ques for brown 1442 | Autism PDD

So what is "subclinical" aspergers??

Table 2.

Clinical Expression of Autism: Severe to Subclinical Forms

	Severe (IQ <50)	Moderate (IQ 50-60)	Mild (IQ >70)	Subclinical (IQ >70)
Developmental course	Onset usually reported during first year, developmental spurts, plateaus until adulthood.	Onset usually reported during 12 to 24 months, developmental spurts, plateaus until adulthood.	Onset usually reported up to school years, developmental spurts and plateaus until adulthood.	Onset reported in school years or adolescence, may be just considered "odd," "a loner," "peculiar."
Sensory motor symptoms	Motility disturbances / stereotypes, over / under reactions to sensory inputs	Same as severe. Motility symptoms wax and wane, needs routines, lifelong.	Same as moderate. Symptoms may abate further or disappear, needs routines, lifelong.	Attached to / manipulates objects / parts of objects when young. Repetitive activities, needs routines, may be clumsy.
Social relatedness symptoms	Eye contact not used, aloof, uses others as objects, no appropriate affect, lifelong.	Intermittent eye contact, aloof / overattached to caretaker, obvious social deficits, lifelong.	Lacks friends, lacks empathy. Relates awkwardly and inappropriately, misses social cues, lifelong.	Lacks friends, lacks empathy, misses social cues, awkward reciprocal interaction. May appear normal or considered "odd."
Cognitive, language, speech symptoms	Mute or loses speech at 19 to 20 months. Echolalia, single words / phrases. Pronoun misuse. Uses others as extension of self, signs, lifelong.	Single words, echolalia, speech problems, pronoun reversal. Concrete functional speech. No symbolic use, isolated cognitive skills, lifelong.	Echolalia plus usable speech. Special skills, interests. Perseverative, concrete thinking, impaired symbolic use.	No general delay or retardation. Speech may be pedantic, lengthy, aprosodic word invention. Good rote memory, impaired symbolic use. Decreased imagination / creativity.
Level of social functioning	Lifelong constant professional supervision required.	Lifelong supervision at home or community-based group home required.	Usually requires lifelong minimal community-based supervision. No close friends or sexual partners. None reported to have married.	Socially awkward, bullied at school. Can live independently. Absent / impaired dating. May marry but dependent upon spouse. Performs sex mechanically, have children.
Educational occupational level	Lifelong, structured, behaviorally based, individual educational program.	Same as severe, but mainstreaming possible. May acquire reading, writing, math skills.	Educational needs same as moderate. May complete higher education. Special interests rather than education level determine occupation. Capable of supervised or independent employment.	May complete higher education. Relies on memory / special cognitive skills, independent employment, not creative, repetitive or technical work is best.
Medical follow-up required	Assess for concurrent diseases and seizures. Short-term tranquilizers for behavior control. Fonfluramine decreases motor symptoms in some.	Same as severe. Girls have more severe course.	May require psychiatric treatment in teen and adulthood for social adjustment, depression & psychotic reactions. One suicide reported.	Same as mild.

They fit the classic definition of "subclinical" (i.e., symptoms present but too mild to have warranted medical attention). That is interesting--for us, dd's cognitive score is 140, however she is dx
w/ mild to moderate autism. She does also have static encephalopaty,
seizures, & other developmental delays & issues (SPD, apraxia, hypotonia,
tics & tremor). I've never seen anything like this written out & wonder, it
appears to be based on a study? From this, I guess I can understand
more why our psych said dd may truly be 'moderate to severe' in her daily
functioning & future development (when you add her other dx's into her
autism equation).

I guess if this was a study, it's just that, based on those stats. But, I have
read of children/adults with very high IQ's, and that often they may have
more issues than what's suggested here. Sometimes, these people get
very obsessed (to where that is their sole focus, life around them doesn't
matter) with their ideas & so their genius ends up, in a way, disabling
them. I also have heard of people getting various scores on IQ--we've
been told these are not very accurate, and should only be one factor in
diagnosis. http://www.faaas.org/doc.php?32,172,1371743,6,,,Doc,page.htm lWow...that's a lot of great info.

Thanks so much!so brown1442......what is being done for your son? does he qualify for anything?

Thanks for posting that chart...it tracks with what I've thought about Jason's "functioning levels"...all except his IQ, which hasn't been tested as yet.

Moderately/Severely autistic. Why oh why does this sometimes still hit really hard?

Thank you, though, for posting that. I was curious about what the "subclinical" criteria was, too.

your welcome

There is NO IQ criteria for any Autism Spectrum Disorder medical diagnosis. None. Mental Retardation is the only medical diagnosis that require IQ criteria (less than 60, with "borderline MR" being 60-69). There are definitely criteria for ALL the Autism Spectrum Disorders, including Asperger Syndrome. "Subclinical" means that the person meets MOST of the criteria for that disorder but not enough to qualify, medically, for the disorder. You can find the official criteria for meeting the dx's of Autism, PDD-NOS or Asperger Syndrome in the DSM-IV, the official psychiatric manual, which doctors use when determining an official diagnosis. Of course, IQ has a bearing on a child's prognosis, but the score is not considered at all when a diagnosis of a PDD is given, medically. Or educationally, either. In fact, the legal definition of autism in NY SAYS it occurs at all levels of intelligence. However, the Federal definition says nothing about intelligence. It is below and it covers ALL the MEDICAL Pdd's -- autism, pdd-nos, asperger's, rett's and CDD:

(1)(i) Autism means a developmental disability significantly affecting verbal and nonverbal communication and social interaction, generally evident before age 3, that adversely affects a child's educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual responses to sensory experiences. The term does not apply if a child's educational performance is adversely affected primarily because the child has an emotional disturbance, as defined in paragraph (b)(4) of this section.

Gosh... I totally missed this post... sorry about that

To answer your question... my son meets a number of the criteria for Asperger's but at this point in his life it isn't interfering with his ability to function so they are calling it "subclinical". I guess the symptoms need to interfere with daily life in order to warrent a diagnosis.?!?! For now he does well and can fool most people but he's still young and that could change dramatically as the social world gets more complex for him as he ages. We are keeping very close tabs on him.

At 2.5 when we first sought a diagnosis for him he did a lot of spinning wheels, flipping light switches on and off, and watching fans. He had language but had a pragmatic language delay and absolutely NO interest in peers. He even ignored most adults at that age. That all changed quickly though. I rarely see him doing any stimming any more but he still does have some lingering social awkwardness with peers... does GREAT with adults now. He's got a high IQ (140) and has no delays..... but he's certainly not typical

Currently he's in 2 preschools... an integrated one through the school district that he started at age 3 with a mild pramatic speech delay (which is gone... he tests at a 7-8 year old level verbally now) they currently use him as a typical there even though he still "technically" has an IEP. The other school is a regular typical church based preschool where he is thriving wonderfully. He also attends 3 social skills groups... one speech based led by a ST, another led by a pyschologist, and another is more of a facilitated playdate with a developmental specialist. He's "graduated" out of all one on one therapies... ST, OT, etc.