Asperger’s syndrome (AS) is usually diagnosed based on the lack of social skills, which makes diagnosing it in young children difficult. Although parents may notice other differences in their child, such as not participating in pretend play or having an intense interest, these traits are often attributed to personality and not seen as problems that should be addressed by a doctor.
As your child matures, but doesn’t seem to develop the skills needed to make or keep friends, continued meltdowns or if your child is struggling in school, you may begin to worry and look for answers. This often occurs around middle school age; the American Journal of Psychiatry indicates that the average age for diagnosing AS in the United States is 11 years old.  While your first stop may be with your family doctor or pediatrician, they usually don’t complete an evaluation for autism or AS but will refer you to a specialist, such as a psychologist or psychiatrist.
Preparing for the Evaluation
Your doctor will want to know why you believe your child has AS or want to know what symptoms/problems your child is experiencing and some examples of behaviors you are seeing. Think about the following areas and write down examples of how your child acts/reacts to situations:
Pretend play – does your child use toys for more than one use, can your child “imagine” situations that have not occurred?
Social interactions – Does your child interact more often with adults than children his/her own age, does your child make eye contact, does your child talk incessantly about one topic, do conversations with your child seem one-sided, does your child have a hard time understanding sarcasm or humor?
Sensory issues – Is your child highly sensitive to temperature, sound, touch or textures of food, does he refuse to wear clothes with tags or scratchy material, does he eat the same foods every day refusing to try other foods?
Thinking processes – Does your child see the world in “black and white,” does your child take everything literally, not understanding concepts, does he have an excellent memory for facts, figures, dates, etc?
Language – Does your child have an extensive vocabulary, does his high language skills revolve around a specific topic or interest?
Motor skills – Is your child clumsy or uncoordinated, did he have problems learning to ride a bike, scooter or skates, does he avoid sports because he isn’t very good at them, does he have illegible handwriting, have problems tying his shoes or find it hard to use utensils such as silverware or pencils?
This list shouldn’t be considered a diagnostic tool but is meant to help you think of traits that are common in children with AS. Having examples of characteristics your child shows will help your doctor better understand your concerns.
During the Evaluation
Once you have outlined your concerns to your doctor, you will probably be asked to complete a rating scale. You will be given a number of situations or questions and asked to rate how often your child exhibits certain behaviors. For example, rating scales for AS may ask how often your child engages in pretend play. Based on your child’s age and areas of difficulty, your doctor may ask you to have your child’s teacher complete a rating scale as well. Take your time when completing the rating scale. You should provide accurate answers to help the doctor determine if there is a problem.
Your doctor will probably ask questions about your child’s development. He may ask about speech delays or when your child spoke his first word, what that word was and when your child put words together to form sentences. He will want to know when your child rolled over, sat up and walked. One of the differentiating factors between autism and AS is there is no speech delays in AS.
Other psychological tests, such as IQ tests and language tests may be given. Depending on your child’s age, your doctor may ask him questions as well. If you have had other evaluations completed, you should bring the reports with you for the doctor to review.
Because children with AS often develop other disorders, such as anxiety or depression, your doctor may ask about symptoms that seem unrelated to AS, such as if your child becomes anxious in certain situations, such as a crowded room, or if he shows signs of depression.
Depending on your child’s age, your doctor may ask him questions and listen to his language development. Children with AS don’t use speech inflection and young children often misuse pronouns.
Your doctor will review all of the information before determining if your child has AS. This can sometimes take several weeks. Once your doctor has made a determination you should sit down together to review his findings and decide on further treatment or therapies to help your child in weak areas, for example, the doctor may suggest social skills training.
 “Asperger’s Syndrome: Diagnosis and Treatment,” 2008, Karen Toth, Bryan H. King, The American Journal of Psychiatry 165:958-963
The Essential Guide to Asperger’s Syndrome, 2012, Eileen Bailey, Robert Montgomery, Penguin Books, New York
Published On: July 03, 2012