi, I have four children, one with Aspregers, Thierry and one with PPD NOS (Keith). The differences are very clear to me. Thierry spoke really well from an early age, always gramatically correct used advanced vocabulary etc, Keith came along 5 years later, he had seriously delayed speach, he speaks like a foreign language learner, is gramatically impaired, bright but struggles verbally, no sense of pronouns. He also meows like a cat.
What they both have in common is a literal understanding of language, put the two next to each other and there is no way you could say that they have the same diagnoses. PDD and Aspergers are two different things entirely!