Autism Spectrum Disorder
An Autism Spectrum Disorder is a serious condition that affects approximately 6 out of 1000 people. The most recent statistics from the Centers for Disease Control and Prevention, 1 out of 68 children meet criteria for an Autism Spectrum Disorder.
Over the past decade, the incidence of Autism Spectrum Disorders has increased 78% in children. Some reasons for this increase include a better understanding and diagnosis of ASD, but scientists are still researching other factors that could be involved. Importantly, the scientific community is in agreement that vaccines are NOT responsible for the increase in the incidence of ASD.
Autism Spectrum Disorders are characterized by problems with communication, social interactions, a restricted range of interests, and repetitive behavioral patterns. Autism Spectrum Disorders include Asperger’s Syndrome, which is defined below.
At the ApaCenter, our assessments, therapy and behavioral interventions are generally targeted toward children, teens and adults with Asperger’s Syndrome and High Functioning Autism. More severe forms of autism are generally detected and diagnosed through ones pediatrician.
Asperger’s Syndrome Defined
Asperger’s Syndrome (also known as Asperger’s Disorder) is a neurodevelopmental condition defined by social competence difficulties and restricted areas of interest and/or stereotyped behaviors and activities. It is considered to be one of five pervasive developmental disorders within the “autistic spectrum” (the other four being Autistic Disorder, Pervasive Developmental Disorder – Not Otherwise Specified, and the much rarer Rett’s Disorder and Childhood Disintegrative Disorder). Unlike in autism, in Asperger’s both language and cognitive ability are generally intact from an early age. Individuals with Asperger’s often have trouble deciphering nonverbal cues and behavior such as tone of voice, gestures, facial expressions, sarcasm, jokes, social nuances, and body language. They also may have frequent trouble learning from new experiences, become anxious with change in routine, and have difficulty with flexibility. For example, a child with Asperger’s may become upset if an exception is made in a classroom rule or schedule. For this reason, children with Asperger’s Syndrome have been referred to as “little professors without social skills” and are often considered strange or weird by their peers. Many have difficulty making friends and may be frequently teased by others.
Although not part of official diagnostic criteria, a number of secondary characteristics are frequently associated with Asperger’s, including egocentric and idiosyncratic behavior, motor clumsiness, attention difficulties, inappropriate expression, pedantic speech, impaired use of social language, advanced vocabulary, odd eye contact, difficulty demonstrating empathy and taking another’s perspective (“theory of mind” difficulties), and auditory processing difficulties. These characteristics vary in intensity, and may be present in some individuals but not in others.
Individuals with Asperger’s may seem to gaze off or stare through others when conversing, and not respond appropriately in conversation. They may also have some sensory dysfunction, such as an extreme sensitivity to touch or sound. Many children and adults with Asperger’s also meet the criteria for intellectual giftedness.
In recent years, many people have come to view Asperger’s Syndrome not as a disorder, but simply as a different and unique way of being. As Hans Asperger said in 1938, “Not everything that steps out of line, and thus “abnormal”, must necessarily be “inferior.” In fact, many people with Asperger’s make significant contributions to society and lead happy lives using their particular interests and talents to become successful.
High Functioning Autism Defined
Autism is a neurodevelopmental disorder affecting an individual’s ability to communicate, form relationships with others, and respond appropriately to environmental cues. Autism is usually considered “high functioning” when average to above average intelligence and verbal ability are present. Like Asperger’s Syndrome, high functioning autism is characterized by difficulties with social competence and stereotyped or restricted behaviors/activities. In addition, children and adults with high functioning autism have difficulty reading nonverbal cues, adjusting to changes in routine and taking another’s perspective. Frequently, they also have attention difficulties and sensory integration difficulties. However, unlike Asperger’s Syndrome, autism is diagnosed when significant deficits or delays in communication are present (i.e., single words not produced by 2 years, or phrases by 3 years). Also, symptoms must be present before the age of 3 and usually begin in infancy.
Other Differences between Asperger’s Syndrome and High Functioning Autism
Many practitioners have difficulty distinguishing Asperger’s Syndrome from high functioning autism. In fact, there is an ongoing debate in the literature about where the differences lie. Although the following observations are not currently included in accepted diagnostic criteria, recent research suggests several differences. In addition to later onset for Asperger’s, there appears to be a different pattern of strengths and weaknesses between the two conditions. Whereas individuals with Asperger’s tend to have stronger verbal ability and weaker visual-spatial ability, individuals with high functioning autism often have the opposite profile. Social competence and communication difficulties are more pervasive and severe in high functioning autism. Also, imaginative play and a sense of humor (albeit unusual) are more commonly seen in Asperger’s Syndrome.
Benefits of an Assessment for Asperger’s Syndrome or High Functioning Autism
The psychologist you work with will help:
- Identify specific strengths and weaknesses unique to each individual
- Recommend appropriate interventions to compensate for difficulties
- Rule out other difficulties that may be contributing to symptoms
- Help obtain appropriate school/college services
- Obtain greater self-understanding and validation of experiences
Asperger’s Syndrome and High Functioning Autism (HFA) Assessments
Although there is no single standardized test that can diagnose an autism spectrum disorder, a number of autism rating scales and structured interviews now exist that are helpful in determining the likelihood of such disorders. While assessments look for the main characteristics of an autism spectrum disorder (social impairment, communication difficulties, reliance on repetitive routines/ narrowness of interests), a comprehensive evaluation will assess the following areas of functioning through a combination of individualized standardized testing, self-report measures, behavioral checklists, interviews, and observations:
- Developmental and medical history
- Cognitive abilities and academic achievement
- Social competence and social perception
- Emotional and behavioral functioning
- Communication and language skills
- Perceptual-motor/visual-spatial ability
- Assessment of attention and memory as indicated
The ApaCenter may also recommend a full medical evaluation to rule out other medical conditions that may be causing symptoms (e.g., hearing loss). Diagnosis of an autism spectrum disorder takes particular care, because the presentations of these disorders vary from person to person, and symptoms often change with development. More often than not, clients with Asperger’s or HFA also experience other related difficulties such as ADD/ADHD, depression, and learning disabilities that confound diagnosis. In addition, many times individuals who have characteristics that fit an Asperger’s profile are actually experiencing other difficulties. For example, it is sometimes challenging to distinguish Asperger’s Syndrome from symptoms experienced by a shy, depressed child who is verbally gifted. Symptoms common to autism spectrum disorders also need to be distinguished from symptoms that result from trauma. For this reason, the consideration of current life stressors is extremely important for a reliable diagnosis. Finally, an awareness and sensitivity to cultural factors that may confound accurate diagnosis is essential (e.g., the norms for respectful eye contact and communication vary from culture to culture).
If you have additional questions or would like to set up an appointment with one of our professionals, please contact us at (512) 891-1500.