High Functioning Autism (HFA) and Asperger’s Syndrome (AS) exist on the Autistic Spectrum, which can be seen as a continuum of conditions. Therefore, they belong to the same ‘family’ – the question is, just how different - or similar - are they?
There is a fair amount of controversy over diagnosis of the two conditions, and experts are still arguing today over aspects of HFA and AS. On its website, The UK National Autistic Society (NAS), citing Gillberg and Ehlers, describes the main areas where the two conditions overlap and diverge:
Cognitive Functioning
It is generally easy to make a distinction between a child with (non high functioning) autism and a child with AS, because on the whole AS presents without learning difficulties. Such cognitive functioning is also present in HFA.
However, Hans Asperger, who first described AS in the 1940’s, noted that symptoms of AS could co-exist with learning difficulties.
Motor Skills
It is accepted that physical motor difficulties and poor co-ordination are an inherent part of AS. This is shared by many youngsters with HFA.
Language Development
Some authorities state that spoken language development must be normal for AS to be diagnosed; HFA is often accompanied by significant delay in this area. On the other hand Asperger himself observed speech and language peculiarities in AS.
The NAS concludes: ‘the fundamental presentation of the two conditions is largely the same’. Clinical psychologist Tony Atwood, in his 1998 book Asperger’s Syndrome agrees. He cites numerous studies that ‘suggest there seems to be no meaningful differences between them. They are more the same than they are different.’
Diagnostic Bias
Atwood makes an interesting point about a false distinction sometimes being drawn between HFA and Asperger’s Syndrome for two very different reasons:
Lack of Knowledge
The body of understanding, literature and training in autism far outweighs that for AS. Of course this will vary from expert to expert, and may explain how the same child can be disgnosed with HFA by one expert and AS by another elsewhere.
Funding
Some government agencies, according to Atwood, provide funding more readily for a youngster diagnosed with HFA. He says: ‘the term Asperger’s syndrome has yet to be included as an approved condition with associated entitlements.’
According to Atwood, a diagnosis of HFA, rather than AS, inevitably leads to better access to services designed to help the child with Autistic Spectrum Disorder.
The NAS points out that the opposite can be the case: ‘Some professionals have felt that Asperger syndrome is a more acceptable diagnosis from the point of view of parents. They argue that there is a social stigma attached to autism which is not attached to the term Asperger Syndrome.
The breadth of knowledge about HFA and AS can only grow with time. Hopefully the controversy and confusion surrounding both terms will gradually diminish and lead to better management of these conditions.
Sources:
'High-functioning autism and Asperger syndrome: what's the difference?' on the NAS website: www.autism.org.uk/nas/jsp/poloploy.jsp
Asperger's Syndrome, Tony Atwood, Jessica King publishers, 1998, pages 150-151
