There is such thing as Aspergers?
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10 Mar 2009, 5:56 am
[Inspired in these thread]
http://web.syr.edu/~rjkopp/data/as_diag_list.html
Asperger Syndrome according the DSM
Quote:
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.
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.
Asperger syndrome according to Gillberg:
Quote:
A. Severe impairment in reciprocal social interaction as manifested by at
least two of the following four:
1. Inability to interact with peers.
2. Lack of desire to interact with peers.
3. Lack of appreciation of social cues.
4. Socially and emotionally inappropriate behaviour.
B. All-absorbing narrow interest, as manifested by at least one of the
following three:
1. Exclusion of other activities.
2. Repetitive adherence.
3. More rote than meaning.
C. Speech and language problems, as manifested by at least three of the
following five:
1. Delayed development of language.
2. Superficially perfect expressive language.
3. Formal, pedantic language.
4. Odd prosody, peculiar voice characteristics.
5. Impairment of comprehension, including misinterpretations of
literal/implied meanings.
D. Non-verbal communication problems, as manifested by at least
one of the following five:
1. Limited use of gestures.
2. Clumsy/gauche body language.
3. Limited facial expression.
4. Inappropriate expression.
5. Peculiar, stiff gaze.
E. Motor clumsiness, as documented by poor performance on
neurodevelopmental examination.
least two of the following four:
1. Inability to interact with peers.
2. Lack of desire to interact with peers.
3. Lack of appreciation of social cues.
4. Socially and emotionally inappropriate behaviour.
B. All-absorbing narrow interest, as manifested by at least one of the
following three:
1. Exclusion of other activities.
2. Repetitive adherence.
3. More rote than meaning.
C. Speech and language problems, as manifested by at least three of the
following five:
1. Delayed development of language.
2. Superficially perfect expressive language.
3. Formal, pedantic language.
4. Odd prosody, peculiar voice characteristics.
5. Impairment of comprehension, including misinterpretations of
literal/implied meanings.
D. Non-verbal communication problems, as manifested by at least
one of the following five:
1. Limited use of gestures.
2. Clumsy/gauche body language.
3. Limited facial expression.
4. Inappropriate expression.
5. Peculiar, stiff gaze.
E. Motor clumsiness, as documented by poor performance on
neurodevelopmental examination.
Asperger Syndrome according to Szatmari:
Quote:
A. Solitary, as manifested by at least two of the following four:
1. No close friends.
2. Avoids others.
3. No interest in making friends.
4. A loner.
B. Impaired social interaction, as manifested by at least one of the
following five:
1. Approaches others only to have own needs met.
2. A clumsy social approach.
3. One-sided responses to peers.
4. Difficulty sensing feelings of others.
5. Detached from feelings of others.
C. Impaired non-verbal communication, as manifested by at least one
of the following seven:
1. Limited facial expression.
2. Unable to read emotion from facial expressions of child.
3. Unable to give messages with eyes.
4. Does not look at others.
5. Does not use hands to express oneself.
6. Gestures are large and clumsy.
7. Comes too close to others.
D. Odd speech, as manifested by at least two of the following six:
1. abnormalities in inflection.
2. talks too much.
3. talks too little.
4. lack of cohesion to conversation.
5. idiosyncratic use of words.
6. repetitive patterns of speech.
E. Does not meet criteria for Autistic Disorder.
1. No close friends.
2. Avoids others.
3. No interest in making friends.
4. A loner.
B. Impaired social interaction, as manifested by at least one of the
following five:
1. Approaches others only to have own needs met.
2. A clumsy social approach.
3. One-sided responses to peers.
4. Difficulty sensing feelings of others.
5. Detached from feelings of others.
C. Impaired non-verbal communication, as manifested by at least one
of the following seven:
1. Limited facial expression.
2. Unable to read emotion from facial expressions of child.
3. Unable to give messages with eyes.
4. Does not look at others.
5. Does not use hands to express oneself.
6. Gestures are large and clumsy.
7. Comes too close to others.
D. Odd speech, as manifested by at least two of the following six:
1. abnormalities in inflection.
2. talks too much.
3. talks too little.
4. lack of cohesion to conversation.
5. idiosyncratic use of words.
6. repetitive patterns of speech.
E. Does not meet criteria for Autistic Disorder.
Asperger Syndrome according to the ICD:
http://www.mentalhealth.com/icd/p22-ch07.html
Quote:
A disorder of uncertain nosological validity, characterized by the same kind of qualitative abnormalities of reciprocal social interaction that typify autism, together with a restricted, stereotyped, repetitive repertoire of interests and activities. The disorder differs from autism primarily in that there is no general delay or retardation in language or in cognitive development. Most individuals are of normal general intelligence but it is common for them to be markedly clumsy; the condition occurs predominately in boys (in a ratio of about eight boys to one girl). It seems highly likely that at least some cases represent mild varieties of autism, but it is uncertain whether or not that is so for all. There is a strong tendency for the abnormalities to persist into adolescence and adult life and it seems that they represent individual characteristics that are not greatly affected by environmental influences. Psychotic episodes occasionally occur in early adult life.
Diagnostic Guidelines
Diagnosis is based on the combination of a lack of any clinically significant general delay in language or cognitive development plus, as with autism, the presence of qualitative deficiencies in reciprocal social interaction and restricted, repetitive, stereotyped patterns of behaviour, interests, and activities. There may or may not be problems in communication similar to those associated with autism, but significant language retardation would rule out the diagnosis.
Diagnostic Guidelines
Diagnosis is based on the combination of a lack of any clinically significant general delay in language or cognitive development plus, as with autism, the presence of qualitative deficiencies in reciprocal social interaction and restricted, repetitive, stereotyped patterns of behaviour, interests, and activities. There may or may not be problems in communication similar to those associated with autism, but significant language retardation would rule out the diagnosis.
Then, you have four diferent "Asperger Syndromes".
Now, we also have that (from wikipedia), "A small 2008 study of children referred with a tentative diagnosis of AS found poor agreement among the four sets of criteria, with one overlap being only 39%" (the study: http://www.springerlink.com/content/f503718703044q54)
If there are 4 different definitions of what is AS, and if many people have AS according to one definition but not according to one of the others, these mean that, at least, 3 of the 4 diagnosis criteria are wrong (or, at least, don't correspond to an objective reality). And, if 3 in 4 are wrong, perhaps all are wrong?
Then, this not mean that Asperger Syndrome does not exist as an objective reality but it is only an arbitrary convention?
Or, a more moderate version of this: Asperger Syndrome exists, but the demarcation lines between AS and other disorders, for one side, and between AS and "normality", at other side, are arbitrary conventions.
10 Mar 2009, 8:14 am
The DSM-IV-TR and ICD-10 are the international standard, but there's some institutions who use Gillberg's Criteria as they feel that it captures Hans Asperger's original image better.
Attwood for example uses Gillberg's for AS and the DSM-IV-TR for Autism. Whereas most doctors will just use the ICD-10 or DSM-IV-TR.
It's kinda like the whole, Autism, Asperger's, PDD-NOS, Schizoid PD, Simple Schizophrenia, Chronic Schizophrenia, etcetera, overlaps; some people may be diagnosed with one in one country, but will be diagnosed with another in a different country.
It adequately catches everyone, really, it's just the pedantic hair splitters that it bothers (see: me).
10 Mar 2009, 9:31 am
I think that in my country several institutions use the Gillberg's Criteria, indeed.
My ideia is that Gillberg AS is (or could be) a more severe condition than DSM AS (I know that the criterias are to be interpreted by psychs, not by ourselfes; howver, I suspect that I match the DSM but not Gillberg - or I can be only a mental hipocondriac, of course).
