Wednesday, May 12, 2004

just a little diagnostic criteria...

Some Diagnostic criteria for Asperger's Syndrome


A couple of people have asked me about Aperger's as well as autism, wondering about a check-list, etc. Here is some pretty good information for Asperger's. I am looking for something equally succinct for autism.

This is an explanation of the diagnostic criteria for AS:

Diagnostic Criteria:

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

- Marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
- Failure to develop peer relationships appropriate to developmental level
- 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)
- Lack of social or emotional reciprocity [i.e. apparent lack of empathy, comforting/complimenting others, lack of and lack of understanding of the principles of sharing/turn-taking, lack of conversation skills, often one-sided conversations that are practically monologues]

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

- Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
- Apparently inflexible adherence to specific, nonfunctional routines or rituals
- Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
- 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 social interaction), and curiosity about the environment in childhood

[Added: Delay in acquisition of motor skills is fairly common though, as well as clumsiness and "odd"/slow use of hands/fingers]

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

The language/speech criteria are better addressed on Gillberg & Gillberg's AS rating scale, which I personally find more in-depth and accurate:

1. Social impairment – extreme egocentricity (at least in two of the following):
- Inability to interact with peers
- Lack of desire to interact with peers
- Lack of appreciation of social cues
- Socially and emotionally inappropriate behaviour.

2. Narrow interest (at least one of the following):
- Exclusion of other activities
- Repetitive adherence
- More rote than meaning.

3. Repetitive routines (at least one of the following):
- On self, on aspects of life
- On others.

4. Speech and language peculiarities (at least three of the following):
- Delayed development [Although this is usually more the case with HFA]
- Superficially perfect expressive language
- Formal pedantic language
- Odd prosody, peculiar voice characteristics
- Impairment of comprehension, including misinterpretations of literal / implied meanings.

5. Non-verbal communication problems (at least one of the following):
- Limited use of gestures
- Clumsy body language
- Limited facial expression
- Inappropriate expression
- Peculiar stiff gaze.

7. Motor clumsiness [movement skills]
- Poor performance on neuro-developmental examination.


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