Asperger's Syndrome - Asperger's Syndrome Diagnosis

Written by Robert Myers, PhD

How is it diagnosed?

The diagnosis of AS is complicated by the lack of a standardized diagnostic screen or schedule. In fact, because there are several screening instruments in current use, each with different criteria, the same child could receive different diagnoses, depending on the screening tool the doctor uses.

To further complicate the issue, some doctors believe that AS is not a separate and distinct disorder. Instead, they call it high-functioning autism (HFA), and view it as being on the mild end of the ASD spectrum with symptoms that differ -- only in degree -- from classic autism. Some clinicians use the two diagnoses, AS or HFA, interchangeably. This makes gathering data about the incidence of AS difficult, since some children will be diagnosed with HFA instead of AS, and vice versa.

advertisement

Most doctors rely on the presence of a core group of behaviors to alert them to the possibility of a diagnosis of AS. These are:

• abnormal eye contact
• aloofness
• the failure to turn when called by name
• the failure to use gestures to point or show
• a lack of interactive play
• a lack of interest in peers

Some of these behaviors may be apparent in the first few months of a child's life, or they may appear later. Problems in at least one of the areas of communication and socialization or repetitive, restricted behavior must be present before the age of 3.

The diagnosis of AS is a two-stage process. The first stage begins with developmental screening during a "well-child" check-up with a family doctor or pediatrician. The second stage is a comprehensive team evaluation to either rule in or rule out AS. This team generally includes a psychologist, neurologist, psychiatrist, speech therapist, and additional professionals who have expertise in diagnosing children with AS.

The comprehensive evaluation includes neurologic and genetic assessment, with in-depth cognitive and language testing to establish IQ and evaluate psychomotor function, verbal and non-verbal strengths and weaknesses, style of learning, and independent living skills. An assessment of communication strengths and weaknesses includes evaluating non-verbal forms of communication (gaze and gestures); the use of non-literal language (metaphor, irony, absurdities, and humor); patterns of inflection, stress and volume modulation; pragmatics (turn-taking and sensitivity to verbal cues); and the content, clarity, and coherence of conversation. The physician will look at the testing results and combine them with the child's developmental history and current symptoms to make a diagnosis.

Are there treatments available?

The ideal treatment for AS coordinates therapies that address the three core symptoms of the disorder: poor communication skills, obsessive or repetitive routines, and physical clumsiness. There is no single best treatment package for all children with AS, but most professionals agree that the earlier the intervention, the better.

An effective treatment program builds on the child's interests, offers a predictable schedule, teaches tasks as a series of simple steps, actively engages the child's attention in highly structured activities, and provides regular reinforcement of behavior. This kind of program generally includes:

• social skills training, a form of group therapy that teaches children with AS the skills they need to interact more successfully with other children
• cognitive behavioral therapy, a type of "talk" therapy that can help the more explosive or anxious children to manage their emotions better and cut back on obsessive interests and repetitive routines
• medication, for co-existing conditions such as depression and anxiety
• occupational or physical therapy, for children with sensory integration problems or poor motor coordination
• specialized speech/language therapy, to help children who have trouble with the pragmatics of speech - the give and take of normal conversation
• parent training and support, to teach parents behavioral techniques to use at home

Do children with AS get better? What happens when they become adults?

With effective treatment, children with AS can learn to cope with their disabilities, but they may still find social situations and personal relationships challenging. Many adults with AS are able to work successfully in mainstream jobs, although they may continue to need encouragement and moral support to maintain an independent life.

Where can I get more information?

US Autisim & Asperger Association

Asperger Syndrome Foundation

Asperger Foundation International

MAAP Services for Autism, Asperger's, and PDD

National Institute of Mental Health (NIMH)

Helpful Books on Asperger's Syndrome:

 

1.		2.		3.
	Asperger's Syndrome: A Guide for Parents and Professionals		Helping a Child with Nonverbal Learning Disorder or Asperger's Syndrome: A Parent's Guide		Asperger Syndrome and the Elementary School Experience: Practical Solutions for Academic & Social Difficulties
4.		5.		6.
	Asperger's: What Does It Mean to Me?		Asperger Syndrome and Adolescence: Helping Preteens & Teens Get Ready for the Real World		Asperger Syndrome And Difficult Moments: Practical Solutions For Tantrums, Rage And Meltdowns
7.		8.		9.
	Everybody Is Different: A Book for Young People Who Have Brothers or Sisters With Autism		Asperger Syndrome and Adolescence: Practical Solutions for School Success		Freaks, Geeks & Asperger Syndrome: A User Guide to Adolescence

next: Autism Fact Sheet