Disconnected With NT's

[Aet1985]

I was wondering is it normal, to feel ''distant'' or not on the same page? I never really ''fit in'' growing up, and now at 40 I still feel ''someplace else'' as opposed to guys my age. I do ok with women and getting dates no problem, but the entire ''NT World'' I can't ''keep up.'' I see guys I went to high school with, can handle being doctors, lawyers, cops, working in the city, all while having a big family on top of that. I was wondering and I am not talking anyone down, or think I am better than, but do Aspies still have small remnants, of classic Autism such as preferring our own mind and imagination? yet we know what is really go on?

 

[Neonatal RRT]

Welcome to the club. 

We've all got a story to tell, but what you are describing... more or less... is very common.

 

[the_tortoise]

do Aspies still have small remnants, of classic Autism such as preferring our own mind and imagination? yet we know what is really go on?

...um...this classic autistic knows "what is really going on" just like you do, aspie brother.

Virtually all ASDers experience the "odd person out"/"misfit" thing at some point...

You seem to believe there is a huge and clear categorical divide...when really all ASD categories (past and present) blend into one another on a gradual spectrum (or really set of spectrums)...

And you are not alone...this is a commonly held misperception, and likely will be for a long time -- if not forever...

ASD, and ability generally, go from highest to lowest "severities" or "levels of development" like a very very gently angled ramp....not a set of stairs or a ladder where each "level" is clearly and distinctly separate from all the others and separated by a lot of distance.

All the PDD (Pervasive Developmental Disorder) diagnoses were merged because of 2 main things:

1. There was so much lack of consistency and adherence to diagnostic criteria -- many doctors and entire clinics basically made up their own rules, or would diagnose people as having "Asperger's" vs "Autism" solely on the basis of IQ (which was not ever a differentiating thing all by itself; Asperger's excluded intellectual disability, but Autistic Disorder (aka "Kanner's" or "classic" autism) has included the entire IQ spectrum since Kanner's original patient set);

Or based on what would get a person services;

Or on desire not to limit a patient's future....(because of Asperger's being conceptualized in the minds of the uninformed or barely informed general populace [and apparently also most of the ASD community] as SO SO VERY DIFFERENT AND MILD compared to Classic Autism...when it could be, sure, but never was as a differentiating rule for all classic autistics...

The presumption here was that nobody would see the patient's potential or abilities if they were diagnosed with classic autism, but people might be able to see those things if they were "only" diagnosed with Asperger's)

2. In adulthood, when you control for IQ and language development as separate things to all other criteria, it was usually impossible to reliably differentiate people diagnosed with Asperger's from people diagnosed with Autistic Disorder (aka classic autism). I cannot even tell you how many research papers I read about this....

(Language development in DSM-IV was not even, not by itself, a differentiating criterion!

A person could meet classic autism criteria without delayed or unusual language development, it was one of several possible criteria that could fulfill requirements for a specific subset of the symptoms required for diagnosis [I was not such a person, my language development was both delayed and very strange and my language skills are mildly impaired to this day - noticeably in speech...and I apparently met literally all the criteria for classic autism...but my point about this stands].

In fact, this is why one of the [usually-ignored] criteria for being diagnosed with Asperger's Syndrome was that a person did not ALSO meet criteria for Autistic Disorder, because many aspies did/do meet criteria for BOTH -- and in that case what was supposed to happen [but rarely did], was that "Autistic Disorder" [aka classic autism] was supposed to take precedence...Meaning that if you met criteria for both Asperger's and Autistic Disorder, you were supposed to be diagnosed with Autistic Disorder.)

These two things (there were others but these seem to have been the most researched and hotly debated) led clinicians, researchers and policy-makers to question whether the distinct diagnostic categories -- particularly the separation of Autistic Disorder and Asperger's -- actually served any valid purpose in terms of understanding etiology, in terms of prognosis, in terms of reccomending appropriate interventions (i.e. therapies, educational programming, accomodations and daily life supports), in terms of public awareness and education, in terms of allocating health and human services resources appropriately.

 

[Matthias]

I think nearly everyone who is autistic feels similarly. I think classic autism is just more intense traits combined with a genetic condition or intellectual disability.

 

[the_tortoise]

Language development in DSM-IV was not even, not by itself, a differentiating criterion!

A person could meet classic autism criteria without delayed or unusual language development, it was one of several possible criteria that could fulfill requirements for a specific subset of the symptoms required for diagnosis

Note that "delay in, or total lack of, the development of spoken language" is just ONE out of FOUR possible communication criteria that could fulfill the requirement for diagnosis for this particular section of the diagnostic criteria for Autistic Disorder in the DSM-IV;

Note that 2/4 possible symptom criteria either say nothing about language skills or else explicitly presume "adequate speech";

Note that meeting only 1/4 of these criteria was sufficient to fulfill requirements for this section of the diagnostic criteria

Taken from full criteria for Autistic Disorder (299.00 in DSM-IV) which you can read here: DSM IV Diagnostic Criteria for Autism
[emphasis mine:]

(B) qualitative impairments in communication as manifested by at least one of the following:

1. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)

2. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others

3. stereotyped and repetitive use of language or idiosyncratic language

4. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

And if you read through the criteria for
Autistic Disorder, you will notice that Intellectual Disability is not a requirement. (It may have been in a waaaaay older version of the DSM, I cannot remember anymore, but is has not always been and if it was I am pretty sure was removed as a criterion before either OP or myself was born.

Absence of significant cognitive delay/impairment and absence of significant language delay/impairment are/were requirements for Asperger's to be diagnosed -- but again, presence of either was not required for diagnosis of Autistic Disorder....

one of the [usually-ignored] criteria for being diagnosed with Asperger's Syndrome was that a person did not ALSO meet criteria for Autistic Disorder, because many aspies did/do meet criteria for BOTH -- and in that case what was supposed to happen [but rarely did], was that "Autistic Disorder" [aka classic autism] was supposed to take precedence...Meaning that if you met criteria for both Asperger's and Autistic Disorder, you were supposed to be diagnosed with Autistic Disorder.

Taken from full criteria for Asperger's Syndrome (299.80 in DSM-IV), which you can read here:
DSM IV Diagnostic Criteria for Asperger's Syndrome
[emphasis mine:]

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia."