In the United States, many children with Asperger's syndrome (AS) are not diagnosed until the teen years because symptoms are mild, often overlooked or simply considered as extreme shyness. AS is on the autism spectrum, but currently, has separate diagnostic criteria in the Diagnostic and Statistical Manual (DSM), a commonly used diagnostic tool published by the American Psychiatric Association. The separate diagnosis is being reviewed to determine if AS should be included within the diagnosis of autism, although this has sparked much controversy (See: Proposed Changes to the Diagnostic Criteria for Asperger's Syndrome.)
Current Diagnostic Criteria
Right now, the diagnostic criteria, as listed in the DSM is:
Significant impairment in social interactions. Must have at least two of the following:
- Impairment of non-verbal behaviors
- Impairment in developing peer relationships
- Lack of sharing emotions, interests or achievements with others
- Difficulty with social relationships
Repetitive behaviors, interests and activities. Must have at least one of the following:
- Intense preoccupation with one or more interests
- Requiring strict routines/rituals
- Repetitive movements
- Strong interest in parts of objects
The DSM also states that there is no significant delay in either language or cognitive development in children with AS.
While the actual process for diagnosing AS may differ from doctor to doctor there are some standard tools doctors use:
The DSM - Symptoms are compared to the DSM
IQ Test - Individuals with AS have a normal or above normal IQ and so administering an IQ test helps the doctor rule out other conditions
Adaptive skills assessment - This assessment normally focuses on a person's ability to navigate complex social situations
Parent interview - also called Autism Diagnostic Interview or ADI, the parent interview helps the medical practitioner look at early developmental milestones, current functioning in social situations, communication and behavior. An ADI is helpful even when assessing an adult for AS as symptoms of AS are usually present throughout childhood and this assessment would allow the doctor to view how the adult behaved throughout his life.
Autism diagnostic observation schedule, module IV (ADOS) - this assessment looks at social and communication skills and although it is considered for autism, module four specifically looks at these skills in high-functioning autism, which is similar to AS. Some of the specifics looked at in this evaluation are:
- Ability to have reciprocal conversations
- Does the person have an interest in another person's thoughts or feelings
- The use of non-verbal communication such as facial expressions, body language and gestures
Medical providers will put together the information collected from the different assessments to make a diagnosis of AS.
In addition to these assessments, your doctor may look at and ask questions about other common AS traits, such as sensory integration issues, clumsiness, uncoordinated, poor muscle tone and special interests.
Asperger's Syndrome Guidelines for Assessment and Diagnosis, 1995, Ami Klin, Ph.D. and Fred R. Volkmar, M.D., Yale Child Study Center, Learning Disabilities Association of America
Diagnostic and Statistical Manual - IV Edition, 1994, American Psychiatric Association
Published On: December 27, 2011