How is
Asperger's Syndrome diagnosed?
The diagnosis of AS is complicated by the lack of a standardized
diagnostic screen or schedule. In fact, because there are several
screening instruments in current use, each with different criteria, the
same child could receive different diagnoses, depending on the screening
tool the doctor uses.
To further complicate the issue, some doctors believe that AS is not a
separate and distinct disorder. Instead, they call it high-functioning
autism (HFA), and view it as being on the mild end of the ASD spectrum
with symptoms that differ -- only in degree -- from classic autism. Some
clinicians use the two diagnoses, AS or HFA, interchangeably. This makes
gathering data about the incidence of AS difficult, since some children
will be diagnosed with HFA instead of AS, and vice versa.
Most doctors rely on the presence of a core group of behaviors to alert
them to the possibility of a diagnosis of AS. These are:
• abnormal eye contact
• aloofness
• the failure to turn when called by name
• the failure to use gestures to point or show
• a lack of interactive play
• a lack of interest in peers
Some of these behaviors may be apparent in the first few months of a
child’s life, or they may appear later. Problems in at least one of the
areas of communication and socialization or repetitive, restricted
behavior must be present before the age of 3.
The diagnosis of AS is a two-stage process. The first stage begins with
developmental screening during a “well-child” check-up with a family
doctor or pediatrician. The second stage is a comprehensive team
evaluation to either rule in or rule out AS. This team generally
includes a psychologist, neurologist, psychiatrist, speech therapist,
and additional professionals who have expertise in diagnosing children
with AS.
The comprehensive evaluation includes neurologic and genetic assessment,
with in-depth cognitive and language testing to establish IQ and
evaluate psychomotor function, verbal and non-verbal strengths and
weaknesses, style of learning, and independent living skills. An
assessment of communication strengths and weaknesses includes evaluating
non-verbal forms of communication (gaze and gestures); the use of
non-literal language (metaphor, irony, absurdities, and humor); patterns
of inflection, stress and volume modulation; pragmatics (turn-taking and
sensitivity to verbal cues); and the content, clarity, and coherence of
conversation. The physician will look at the testing results and combine
them with the child’s developmental history and current symptoms to make
a diagnosis.
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Copyright © 2006 Learning Difficulties Network of Cyprus, All rights reserved.
Last Updated 9/2/2007