Differential Diagnosis: Autism versus Aspergers

Autism and Asperger’s Disorder are diagnoses which both present with a hallmark feature of social impairment. There are several differences between Asperger's Childthe two diagnoses which help classify the two disorders.

Autism Diagnosis:

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IV-TR), which is the diagnostic guidebook published by the American Psychiatric Association, indicates that there are three domains of diagnostic criteria for a diagnosis of Autism. Impairment with social relationships is the first domain which includes impaired nonverbal communication (poor eye contact and lack of gestures), poor peer relationships (lack of social interest when young to one-sided social interactions when older), poor joint attention (lack of pointing to show interest, not bringing items to show parents), and a lack of emotional reciprocity (failure of the child to notice parents and peers emotions). The second area is impairment in language which includes: language delay (not speaking at a year, or not speaking in sentences at two years), inability to carry on a give-and-take conversation, perseverative and repetitive language (repeating lines from television shows or the same thing over and over), and absent or delayed pretend play. The final area of Autism is repetitive behaviors which include: preoccupations or over-interest with favorite objects or topics that are unusual for the child’s age, routines and rituals that cause distress if interrupted, stereotypical movements (rocking, hand flapping, spinning), and interest in parts of objects (playing with only the wheels on a car). According to the DSM-IV, the main differential between the diagnoses of Autism (as described above) versus Asperger’s Disorder is that children with a diagnosis of Aspergers do not evidence impairment in language.

Asperger’s Diagnosis:

Neuropsychological studies have documented that children with Asperger’s Disorder often exhibit relative strength with regard to their verbal skills with deficits in their visual spatial and visual motor ability. Whereas children with Autism will often exhibit the opposite profile; strength with visual spatial and visual motor ability and weakness with verbal skills (Wolf, Fein, Akshoomoff, 2007).

Overall, the diagnoses of Autism and Asperger’s Disorder are quite similar in that they both feature impairment with social relationships and repetitive behaviors. The main exception between the two diagnoses is that children with Asperger’s do not exhibit the concern with language functioning.

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