An Overall Synopsis of Asperger's Syndrome

From DSM IV (p77):

Diagnostic Criteria FOR 299.80 Asperger's Disorder

A. Qualitative impairment in social interaction, as manifested by at least two of the following:
  1. marked impairments in the use of multiple nonverbal behaviors 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 achievements with other people (e.g. 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 behavior, 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 (e.g., hand or finger flapping or twisting, or complex whole-body movements)
  4. persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairments 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 behavior (other than social interaction), and curiosity about the environment in childhood

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


GILLBERG'S CRITERIA FOR ASPERGER'S DISORDER

  1. Severe impairment in reciprocal social interaction
    (at least two of the following)
    • (a) inability to interact with peers
    • (b) lack of desire to interact with peers
    • (c) lack of appreciation of social cues
    • (d) socially and emotionally inappropriate behavior

  2. All-absorbing narrow interest
    (at least one of the following)
    • (a) exclusion of other activities
    • (b) repetitive adherence
    • (c) more rote than meaning

  3. Imposition of routines and interests
    (at least one of the following)
    • (a) on self, in aspects of life
    • (b) on others

  4. Speech and language problems
    (at least three of the following)
    • (a) delayed development
    • (b) superficially perfect expressive language
    • (c) formal, pedantic language
    • (d) odd prosody, peculiar voice characteristics
    • (e) impairment of comprehension including misinterpretations of literal/implied meanings

  5. Non-verbal communication problems
    (at least one of the following)
    • (a) limited use of gestures
    • (b) clumsy/gauche body language
    • (c) limited facial expression
    • (d) inappropriate expression
    • (e) peculiar, stiff gaze

  6. Motor clumsiness: poor performance on neurodevelopmental examination

(All six criteria must be met for confirmation of diagnosis.)


A More Down-to-Earth Description by Lois Freisleben-Cook.

NOTE:(This was originally a post to the bit.listserv.autism newsgroup/listserv)

I saw that someone posted the DSM IV criteria for Asperger's but I thought it might be good to provide a more down to earth description. Asperger's Syndrome is a term used when a child or adult has some features of autism but may not have the full blown clinical picture. There is some disagreement about where it fits in the PDD spectrum. A few people with Asperger's syndrome are very successful and until recently were not diagnosed with anything but were seen as brilliant, eccentric, absent minded, socially inept, and a little awkward physically. Although the criteria state no significant delay in the development of language milestones, what you might see is a "different" way of using language. A child may have a wonderful vocabulary and even demonstrate hyperlexia but not truly understand the nuances of language and have difficulty with language pragmatics. Social pragmatics also tend be weak, leading the person to appear to be walking to the beat of a "different drum". Motor dyspraxia can be reflected in a tendency to be clumsy. In social interaction, many people with Asperger's syndrome demonstrate gaze avoidance and may actually turn away at the same moment as greeting another. The children I have known do desire interaction with others but have trouble knowing how to make it work. They are, however, able to learn social skills much like you or I would learn to play the piano. There is a general impression that Asperger's syndrome carries with it superior intelligence and a tendency to become very interested in and preoccupied with a particular subject. Often this preoccupation leads to a specific career at which the adult is very successful. At younger ages, one might see the child being a bit more rigid and apprehensive about changes or about adhering to routines. This can lead to a consideration of OCD but it is not the same phenomenon. Many of the weaknesses can be remediated with specific types of therapy aimed at teaching social and pragmatic skills. Anxiety leading to significant rigidity can be also treated medically. Although it is harder, adults with Asperger's can have relationships, families, happy and productive lives. Dr. Lois Freisleben-Cook

"Asperger's Syndrome Characteristics"

by Roger Meyer

Below is a list of Aspergerís Syndrome characteristics. Most have been extracted from medical diagnostic criteria, descriptions offered by medical and counseling professionals, articles by educators and from employment biographies of approximately a dozen independent-living, medically or self-diagnosed AS adults over the age of 25. While every adult occasionally manifests these characteristics, what distinguishes adults with AS is their consistency of appearance, their intensity, and the sheer number of them appearing simultaneously. Some characteristics do not apply to everyone, so persons consulting this list should not feel compelled to find them all. Adults with AS who wish to compose employment biographies for their own enlightenment and/or as contributions to research should weigh the significance of the ones they share, and have their compositions accurately reflect that impact.

[Note: I have created a list of radio buttons to show how much I feel like I fit these characteristics --josef]

Definitely Agree Slightly Agree Slightly Disagree Strongly Disagree

Social Characteristics

Difficulty in accepting criticism or correction
Difficulty in offering correction or criticism without appearing harsh, pedantic or insensitive
Difficulty in perceiving and applying unwritten social rules or protocols
"Immature" manners
Failure to distinguish between private and public personal care habits: i.e., brushing, public attention to skin problems, nose picking, teeth picking, ear canal cleaning, clothing arrangement
NaÔve trust in others
Shyness
Low or no conversational participation in group meetings or conferences
Constant anxiety about performance and acceptance, despite recognition and commendation
Scrupulous honesty, often expressed in an apparently disarming or inappropriate manner or setting
Bluntness in emotional expression
"Flat affect"
Discomfort manipulating or "playing games" with others
Unmodulated reaction in being manipulated, patronized, or "handled" by others
Low to medium level of paranoia
Low to no apparent sense of humor; bizarre sense of humor (often stemming from a "private" internal thread of humor being inserted in public conversation without preparation or warming others up to the reason for the "punchline")
Difficulty with reciprocal displays of pleasantries and greetings
Problems expressing empathy or comfort to/with others: sadness, condolence, congratulations, etc.
Pouting,, ruminating, fixating on bad experiences with people or events for an inordinate length of time
Difficulty with adopting a social mask to obscure real feelings, moods, reactions
Using social masks inappropriately (you are "xv" while everyone else is ????)
Abrupt and strong expression of likes and dislikes
Rigid adherence to rules and social conventions where flexibility is desirable
Apparent absence of relaxation, recreational, or "time out" activities
"Serious" all the time
Known for single-mindedness
Flash temper
Tantrums
Excessive talk
Difficulty in forming friendships and intimate relationships; difficulty in distinguishing between acquaintance and friendship
Social isolation and intense concern for privacy
Limited clothing preference; discomfort with formal attire or uniforms
Preference for bland or bare environments in living arrangements
Difficulty judging othersí personal space
Limited by intensely pursued interests
Often perceived as "being in their own world"
Definitely Agree Slightly Agree Slightly Disagree Strongly Disagree

Physical Manifestations

Strong sensory sensitivities: touch and tactile sensations, sounds, lighting and colors, odors, taste
Clumsiness
Balance difficulties
Difficulty in judging distances, height, depth
Difficulty in recognizing othersí faces (prosopagnosia)
Stims (self-stimulatory behavior serving to reduce anxiety, stress, or to express pleasure)
Self-injurious or disfiguring behaviors
Nail-biting
Unusual gait, stance, posture
Gross or fine motor coordination problems
Low apparent sexual interest
Depression
Anxiety
Sleep difficulties
Verbosity
Difficulty expressing anger (excessive or "bottled up")
Flat or monotone vocal expression; limited range of inflection
Difficulty with initiating or maintaining eye contact
Elevated voice volume during periods of stress and frustration
Strong food preferences and aversions
Unusual and rigidly adhered to eating behaviors
Bad or unusual personal hygiene
Definitely Agree Slightly Agree Slightly Disagree Strongly Disagree

Morbid (shared, dual, multiple) Diagnostic Conditions

Learning Disability
Attention Deficit Disorder (ADD)
Obsessive Compulsive Disorder (OCD)
Central Auditory Processing Disorder (CAPD)
Hyperlexia
Depression
Anxiety
Non-verbal Learning Disorder (NVLD)
Hypertension
Semantic Pragmatic Language Disorder
Touretteís Syndrome
Dysthymia
Definitely Agree Slightly Agree Slightly Disagree Strongly Disagree

Cognitive Characteristics

Susceptibility to distraction
Difficulty in expressing emotions
Resistance to or failure to respond to talk therapy
Mental shutdown response to conflicting demands and multi-tasking
Generalized confusion during periods of stress
Low understanding of the reciprocal rules of conversation: interrupting, dominating, minimum participation, difficult in shifting topics, problem with initiating or terminating conversation, subject perseveration
Insensitivity to the non-verbal cues of others (stance, posture, facial expressions)
Perseveration best characterized by the term "bulldog tenacity"
Literal interpretation of instructions (failure to read between the lines)
Interpreting words and phrases literally (problem with colloquialisms, cliches, neologism, turns of phrase, common humorous expressions)
Preference for visually oriented instruction and training
Dependence on step-by-step learning procedures (disorientation occurs when a step is assumed, deleted, or otherwise overlooked in instruction)
Difficulty in generalizing
Preference for repetitive, often simple routines
Difficulty in understanding rules for games of social entertainment
Missing or misconstruing othersí agendas, priorities, preferences
Impulsiveness
Compelling need to finish one task completely before starting another
Rigid adherence to rules and routines
Difficulty in interpreting meaning to othersí activities; difficulty in drawing relationships between an activity or event and ideas
Exquisite attention to detail, principally visual, or details which can be visualized ("Thinking in Pictures") or cognitive details (often those learned by rote)
Concrete thinking
Distractibility due to focus on external or internal sensations, thoughts, and/or sensory input (appearing to be in a world of oneís own or day-dreaming)
Difficulty in assessing relative importance of details (an aspect of the trees/forest problem)
Poor judgment of when a task is finished (often attributable to perfectionism or an apparent unwillingness to follow differential standards for quality)
Difficulty in imagining othersí thoughts in a similar or identical event or circumstance that are different from oneís own ("Theory of Mind" issues)
Difficulty with organizing and sequencing (planning and execution; successful performance of tasks in a logical, functional order)
Difficulty in assessing cause and effect relationships (behaviors and consequences)
An apparent lack of "common sense"
Relaxation techniques and developing recreational "release" interest may require formal instruction
Rage, tantrum, shutdown, self-isolating reactions appearing "out of nowhere"
Substantial hidden self-anger, anger towards others, and resentment
Difficulty in estimating time to complete tasks
Difficulty in learning self-monitoring techniques
Disinclination to produce expected results in an orthodox manner
Psychometric testing shows great deviance between verbal and performance results
Extreme reaction to changes in routine, surroundings, people
Stilted, pedantic conversational style ("The Professor")
Definitely Agree Slightly Agree Slightly Disagree Strongly Disagree

Work Characteristics

Many of the manifestations found in the categories above can immediately translate into work behaviors or preferences. Here are some additional ones:
Difficulty with "teamwork"
Deliberate withholding of peak performance due to belief that oneís best efforts may remain unrecognized, unrewarded, or appropriated by others
Intense pride in expertise or performance, often perceived by others as "flouting behavior"
Sarcasm, negativism, criticism
Difficulty in accepting compliments, often responding with quizzical or self-deprecatory language
Tendency to "lose it" during sensory overload, multitask demands, or when contradictory and confusing priorities have been set
Difficult in starting project
Discomfort with competition, out of scale reactions to losing
Low motivation to perform tasks of no immediate personal interest
Oversight or forgetting of tasks without formal reminders such as lists or schedules
Great concern about order and appearance of personal work area
Slow performance
Perfectionism
Difficult with unstructured time
Reluctance to ask for help or seek comfort
Excessive questions
Low sensitivity to risks in the environment to self and/or others
Difficulty with writing and reports
Reliance on internal speech process to "talk" oneself through a task or procedure
Stress, frustration and anger reaction to interruptions
Difficulty in negotiating either in conflict situations or as a self-advocate
Very low level of assertiveness
Reluctance to accept positions of authority or supervision
Strong desire to coach or mentor newcomers
Difficulty in handling relationships with authority figures
Often viewed as vulnerable or less able to resist harassment and badgering by others
Punctual and conscientious
Avoids socializing, "hanging out," or small talk on and off the job


Asperger Definitions


References