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Full Version: DSM IV diagnostic criteria for autism and Asperger's
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I am posting this for information purposes, not because the DSM is perfectly right and an absolute authority, but it is used by professionals for diagnosis, and may make things clearer for people trying to go through the diagnostic procedure.

"ASPERGER's DISORDER" (DSM IV Diagnostic Criteria)

DIAGNOSTIC FEATURES

The essential features of Asperger's Disorder are:
Criterion A. Severe and sustained impairment in social interaction
Criterion B. The development of restricted, repetitive patterns of
behaviour, interests, and activities
Criterion C. The disturbance must cause clinically significant impairment
in social, occupational, or other important areas of
functioning.
Criterion D. In contrast to Autistic Disorder, there are no clinically
significant delays in language (eg: single words are used
by age 2 years, communicative phrases are used by age 3
years).
Criterion E. There are no clinically significant delays in cognitive
development or in the development of age-appropriate
self-help skills, adaptive behaviour (other than in social
interaction), and curiosity about the environment in
childhood.
Criterion F. The diagnosis is not given if the criteria are met
for any other specific Pervasive Developmental Disorder or
for Schizophrenia.

ASSOCIATED FEATURES AND DISORDERS

Asperger's Disorder is sometimes observed in association with general medical conditions. Various nonspecific neurological symptoms or signs may be noted. Motor milestones may be delayed and motor clumsiness is often observed.

PREVALENCE

Information on the prevalence of Asperger's Disorder is limited, but it appears to be more common in males.

COURSE

Asperger's Disorder appears to have a somewhat later onset than Autistic Disorder, or at least to be recognised somewhat later. Motor delays or motor clumsiness may be noted in the preschool period. Difficulties in social interaction may become more apparent in the context of school. It is during this time that particular idiosyncratic or circumscribed interests (eg: a fascination with train schedules) may appear or be recognised as such. As adults, individuals with the condition may have problems with empathy and modulation of social interaction. This disorder apparently follows a continuous course and, in the vast majority of cases, the duration is lifelong.

FAMILIAL PATTERN

Although the available data are limited, there appears to be an increased frequency of Asperger's Disorder among family members of individuals who have the disorder.

DIFFERENTIAL DIAGNOSIS

Asperger's Disorder is not diagnosed if criteria are met for another Pervasive Developmental Disorders or for Schizophrenia. Asperger's Disorder must also be distinguished from Obsessive-Compulsive Disorder and Schizoid Personality Disorder. Asperger's Disorder and Obsessive-Compulsive Disorder share repetitive and stereotyped patterns of behaviour. In contrast to Obsessive-Compulsive Disorder, Asperger's Disorder is characterised by a qualitative impairment in social interaction and a more restricted pattern of interests and activities. In contrast to Schizoid Personality Disorder, Asperger's Disorder is characterised by stereotyped behaviours and interests and by more severely impaired social interaction.

DIAGNOSTIC CRITERIA FOR ASPERGER'S DISORDER (DSM IV)


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

1) marked impairment in the use of multiple nonverbal behaviours such
as eye-to-eye gaze, facial expression, body postures, and gestures
to regulate social interaction;
2) failure to develop peer relationships appropriate to developmental
level;
3) a lack of spontaneous seeking to share enjoyment, interests or
achievments with other people (eg: by a lack of showing, bringing,
or pointing out objects of interest to other people);
4) 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:

1) encompassing preoccupation with one or more stereotyped and
restricted patterns of interest that is abnormal either in intensity
or focus;
2) apparently inflexible adherence to specific, nonfunctional routines
or rituals;
3) stereotyped and repetitive motor mannerisms (eg: hand or finger
flapping or twisting, or complex whole-body movements);
4) 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
(eg: 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.


DSM Criteria for "Autistic Disorder"

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):

(1) qualitative impairment in social interaction, as manifested by at least two of the following:
(a) marked impairment in the use of multiple nonverbal behaviors, such as eye-to- eye gaze, facial expression, body postures, and gestures to regulate social interaction
(b) 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)
(d) lack of social or emotional reciprocity

(2) qualitative impairments in communication, as manifested by at least one of the following:

(a) delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
(b) in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
© stereotyped and repetitive use of language or idiosyncratic language
(d) lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(3) restricted, repetitive, and stereotyped patterns of behavior, interests, and activities as manifested by at least one of the following:

(a) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(b) apparently inflexible adherence to specific, nonfunctional routines or rituals
© stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting or complex whole-body movements)
(d) persistent precoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.

C. The disturbance is not better accounted for by Rett's disorder or childhood disintegrative disorder.
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