Wednesday, February 27, 2008

Autism Disorder Versus Asperger's Syndrome

The Autism Society of America has published a good overview of Autism Disorder and Asperger's Syndrome on The article contains a basic description of both Autism Disorder and Asperger's Syndrome and helps distinguish between the two similar but distinct disorders:

What distinguishes Asperger's Syndrome from autism is the severity of the symptoms and the absence of language delays. To the untrained observer, a child with Asperger's may seem just like a normal child behaving differently. They may be socially awkward, not understanding of conventional social rules, or show a lack of empathy. They may make limited eye contact, seem to be unengaged in a conversation, and not understand the use of gestures.

One of the major differences between Asperger's Syndrome and autism is that, by definition, there is no speech delay in Asperger's. In fact, children with Asperger's frequently have good language skills; they simply use language in different ways. Speech patterns may be unusual, lack inflection, or have a rhythmic nature or it may be formal, but too loud or high pitched. Children with Asperger's may not understand the subtleties of language, such as irony and humor, or they may not recognize the give-and-take nature of a conversation.

Another distinction between Asperger's Syndrome and autism concerns cognitive ability. While some individuals with autism experience mental retardation, by definition a person with Asperger's cannot possess a "clinically significant" cognitive delay, and most possess average to above-average intelligence.

1 comment:

Nestor L. Lopez-Duran PhD said...

Hi H, just to add more complexity to the picture. The description provided was correctly a reflection of DSM-IV diagnostic criteria. When it comes to high functioning autism vs. Asperger's the DSM is clear. Language delays = Autism. No language delays = Asperger's.

However, some researchers and clinicians see distinctions that go beyond, and sometimes against, that basic diagnostic difference. At least two new distinctions have been made, one in regards to the nature of the limited social interactions, and the other in regards to their neurocognitive profile.

Some researchers have published data suggesting that children with Asperger's have a significant discrepancy between verbal and non-verbal cognitive skills. They have usually much better verbal skills. Their profile actually looks like the profile of children with Non-verbal Learning Disabilities. This is not the case with children with High Functioning autism who have equally developed verbal and non-verbal skills.

Another more clinical distinction propose speaks to the nature of the limited social contacts experienced by these children. This idea suggests that children with Asperger's have high or normative need for social affiliation, but their social uniqueness make it difficult for them to establish or maintain social relations. So when asked, would you like to have more friends than yo have now? They answer YES. This has been proposed as one possible reason of why children with Asperger's experience more depression and anxiety than children with high functioning autism. On the other hand, the belief is that children with HFA do not have that level of social desirability. So when asked, do you want more friends? they simply say no, I have just enough friends.

In my clinical work, this last clinical hypothesis resonates well with some parents who have noticed similar differences.

So it seems like while there is a clear DSM based diagnostic difference, new proposals are being researched, and these may better explain the phenomenology of these two categories. Cheers, Nestor.