Aspergers diagnosis & screening

There are many different classifications for diagnosis. The key is to try to identify Asperger’s or autism as early as possible.

Currently either a paediatrician or child psychiatrist with an interest in pervasive developmental disorders can diagnose Asperger’s or autism. Trained clinical psychologists can also be involved. Many well developed departments have multidisciplinary teams to examine the various areas e.g. language.

A basic screening checklist for doctors and other health professionals has been devised to try to identify Asperger’s and autism at an early stage. This is called the CHAT or Checklist for Autism in Toddlers. The checklist is used around the 18 month developmental check up.

The test attempts to identify some of the following symptoms:

• noticeable impairments in behaviour, such as lack of eye-to-eye contact, facial expression, body posture, and gestures to regulate social interaction
• failure to make friends amongst peers
• a lack of spontaneous desire to share enjoyment, interests or achievements with other people
• lack of social involvement - not actively participating in simple social play or games, preferring solitary activities
• persistent preoccupation with parts of objects

The most detailed diagnostic tool for Asperger’s and Autism is that from the American Psychiatric Association called the Diagnostic and Statistical Manual (DSM). A similar scheme is available from the World Health Organisation called the International Classification of Disease (ICD).

The diagnosis of Asperger’s is based on the assessment of a number of the following behavioural symptoms:

• The condition results in the impairment in social interaction, such as the failure to develop peer relationships.
• The condition results in repetitive patterns of behaviour, such as inflexible adherence to specific, non-functional routines or rituals
• The condition must impair in social, occupational, or other important activities.
• The symptoms are not caused by clinically significant general delay in language.
• The symptoms are not caused by a clinically significant delay in cognitive development or in the development of age-appropriate self-help skills.
• The symptoms should not be exclusively or directly caused by other mental disorders (e.g. pervasive developmental disorder, schizophrenia)

If subjects show positive responses to a set number of questions in the diagnosis tool, then they would then satisfy the criteria for a diagnosis of Asperger’s.

Autism

Similarly, the diagnosis of autism is based on the assessment of a number of similar behavioural symptoms including.

• Some symptoms of the condition need to have been evident from before 3 years of age
• The condition results in the impairment of social interaction, such as the inability to utilise nonverbal behaviours such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction.
• The condition impairs communication, such as a delay in, or lack of development of spoken language, accompanied by no attempt to compensate through alternative modes of communication such as gesture or mime.
• The symptoms include repetitive patterns of behaviour, interests and activities, such as repetitive mannerisms like hand or finger flapping or twisting, or complex whole-body movements.