Autism, Aspergers and Schizotypal Personality Disorder
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:
communication,
“attention,
abstract reasoning,
cognitive inhibition,
early verbal learning and development,
verbal working memory,
reading social cues,
recognition memory,
social anxiety
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’?
Donna Williams, BA Hons, Dip Ed.
Author, artist, singer-songwriter, screenwriter.
Autism consultant and public speaker.
http://www.myspace.com/nobodynowherethefilm
http://www.donnawilliams.net
http://www.aspinauts.com
Thank you for this blog. I am now 43, and was diagnosed with SPD at sixteen. I don’t recall how I was treated as a child particularly, only that I was segregated. I think that’s fairly typical of children who later develop personality disorders. It’s the easy way out for everyone. But since it later turned out I had SPD I really didn’t care that I was spending a lot of time alone. They gave me stacks of books and i read them. That’s how i became a writer. A great unintentional consequence of what would normally be considered child abuse. I’m trying to become more active in advocacy for those with SPD. Learning as much as I can, aside from whatever I know innately, is where I am right now. So, thank you for this information
Thank you for this. As a child, I looked as though I had autism, but I know this clearly wasn’t and isn’t the case. I always acted funny, yet I understood that, but had lack of control over my laughter or daydreaming. I appeared( and still do sometinmes) very stiff and schizophrenic looking; I also had/have very loosely connected thoughts. I get so angry when I hear that schizotypy is a “personality disorder”, and that any one with social problems as a kid was autistic. The BIG difference between me and any autistic person was that I had extra abstract reasoning, and read social cues more than well.
Why label schizotypal children (who’s biggest area of skill is abstract reasoning) as autistic, which is a disease defined by lack of theory of mind and imagination? It doesent add up and it’s an insult to us all. I propose that schizotypy is not a personality disorder, and that it is genetic like autism, but is the complete opposite. Children with this schizotypal disorder have no problem reading cues, rather they have a problem showing them off to others due to fear. When schizotype genetic grow up, they become more eccentric and start to have visual disturbances. We should never label a child autistic, unless it is plainly obvious that they lack theory of mind, because that is what distinguishes it from other disorders. We should label them as communication impaired if autism isn’t a obvious choice then, then have them retested as they get older to find out the true story. For now, I’m one that has to be told that I’m autistic, a label that contradicts my whole being, my whole life story, just because of ignorance of this society and euphoric excitement over this asperger label that society has developed.
great comment! I identify as idiosyncratic…to the max, and max enough that in its extreme, of course, I fitted Schizotypal Personality Disorder from early childhood through to my 20s then less so in my 30s and less so in my 40s but its still part of my ‘autism fruit salad’. I was rightly dx’d with language processing disorder in late childhood and gained functional speech by age 9-11. I was also face blind with simultagnosia, so I was naturally autistic… but, no, I didn’t have social emotional agnosia so even though I was meaning deaf, meaning blind, face blind, I tuned in extremely to what was left… movement, tone… not at all the ‘Aspie’ world where such things are almost always hold no meaning at all… so I understand fully what you’re saying, but there’s also cases where a schizotypal child has such a degree of agnosias and associated communication disorder that the sensory-perceptual and communication issues lead to such a degree of isolation and self containment that IN INTERACTION with a personality trait ALREADY predisposed to responding to life ‘autistically’, someone like me was effected in that manner. I do love my idiosyncratic nature, have no problem with Schizotypy and can see where this extreme of idiosyncracy (which Einstein was said to be an archetype of) was a wonderful thing for me… I recreated all attachment and interaction within my own world… but in MY case it was exaggerated because interaction with the external world was limited/blocked by the sensory perceptual and communication issues.
I grew up classic autistic, with no speach for the first years of life, routines and so on. Since I’m 12 years old my special interest is religion and psychiatry. It’s kind of funny, because I’m agnostic myself, but if a religion graps my attention, I just read and read into it and so on. A fiew years ago I found out that my half brother had schizophrenia. Despite my highly autistic childhood, my social understanding is lower than normal I guess, but still better than people think. I also developed some depersonalisation and/or dissociation nearly three years ago after a traumatic incident. For me, I “feel” psychotic in a dreamlike state, but still in touch with reality. Actually sometimes it’s a bit scary, but I find it interesting this connection between dissociation and psychotic symptoms and I think there is clearly one in some cases.
I think the relationship is that if one is naturally dissociative AND also has tendencies to brain chemistry imbalances, one may be at higher risk of mental illness as well as the dissociative skills/disorders. As for communication disorders, late speech is normal in a percentage of non autistic children and selective mutism is also common in shy non autistic children and some immediately echolalia is a normal part of language development, so unless one is obviously communication disordered past the age of 3 I don’t take that as a sign of classic autism at all. If one is still only echolalic or only has idiosyncratic speech or loghorrheoa by age 5 onwards then I see that as classically autistic, and if they are aphasic or have severe speech apraxia then that is those things whether in someone with autism or not.
Well aphasie and apraxia are something different than autism I agree, but my opinion is, that speech delay is more common in autistics for several reasons. I started talking in entire sentences and had no need to say something earlier. This behaviour is more often seen in autistics. Of course there is much more to it, like routines, problems in social understanding and so on, but in my opinion they go hand in hand. When I was a little child, I was mostly withdrawn and into me routiniced behaviour and no need to talk to anyone. There is a connection of symptoms that occour more often together.