How Asperger’s Syndrome is Diagnosed
Asperger’s Disorder (also known as Asperger’s Syndrome, or AS), like other pervasive developmental disorders (PDDs), involves delays and deviant patterns of behavior in multiple areas of functioning, that often require the input of professionals with different areas of expertise, particularly overall developmental functioning, neuropsychological features, and behavioral status. Hence the clinical assessment of individuals with this disorder is most effectively conducted by an experienced interdisciplinary team.
While Asperger’s syndrome was subsumed into Autism Spectrum Disorder in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (2013), the diagnosis of the disorder is largely the same, no matter the specific diagnostic label given it. This article has been updated to reflect current diagnostic practices, but refers to the disorder by its old name, Asperger’s syndrome (AS), throughout. It is now known as a mild form of Autism Spectrum Disorder.
Given the complexity of the condition, importance of developmental history, and common difficulties in securing adequate services for children and individuals with AS, it is very important that parents are encouraged to observe and participate in the evaluation. This guideline helps to demystify assessment procedures, avails the parents of shared observations that can then be clarified by the clinician, and fosters parental understanding of the child’s condition. All of these can then help the parents evaluate the programs of intervention offered in their community.
Evaluation findings should be translated into a single coherent view of the child: easily understood, detailed, concrete, and realistic recommendations should be provided. When writing their reports, professionals should strive to express the implications of their findings to the patient’s day-to-day adaptation, learning, and vocational training.
Because many healthcare professionals remain unaware of the features of the disorder and its associated disabilities, it’s often necessary for direct and continuous contact on the part of the evaluators with the various professionals securing and implementing the recommended interventions. This is particularly important in the case of Asperger’s syndrome, as most of these individuals have average levels of Full Scale IQ, and are often not thought of as in need for special programming.
The disorder is a serious and debilitating developmental syndrome impairing the person’s capacity for socialization — it not merely a transient or mild condition. Ample opportunity should be given to clarify misconceptions and establish a consensus about the patient’s abilities and disabilities, which should not be simply assumed under the use of the diagnostic label.
In the majority of cases, a comprehensive assessment will involve the following components: history, psychological assessment, communication and psychiatric assessments, further consultation if needed, parental conferences, and recommendations.
Taking a History of the Asperger’s Patient
A careful history should be obtained, including information related to pregnancy and neonatal period, early development and characteristics of development, and medical and family history. A review of previous records including previous evaluations should be performed and the information incorporated and results compared in order to obtain a sense of course of development.