Asperger Syndrome Screening

By Dr Ananya Mandal, MD

Asperger syndrome, like other autism related disorders, is usually detected by parents when the child is around two years old. In rare cases mild symptoms may mean the disorder can go undetected until adulthood.

Diagnosis of Asperger syndrome in children

Children whose parents suspect a disorder in their development need to consult their paediatricians. Paediatricians, general physicians and developmental paediatricians deal with diagnosing a referral of these children.

A common checklist of questions is used initially for detection in toddlers. It is called the CHAT questionnaire. The questions include:-

  • Does the child take an interest in other children?
  • Does the child ever pretend play?
  • Does the child ever bring objects to show to their parents?

A multidisciplinary team including a psychologist, a psychiatrist, a paediatrician or a developmental paediatrician are involved in diagnosis of Asperger syndrome.

Diagnosis according to the DSM-IV criteria

“The Diagnostic and Statistical Manual of Mental Disorders IV states the presence of Asperger syndrome in case of:–

  • impaired use of non-verbal behaviors to regulate social interaction
  • failure to develop age-appropriate peer relationships
  • lack of spontaneous interest in sharing experiences with others
  • lack of social or emotional reciprocity

In addition there are repetitive, restrictive and stereotyped patterns of activities, behaviours and interests. There may be:-

  • preoccupation with one or more stereotyped and restricted pattern of interest
  • inflexible adherence to specific non-functional routines or rituals
  • stereotyped or repetitive motor mannerisms
  • preoccupation with parts of objects

In addition there must be no significant associated –

  • Delay in either general cognitive function
  • Self-help/adaptive skills
  • Interest in the environment or
  • overall language development.

Christopher Gillberg, a Swedish physician who elaborated on the six criteria for the diagnosis of Asperger syndrome. These include –

  • Social impairment with extreme egocentricity including inability to interact with peers, lack of desire to interact with peers, poor appreciation of social cues, socially and emotionally inappropriate responses.
  • Limited interests and preoccupations that include more rote than meaning relatively exclusive of other interests, repetitive adherence, repetitive routines or rituals that could be imposed on self or others.
  • Speech and language peculiarities that include delayed early development but not consistently seen and others including odd prosody, peculiar voice characteristics, impaired comprehension including misinterpretation of literal and implied meanings.
  • Non-verbal communication problems including limited use of gesture, clumsy body language, limited or inappropriate facial expression, peculiar "stiff" gaze, difficulty adjusting physical proximity etc.

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)

Sources

  1. http://www.nhs.uk/Conditions/Autistic-spectrum-disorder/Pages/Diagnosis.aspx
  2. http://www.advice.salford.ac.uk/cms/resources/uploads/File/NAS%20what%20is%20AS.pdf
  3. http://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs/Asperger_Syndrome.pdf
  4. http://www.aspennj.org/pdf/information/articles/aspergers-syndrome-through-the-lifespan.pdf
  5. http://www.researchautism.org/resources/OAR_Guide_Asperger.pdf
  6. http://www-users.cs.york.ac.uk/alistair/survival/survival.pdf
  7. http://ethesis.helsinki.fi/julkaisut/laa/kliin/vk/nieminen-wendt/ontheori.pdf

Further Reading

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