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ASPERGER'S SYNDROME

Diagnosis/Assessment:  Asperger's Syndrome (ASD) is by no means an easy diagnosis.  It can contain elements of the following diagnoses:

  • ADHD (usually inattentive type)
  • Social Anxiety Disorder
  • OCD
  • Oppositional Defiant Disorder (ODD)
  • Depression
  • Impulse Control Not Otherwise Specified

Most individuals I see often have trouble "connecting" with others.  The main difference between AS and Autism is that the autistic child doesn't express much of a wish for friendships to the extent children with AS do and basic language communication is much better with individuals with AS.  Both populations have trouble with pragmatic social and language functioning.

Usually individuals with AS have one or more intense fascinations that they will talk about endlessly without checking out another's level of interest.  They neglect obvious social cues to know when to end conversations and have difficulty sustaining "two-way" communications.

Common areas of intense interest often include, but are not limited to:

  • Computers and technology
  • History
  • Trains and other transportation

Referring your child for evaluation

It is important that other, more common diagnoses be ruled out before considering an AS diagnosis.  ADHD and ODD appearing in a very bright child can sometimes lead parents to conclude their child has AS.  Usually the child with AS speaks in a manner where his or her voice inflection changes little.  Smiling easily and naturally does not readily come to kids with AS.  They often will say things or make jokes that others do not find amusing.  Inflexibility or a strict adherence to rules doesn't insure this diagnosis, but many individuals with AS have these qualities.

A thorough assessment should include the following:

Cognitive and Academic functioning, not just a brief screening tool either, but a comprehensive evaluation that looks at verbal and thinking abilities; cognitive efficiency and fluidity; the ability to quickly learn new information; and reading ability versus reading and oral comprehension.

For adults, I suggest families seek assessments that primarily focus on "academic survival skills," such as telling time properly, making proper change, following a recipe, understanding common abbreviations, writing a resume, knowing how to get around their immediate environment without getting lost, knowing how to ask for help, etc.

Assessment of Executive functioning skills.  Executive functioning includes the ability to inhibit responses; initiate actions; plan, follow through, and evaluate success; self-monitoring; emotional control; and general attentiveness.  This part of an assessment should ideally be assessed using a blend of rating surveys, such as the BRIEF, thorough psychodiagnostic and/or neuropsychological testing.

Social behavior and independence can be assessed through adaptive rating scales and by going out somewhere for a qualitative, real-life sample of how the individual functions going for a walk, crossing the street, picking up a soda in the market, etc.  By taking the child or adult out, an astute clinician can better determine how aware the client is of their world, how they interact with others, and whether there are important behaviors to target for proposed interventions.

Consideration of a Functional Assessment

Click here for school link on this topic


Some of the best information I know of comes from the Yale Child Study Center.  Click below to view to older, but highly useful articles.

What is AS?

What are ways of treating AS?