Asperger's Disorder

In 1944 Hans Asperger, an Austrian physician, published an account describing children with impaired social interactions and communication.  Today the term Asperger's Disorder is currently defined by the American Psychiatric Association (APA), in the fourth edition of their diagnostic manual: "Diagnostic and Statistical Manual of Mental Disorders" (DSM-IV). 1994 was the first year Asperger's Disorder appeared in the DSM manual. While this formal definition is relatively new to the American professional community, it has been accepted by some European professionals since the publication of Hans Asperger's paper.

In the DSM-IV manual, Asperger's is one of five disorders defined under the category of Pervasive Developmental Disorder.  The other four disorders are Autistic Disorder, Rett's Disorder, Childhood Disintegrative Disorder, and Pervasive Developmental Disorder Not Otherwise Specified - PDDNOS. According to the DSM-IV, the criteria for Asperger's are as follows:

299.80 Asperger's

A) Qualitative impairment in social interaction, as manifested by at least two of the following:

1.  marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction

2.  failure to develop peer relationships appropriate to developmental level

3.  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)

4.  lack of social or emotional reciprocity.

(B) Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:

1.  encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

2.  apparently inflexible adherence to specific, non-functional routines or rituals

3.  stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

4.  persistent preoccupation with parts of objects

(C) The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.

(D) There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)

(E) There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood.

(F) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.

How does the diagnosis of Asperger Syndrome differ from autism?  How are the two diagnoses similar?
Both autism and Asperger Syndrome (AS) are defined in the DSM-IV as Pervasive Developmental Disorders.  This means there are commonalities between the two, namely impairments in social interaction, communication, and range of interests and activities.  Differences exist primarily in the degree of impairment.  For example, while an individual with autism may experience a delay in, or total lack of speech, an individual with AS can not possess a "clinically significant general delay" in certan types of language.  An individual with AS may however, experience difficulty in understanding spoken language - particularly in terms of irony, humor, or other abstractions or symbolism.

A second distinction made by the DSM-IV concerns cognitive ability.  While some individuals with autism experience mental retardation, by definition a person with AS can not possess a "clinically significant" cognitive delay.  This is not to imply that all individuals with autism also have mental retardation.  Some do and some do not, but a person with AS possesses an average to above average intelligence.

What are effective strategies for working with an individual with Asperger Syndrome?
People with AS need assistance in developing their social and communication skills.  Some of the social and communication skills programming that has been developed for people with "high functioning" autism may be appropriate for a person with Asperger Syndrome.

Please note that the term "high functioning" is a subjective term.  There are no accepted clinical criteria defining "high functioning autism" as opposed to any other type of autism.  Sometimes parents and professionals use the term to describe a person with autism who has average intelligence and more highly developed language than other individuals within the autism spectrum.