What’s the difference between autism and Asperger’s disorder?

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Swedish climate activist Greta Thunberg describes herself as having Asperger’s while others on the autism spectrum, such as Australian comedian Hannah Gatsby, describe themselves as “autistic”. But what’s the difference?

Today, the previous diagnoses of “Asperger’s disorder” and “autistic disorder” both fall within the diagnosis of autism spectrum disorder, or ASD.

Autism describes a “neurotype” – a person’s thinking and information-processing style. Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.

When these challenges become overwhelming and impact how a person learns, plays, works or socialises, a diagnosis of autism spectrum disorder is made.

Where do the definitions come from?

The Diagnostic and Statistical Manual of Mental Disorders (DSM) outlines the criteria clinicians use to diagnose mental illnesses and behavioural disorders.

Between 1994 and 2013, autistic disorder and Asperger’s disorder were the two primary diagnoses related to autism in the fourth edition of the manual, the DSM-4.

In 2013, the DSM-5 collapsed both diagnoses into one autism spectrum disorder.

How did we used to think about autism?

The two thinkers behind the DSM-4 diagnostic categories were Baltimore psychiatrist Leo Kanner and Viennese paediatrician Hans Asperger. They described the challenges faced by people who were later diagnosed with autistic disorder and Asperger’s disorder.

Kanner and Asperger observed patterns of behaviour that differed to typical thinkers in the domains of communication, social interaction and flexibility of behaviour and thinking. The variance was associated with challenges in adaptation and distress.

Children in a 1950s classroom
Kanner and Asperger described different thinking patterns in children with autism.
Roman Nerud/Shutterstock

Between the 1940s and 1994, the majority of those diagnosed with autism also had an intellectual disability. Clinicians became focused on the accompanying intellectual disability as a necessary part of autism.

The introduction of Asperger’s disorder shifted this focus and acknowledged the diversity in autism. In the DSM-4 it superficially looked like autistic disorder and Asperger’s disorder were different things, with the Asperger’s criteria stating there could be no intellectual disability or delay in the development of speech.

Today, as a legacy of the recognition of the autism itself, the majority of people diagnosed with autism spectrum disorder – the new term from the DSM-5 – don’t a have an accompanying intellectual disability.

What changed with ‘autism spectrum disorder’?

The move to autism spectrum disorder brought the previously diagnosed autistic disorder and Asperger’s disorder under the one new diagnostic umbrella term.

It made clear that other diagnostic groups – such as intellectual disability – can co-exist with autism, but are separate things.

The other major change was acknowledging communication and social skills are intimately linked and not separable. Rather than separating “impaired communication” and “impaired social skills”, the diagnostic criteria changed to “impaired social communication”.

The introduction of the spectrum in the diagnostic term further clarified that people have varied capabilities in the flexibility of their thinking, behaviour and social communication – and this can change in response to the context the person is in.

Why do some people prefer the old terminology?

Some people feel the clinical label of Asperger’s allowed a much more refined understanding of autism. This included recognising the achievements and great societal contributions of people with known or presumed autism.

The contraction “Aspie” played an enormous part in the shift to positive identity formation. In the time up to the release of the DSM-5, Tony Attwood and Carol Gray, two well known thinkers in the area of autism, highlighted the strengths associated with “being Aspie” as something to be proud of. But they also raised awareness of the challenges.

What about identity-based language?

A more recent shift in language has been the reclamation of what was once viewed as a slur – “autistic”. This was a shift from person-first language to identity-based language, from “person with autism spectrum disorder” to “autistic”.

The neurodiversity rights movement describes its aim to push back against a breach of human rights resulting from the wish to cure, or fundamentally change, people with autism.

Boy responds to play therapist
Autism is one of the forms of diversity in human thinking, which comes with strengths and challenges.
Alex and Maria photo/Shutterstock

The movement uses a “social model of disability”. This views disability as arising from societies’ response to individuals and the failure to adjust to enable full participation. The inherent challenges in autism are seen as only a problem if not accommodated through reasonable adjustments.

However the social model contrasts itself against a very outdated medical or clinical model.

Current clinical thinking and practice focuses on targeted supports to reduce distress, promote thriving and enable optimum individual participation in school, work, community and social activities. It doesn’t aim to cure or fundamentally change people with autism.

A diagnosis of autism spectrum disorder signals there are challenges beyond what will be solved by adjustments alone; individual supports are also needed. So it’s important to combine the best of the social model and contemporary clinical model.The Conversation

Andrew Cashin, Professor of Nursing, School of Health and Human Sciences, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Brown Rice vs Buckwheat – Which is Healthier?

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    Our Verdict

    When comparing brown rice to buckwheat, we picked the buckwheat.

    Why?

    In terms of macros, brown rice has more carbs, while buckwheat has nearly 2x the fiber, and more protein. An easy choice here: buckwheat for the win.

    In the category of vitamins, brown rice has more of vitamins B1, B2, B3, B6, and E, while buckwheat has more of vitamins B9, K, and choline. A win for brown rice this time, although as a point in buckwheat’s favor, while most of the margins of difference are comparable, buckwheat has nearly 10x the vitamin K.

    When it comes to minerals, brown rice has more manganese, phosphorus, selenium, and zinc, while buckwheat has more calcium, copper, iron, and magnesium. A win for buckwheat again this time.

    A quick note on gluten: both of these are naturally gluten-free, so that’s not an issue here. Buckwheat, despite its name, is not a wheat, nor even closely related to wheat. It’s not even technically a grain; it’s a flowering plant of which we eat the groats. In taxonomic terms, buckwheat is about as related to wheat as a lionfish is to a lion.

    Adding up the sections makes for an overall 2:1 win for buckwheat, though even if it weren’t for that, which is someone more likely to hear from a doctor, “you need to eat more fiber”, or “you need to eat more vitamin E”? Thus, even had the categories been tied (let’s imagine it had been tied on minerals, say) that’d have been a tiebreaker in favor of buckwheat. As it is, buckwheat already won by strength of numbers anyway.

    Of course, do enjoy either or both; diversity is good!

    Want to learn more?

    You might like to read:

    Grains: Bread Of Life, Or Cereal Killer?

    Enjoy!

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  • Taurine: An Anti-Aging Powerhouse? Exploring Its Unexpected Benefits

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    Dr. Mark Rosenberg explains:

    Not a stimulant, but…

    • Its presence in energy drinks often causes people to assume it’s a stimulant, but it’s not. In fact, it’s a GABA-agonist, thus having a calming effect.
    • The real reason it’s in energy drinks is because it helps increase mitochondrial ATP production (ATP = adenosine triphosphate = how cells store energy that’s ready to use; mitochondria take glucose and make ATP)
    • Taurine is also anti-inflammatory, antioxidant, and anticancer.
    • In the category of aging, human studies are slow to give results for obvious reasons, but mouse studies show that supplementing taurine in middle-aged mice increased their lifespan by 10–12%, as well as improving various physiological markers of aging.
    • Taking a closer look at aging—literally; looking at cellular aging—taurine reduces cellular senescence and protects telomeres, thus decreasing DNA mutations.

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  • Eat To Avoid (Or Beat) PCOS

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    Polycystic ovary syndrome, PCOS, affects very many people; around 1 in 5 women. It can show up unexpectedly, and usually the first-identified sign is irregular vaginal bleeding. We say “vaginal” rather than “menstrual” as it’s not technically menses, although it’ll look (and can feel) the same.

    Like many “affects mostly women” conditions, science’s general position is “we don’t know what causes it or how to cure it”.

    Quick book recommendation before we continue:

    Unwell Women: Misdiagnosis and Myth in a Man-Made World – by Dr. Elinor Cleghorn

    …is a top-tier book about medical misogyny. We’d say more here, but well, you can read our review there 🙂

    What doesn’t work

    Since PCOS is characterized by excessive androgen production, it is reasonable to expect that foods containing phytoestrogens (such as soy) may help. They won’t. The human body can’t use those as estrogen, and in fact, consuming unusually large quantities of phytoestrogens can actually get in the way of your own (or bioidentical) estrogen, by competing for the same receptors but not really doing the job.

    But, you won’t get that problem from moderate consumption of soy; the warning is more for those tempted to self-medicate with megadoses, or are opting for dubious supplements such as Pueraria mirifica ← will have to do a research review on that one of these days, but suffice it to say meanwhile, it has some serious drawbacks

    See also: What Does “Balance Your Hormones” Even Mean?

    What can work

    There are some supplement-based approaches that actually can help, and those are the ones that rather than trying to manufacture estrogen out of thin air, work to reduce testosterone and/or reduce the conversion of free testosterone to its more potent form, dihydrogen testosterone (DHT); here are two examples:

    What will work

    …or at least, barring additional confounding factors, what the evidence strongly supports working. Here’s where we get into diet properly, and there are three main dietary approaches:

    Low-GI diet: focus on high-fiber, low-carb foods (e.g. whole grains, legumes, berries, leafy greens). Eating this way results in improved insulin sensitivity, lower fasting insulin, cholesterol, triglycerides, waist circumference, and (for women) yes, lower testosterone levels.

    See: What Do The Different Kinds Of Fiber Do? 30 Foods That Rank Highest

    High antioxidant diet: focus on foods rich in antioxidants (e.g. vitamin A, α-tocopherol specifically, vitamins C and D, and polyphenols) as these lower PCOS incidence.

    See: 21 Most Beneficial Polyphenols & What Foods Have Them

    Ketogenic diet: focus on high-fat, very low-carb foods (e.g. fatty fish, dairy, leafy greens). This significantly reduces androgen levels, improves insulin sensitivity, and regulates hormones. But… It’s recommended for short-term use only due to its negative health impacts from poor (i.e. narrow) nutritional coverage:

    See: Ketogenic Diet: Burning Fat, Or Burning Out?

    It is also reasonable to supplement, for example:

    Omega-3 fatty acids and vitamin D have powerful anti-inflammatory and antioxidant properties that significantly improve insulin sensitivity and reduce androgen levels in metabolic syndromes like PCOS. A higher intake of omega-3 and vitamin E also alleviates mental health parameters and gene expression of PPAR-γ, IL-8, and TNF-α in women with PCOS.

    Dietary supplements, such as antioxidants like N-acetylcysteine (NAC), vitamin D, inositol, and omega-3 fatty acids, and mineral supplements (zinc, magnesium selenium, and chromium) help in reducing insulin resistance. These supplements also enhance ovulatory function and decrease inflammation in PCOS patients.

    Omega-3 fatty acid supplements improve biochemical parameters LH, LH/FSH, lipid profiles, and adiponectin levels and regularize the menstrual cycle in women with PCOS. A recent RCT also indicated that probiotic/symbiotic supplementation significantly improves triglyceride, insulin, and HDL levels in women with PCOS.❞

    Source: The Role of Lifestyle Interventions in PCOS Management: A Systematic Review

    Want to know more?

    You might like this book that we reviewed a little while back:

    PCOS Repair Protocol – by Tamika Woods

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

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    We could indeed! We’ll be sure to write more, but while you’re waiting, you might like to read our main feature from a while back:

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    …as it does include a lot about the use of a supplement that helps against Benign Prostatic Hyperplasia, with performance comparable to the most common drug prescribed for such.

    And since (like that drug) it’s a 5α-reductase inhibitor (meaning it works by blocking the conversion of testosterone to DHT), this means it helps against prostate problems (and also, incidentally, male pattern hair loss) without reducing overall testosterone levels. In fact, because less testosterone will be converted to DHT, you’ll actually (all other things being equal) end up with slightly higher free testosterone levels.

    ❝My BMI is fine, but my waist is too big. What do I do about that? I am 5′ 5″ tall and 128 pounds and 72 years old.❞

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    ❝Is there anything special that might help someone with Tourette’s syndrome?❞

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    ❝Natural solutions for osteoarthritis. Eg. Rosehip tea, dandelion root tea. Any others??? What foods should I absolutely leave alone?❞

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  • Hate salad or veggies? Just keep eating them. Here’s how our tastebuds adapt to what we eat

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Do you hate salad? It’s OK if you do, there are plenty of foods in the world, and lots of different ways to prepare them.

    But given almost all of us don’t eat enough vegetables, even though most of us (81%) know eating more vegetables is a simple way to improve our health, you might want to try.

    If this idea makes you miserable, fear not, with time and a little effort you can make friends with salad.

    Why don’t I like salads?

    It’s an unfortunate quirk of evolution that vegetables are so good for us but they aren’t all immediately tasty to all of us. We have evolved to enjoy the sweet or umami (savoury) taste of higher energy foods, because starvation is a more immediate risk than long-term health.

    Vegetables aren’t particularly high energy but they are jam-packed with dietary fibre, vitamins and minerals, and health-promoting compounds called bioactives.

    Those bioactives are part of the reason vegetables taste bitter. Plant bioactives, also called phytonutrients, are made by plants to protect themselves against environmental stress and predators. The very things that make plant foods bitter, are the things that make them good for us.

    Unfortunately, bitter taste evolved to protect us from poisons, and possibly from over-eating one single plant food. So in a way, plant foods can taste like poison.

    For some of us, this bitter sensing is particularly acute, and for others it isn’t so bad. This is partly due to our genes. Humans have at least 25 different receptors that detect bitterness, and we each have our own genetic combinations. So some people really, really taste some bitter compounds while others can barely detect them.

    This means we don’t all have the same starting point when it comes to interacting with salads and veggies. So be patient with yourself. But the steps toward learning to like salads and veggies are the same regardless of your starting point.

    It takes time

    We can train our tastes because our genes and our receptors aren’t the end of the story. Repeat exposures to bitter foods can help us adapt over time. Repeat exposures help our brain learn that bitter vegetables aren’t posions.

    And as we change what we eat, the enzymes and other proteins in our saliva change too. This changes how different compounds in food are broken down and detected by our taste buds. How exactly this works isn’t clear, but it’s similar to other behavioural cognitive training.

    Add masking ingredients

    The good news is we can use lots of great strategies to mask the bitterness of vegetables, and this positively reinforces our taste training.

    Salt and fat can reduce the perception of bitterness, so adding seasoning and dressing can help make salads taste better instantly. You are probably thinking, “but don’t we need to reduce our salt and fat intake?” – yes, but you will get more nutritional bang-for-buck by reducing those in discretionary foods like cakes, biscuits, chips and desserts, not by trying to avoid them with your vegetables.

    Adding heat with chillies or pepper can also help by acting as a decoy to the bitterness. Adding fruits to salads adds sweetness and juiciness, this can help improve the overall flavour and texture balance, increasing enjoyment.

    Pairing foods you are learning to like with foods you already like can also help.

    The options for salads are almost endless, if you don’t like the standard garden salad you were raised on, that’s OK, keep experimenting.

    Experimenting with texture (for example chopping vegetables smaller or chunkier) can also help in finding your salad loves.

    Challenge your biases

    Challenging your biases can also help the salad situation. A phenomenon called the “unhealthy-tasty intuition” makes us assume tasty foods aren’t good for us, and that healthy foods will taste bad. Shaking that assumption off can help you enjoy your vegetables more.

    When researchers labelled vegetables with taste-focused labels, priming subjects for an enjoyable taste, they were more likely to enjoy them compared to when they were told how healthy they were.

    The bottom line

    Vegetables are good for us, but we need to be patient and kind with ourselves when we start trying to eat more.

    Try working with biology and brain, and not against them.

    And hold back from judging yourself or other people if they don’t like the salads you do. We are all on a different point of our taste-training journey.The Conversation

    Emma Beckett, Senior Lecturer (Food Science and Human Nutrition), School of Environmental and Life Sciences, University of Newcastle

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Cabbage vs Carrots – Which is Healthier?

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    Our Verdict

    When comparing cabbage to carrots, we picked the carrots.

    Why?

    Both are top-tier vegetables! But as the Highlander said, “there can be only one”, and we say carrots get a marginal victory;

    In terms of macros, nominally cabbage has slightly more protein (but it’s a tiny amount, and thus an even tinier difference) while carrots have slightly more fiber and carbs (but again, not big differences), as well as the lower glycemic index (but nobody is getting metabolic disease from eating cabbage). We could call this category a tie because it’s all so close, but by the numbers, it’s a slender victory for carrots.

    In the category of vitamins, carrots have more of vitamins A, B1, B2, B3, B5, B6, and E, while cabbage has more of vitamins B9, C, K, and choline. Thus, a win for carrots, especially as carrots’ vitamin A is 167x what cabbage has.

    When it comes to minerals, cabbage has more calcium, iron, manganese, and selenium, while carrots have more copper, phosphorus, potassium, and zinc. They’re both equal on magnesium, and their respective margins of difference for the other minerals were not big, so this round’s a clear tie.

    Adding up the sections makes for an overall win for carrots, but by all means enjoy either or both (together, even, if you like!); diversity is good!

    Want to learn more?

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    Enjoy!

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