The Diagnostic and Statistical Manual of Mental Disorders (DSM) is published by the American Psychiatric Association (APA.) The DSM lists diagnostic criteria for a variety of mental diseases, disorders, and conditions, including Asperger’s syndrome and other pervasive developmental disorders.
What is Asperger’s Syndrome?
Asperger’s Syndrome is one of several developmental disabilities on the autism spectrum, classified in the DSM-IV under Pervasive Developmental Disorders. Colloquially known as “Little Professor’s Syndrome," Asperger’s is defined by high academic intellect, marked impairment of social skills development, rigid adherence to routines, restrictive interests or patterns of behavior, poor balance and coordination skills, sensor problems, and other challenges.
As a developmental disability with similar and overlapping symptoms as Autistic Disorder, children with Asperger’s do not necessarily display the same delayed language development as autistic children. However, Asperger’s is considered a form of high functioning autism and falls on a continuum of Autism Spectrum Disorders (ASDs.)
Asperger's Syndrome and Diagnostic Criteria: Specific Requirements for Diagnosis
In terms of Asperger’s syndrome and diagnostic criteria, there are specific requirements that must be present to such an extent as to inhibit a child’s ability to function in normal age-appropriate environments. In order to qualify for an Asperger’s syndrome diagnosis, a child must meet these criteria. However, other disorders or conditions with similar symptoms must be ruled out prior to diagnosis.
As currently published, the DSM-IV (Text Revised) requires patients to present with a minimum of two behaviors or symptoms listed in Group A below, as well as at least one from Group B. Additional symptoms and conditions must also be met. Of note, the DSM 5, currently in review phase for publication in 2013, includes proposals to subsume Asperger’s syndrome and diagnostic criteria for it into a single Autistic Disorder diagnosis.
Impairments in social functioning
- Lack of nonverbal communications, including eye contact, body language, or facial expressions
- Lack of age-appropriate relationships with others
- Does not spontaneously interact with others, invite them to play, point out objects or curiosities
- Does not respond to or return displays of affection or other socially acceptable reciprocity
Restricted, abnormally focused interests, stereotypical behavior patterns
- Abnormally focused or extremely intense and restrictive interest in a particular subject matter
- Inflexibility with regard to routines and rituals
- Repetitive body movements (hand flapping, etc.)
- Abnormal or intense interest with object parts
Additional Symptoms or Conditions
- Impairments and behaviors must significantly interfere with the child (or adult’s) ability to function in normal environments
- No language delays of a significant nature are present
- No other cognitive developmental delays are present
- Patient does not meet criteria for other Pervasive Developmental Disorder or Schizophrenia
What Should Parents Do if They Notice Symptoms?
Unlike Autistic Disorder, which most often presents before age three, Asperger’s syndrome diagnoses can occur as late as 7-11 years old. It is not uncommon for parents to realize the onset of early symptoms in retrospect, once more noticeable symptoms become problematic or a medical or education professional points out delays.
No matter when a parent notices worrisome symptoms and behaviors that indicate the possibility of Asperger’s syndrome, proper testing and evaluation should begin as soon as possible. The Harvard Medical School recommends children undergo evaluation with a child or developmental psychologist, child psychiatrist, or neurologist for proper diagnosis. Considering the prevalence of Pervasive Developmental Disorders like Asperger’s and the subsequent increase such prevalence brings to research efforts, tests and evaluation methods continue to improve. Such improvements result in more accurate diagnoses, earlier identification and earlier treatment.
References and Resources
Harvard Medical School Family Health Guide: http://www.health.harvard.edu/fhg/updates/update0305a.shtml
DSM 5 Revision Proposals: http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=97
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