Identifying Asperger's Syndrome and Autism

What is Autism?
Autism is defined as a developmental disorder that affects the child’s ability to make contact, develop language, and engage in interpersonal communication. The syndrome is included in the diagnostic spectrum called PDD pervasive developmental disorder (DSM-IV 1994). It is a 'spectrum disorder' - it can have a range of symptoms and severity.

What is Asperger's Syndrome?
There is general agreement that Asperger's syndrome is a type of autism. However, children and adults with Asperger's symdrome typically function better and also have normal intelligence and near-normal language development (although they may develop problems communicating as they get older).

Common symptoms include:

  • Problems with social skills: Children with Asperger's syndrome generally have difficulty interacting with others and often are awkward in social situations. They generally do not make friends easily.
  • Eccentric or repetitive behaviors: Children with this condition may develop odd, repetitive movements, such as hand wringing or finger twisting.
  • Unusual preoccupations or rituals: A child with Asperger's syndrome may develop rituals that he or she refuses to alter, such as getting dressed in a specific order.
  • Communication difficulties: People with Asperger's syndrome may not make eye contact when speaking with someone. They may have trouble using facial expressions and gestures, and understanding body language. They also tend to have problems understanding language in context.
  • Limited range of interests: A child with Asperger's syndrome may develop an intense, almost obsessive, interest in a few areas, such as sports schedules, weather, or maps.
  • Coordination problems: The movements of children with Asperger's syndrome may seem clumsy or awkward.
  • Skilled or talented: Many children with Asperger's syndrome are exceptionally talented or skilled in a particular area, such as music or math.

The Diagnostic Handbook of the Psychiatric Association DSM IV defines Asperger's syndrom as follows:

(I) Qualitative impairment in social interaction, as manifested by at least two of the following:
  • Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
  • Failure to develop peer relationships appropriate to developmental level
  • A lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
  • Lack of social or emotional reciprocity

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
  • Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
  • Apparently inflexible adherence to specific, nonfunctional routines or rituals
  • Stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
  • Persistent preoccupation with parts of objects

(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.

(IV) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)

(V) There is no clinically significant delay in cognitive development or in the development of age-appropriate self help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia."


Characteristics of the Autistic Disorder

The criteria that characterize autism are defined in the Diagnostic Handbook of the Psychiatric Association DSM IV. It is important to state that at least 6 of the following parameters should be apparent in order to suspect autism.

Clear Inability to Interact Socially
  • Absence of non-verbal communication, such as eye contact, facial expression, body language
  • Basic inability to relate to others
  • Inability to share or participate in a pleasurable activity
  • Inability to express affection

Clear Inability to Communicate
  • Lack of language development
  • Lack of initiative for verbal expression
  • Repetitive sounds

Stereotypical Ritualistic Behavior
  • Limited interest in objects
  • Intensive, obsessive use of specific objects
  • Stereotypical, repetitive movements
  • Lack of spontaneous and imaginary play

Identified by Clinical Observations
  • Does not respond to their (own) name
  • Inappropriate laughter or crying
  • Lack of ability to interpret facial expressions
  • Often verbal or babbling (preverbal) sounds are lacking
  • Use of the adult’s hand to obtain what is desired
  • Attachment to a certain object
  • Various phobias such as water, noises, toilet training
  • Food fixations

Evaluating Autism Treatments
We use the autism evaluation scale from the Autism Research Institute (www.autism.com) when working with clients. The ATEC online questionnaire is particularly useful for measuring change due to autism treatments.


References



Revision History
2.0 November 11, 2011: Added the symptoms of Asperger's syndrome.
1.0 Sept 29, 2009: First draft.