Where is Asperger's syndrome on the autism spectrum?

Asperger Syndrome is at the higher functioning end of the spectrum. In the DSM-IV, there are five conditions on the autism spectrum. Two of them (Rett Syndrome and Childhood Disintegrative Disorder) are extremely rare, so the majority of people on the autism spectrum have a diagnosis of either autism, PDD NOS or Asperger Syndrome.

Asperger Syndrome(AS) requires that the person said their first words by 2 and their first sentences by 3, and have no major delays in cognitive skills or adaptive functioning. (Although many psychologists ignore the adaptive functioning criteria, allowing kids with normal IQ and verbal skills to be diagnosed as AS even if they have significant nonverbal delays.) So therefore AS is at the higher functioning end. Where it gets complicated is that autism and PDD NOS have no functioning requirements.

Autism is typically diagnosed when the kid has a significant language delay. But whereas some autistic kids never learn to talk or speak very poorly even into adulthood, some overcome their early language delays and end up pretty much indistinguishable from AS kids. This is often referred to as high functioning autism or HFA, although others use that term to include anyone on the higher functioning end of the autism spectrum regardless of diagnosis.

PDD NOS is diagnosed when the kid doesn't meet criteria for a specific autism spectrum condition, but the psychologist feels they belong on the autism spectrum. As such, these kids are even more variable. PDD NOS is sometimes diagnosed in kids who are too young or low functioning to show some of the signs of autism, such as lack of pretend play (if they are below an 18 month old level they wouldn't play pretend anyway).

As a result, PDD NOS can include the lowest functioning autistic individuals, such as someone who is unable to walk due to profound cognitive impairment. On the other hand, it can also be used for people whose issues are too mild for an AS diagnosis, who would be the highest functioning kids. And it can be used for atypical autistic traits at any functioning level, such as a kid who has autistic-style social impairment but doesn't show any repetitive behavior.

For one example, kids with Newson Syndrome, a suggested new category of autism spectrum condition, are usually diagnosed with PDD NOS. These kids show social impairment, sensory issues and usually language delay, but also defiant behavior caused by a phobia of being controlled, and many are quite sociable. In addition, they often have increased pretend play and socially oriented obsessions.

So psychologists think they probably fit on the autistic spectrum, but they're clearly atypical.So, Asperger Syndrome has to be high functioning, but the other two common autism spectrum diagnoses can be at any level of functioning. (CDD and Rett Syndrome are always low functioning.).

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