This post is in the Autistic Spectrum Disorders category

The two diagnostic criteria cited below are in common use around the world, but they are not the only criteria, and there are a number of tools for use by clinical psychologists.  These can result in situations where a child can be diagnosed with the condition on one set of criteria, but be ineligible for  support within a state school system under another. An example of this is that in Queensland, a paediatrician must confirm the diagnosis to the State Schools system for “ascertainment” –  dreadful term – but the diagnosis itself can only be made by a clinical psychologist for Social Services purposes.  There have been numerous instances where the two professionals use different tools and criteria and the family is left with no support.  There is widespread call for a more unified approach, and one that concentrates on individual traits, but perusal of current journals does nothing to suggest that this is likely any time soon.

DSM-iv Criteria (American Psychiatric Association, 1994)

Diagnostic Criteria For 299.80 Asperger’s Disorder

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

  • marked impairments in the use of multiple nonverbal behaviours 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

B. Restricted repetitive and stereotyped patterns of behaviour, 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, non-functional 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 behaviour (other than social interaction), and curiosity about the environment in childhood

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

(American Psychiatric Association, 1994)

Gillberg’s Criteria (Gillberg, 1989)

1.Severe impairment in reciprocal social interaction (at least 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 behavior

2.All-absorbing narrow interest (at least one of the following)

  • exclusion of other activities
  • repetitive adherence
  • more rote than meaning

3.Imposition of routines and interests (at least one of the following)

  • on self, in aspects of life
  • on others

4.Speech and language problems (at least three of the following)

  • delayed development
  • 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/gauche body language
  • limited facial expression
  • inappropriate expression
  • peculiar, stiff gaze

6.Motor clumsiness: poor performance on neurodevelopmental examination

These criteria are referred to throughout this dissertation as they are the most commonly cited descriptions of Asperger’s Syndrome. The Diagnostic and Statistical Manual of Mental Disorders is currently under review for version V and Asperger’s Syndrome is expected to be subsumed into the general classification of Autistic Disorder.

Leave a Reply