mailing list For webmasters
Welcome Guest
"Dr. Livingstone, I Presume?" Options
Daemon
Posted: Thursday, March 19, 2015 12:00:00 AM
Rank: Advanced Member

Joined: 3/7/2009
Posts: 33,839
Neurons: 100,695
Location: Inside Farlex computers
"Dr. Livingstone, I Presume?"

David Livingstone, a Scottish missionary and explorer, was the first European to cross the African continent. Among his many discoveries are the Zambezi River and Victoria Falls. Though he aimed to facilitate the abolition of the slave trade by opening Africa to commerce and missionary stations, he inadvertently contributed to the "Scramble for Africa" instead. He is the subject of the popular quotation, "Dr. Livingstone, I presume?" Who uttered the famous phrase upon meeting him in 1871? More...
JUSTIN Excellence
Posted: Thursday, March 19, 2015 4:12:46 AM

Rank: Advanced Member

Joined: 6/25/2014
Posts: 401
Neurons: 2,787
Location: Veinau, Baden-Wuerttemberg Region, Germany
David have Asperger’s ?! ... Referring to the note 11 of TFD’s article {See David Livingstone - Did he exhibit Asperger's Syndrome? by Andrew Basden.}



First identified in the professional literature by Leo Kanner and Hans Asperger in 1943 and 1944, autism~Asperger Syndrome (AS) remained primarily of interest to professionals working with these children and their families for the next four decades. This changed in 1988 with the release of the film Rain Man.

The terms Asperger Syndrome and high functioning autism have their origins in 1943 and 1944, when the seminal papers by Leo Kanner and Hans Asperger were first published. Although they never met, Asperger and Kanner had much in common. They were both born in Austria and trained in Vienna. Kanner was born in 1906, 10 years before Asperger. Kanner came to the United States in 1924 and eventually became head of the Child Psychiatric Clinic at Johns Hopkins University. Asperger remained in Vienna and became Chair of Pediatrics at the University of Vienna. Both were popular and respected authors in their fields; Kanner is credited with founding a new discipline through his first textbook on Child Psychiatry.


Amazingly, within a year of one another, each published a paper describing a group of children they noted to be different from others they saw in their clinics. Both even proposed variations of Bleuler’s term “autism” as a diagnostic label, although that term later became associated with the group Kanner described but not Asperger’s children. The name they suggested for these children is not the only similarity between the two groups. There were many others, especially difficulties with social relationships, communication, and narrow, repetitive behaviors and routines. There were also important differences; Asperger’s group was less commonly delayed in speech, had more motor deficits, had a later onset of problems, and were all boys. Questions arose in those days and persist today as to whether these were two separate disorders or perhaps artifacts of differences in the authors’ interests, clinical referrals, or cultural biases.

KANNER'S ORIGINAL PAPER

Leo Kanner’s 1943 paper described 11 children from his Child Psychiatric Unit who were more similar to one another than to the typical referrals he received. Their commonalities were symptoms fitting into three categories: peculiar language, social isolation, and insistence on sameness. Kanner’s initial description was remarkable. Based only on his own observations, since no other reference work was available, he was able to highlight the characteristics that today define autism.

Specifically, he noted social difficulties, communication problems, and repetitive and restricted activities (the so-called “triad of impairments” as they were labeled by Wing & Gould in 1979). Kanner viewed the social deficit as primary and chose the name “autism” as a way of highlighting this central feature of the disability.

Kanner distinguished autism from the childhood schizophrenia he typically saw in his clinic in several ways. He noted that people with schizophrenia withdrew from social relationships while children with autism never developed them in the first place: “There is from the start an extreme autistic aloneness that, whenever possible, disregards, ignores, shuts out anything that comes to the child from the outside”(1943, p. 242). He also noted the idiosyncratic features of language that were much more characteristic of autism than of schizophrenia.

Kanner was fascinated by echolalia, pronoun reversals, and the unique forms of expression that characterized his group. Although Kanner saw autism and schizophrenia as separate in children, he assumed that autism was the earliest form and a precursor of adult schizophrenia! But later this assertion has since been disproven...

Kanner’s paper was widely read and extremely influential, unusual for a first paper on a disorder. The reason for this is unclear, but perhaps it is because so many professionals were seeing children with these characteristics but had no way of conceptualizing or classifying them. One problem that has resulted is that the misconceptions in the original paper have been hard to overcome. Even though Kanner’s work was remarkably accurate for a first description based on only 11 cases, he did argue that the children were mostly of normal or higher than normal intelligence, with parents from the higher social classes, and without neurological impairments. He also asserted that social deficits were primary. Since Kanner’s time the definition of autism has expanded and some of these proposals have been refuted. Many of his other ideas, however, are as accurate and relevant today as they were almost 60 years ago.

ASPERGER'S ORIGINAL PAPER

Asperger’s paper (1944) was his doctoral thesis. Asperger’s manuscript did not have the same impact as Kanner’s, probably because it was published in German during World War II. Few English speakers had even heard of the paper before Lorna Wing’s (1981) review of it almost 40 years later. From the available materials it seems as if Kanner was unaware of Asperger’s work, although Asperger had read Kanner’s and did, in fact, respond to his papers.

Asperger’s initial observations of these children were made during summer camp programs on his ward. During these activities Asperger noticed that some of the children did not fit in with the rest of the group, preferring to play alone and avoiding rough and tumble games. Asperger was concerned about these children and he set out to discover why and how they were different from the other children on the ward. With precision and empathy, Asperger described four boys and used the label “autistic psychopathy.” This label has also been translated as “autistic personality disorder,” which reflects Asperger’s view of this syndrome as a stable personality trait present from birth, rather than a psychotic process.

Asperger described many different characteristics in his original paper. Like Kanner’s, his observations were interesting, thoughtprovoking, and vivid. Unlike Kanner, however, Asperger did not articulate which of the characteristics he thought were essential for diagnosis, and which were not. Asperger’s description reads like a detailed account of many common features he noted in the children, rather than a diagnostic description and analysis. Asperger never clarified if he thought the primary feature in his children was a disturbance in social contact. He noted only one linguistic peculiarity, which involved pragmatic language deficits (problems with using language functionally and appropriately). He interpreted the pragmatic language difficulties as he interpreted problems with eye gaze; these were seen as part of a fundamental disturbance in the expressive behaviors needed for social interaction. Asperger described the children he observed as unequal partners in social interactions, who were unable to interpret complex social cues. Asperger also noted the repetitive activities emphasized by Kanner. He saw them as another way the children used to follow their own interests and preoccupations at the expense of interacting, contacting, and learning from others.


Asperger placed greatest emphasis on one feature of his syndrome, which he termed “autistic intelligence.” He viewed this as a form of independence and originality in thought which the children displayed, especially at school. This feature was both a strength and a weakness according to Asperger. Unlike other children who struggled to progress from mechanical learning to original thought, children with AS were capable only of forming their own strategies. They could not, or did not, follow those used by their teachers. To Asperger, this tendency reflected an intellectual strength, but also a lack of contact with those who tried to help them.


One example was a patient of Asperger’s, Harro. Harro solved the problem “47 – 15” in this way: “Either add 3 and also 3 to that which should be taken away, or first take away 7 and then 8”. That method was so indirect that it often led to errors. This cumbersome and often impractical approach to problems, combined with difficulties in groups, was Asperger’s explanation for the school difficulties so many of these children had in spite of average intelligence. Asperger recommended instruction in very basic and elementary academic skills and strategies, rather than allowing the children to use the faulty strategies they created on their own. Although school difficulties were a concern, a more positive characteristic was the way these children channeled their intelligence and original thought into certain specific interests. Virtually all of Asperger’s children had all-consuming interests in topics like chemistry, machinery, or space travel. Narrow in focus, these interests consumed a great deal of their time and energy.


Asperger’s descriptions of their interests were accompanied by discussions of what he viewed as the negative aspect of their intelligence, “autistic acts of malice.” Asperger interpreted some of the aberrant behaviors he observed as cunning uses of intelligence for malicious ends. For example, Asperger explained that Fritz deliberately misbehaved in his class because he enjoyed seeing his teacher become angry. A study has asserted that Asperger misinterpreted the intense pursuit of interests and lack of social understanding as malicious rather than oblivious. Asperger later modified his theory, stating that the children could not know how much they hurt other people, physically or emotionally.

SIMILARITIES BETWEEN KANNER AND ASPERGER

Both Asperger and Kanner noted symptoms falling into each of the three areas of the triad of impairment: social difficulties, communication problems, and repetitive and restricted activities. Both authors also took care to separate the children they described from those diagnosed with childhood schizophrenia. Although their interpretations were different, both noted that the parents of these children shared some of their behavioral features. Kanner’s interpretation was that the parents’ intellectual and cold demeanors may have caused their children to withdraw socially, contributing to their autism. This theory was later dismissed as evidence mounted that parents’ behavior was not the cause of autism. Asperger saw parental behavior as evidence for a genetic phenotype. Asperger was also more aware of the social value of these characteristics; he noted that many of the parents were quite successful.


Both Kanner and Asperger also observed more males than females with these symptoms. In fact, Asperger originally thought that the syndrome existed only in males, a view he later reversed. Another feature noted by both authors was the clumsiness of the youngsters. Kanner mentioned it as an aside, while Asperger gave it a more central place as a defining characteristic. Today clumsiness is thought by some to be an important distinguishing feature between AS and HFA. Both Kanner and Asperger placed great emphasis on their clients’ strengths and positive characteristics, frequently noting their special skills, absorbing interests, and strong rote memories.

BIASES, CULTURAL NORMS, AND REFERRAL SAMPLES

Although the similarities between the Kanner and Asperger descriptions are compelling, there were also some significant differences in their descriptions of the two groups. Before examining these differences in detail, it is important to acknowledge the strong cultural differences between the United States and Austria during the early 1940s, in order to separate cultural factors from actual differences between the children they were describing.

The most important cultural difference between the two countries was the influence of the Nazi Party in Vienna at the time of Asperger’s work. It was reported that Asperger’s work was treated lightly in Austria because he was not a party activist. Also, Asperger was describing children with social problems in an environment where it could have been life-threatening to differ from the party ideal. Asperger was undoubtedly protective of his clients, so it is conceivable that he overemphasized the social value of their symptoms in order to protect the children. For example, he asserted that the children showed, “....a predestination for a particular profession from earliest youth. A particular line of work often grows naturally out of their special abilities .... A good professional attitude involves single-mindedness as well as the decision to give up a large number of other interests”. Even though this emphasis on strengths might have been extreme and overstated, it represents a pleasant contrast to other psychiatric writings of that time which ignored positive qualities while overemphasizing weaknesses.


In terms of etiology and underlying deficits, the two authors seemed inclined to apply theories supported by their professional communities. Kanner was surrounded by proponents of psychodynamic theory. This could help explain Kanner’s examination of parental characteristics and his misconception that autism was a reaction to parental rejection. His initial articles were followed by considerable psychodynamic theorizing on the etiology of autism. It is fortunate, and a tribute to Kanner’s scientific openness, that later scrutiny led him to reject this psychodynamic interpretation.

Asperger’s work, on the other hand, did not have strong psychodynamic influences, despite Freud’s early popularity in Vienna. By the time Aspergers thesis was published, Freud had left the country. A study reports that Asperger’s mentor, Lazar, formerly had employed a child psychoanalyst but later turned away from the theory, pronouncing it as inappropriate for children. Asperger must have concurred, as he considered AS genetic and did not even suggest psychodynamic or other environmental explanations.

Referral biases are also probable. Both authors worked with samples of children that were biased toward the higher end of the socioeconomic scale. In both countries in the 1940s, few families with limited economic resources sought psychiatric help. For this reason, highly successful and intelligent families were over-represented in psychiatric clinics. Therefore, both Kanner and Asperger overestimated the average economic and educational levels of families of children with AS/HFA.



Another referral bias, however, might have affected the authors differentially. Because Kanner’s clinic focused on childhood schizophrenia, most of his referrals were initially thought to be schizophrenic, which suggests that they had the language skills to express unusual thoughts and perceptions. Thus, his original description of autism was based on this relatively high functioning group, which could explain his impression that children with autism have average intelligence.

Asperger, on the other hand, had a reputation for helping children with disruptive behavior problems, and was most likely to see these types of children... Those AS children who did not disrupt their classrooms were probably referred to other doctors in Austria, or perhaps not referred at all. Similarly, Frith (1991) suggested that during the 1940s, Austrians in general were more preoccupied with discipline than were Americans, and thus Asperger paid more attention to misbehavior. This could account for a higher incidence of mischief and malice in his AS students, which far exceeds the reports of any other investigator either during the period when Asperger wrote or afterwards.



DIFFERENCES BETWEEN KANNER'S AND ASPERGER'S DESCRIPTIONS

Beyond these potential biases lie further substantive differences between the two groups. Some of these may simply reflect the samples that each investigator selected but others may be keys to the differential diagnosis of separate disorders. In general, Asperger’s clients were not as impaired as those of Kanner. Asperger’s group was older by the time he saw them, and their communication problems seemed less severe. All of Asperger’s patients were verbal but some of Kanner’s were not. Also the Asperger children had less severe impairments in adaptive functioning, did better at school, and were less restricted in their activities.

The language in the Asperger group was more odd than impaired. He described his children as speaking like “little adults,” in a pedantic manner using a large vocabulary. Kanner noted the extreme literalness in the children he saw who did speak. Social impairments in Asperger Syndrome were also less severe. All of the differences described to this point could merely be a function of the level of impairment, with the Kanner group being more impaired overall than the Asperger group.

There are, however, some differences between the two groups which cannot be explained simply on the basis of differences in overall functioning level. Kanner emphasized his patients’ impaired relationships to people despite intact relationships to objects. Asperger saw both relationships as impaired. Asperger noted that his group collected objects just to possess them, rather than to make something out of them, change them, or play with them. Asperger also noted attention problems in his patients. Unlike impulsive and distractible children he had worked with, the children in this group attended to their own cues, rather than cues highlighted by teachers and parents. These attention problems caused school difficulties, even when Asperger’s children had average or above intelligence.

These factors of attention differences and interest in collecting objects could have represented substantial differences between the groups. It is also possible, however, that Asperger made note of these characteristics while Kanner did not focus on them. Currently the controversy continues and there is not yet consensus on whether the groups are actually different or not.

OTHER NAMES FOR SIMILAR GROUPS

Before Asperger’s seminal work, people with similar traits were described and discussed in the psychiatric literature under various names. Kretschmer (1925) included several Asperger-like symptoms in the case descriptions he used to categorize psychiatric patients into types. One form of “schizothymic” personality, which he called the “world-hostile idealist,” was described as clinging rigidly to a favorite idea or “calling.” This characteristic resembles the narrow interests of AS. Kretschmar also noted that this group was shy and awkward, only having friends who would participate in their interests. Robinson and Vitale (1954) described three children with “circumscribed interest patterns.” They placed such heavy emphasis on this one symptom that they believed it was the basis for a disorder in its own right. The children they described had significant social impairments but, unlike Kanner and Asperger, these authors believed that the social problems were secondary to the children’s all-absorbing interests. The children became so absorbed in their interests that their social curiosity disappeared. These narrow interests were pursued to the exclusion of everything else.

Robinson and Vitale acknowledged the similarity of their group of children to those with autism. They believed they were different, however, in several important ways. First, they lacked an early emotional unresponsiveness that is typically seen in autism. These children seemed to have been normally-developing babies. At the time of referral, they were less withdrawn than children with autism, and showed less sameness-seeking behavior. Kanner wrote a response to the Robinson and Vitale article, concurring with the authors. He endorsed their differentiating factors and predicted that circumscribed interest patterns would become a separate diagnostic category. Actually, Robinson and Vitale’s group sounds very similar to what we now call Asperger Syndrome.

Adams (1973) discussed Robinson and Vitale’s group and their interests. He placed them on his “obsessive spectrum,” and called their interests “impulsions.” Emphasizing that these were different from compulsions, he went on to explain how impulsions were egodystonic. That means the clients displaying the symptoms had some awareness of how nonproductive and distracting they could be. Adams’ cases would probably now be diagnosed with Obsessive–Compulsive Disorder (OCD). Adams’ placement of children with special interests on the same spectrum with children with OCD, however, suggests that some of his cases actually had AS. Many of the symptoms he mentioned are consistent with AS: lack of spontaneity, poor motor coordination, social awkwardness and eccentricity, solitariness, and pedantic and literal speech.

In a book on learning and attention disorders, Kinsbourne and Caplan (1979) differentiated the “overfocused child” from impulsive children. While both groups had attention problems, the overfocused children were overly attentive to one particular topic to the exclusion of all others. The impulsive children, on the other hand, were simply very distractible, especially in school. Kinsbourne and Caplan also noted other characteristics of these overfocused children, including narrow interests, precision, not knowing when their work was finished, shyness, solitariness, sensitivity to criticism, formal speech, gaze avoidance and stereotypies in times of distress. These symptoms are all common in both HFA and AS. The authors stated that these children were by no means autistic, but had many symptoms reminiscent of autism, although to a lesser degree of severity. The children’s impairments were not considered severe enough to warrant a psychiatric diagnosis but the authors conceptualized a continuum including both overfocused children and those with autism.

One early diagnosis is still used by some workers. Since 1964, Sula Wolff has been studying a group of patients diagnosed with “schizoid personality disorder.” During her earliest presentation of her work, Wolff was unfamiliar with Asperger’s paper and description of his patients (Wolff & Barlow, 1979). After reading Asperger’s work, she asserted that her group was almost identical to his except for two important differences: some of Wolff’s clients were female and some developed schizophrenia in adulthood. She acknowledged that her group indeed had symptoms of autism, but suggested that their degree of impairment was less severe. Wolff chose the term “schizoid personality disorder” for three reasons: (1) the condition was common and permanent; (2) the pattern was unchanging, fitting the definition of a personality disorder rather than an illness; and (3) the adult diagnostic category of schizoid personality disorder was comparable to what she saw in her children. Although the relationship between schizoid personality disorder and AS is still in dispute, Wolff’s work has clearly demonstrated that their categories overlap significantly, and might actually be identical.

ASPERGER SYNDROME BEFORE WING'S PAPER


Lorna Wing, a British psychiatrist, is generally credited with introducing Asperger’s work to the English-speaking autism community in 1981, in an important paper in which she reviewed Asperger’s description, then added her own perspectives and clinical examples. However, years earlier Van Krevelen and Kuipers had mentioned Asperger in their 1962 article in English, and in 1971, Van Krevelen had written a paper about autism and AS. These papers, however, did not create the interest that followed Wing’s later description. The problem was probably their early dates of publication, since autism had not yet been included in the DSM, the major classification system of psychiatric disorders, and there was not yet an active debate about diagnostic precision in autism. Also, these articles were published in child-focused journals, which limited their circulation. The greatest interest in Wing’s article came from psychiatrists working with adults.

In his 1971 article, Van Krevelen directly compared autism and AS, which was still called “autistic psychopathy.” He proposed four main differences between the disorders: (1) The onset of autism was in the first month and the onset of AS was not until the third year or even later; (2) Children with autism walked before talking but Asperger children talked before they walked. Also many children with autism were mute or had severe language delays and children with AS communicated well but one-sidedly; (3) Children with autism had poor eye contact because they were oblivious to others and children with AS avoided eye contact but participated in the world on their own terms; and (4) Autism was a psychotic process with a poor prognosis and AS was a personality trait with a much better prognosis.

These proposed differences reflect some of the misconceptions of those times about autism. For example, autism is no longer considered a psychotic process. Also, the description of AS was altered by Van Krevelen. Asperger did not set the age of onset at age 3 years but rather at 2 years or earlier. He did not interpret the poor eye contact as an aversion but rather as a result of treating people and objects similarly. Also, he thought that poor eye contact resulted from the inability of AS children to understand the communicative value of eye contact. Wing (1981) also noted that in real life symptoms are not as clear-cut as Van Krevelen described.

Although Van Krevelen’s proposed differences have not survived in their present form, they have still contributed to the current conceptualization of the disorders. Another valuable contribution was Van Krevelen’s description of two children in the same family, one with autism and the other with AS. The children’s father also had Aspergerlike symptoms. Van Krevelen proposed that AS was transmitted genetically through the father and that the children with autism would have had AS were it not for unspecified organic factors. Other authors have made this same point in subsequent years. For example, Burgoine and Wing (1983) described a set of identical triplets who had AS. They noted that the brother with the most severe impairments had the most peri-natal and early childhood medical problems. Although they emphasized that the etiologic pathway could not be as simple as Van Krevelen’s description, they concluded that the case study suggested that early severe brain damage can affect the way the condition is manifested. This early connection between brain damage from an insult and genetic factors as causes of autism, separately or in combination, is consistent with current thinking.

Bosch (1970) made another point that remains relevant today. In describing “autistic psychopathy,” Bosch asserts that the difference between AS and autism is a matter of degree, and that the same person can be diagnosed with each disorder at different points in life. Bosch asserts that many people with AS would have been diagnosed with autism if they had been seen at younger ages. Likewise, some of his patients with autism improved enough with age to be indistinguishable from his adult clients with AS. The possibility of different diagnoses at different ages is still discussed today, though is not adequately reflected in any of the diagnostic systems.

WING'S CONTRIBUTIONS

Although the contributions reviewed in this review have had an important impact, Lorna Wing’s (1981) paper was the major work to stimulate further review of Asperger’s description and its relationship to that of Kanner. Even prior to her seminal article, Wing had described children with autistic features who did not fit Kanner’s definition of autism precisely, but who were similar and could benefit from the same services (Wing, 1976). She described the work of Asperger and Van Krevelen and differentiated their groups from children with autism. Wing estimated that Kanner’s definition only applied to 10% of children with autism, and she called attention to the need for new diagnoses or a broader definition of the disorder. In a 1979 community prevalence study, Wing and Gould found a “general impairment of reciprocal interaction” to be much more common than autism.

Wing (1986) wrote her 1981 article partially in response to Wolff and Barlow (1979). She disagreed with their classification of AS as a personality disorder, instead viewing it as a developmental problem on the autistic spectrum. The paper reflected Wing’s desire for a broader conceptualization of autism. She described Asperger’s cases, as well as her own, and changed the disorder’s name from “autistic psychopathy” to “Asperger’s Syndrome.” Wing reasoned that the term “psychopathy” was too often associated with anti-social behavior and could cause too much confusion. Wing also included girls among her cases, arguing that although AS was more common in males, it clearly could occur in females as well.

In addition to changing the name and including girls, Wing made other modifications in the definition of the disorder. First she highlighted aspects of developmental history that Asperger had not mentioned. She noted that before one year of age children with AS showed little interest or pleasure in social contact, limited babbling, and no joint attention. An example was if a child saw an interesting toy in the store he would not demand a parent’s attention by pointing to it. Normally developing children, in contrast, have an “intense urge to communicate” before the development of speech, according to Wing. Wing also noted that some children with AS had no pretend play. Those able to pretend confined their play to a few set themes, often enacting scenes repetitively. These children did not involve others in their play, unless the other children followed commands and allowed the child with AS to dominate the scene.

Another modification was Wing’s assertion that children with AS did not necessarily excel in language as Asperger originally claimed. Her patients eventually developed good grammar and a large vocabulary, but the content of their speech was impaired and much of it was copied from other people or from books. To Wing, it seemed as if they had learned language by rote. Her patients often knew difficult words but not easier ones. There was also a pronounced impairment in nonverbal communication. Wing examined motor and language milestones noting that fewer than half of her patients walked at the usual age and many were slow talkers. These observations refuted Asperger’s and Van Krevelen’s belief that children with AS talked before they walked. They are also inconsistent with the current DSM-IV definition (to be discussed in the future!!) that emphasizes normal language development.

As noted previously, Asperger emphasized his clients’ originality and creativity in their chosen fields. Wing modified this to a more measured view of the skills and interests in AS. She noted that her patients often selected an unusual aspect of a commonly interesting topic, rendering the topic somewhat inappropriate. She described their pursuit of interests as “narrow, pedantic, literal, but logical” (p. 118). Rather than an indication of unusually high intelligence, the interests and special skills were largely based on rote memory. Understanding of meaning was universally poor. Wing did not dismiss Asperger’s rosier view of interests completely, however, since she noted that her patients were more severely impaired than Asperger’s.

Wing’s final modification involved the prognosis of people with AS. She emphasized that it was possible to have both AS and mental retardation. Because not all people with AS were of normal or high intelligence, Wing insisted that the generally accepted notions about the disorder’s prognosis needed to be altered to reflect variations in intelligence levels. Also, comorbid psychiatric disorders often affected the prognosis. Depression and anxiety were common, and Wing surmised this was because of these clients’ increased awareness that they were different from others. This awareness typically came during adolescence or young adulthood.

Wing’s documentation of poor prognoses and more comorbidity in her sample represents a broadening of Asperger’s definition of AS to include lower functioning people. Disagreeing with Asperger, Van Krevelen, and Wolff, Wing concluded that, at the time of her writing, the available evidence pointed to a distinction between AS and autism based on severity. The other authors believed that there were fundamental differences in the nature of the disorders. Nevertheless, Wing advocated keeping the term AS, although she has reevaluated this position more recently and now questions whether a separate diagnosis of Asperger’s Syndrome is really productive after all!!! Following Wing’s 1981 paper, there was an explosion of research attempting to clarify qualitative differences between HFA and AS. The issue has still not been settled and will be addressed in the future of us.

Wing (1986) has noted important sequelae from her paper. Referrals from adult psychiatrists, suspecting that their patients had AS, increased significantly. Unexpectedly, these included referrals from forensic psychiatrists who surmised that their patients had committed crimes because of their narrow interests and limited social understanding. These referrals helped Wing to gain more information about the clinical picture of AS in adulthood. The disadvantage of these cases for understanding AS was that they generally relied on retrospective reports of developmental histories. Such retrospective reports are notoriously unreliable and can often result in misdiagnoses and misperceptions of the developmental histories of disorders. Confusion based on retrospective reports is especially troubling in identifying whether a link exists between criminality and AS, which is still difficult to determine.

Another consequence of the Wing publication has been an expansion of the understanding of autism. Wing helped increase public awareness that the autism spectrum includes more than Kanner’s initial definition. As a result of her work, misdiagnoses of higher functioning people with autism or AS have dramatically decreased.



[image not available]


SUMMARY AND CONCLUSION

Beginning in the early 1940s and continuing to the present, studies of HFA and AS have increased our understanding in a parallel fashion to the development of knowledge in the field of autism in general. Although they were not familiar with one another’s work, Kanner and Asperger described many similar and overlapping characteristics. Later investigations analyzed similarities and differences between these descriptions and also have looked at the overlap between both of them and related conditions like schizoid personality disorders or learning and attention problems. The work of Lorna Wing in the 1980s has been instrumental in highlighting AS and its relationship to high functioning autism.

Current researchers continue to build on the strong foundation that has been provided. The result has been a dramatic increase in our understanding of high functioning people with autism. The distinction between autism and AS, however, remains unclear and unresolved... Current research continues to focus on the question of whether HFA and AS should be considered as separate conditions. With this historical background, we will turn to what has been learned about the people who have been identified with these conditions.

References:

1) Asperger, H. (1944/1991). “Autistic Psychopathy” in childhood. In U. Frith (Ed. & Trans.), Autism and Asperger syndrome (pp. 37–92). Cambridge: Cambridge University Press. (Original work published 1944).

2) Asperger, H. (1979). Problems of infantile autism. Communication, 13, 45–52.

3) Attwood, T. (1998). Asperger’s syndrome: A guide for parents and professionals. Philadelphia: Jessica Kinglsey.

4) Freeman, B. J., Lucas, J. C., Forness, S. R., & Ritvo, E. R. (1985). Cognitive processing of high-functioning autistic children: Comparing the K-ABC and WISC-R. Journal of Psychoeducational Assessment, 4, 357–362.

5) Marriage, K. J., Gordon, V., & Brand, L. (1995). A social skills group for boys with Asperger’s syndrome. Australian and New Zealand Journal of Psychiatry, 29,
58–62

6) Shea, V. (1984). Explaining mental retardation and autism to parents. In E. Schopler & G. B. Mesibov (Eds.), The effects of autism on the family, (pp. 265–288). New York: Plenum Press.

7) Wing, L. (1976). Diagnosis, clinical description, and prognosis. In L. Wing (Ed.). Early childhood autism: Clinical, educational, and social aspects (2nd ed., pp. 15–64). Oxford: Pergamon.
striker
Posted: Thursday, March 19, 2015 9:17:34 AM
Rank: Advanced Member

Joined: 5/30/2014
Posts: 1,698
Neurons: 5,079,026
Location: Boston, Massachusetts, United States
read the book the white nile it describe the pain and suffer this man went through to discover where the nile started
monamagda
Posted: Thursday, March 19, 2015 12:32:30 PM

Rank: Advanced Member

Joined: 2/4/2014
Posts: 8,848
Neurons: 7,700,132
Location: Bogotá, Bogota D.C., Colombia
Dr Livingstone, I Presume?


Many who know little about Livingstone have in their mind an image of his meeting with Stanley at Ujiji in 1871, immortalised by Stanley’s words ‘Dr Livingstone, I presume.’ What Livingstone could not know was that this moving moment represented the meeting of two radically different approaches to Africa and Africans and that his approach was doomed to give way to the new. In all his thousands of miles of travel, Livingstone, though always showing willingness to fight if he had to, negotiated his way among the many chieftaincies he encountered, studying traditional custom and honouring it. Stanley, though briefly emotionally affected by Livingstone, represented the new European approach to Africa, which would, in the decade of the ‘Scramble’, conquer the continent with the Martini-Henry and the Gatling gun. By 1895 Africa had been ‘brought into the family of nations’ but not as Livingstone had envisaged when he coined the phrase, holding up Xhosa and Magyar as comrades in the struggle for freedom. -

See more at: http://www.historytoday.com/andrew-ross/dr-livingstone-i-presume#sthash.bbYu6jcs.dpuf
Milica Boghunovich
Posted: Thursday, March 19, 2015 2:36:33 PM
Rank: Advanced Member

Joined: 8/5/2014
Posts: 1,016
Neurons: 156,985
"Dr. Livingstone, I Presume?"

David Livingstone, a Scottish missionary and explorer, was the first European to cross the African continent. Among his many discoveries are the Zambezi River and Victoria Falls. Though he aimed to facilitate the abolition of the slave trade by opening Africa to commerce and missionary stations, he inadvertently contributed to the "Scramble for Africa" instead. He is the subject of the popular quotation, "Dr. Livingstone, I presume?" Who uttered the famous phrase upon meeting him in 1871? More...

An interesting phenomenon! ....the British thinking that the world has not existed where they had not tread before with their foot. They "discovered" rivers, lakes, etc. .. and he opened Africa to more foreign destruction and exploitation ... Read Chinua Achebe, ....!!!
Fredric Frank Myers
Posted: Thursday, March 19, 2015 5:16:00 PM

Rank: Advanced Member

Joined: 1/31/2015
Posts: 208
Neurons: 22,366
Location: Apache Junction, Arizona, United States
It is interesting, to state the very least, how so often we start out to prove/do something but the totally opposite results occurs.
Users browsing this topic
Guest


Forum Jump
You cannot post new topics in this forum.
You cannot reply to topics in this forum.
You cannot delete your posts in this forum.
You cannot edit your posts in this forum.
You cannot create polls in this forum.
You cannot vote in polls in this forum.