Schizotypal personality disorder has an extremely high co-occurrence with both Autism and Dissociative Disorders. Schizotypal Personality Disorder is also deemed to be along the same spectrum as Schizophrenia at the extreme end and Schizoid Personality Disorder at the more mild end. So it may be that Schizophrenia is not as much the antithesis of Autism as we had imagined.
Prior to the diagnosis of autism by Kanner in 1943, those with autism were thought to have infantile Schizophrenia and only by the 50s and 60s was this more generalised to being called Childhood Psychosis. In fact as late as the 80s autism was still deemed a childhood psychosis. Presently, we understand Autism as associated with many more things that being Schizotypal or Schizoid, including the high overlap between Autism and brain injury, Agnosias, Aphasias, Dyspraxias, seizure disorders, mood, anxiety and compulsive disorders, attention deficits and gut, immune, metabolic and more recently mitochondrial disorders. So the term ‘Autism’ has become an umbrella term, a grab bag, and there may come a day where we speak of ‘personality-related autism’ versus ‘brain injury related autism’ and realise that some people through roll of the dice dynamics, inbreeding or chance, will be combination of the two camps.
Schizotypal Personality Disorder does not fit the criteria for Schizophrenia but those with it (and with Aspergers) have commonly been previously diagnosed as Schizophrenic.
There’s also 58% overlap between Schizotypal Personality Disorder and dissociative tendencies. Given that dissociation is normal in children up to age 5, what does excessive dissociative tendencies look like in a child of 7, or 10, or 15? Does it look more ‘Autistic’?
With higher dissociative tendencies, natural tendencies toward derealisation and wandering, natural aversion to forced conformity, natural tendencies toward non-conformity to the degree they struggle to track and gauge ‘normality’, and an inbuilt tendency to take refuge in their own world, what is the developmental impact? In children, perhaps particularly in those with Schizotypal Personality Disorder who also have significant sensory perceptual disorders adding to their disorientation, is that developmental impact likely to look fairly Autistic? Could it be that the same issues occurring in a child without Schizotypal or Schizoid personality disorders would look less ‘autistic’ than when they exacerbate the degree and appearance of these personality disorders?
Children with Schizotypal Personality Disorder also tend toward problems with:
early verbal learning and development,
verbal working memory,
reading social cues,
general intellectual functioning
and associated social isolation.
Presently we don’t diagnose personality disorders in children, yet we’re OK with calling Schizotypal and Schizoid children ‘Autistic’. Perhaps if we distinguished their personality disorders, sensory perceptual disorders, health disorders etc, from ‘The Autism’ would we even find that we could find this mysterious singular thing we imagine as ‘Autism’?