Question about Asperger Syndrome and "Severe Asperger"

[Oz67]

Warning: Outdated Terminology

To my knowledge, Asperger Syndrome is known to be a mild form of Autism, but some people say the word "Severe Asperger". My question, what does it mean exactly and is it another term for some people with Autism Spectrum Disorder level 3, but function well in society?

I just don't understand what "Severe Asperger" is, as all Pervasive Developmental Disorders are just ASD with different levels of severity.

 

[kriss72]

The criteria might have been different depending on where you live as there are different standards depending on where you live. There are two standards I know of the ICD and the DSM each with a number after them. I think ICD is originated from WHO and DSM from the US

I have an Aspergers diagnosis from ICD-10, the reason I got that one was that it couldn't be proven that I showed autistic traits as a 3(?) Year old. It wasn't about how I am now, but about at which age it could be proven it was detectable. There were no levels of aspergers in the criteria used when I was diagnosed.

The new criteria we are/have switched to in ICD-11 just have ASD and then a level, but it is not related directly to your support needs like I understand it is in DSM-5 (?), it's rather a matrix with IQ on one axis, and your language skills on the other.

 

[VictorR]

some people say the word "Severe Asperger".

My question would be who are these people? I've haven't heard of that term before, and when I did an internet search, two of the top results were this thread here and a thread you started on another forum.

---

Technically speaking, just as PDD-NOS can be mapped to ASD1, ASD2, or ASD3 on DSM-5, Asperger's could also be mapped to ASD1, ASD2, or ASD3 on DSM-5.

That being stated, to my understanding, the majority (~60%-70%?) of those with Asperger's likely would be diagnosed as ASD1, with most of the rest (~30-35%) being ASD2, and a very small number being ASD3.

I would venture that someone described as having "severe Asperger" would likely be considered to be ASD2 under DSM-5.

 

[GrownupGirl]

You're not supposed to call it Asperger Syndrome anymore. But I hate the functioning labels so much.
I live in my own apartment, shop weekly for groceries, look after my cat, and handle chores such as cooking, doing laundry, vacuuming my bedroom and taking out the garbage. I guess I must be high-functioning. But wait!
I didn't learn to tie my shoelaces until I was 9 or 10 years old, never learned how to ride a bike or driver a car, and I've never had a real job and it's only because of the government and extra money each month from my mother that I'm able to live in an apartment... so far. So I must be low functioning!

No, I'm just a complete loser and a burden on society.

 

[kriss72]

You're not supposed to call it Asperger Syndrome anymore. But I hate the functioning labels so much.
I live in my own apartment, shop weekly for groceries, look after my cat, and handle chores such as cooking, doing laundry, vacuuming my bedroom and taking out the garbage. I guess I must be high-functioning. But wait!
I didn't learn to tie my shoelaces until I was 9 or 10 years old, never learned how to ride a bike or driver a car, and I've never had a real job and it's only because of the government and extra money each month from my mother that I'm able to live in an apartment... so far. So I must be low functioning!

No, I'm just a complete loser and a burden on society.

I really don't like those high/low functioning labels, they are way too one dimensional.

@GrownupGirl you are not a burden to society in my world, you are a gift to it, like every other human.

 

[Suzanne]

How I understand it, if one's score comes out very high, then they are closer to having classic autism.

When I was being diagnosed, the "expert" said that I do not have autism; I have Asperger's syndrome, but due to the medical world not wanting to recognise that name, it is now referred to as: ASD ( Autism Spectrum Disorder) and I come into the middle ground ie level 2.

So, no, there is no severe Aspergers ( never heard of it being referred to).

 

[marc_101]

I never heard of "severe" Asperger's either.

The numbers after ASD in the DSM-5 do not refer to how "bad" ASD is in a person but rather the level of support the person needs. They are called "current severity." So severity means level of support at the time of diagnosis. Nowhere it says what support means. Have you met a 2-year old who doesn't need support?

Keep in mind why the DSM or the ICD criteria exist: to standardize the clinical diagnosis of an otherwise diverse cluster of traits and to determine the medical and social services a person can have access to. It's a tool of bureaucracy in a very real sense. It's not an statement about value to society.

A key part of autism is problems with social interactions, so the environment determines severity. It's a moving target.

 

[Neonatal RRT]

Warning: Outdated Terminology

To my knowledge, Asperger Syndrome is known to be a mild form of Autism, but some people say the word "Severe Asperger". My question, what does it mean exactly and is it another term for some people with Autism Spectrum Disorder level 3, but function well in society?

I just don't understand what "Severe Asperger" is, as all Pervasive Developmental Disorders are just ASD with different levels of severity.

Do understand that autism is made up of several metrics. One person with Asperger's/ASD-1 may have certain metrics that seem rather mild, but then have other metrics that can be rather debilitating, or at least present with rather obvious deficits. Obviously, there is some degree of subjectivity here, on the part of the psychologist, as to what they perceive is the threshold between an ASD-1 and an ASD-2, and who qualifies for different levels of assistance, etc. I am not aware that "severe Asperger" is a clinical term, but may certainly refer to someone who is not receiving assistance, but probably should. Which may beg the question, are they Asperger's/ASD-1, or something different? Are there other co-morbidities they have such as ADHD and OCD that may be contributing to their difficulties? There are seemingly infinite variability within the autistic community, likely even within the perspective of Asperger's/ASD-1 variants. What makes Asperger's a so-called "mild" variant is often the intellectual component, with the person with normal to above normal intelligences. It is an advantage, certainly, having the ability to present with some degree of self-discipline and masking, may allow the person to have a successful career, etc. but it may not necessarily take away any of the sensory issues, the "mind-blindness", the social and communication difficulties, etc. (example: Elon Musk) On the other hand, having normal and above normal intelligences often means one can be self aware of the condition, know one is different, know one isn't fitting in, know one is having difficulty, self-conscious, depressed, self-deprecating, and even have suicidal ideation. It's a double-edged sword, for sure.

 

[Oz67]

My question would be who are these people? I've haven't heard of that term before, and when I did an internet search, two of the top results were this thread here and a thread you started on another forum.

---

Technically speaking, just as PDD-NOS can be mapped to ASD1, ASD2, or ASD3 on DSM-5, Asperger's could also be mapped to ASD1, ASD2, or ASD3 on DSM-5.

That being stated, to my understanding, the majority (~60%-70%?) of those with Asperger's likely would be diagnosed as ASD1, with most of the rest (~30-35%) being ASD2, and a very small number being ASD3.

I would venture that someone described as having "severe Asperger" would likely be considered to be ASD2 under DSM-5.

I never met them in person, and I don't remember their legal or username, but found them randomly online.

 

[Mary Terry]

You're not supposed to call it Asperger Syndrome anymore. But I hate the functioning labels so much.
I live in my own apartment, shop weekly for groceries, look after my cat, and handle chores such as cooking, doing laundry, vacuuming my bedroom and taking out the garbage. I guess I must be high-functioning. But wait!
I didn't learn to tie my shoelaces until I was 9 or 10 years old, never learned how to ride a bike or driver a car, and I've never had a real job and it's only because of the government and extra money each month from my mother that I'm able to live in an apartment... so far. So I must be low functioning!

No, I'm just a complete loser and a burden on society.

You're a winner, @GrownupGirl, and living proof that labels often do not matter or reflect your many capabilities!

 

[Misty Avich]

You're not supposed to call it Asperger Syndrome anymore. But I hate the functioning labels so much.
I live in my own apartment, shop weekly for groceries, look after my cat, and handle chores such as cooking, doing laundry, vacuuming my bedroom and taking out the garbage. I guess I must be high-functioning. But wait!
I didn't learn to tie my shoelaces until I was 9 or 10 years old, never learned how to ride a bike or driver a car, and I've never had a real job and it's only because of the government and extra money each month from my mother that I'm able to live in an apartment... so far. So I must be low functioning!

No, I'm just a complete loser and a burden on society.

Well you can't tick all the boxes. I'm high-functioning but there's still one or two things I struggle with.

 

[Judge]

Part of me wants to smirk while the other grimaces. That the professional medical community in part seems to "freelance" autism diagnoses, using multiple sources and protocols, regardless of whether they have been revised or not. So it's not surprising if and when the general public (to some degree) freelances such terms to their own reckoning, such as the popular, but technically incorrect description of maladies like Norovirus as "Stomach Flu".

Of course the DSM-V essentially did away with the original term "Aspergers Syndrome" in May of 2013. Effectively replacing it with "ASD levels 1,2 &3. And the ICD-11 seems to have adopted most of what the DSM-V has been about for some time now.

In the meantime I suppose there will be many who will continue to use terms like "High Functioning", which may or may not imply independent living without any formal support mechanisms. Even then, I suspect it's unlikely that most of such people lead idyllic lives by their own account.

 

[Misty Avich]

Everything has severity levels so it's hard to call something as broad and diverse as autism as just autism for everyone. It's almost like it's a blanket statement and makes some of us question whether we have it or not. Then if someone explains that is because we are on the spectrum but just mild, that kind of contradicts the reason they took out the severity levels.

With alcoholics they call some "high-functioning alcoholics". To me an alcoholic is an alcoholic and is different to a person who just likes their drink - especially when you come from a culture that's quite highly dependent on alcohol, where is the line drawn between a non-alcoholic who likes to drink even at home (as a way to relax in the evening after work), a high-functioning alcoholic, and an alcoholic?

But I guess alcoholics know better than I do about alcoholism, as being teetotal I am an entirely different species (lol). So the same goes for autism spectrum disorders. Autism is different for everyone, and if you're on the high-functioning/less severe end of the spectrum you're still not going to exactly tick all the boxes of high-functioning, otherwise you probably wouldn't have the disorder at all. You're on the spectrum for a reason, which is whichever symptoms you have, so even if you are generally high-functioning that doesn't mean you have no symptoms. Also co-morbids can play a part too.

 

[Judge]

With alcoholics they call some "high-functioning alcoholics". To me an alcoholic is an alcoholic and is different to a person who just likes their drink - especially when you come from a culture that's quite highly dependent on alcohol, where is the line drawn between a non-alcoholic who likes to drink even at home (as a way to relax in the evening after work), a high-functioning alcoholic, and an alcoholic?

I use such a term generally to describe a former girlfriend. Who in essence went to a good deal of trouble to superficially hide her drinking problem, and could deceive a great many for a short duration of time. Of course over time anyone consistently within her social orbit eventually catches on that she's buzzed or blitzed.

So to me it's a description that ultimately describes form and not substance.

Tragic to know so many decades later that she never sought the help she truly needed. When it's doubtful she could fool anyone for any amount of time.