Is Aspergers Truly on the Autism Spectrum?

[Guest guest]

Is Aspergers Truly on the Autism Spectrum?

No rush to judgment

[by Rowan Hooper for The Japan Times.]

http://www.japantimes.co.jp/cgi-bin/getarticle.pl5?fe20031023rh.htm

In a meeting in Heidelberg earlier this month, science historians

concluded that German science between 1933 and 1945 was exploitative and

unethical. The organizer of the meeting, Wolfgang Eckhart, head of history

of medicine at the University of Heidelberg, said in Nature last week: " We

have proven that the DFG [Germany's main research agency] was willingly

involved in the full range of medical crimes during the Nazi era. "

It is perhaps not surprising that scientists in Nazi Germany

suppressed ethical concerns. (That's putting it mildly: A letter from one

scientist to the head of the medical section of the DFG praises the

" excellent conditions for researchers in Auschwitz. " ) But what is surprising

is that amid the atrocities of the Third Reich, there was a clinic in Vienna

that treated autistic children with extraordinary gentleness and intuition.

The director of The Vienna University Pediatric Clinic had a Heilpadagogik

(therapeutic pedagogy) department, and its head was Hans Asperger.

Asperger recognized that some autistic children, far from being

parasitic on the Nazi state, had remarkable gifts. It is this " higher

functioning " autism that he is now known for, but his work, published in

German in 1944, was not discovered for 40 years. That happened in the 1980s

when a London Institute of Psychiatry researcher, Lorna Wing, published a

study on autistic children and " Asperger's Syndrome. "

Since then Asperger's Syndrome has been diagnosed more and more frequently,

and there has been a sudden rush of new psychiatric disorders.

The " disorder rush " has worried many. The response of

Longworth, a GP in Leicester, England, is typical: " Could someone please

tell me where shyness ends and 'social anxiety disorder' begins? " he wrote

in the British Medical Journal. " Isn't this just another appalling example

of the creeping (galloping?) medicalisation of everyday life? Would it be

written about at all if suggested treatments didn't include expensive

SSRIs? "

SSRIs are Selective Serotonin Reuptake Inhibitors, drugs like

Fluoxetine (also known as Prozac) that block the re-uptake of serontonin and

are prescribed for conditions such as depression and obsessive compulsive

disorder. It is a huge market. How huge? Well, with the number of U.S.

depressives forecast to reach 48.1 million by 2005, there's lots of money to

be made.

Asperger's and autism are behaviorally classified and there is some

overlap between them. There is, some researchers maintain, a spectrum of

symptoms. " Autistic spectrum disorders share a triad of impaired social

interaction, communication and imagination, associated with a rigid,

repetitive pattern of behavior, " Lorna Wing wrote in the BMJ in 1996.

But the existence of the spectrum is controversial.

Simpson, consultant child and adolescent psychiatrist at the Tavistock

Clinic in London, said in the BMJ this year that considerable doubt remained

about an autism spectrum.

" In autism, " he wrote, " children are socially withdrawn, while in

Asperger's Syndrome they usually desire social contact but cannot negotiate

social rules: The danger of confusing Asperger's syndrome with autism in a

broad definition is that not only that it might hamper research but that it

risks over diagnosis. A growing problem in child psychiatry is where parents

of troubled children increasingly demand diagnostic certainty at the risk of

error. "

Diagnostic certainty is difficult because the causes of autism and

Asperger's are unknown. Autism ( " self-ism " ) is characterized by impairments

in social functioning and interactions: Perhaps the disorder occurs because

other people (other " selves " ) are not interpreted as such by the brain?

This is just what Yale researchers found in 2000. Schultz,

director of the neuroimaging research program in autism at Yale, lead a team

that used functional magnetic resonance imaging to study brain organization

in autism and Asperger's patients.

The team found that the patients perceived faces as if they were objects.

One of the characteristics of the disorders is the difficulty in recognizing

other people by their faces.

The three-year study resulted in the discovery of reduced activation

in the fusiform gyrus -- the face-processing area of the cerebral cortex.

Researchers also observed increased activation in an adjacent region of the

brain that processes non-face objects.

" This finding is very compelling since it fits with our clinical

experience of autism, " Schultz said. " Persons with autism and Asperger's

have very little interest in people, and our study shows that this

disinterest is reflected in the manner in which the visual processing

centers are organized in their brains. "

Schultz stresses that he doesn't know whether this difference in brain

organization and function is at the heart of the cause of autism and related

disorders, but speculates:

" Of the things that the developing child routinely encounters, the

human face is probably the most frequent and important, " he said. " The

ability to recognize and remember people by their face is critical for all

types of interpersonal relationships. The face conveys many important types

of information, including a person's age, sex and emotional state. Decoding

this information is critical to successful functioning within a group. It is

precisely these things that are so difficult for these patients. "

Hans Asperger's work, conducted in the unethical climate of German science

50 years ago, was remarkable for its compassion and insight. Today his

work -- and that of his successors who explore autism -- has direct bearing

on the most profound of biological mysteries: the development, organization

and function of the human brain.

Asperger's syndrome is explored in " American Normal " (Copernicus) by

Lawrence Osborne and in the novel " The Curious Incident of the Dog in the

Night-Time " ( Cape) by Mark Haddon. Rowan Hooper is a researcher at

Trinity College, Dublin. He welcomes comments at rowan.hooper@...

© All rights reserved

________________________________

Ooops....Wrong Planet! Syndrome

Autism Spectrum Resources

www.PlanetAutism.com

jypsy@...

[Guest guest]

On this business of face recognition there are some fairly simple

experiments.

People with so-called " face blindness " , Prospagnosia, are better able

to memorize and recognize photographs of human faces when they are

presented upside down.

NTs are more able to recognize when they are presented right side up.

With my son and I (we are both diagnosed Asperger's) it makes no

difference, we can recognize faces either way up equally well.

I think that experiment is very telling.

What follows is mere speculation.....

My speculation is that the human brain has two face related parts.

One part decides whether the object is a face or not. A second part

is a recognition engine specialized for faces. The first part acts as

a switch routing information to either the second part or some

general purpose recogintion engine. In the prospagnosia aflicted

people the second part is broken but the first part is not. In the

Asperger people the first part is broken and the general purpose

recognition engine is used on faces as well as non-faces. It's not a

disconnect between self and others, it's a failure to view humans as

being " special " , as being in a distinct class from other creatures

and objects. To the NTs it's so natural to view people as " special "

that they don't even realize that they are doing it and that not

everyone does. That's my speculation.

Holly

> Is Aspergers Truly on the Autism Spectrum?

>

> No rush to judgment

>

> [by Rowan Hooper for The Japan Times.]

>

> http://www.japantimes.co.jp/cgi-bin/getarticle.pl5?fe20031023rh.htm

>

> In a meeting in Heidelberg earlier this month, science historians

> concluded that German science between 1933 and 1945 was

[Guest guest]

Holly wrote:

>People with so-called " face blindness " , Prospagnosia, are better able

>to memorize and recognize photographs of human faces when they are

>presented upside down.

>NTs are more able to recognize when they are presented right side up.

>With my son and I (we are both diagnosed Asperger's) it makes no

>difference, we can recognize faces either way up equally well.

Are you saying there's no overlap? I've been thinking of myself

as both autistic and faceblind (and I know a few other people

who consider themselves both, also). On the prosopagnosia list,

I've frequently commented (in response to posts from non-

autistic faceblind people) that I find it hard to untangle the

two conditions in order to tell which one to " blame " for my

deficits in particular situations.

I've never been tested for prosopagnosia, simply assumed I

had it because it takes me so long to learn to recognize

people. On the other hand, it's obvious to me that I don't

" prioritize " humans (or rather that I give higher priority

to many other things; humans are not at the top of my

interest list).

Anyway....I find it confusing.

Jane

[Guest guest]

Holly wrote:

>My speculation is that the human brain has two face related parts.

>One part decides whether the object is a face or not. A second part

>is a recognition engine specialized for faces. The first part acts as

>a switch routing information to either the second part or some

>general purpose recogintion engine. In the prospagnosia aflicted

>people the second part is broken but the first part is not. In the

>Asperger people the first part is broken and the general purpose

>recognition engine is used on faces as well as non-faces. It's not a

>disconnect between self and others, it's a failure to view humans as

>being " special " , as being in a distinct class from other creatures

>and objects. To the NTs it's so natural to view people as " special "

>that they don't even realize that they are doing it and that not

>everyone does. That's my speculation.

>

>

If that were true, then we would learn facial recognition over time to a

great extent than we do.

There is some evidence that the part of the brain that is normally

hard-wired for facial recognition is

much smaller in autistic people.

I am terrible at facial recognition myself.

Ride the Music

AndyTiedye

[Guest guest]

> Holly wrote:

> >People with so-called " face blindness " , Prospagnosia, are better able

> >to memorize and recognize photographs of human faces when they are

> >presented upside down.

> >NTs are more able to recognize when they are presented right side up.

> >With my son and I (we are both diagnosed Asperger's) it makes no

> >difference, we can recognize faces either way up equally well.

>

> Are you saying there's no overlap? I've been thinking of myself

> as both autistic and faceblind (and I know a few other people

> who consider themselves both, also). On the prosopagnosia list,

> I've frequently commented (in response to posts from non-

> autistic faceblind people) that I find it hard to untangle the

> two conditions in order to tell which one to " blame " for my

> deficits in particular situations.

>

> I've never been tested for prosopagnosia, simply assumed I

> had it because it takes me so long to learn to recognize

> people. On the other hand, it's obvious to me that I don't

> " prioritize " humans (or rather that I give higher priority

> to many other things; humans are not at the top of my

> interest list).

>

> Anyway....I find it confusing.

>

> Jane

Here's another thought that I'll toss out...

Faces are animated objects. If someone has difficulty processing visual

sensory input, maybe a face, which is constantly changing, cannot be decoded

and stored.

My son got better at recognizing people by their faces as a sort of side

effect of practicing his visual processing. Before that, he recognized

people mainly by their clothes, I think. After a summer break from OT at

preschool, he was concerned that his OT wouldn't recognize him because he

was wearing a shirt that she had never seen.

[Guest guest]

jypsy [ janet norman-bain ] wrote:

> " In autism, " he wrote, " children are socially withdrawn, while in

> Asperger's Syndrome they usually desire social contact but cannot

> negotiate social rules:

Aah, yes; this old yarn (or should I say 'yawn') again. I can cite as

many examples of exceptions to this as I can examples of people that

conform.

> The danger of confusing Asperger's syndrome

> with autism in a broad definition is that not only that it might

> hamper research

How would this work? This doesn't even make sense on its surface. I

participated in autism research, and the people doing it told me that

they don't consider there to be any difference in the conditions... if

it was hampering them, they didn't seem to know aout it. They were

looking for test subjects with AS or autism; both the aspies and the

autistics would be given the same tests.

> but that it risks over diagnosis.

" It " risks overdiagnosis? " It " can't do anything. If overdiagnosis is

taking place, that is occurring because doctors are overdiagnosing.

> A growing problem

> in child psychiatry is where parents of troubled children

> increasingly demand diagnostic certainty at the risk of error. "

And if they demand the doctor give them a new car every time they come

in to have their child evaluated, do they get that too? Demanding

something does not imply a right to have it, nor a responsibility for

someone else to give it to them.

This is just more rubbish being spouted by people that should know

better, but don't. It is known that AS and autism both run together in

families (right, Jypsy?), and that having someone with AS in the family

is equally as predictive of having a child with autism as is having

someone with autism in the family. In addition, monozygotic siblings

(identical twins, triplets, etc) have been noted, where one or more

siblings are autistic, and another has AS. It is known that autism and

AS are conditions that have a strong genetic component, and when you

have one identical twin that has AS and another that is autistic, and

you know that both have the identical set of genes, then you can

reasonably conclude that AS and autism are the same condition,

differently expressed in terms of phenotype.

Do these psychiatrists who doubt an autism spectrum really need me to

come point out the obvious to them? If so, I am going to have to ask

someone else to extract their heads from their collective asses

(assuming we can tell which end is which) before I go about the task.

Sheesh...

[Guest guest]

I have thought for some time that I may have " mild prospagnosia. " I can

recognize a few peoples' faces, people I know very well. I can tell my

husband's face apart from his idential twin's face because my husband has 2

scars, a large one from a car accident on his forehead and a smaller one just

above his lip from playing with a razor as a child. I can also recognize my

mother's, sister's, father's, and several other relatives and my closest

friends. It has been a willful act of memorization on my part, however. I

cannot recognize my mother unless I am looking at her face because her hair has

turned gray and I expect it to be dark brown, so when I see her from behind I do

not know it is her because I am scanning for brown hair.

As a child at recess, I always had to remember what my friends were wearing, or

I could not find them. I would go up to everyone with a certain hairstyle to

see if it was my friend. Sometimes, I would spend an entire recess unable to

find them because I had forgotten to note what they were wearing before recess.

In high school, I could not recognize people after they changed their hair, or

if they wore their hair in a different style than usual, for example, male

friends got haircuts every month or two, and then I did not recognize them, and

when female friends got their hair cut or permed or dyed, I could not recognize

them, either.

As a child I was shown pictures of boys and asked to point out which ones were

hitting me, but I was unable to do so because I couldn't recognize people in

pictures. I could only describe them. The conclusion, due to this, was that

the boys were not real, and I was put on Haldol because they thought I was

delusional because I couldn't ID the boys from pictures.

And yet, I do know certain peoples' faces. Is there any such thing as " mild "

face-blindness? How do they diagnose it?

From: " Jane Meyerding "

> Holly wrote:

> >People with so-called " face blindness " , Prospagnosia, are better able

> >to memorize and recognize photographs of human faces when they are

> >presented upside down.

> >NTs are more able to recognize when they are presented right side up.

> >With my son and I (we are both diagnosed Asperger's) it makes no

> >difference, we can recognize faces either way up equally well.

>

> Are you saying there's no overlap? I've been thinking of myself

> as both autistic and faceblind (and I know a few other people

> who consider themselves both, also). On the prosopagnosia list,

> I've frequently commented (in response to posts from non-

> autistic faceblind people) that I find it hard to untangle the

> two conditions in order to tell which one to " blame " for my

> deficits in particular situations.

>

> I've never been tested for prosopagnosia, simply assumed I

> had it because it takes me so long to learn to recognize

> people. On the other hand, it's obvious to me that I don't

> " prioritize " humans (or rather that I give higher priority

> to many other things; humans are not at the top of my

> interest list).

>

> Anyway....I find it confusing.

>

> Jane

[Guest guest]

SUSANNAH ALSIP danced around singing:

>I can also recognize my mother's, sister's, father's, and several other

>relatives and my closest friends. It has been a willful act of

>memorization on my part, however. I cannot recognize my mother unless I

>am looking at her face because her hair has turned gray and I expect it to

>be dark brown, so when I see her from behind I do not know it is her

>because I am scanning for brown hair.

That sure sounds like prosopagnosia to me, and mine is pronounced enough

that if somebody gives me pictures of the same person using different

expressions or in different clothing/lighting/etc my brain identifies each

as an individual human being, not the same one under different

circumstances. I also rely on non-face things like body shape, hair

style/color, clothing, and so forth to recognize people. I also tend to

analyze, then memorize, individual identifying features for when all of the

non-face things fail me. That doesn't always work, though -- I almost

always fail to recognize my partner, despite having dozens of photographs,

when we meet at the airport or in public during my visits.

I sometimes think that it's not that severe a case, until I have a serious

" incident " where I fail to recognize somebody I *really* should know. A

few weeks ago, I was doing volunteer work, and met several seemingly very

different people. Everything went fine until we got our official volunteer

t-shirts -- all of a sudden, all of the men and all of the women with the

same hair color looked identical to me! I knew that they'd been easily

distinguished between before, but I guess I was subconsciously relying on

t-shirts to recognize them, because I sure was baffled when they all had

the same shirt on! :-p

Oh, to answer somebody else's comment... I'm not sure how to classify my

thinking type, but it involves three-dimensional motions and visual ribbons

of color. I can easily envision things and do have a photographic

memory. (I still have near-automatic memorization abilities for most

senses.) My trouble is that I have to " manually " remember faces just like

I have to study other things, and even then, it's a photographic

memorization that can't change to match different circumstances.

What I find amusing is that while I have trouble recognizing faces, my

tendency to identify individuals based on body/hair color & shape means

that I'm excellent at distinguishing between very similar animals. Most

people that are confused by my problems recognizing human beings are

equally baffled by the idea of being able to see the difference between

multiple short-haired gray cats, for example. I see small differences in

the shades of their coats, the way they walk, the size of various body

parts -- it seems obvious to me that they're different, even if I've never

met them before, and I'll remember *them* all by name.

I suspect the section of my brain designed for " individual recognition " is,

like other things about me, more other-animal-like than human-like... I've

noticed that animals have little trouble recognizing friends or foes on a

purely visual basis, even before they can smell one another (something I

also can rely on). However, like me, they have trouble recognizing people

if we change our hair or clothing too much, until they can catch our

scent. Humans (or is it all primates?) are the only ones I'm aware of that

use the face for recognition. Perhaps prosopagnosia is actually having

brain structure that functions more like that of a non-human animal?

DeGraf ~*~ http://www.sonic.net/mustang/moggy

" You shouldn't let people play on your feelings... In this

world you get taken to the cleaners for having a soft heart. "

-- Wynne

[Guest guest]

nah wrote:

>And yet, I do know certain peoples' faces. Is there any such thing as

> " mild " face-blindness? How do they diagnose it?

Congratulations, you're prosopagnosic! You've just

diagnosed yourself.

If you want to learn more about it, there are links

on the links page of my web site:

http://staff.washington.edu/mjane (link to link page

is near the bottom).

It's the case for 99% of all faceblind people that we

*do* (learn to) recognize certain people eventually,

those we see most often and have most to do with. I

really like the " stones " page created by Cecilia. It's

the one you'll find mentioned that way on my links

page.

Jane

[Guest guest]

> This is just more rubbish being spouted by people that should know

> better, but don't. It is known that AS and autism both run

> together in families (right, Jypsy?), and that having someone with >

AS in the family is equally as predictive of having a child with

> autism as is having someone with autism in the family.

Not only that, but for instance in my family, there are people with

different types of autism. And *clearly* different types of autism.

But the interesting bit is that the two main kinds of autism that show

up in our family are *not* " autism and AS " . Some people with each

would be diagnosed with one or the other, based on differences in

expression of the same basic types.

So to really oversimplify to make a point:

My brother has primarily Autism Type 1 (for lack of a better term.)

He's dxed with AS.

I'm primarily Autism Type 2 (for lack of a better term.) I'm dxed

with autistic 'disorder'.

But there are other relatives with Autism Type 1 who would be dxed

with autistic 'disorder'.

And my father would probably be dxed with AS but is clearly Autism Type 2.

I just had to explain to my dad for the first time the other day, by

the way, that neurotypical children do *not* generally learn language

by parroting entire clusters of words and that their first words are

not usually sentences. (His were " See the moon. " ) And that most

people are hardwired so that they understand pretty much what words

are for very early, they don't just hear clusters of sounds and repeat

them. Apparently none of his kids, even the non-autistic one, were

neurotypical enough for him to watch typical language development in a

child.

His response was something like, " So you're like me only more severe. "

(His words, not mine.) And I said, " I already knew I was like you

only with pieces amplified. I've known that for a long time. " I've

been pointing out to him things I do for the last few years, and he's

usually said, " I do that, but only when I'm overloaded " , or " I do

that, but not often " , or " I do that, but less " .

But he would most likely be dxed with AS or PDD-NOS if he were dxed,

and I'm diagnosed with autism. Despite my much-more-similarity to him

than to any people from my mom's side the family who would probably be

dxed with autism if they were born in the last decade or two.

This, of course, is an oversimplification. There seem to be more than

two " types " of autism in our family, and there are a *whole* lot of

other neurological oddities (learning disabilities in both the US and

UK sense of the word, Tourette's, tic disorders that don't technically

qualify as Tourette's but are related, 'hyperactivity', 'bipolar',

epilepsy, and lots of people who are either called 'tetched' or

'simple'.) A friend once commented, " There aren't enough normal brain

cells in your family to assemble one neurotypical brain. " And while

I'd argue with the neuroscience in that comment, I wouldn't argue with

the sentiment. Yet we have people who would be dxed with probably

everything in the 299 section of the DSM except Rett's, even when

they're from the same general subtype.

Which is, by the way, why my family's been enough of a visible

microcosm for me to be aware of the fact that there are more than two

kinds of autism and that even when you've got two main types of

autism, calling one 'autism' and the other 'AS' gets pointless.

Another thing that points to there being little distinction, to me, is

that in the study of people with *any* kind of autism 'spectrum'

diagnosis who acquired the kind of movement problems I've acquired,

they spanned every diagnosis on the autism 'spectrum', and if autism

and AS were really so separate you wouldn't expect to see an increased

incidence of this in *both*. They noted that a completely *different*

trait -- a particular style of relating -- was much more of an

indicator of whether this would happen than whether the person was

dxed autism or AS.

[Guest guest]

There is an attorney in our area that makes T.V. commercials for

his firm. Every time one of the commercials came on, my daughter

would get really close to the screen and scrunch of her face in

concentration. I finally asked her what she was doing, and she

said that she was trying to see his face, but his eyebrows

wouldn't stop moving so she couldn't see him clearly.

One of the attorney's assistants was taking classes at the

University where I used to work, and I told her one day what my

daughter had said. She said she would tell the attorney about it.

He has stopped moving his eyebrows enough that my daughter is not

obsessed with trying to " see his face " , but I notice that they

still move quite a bit.

Louis

In my house, " normal " is only a setting on the dryer.

From: Rakus

Here's another thought that I'll toss out...

Faces are animated objects. If someone has difficulty

processing visual

sensory input, maybe a face, which is constantly changing,

cannot be decoded

and stored.