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Dr-David-Banner

"That" Controversial New York Times Article

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Dr-David-Banner

There was a huge debate on Wrong Planet on the article by Paul Steinberg. This article came out a while before the official Asperger Diagnosis was scrapped. Steinberg makes an interesting series of points, many of which I agree with (although not his assumption a brain scan can simply eradicate the complexities of diagnosing A.S. (or autism). I will forward parts of the article by Steinberg, while adding in double brackets any points I may want to highlight.

The article was hotly debated some time ago on Wrong Planet. In fact, Paul Steinberg's article made for an interesting and constructive discussion. Here are the main segments:

"Considered to be at the high-functioning end of the autism spectrum, Asperger syndrome has become more loosely defined in the past 20 years, by both the mental health profession and by lay people, and in many instances is now synonymous with social and interpersonal disabilities. But people with social disabilities are not necessarily autistic, and giving them diagnoses on the autism spectrum often does a real disservice. ((This debate between HFA and Asperger Syndrome is nothing new and the fact some psychologists accepted A.S. as not being identical to autism doesn't essentially spell the end of the diagnosis, see Paul Cooijman https://paulcooijmans.com/asperger/straight_talk_about_asperger.html

An expert task force appointed by the American Psychiatric Association is now looking into the possibility of changing the way we diagnose Asperger. True autism reflects major problems with receptive language (the ability to comprehend sounds and words) and with expressive language. Pitch and tone of voice in autism are off-kilter. Language delays are common, and syntactic development is compromised; in addition, there can be repetitive motor movements. ((This is not quite "spot-on" as the problem relates to instinctive, non specific or expressed language and not necessarily spoken)).

Eventually, biological markers, now in the beginning stages of development, will help in separating autism-spectrum disorders from social disabilities. For example, researchers at the University of Pittsburgh Medical Center have recently developed three-dimensional brain scans that look at brain wiring. In preliminary studies people with autism-spectrum disorders appear to have too much wiring and disorganized wiring in areas involved with language acquisition. (( Very much doubt it! Again, verbal language wasn't the issue and Asperger's original research showed some of his patients were advanced in spoken language at an early age, such as use of adult expressions and puns. Also most researchers in Germany agreed autism sysmptoms can have either biological or merely psychological factors behind them. I doubt brain scans will ever solve this issue)).

Nevertheless, children and adults with significant interpersonal deficits are being lumped together with children and adults with language acquisition problems. Currently, with the loosening of the diagnosis of Asperger, children and adults who are shy and timid, who have quirky interests like train schedules and baseball statistics, and who have trouble relating to their peers — but who have no language-acquisition problems — are placed on the autism spectrum.((Yes, he makes a good point everybody gets lumped together. I still think he misunderstands the language issue. This is non-verbal and instinctive, not expressed mechanically.))

In recent years speculation has abounded that Albert Einstein must have had Asperger syndrome. Christopher Hitchens speculated that his intellectual hero George Orwell must have had Asperger. Indeed, Orwell had major problems fitting in at British preparatory schools — not surprisingly, he hated the totalitarian tenor of teachers and school administrators — but someone on the autism spectrum could probably never have become a police officer in Lower Burma, as Orwell did. Similarly, writers like Charles Morris have noted that Warren Buffett is thought to have a condition on the autism spectrum, presumably Asperger syndrome. ((Agreed, more or less)

A 1992 United States Department of Education directive contributed to the overdiagnosis of Asperger syndrome. It called for enhanced services for children diagnosed as being on the autism spectrum and for children with “pervasive developmental disorder — not otherwise specified (P.D.D.-N.O.S.),” a diagnosis in which children with social disabilities could be lumped. The diagnosis of Asperger syndrome went through the roof. Curiously, in California, where children with P.D.D.-N.O.S. were not given enhanced services, autism-spectrum diagnoses did not increase. Too little science and too many unintended consequences.

For better or worse, though, Asperger syndrome has become a part of our cultural landscape. Comments about a person’s having “a touch of Asperger’s” seem to be part of everyday conversations. Even an episode of “South Park” last year was devoted to Asperger syndrome. We can only hope that better physiological markers distinguishing between the autism-spectrum disorders and pure social disabilities can stem this tide of ever more pathologizing.

But, as Martha Denckla, a pediatric neurologist at Johns Hopkins University, has lamented, the only Americans in the future who will perhaps not be labeled as having a touch of Asperger syndrome will be politicians and lobbyists. Members of the political establishment may have other kinds of psychopathology; but, unlike the rest of us, they at least cannot be thought of as Aspies.  ((Mostly agreed. I think Hans Asperger himself would have definitely referred to the "Aspie" concept as simply "neurodiversity". He accepted we were not all neurotypical but Asperger mostly dealt with more severe autism. Only one case of rehabilitation into normal school was listed.))

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Dr-David-Banner

Comments made:

(1)"That guy (or maybe NYT) has an agenda and seriously needs to update on his Aspergers trivia (look at all those stereotypes!). If you check his website (link), you'll find he has no authority when it comes to Autism or Aspergers. Just because he has a psych degree, doesn't make him credible. Dude is just an ableist talking out of his ass."

(2)"I think ASD has more to do with a person's mode of thinking rather than their specific social inadequacies. The way I see it, the social problems associated with ASD are merely a side effect of an object-oriented way of looking at the world. Autistic people tend to process the world through the intellect rather than through intuitive social understanding, and this is what leads to issues in normal human interaction.
Diagnostically speaking, I think it makes more sense to examine the root causes of a person's behavior when determining whether ASD or another social disorder is appropriate. The author of this article seems to only look at the symptoms, which is a bit myopic.
That said, it is of course possible that some ASD diagnoses are inappropriate. I just think that he is approaching the problem (if one exists) from the wrong angle."

(3)"They won't be distinct for long following the release of the DSM-V, however. In fact many of the leading researchers in the field of ASD believe that never really has been a huge distinction between AS and HFA, nor is there a consensus over the hierarchical method of diagnosis. I think it makes more sense this way, considering that its called the autism spectrum for a reason. But that is another discussion entirely, and I have already derailed the thread enough."

(4")Dude, I am talking about my experience. I don't know what your experience is. I see, like 30 times in a day, people around me IRL, or people on the web (not talking about WP) saying "AS is so cool", or "I'm cool because I have AS", or "I wanna have AS because people with it are cooler". Sorry, I can't trust those people. I do not think they have AS.
And, when they come close to me after knowing I have AS, and they say they are "disappointed" by my behaviour, and that I can't have AS because I'm not intelligent enough to have it, or because I don't fit the stereotype, or because of any other reason, I just can't trust them, sorry. I think that people with actual Asperger's should know that everyone with AS is different, at least I do, and other people with actual Asperger's I met IRL did. Who are they to decide wheter my diagnosis is correct or not?"
 

(5)"Autism is a mess because it's a spectrum and the new revision is an attempt to clean up that mess and get rid of the ambiguity that is Asperger's and related labels. Placing everything under an umbrella term with levels of functioning is solid logic compared to how it is now."

((Number six made a great point))

(6) "Where do you live? Where I am no one really knows what it is. Strangely, people point out the traits in me when they get to know me - a girl I knew used to mention my lack of expression, and said my voice never revealed my emotional state.Mostly I see more negativity about it than anything positive, online. I can't imagine anyone bragging about it being cool.I was never interested in my diagnosis until now - I got it in early adolescence. It's only a few weeks ago that I read Hans Asperger's paper, and you realize that the media has taken a few soundbites and completely misrepresented what it is. Hans never said that people with Autism were academically inclined, which is simply what some people think. This is where the whole "nerd" stereotype comes from, and this is why I think it can be wrongly diagnosed.The kids Hans described actually performed poorly in education and didn't adjust at all, which was my experience also. However, he mentioned they did excel in some things, and had good rote memory. I think it's the kids who aren't adjusting and making friends that need to be looked for, not the academically-inclined, high-achiever who is a bit on the introverted side. Most of the "geeky" kids I remember at school had fairly good social integration.I understand that this representation is meant to be positive, but it does no service for those who struggle and ultimately get ignored.
I had language delay, and had speech therapy for quite a while. I still put Asperger's on health and safety forms/applications."

(7)"I would say, yes, Asperger's is by definition a form of high-functioning autism. However -- I'm no expert and this is just my understanding from other forums -- those with the label HFA had a noticeable speech/language delay in early childhood, whereas those with Asperger's did not.If a child with speech delay wasn't diagnosed with anything as a child, as an adult he may be diagnosed with Asperger's, because by adulthood the speech delay is (usually) no longer a factor. Technically, however, he would be HFA as it indicates a noticeable delay in language skills in early childhood.But what I see in a lot of places are adult diagnoses where people say, "I always knew I was different than others, but I had no noticeable academic problems" or, "I didn't fail any of the litmus tests that adults used to measure childhood development, so they just assumed I was normal."
I guess what the author of the article is arguing is that if there isn't something blatantly obvious (like a language delay in childhood) that can be compared to "normal" children, the person cannot be autistic. He's equating Asperger's with the more correct HFA label.In thinking about this, it would be the opposite. He doesn't exactly understand what Aspeger's is and that a person can be just as autistic as an HFA but still pass those language test standards. So what he calls Asperger's is more correctly HFA (the noticeable impairment) and what he calls social awkwardness would in fact be Asperger's.This may seem like splitting hairs and a bunch of semantics, but it's actually pertinent to seeing his misunderstanding of the topic."

Edited by Dr-David-Banner

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Dr-David-Banner

My view: I made it clear many times. I think there are a lot of contradictions and much more that needs to be researched. For anyone who does get confused, Tony Atwood is always a good and trusted source. However, I did think it was great to see this actually being discussed because that is a great way to learn more about the condition and to see angles where other people come from.

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