Asperger's Syndrome Diagnosis

Standard diagnostic criteria require:

  1. 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 postures, and gestures to regulate social interaction
    • failure to develop peer relationships appropriate to developmental level
    • a lack of spontaneous seeking to share enjoyment, interests, 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
  2. Restricted repetitive and 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 (a child may become overly interested in a particular subject)
    • apparently inflexible adherence to specific, nonfunctional routines or rituals (a child may be a bit apprehensive about adhering to routines)
    • stereotyped and repetitive motor mannerisms (e.g., flapping fingers, or moving the whole body)
    • persistent preoccupation with parts of objects
  3. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
  4. There is no clinically significant general delay in language (a child may have an excellent vocabulary but does not understand the nuances of language and have difficulty with language pragmatics)
  5. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than social interaction), and curiosity about the environment in childhood
  6. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia

Diagnosis is usually made between the ages of four and eleven.

A comprehensive assessment involves:

    • neurological and genetic assessment
    • tests for cognition,
    • tests for psychomotor function,
    • tests for verbal and nonverbal strengths and weaknesses,
    • tests for style of learning,
    • tests for skills for independent living.

Mistaken diagnosis can lead to medications that worsen behavior. Many children with AS are initially diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Diagnosing adults is even more difficult since the diagnostic criteria are designed for children. Conditions that must be considered in a differential diagnosis include other autism spectrum disorders, the schizophrenia spectrum, ADHD, obsessive compulsive disorder, depression, semantic pragmatic disorder, nonverbal learning disorder, stereotypic movement disorder, bipolar disorder, or Tourette syndrome.