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Do ALL people with Aspergers have the triad of impairment?

StrawberryMilkshake

I've suspected aspergers in my daughter for many years BUT she doesn't have the triad of impairment. When I read up about aspergers she shows so many of the "traits" but no the social impairments. She has a large group of close friends. She's not great with strangers but once she gets to know someone she's fine. She can talk out in a classroom situation with slight nerves but no real problem.

The traits she shows over the years has been lining up toys, not able to play imaginative games, playing "maths" games with her toys rather than imaginaitve one, not great with change which has resulted in a total meltdowns if something is sprung on her without warning, very very high anxiety levels which have sometimes hit peak level (worst case was severe depression and anxiety resulting in not being able to get into school and barely able to leave the house some days. She has high sensitivity with things like hair brushing (you'd think I was ripping her hair out!), can't stand itchy clothes or labels (although the label thing is less of a problem now she's older). She has strong preferences and dislikes with food - which can change regularly. She hates crowds and noisy places. If she has been wronged she CANNOT forgive and forget. It upsets her massively to be wronged and can result in a total meltdown and upset.

Sure there's others but can't think at the moment.

So, are there any people withe aspergers that DON'T have the triad of impairment? Or is she just highly sensitive instead?

Thanks. x

Parents

  • I'm always going on about this so please excuse any repetitions in recent posts.

    The triad is a diagnostic tool that excludes things that can be confused with other conditions. Hence sensory issues such as sensitivity to sounds or sensations is excluded.

    But it also concerns me that the triad is designed primarily to diagnose more marked autism where it is likely that people being assessed will show up on enough points in each section. I think it lets people down badly who are nearer the threshold and may have difficulty ticking off enough characteristics in each of the three areas.

    It is really down to this notion that there is "mild" autism, not helped by the theory that the spectrum is a steady curve towards normal.

    The key difficulties that people seem to have are difficulties with social engagement and difficulties with sensory overload and other environmental factors. The way the triad addresses social engagement issues is rather specific and even quite peripheral.

    Where I've sounded off about this before is what triad questions really mean. I'm looking at one version of DSM-IV in a book, for want of something in front of me, excuse if unfamiliar wording...

    "Marked impairment in the use of mutiple non-verbal behaviours such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction". 

    How do you tell if someone has poor eye contact? It is easy if someone has conspicuous gaze aversion (looks down all the time etc), but many people get conditioned into trying to look at a face, even if looking at the mouth. It is still poor eye contact but how do you spot it? On facial expression and body posture, it is about both reading this information from others (how do you measure that?) and making the right expression/gesture for others to read in a given context, which is also hard to measure.

    "Lack of social or emotional reciprocity" - well if your social engagement is hampered by poor eye contact or difficulty reading facial expressions, that is going to impact on reciprocity - so how do you distinguish an actual lack from one that would be better if the social inputs improved?

    "persistent pre-occupation with parts of objects" OK how do you establish that in an interview context, as distinct from long term observation of behaviour?

    I've analysed other criteria on other posts. The one that amuses me is literal understanding - the examples given are too obvious, and is it always not being able to understand metaphors, or just sometimes having trouble with them? Or just having to think about them longer?

    A lot of the triad has been around for several decades. Knowledge doesn't seem to have advanced much.

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  • I'm always going on about this so please excuse any repetitions in recent posts.

    The triad is a diagnostic tool that excludes things that can be confused with other conditions. Hence sensory issues such as sensitivity to sounds or sensations is excluded.

    But it also concerns me that the triad is designed primarily to diagnose more marked autism where it is likely that people being assessed will show up on enough points in each section. I think it lets people down badly who are nearer the threshold and may have difficulty ticking off enough characteristics in each of the three areas.

    It is really down to this notion that there is "mild" autism, not helped by the theory that the spectrum is a steady curve towards normal.

    The key difficulties that people seem to have are difficulties with social engagement and difficulties with sensory overload and other environmental factors. The way the triad addresses social engagement issues is rather specific and even quite peripheral.

    Where I've sounded off about this before is what triad questions really mean. I'm looking at one version of DSM-IV in a book, for want of something in front of me, excuse if unfamiliar wording...

    "Marked impairment in the use of mutiple non-verbal behaviours such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction". 

    How do you tell if someone has poor eye contact? It is easy if someone has conspicuous gaze aversion (looks down all the time etc), but many people get conditioned into trying to look at a face, even if looking at the mouth. It is still poor eye contact but how do you spot it? On facial expression and body posture, it is about both reading this information from others (how do you measure that?) and making the right expression/gesture for others to read in a given context, which is also hard to measure.

    "Lack of social or emotional reciprocity" - well if your social engagement is hampered by poor eye contact or difficulty reading facial expressions, that is going to impact on reciprocity - so how do you distinguish an actual lack from one that would be better if the social inputs improved?

    "persistent pre-occupation with parts of objects" OK how do you establish that in an interview context, as distinct from long term observation of behaviour?

    I've analysed other criteria on other posts. The one that amuses me is literal understanding - the examples given are too obvious, and is it always not being able to understand metaphors, or just sometimes having trouble with them? Or just having to think about them longer?

    A lot of the triad has been around for several decades. Knowledge doesn't seem to have advanced much.

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