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AS Criteria: A Dialogue, A Work In Progress

07 Sep

The impending mistake of the removal of Asperger’s Disorder from the DSM-V got me to thinking about what the exact opposite would look like: What if Asperger’s had diagnostic criteria not so similar to Autistic Disorder? What would those look like? So, I’ve taken a stab. Mind you, a work in progress, but let me know your thoughts, your additions, your disagreement.

Social Interaction:

  • Eye Gaze: Reduced, averted, sidelong gaze; gaze directed to familiar people more frequently, appropriately and comfortably; reduced or little use of gaze for joint attention.
  • Facial Expressions: Exaggerated (i.e. excited and angry only presentations), limited presentation, and/or limited directedness toward another.
  • Few friends despite a desire to have some; poor understanding of friendship).
  • May interact with others online (i.e. via video games, computer games).
  • Struggles understanding the perspective of others and predicting the behavior of others.
  • May appear to be conversationally competent when interacting with older individuals.
  • May control or conduct imaginative play (if present) with little deviation from a “plan”.
  • Struggles to understand what to say to peers; appears to have little intuitive ability to maintain a conversation.

Cognition

  • IQ may be extremely high, average, or, in rare cases, low average/borderline.
  • Rigid, “black and white” thinking that can result in poor problem solving, understanding cause and effect relationships.
  • Appears to understand or acts like he/she understand more than is accurate.
  • Academic struggles may follow a reading-math split.
  • Despite high/average intellect, may have poor grades due to apparent lack of motivation, dislike of competing homework.
  • Poor organization of self and environment.

Behavior

  • History of specific toy or topical interests that initially may be age-appropriate but present as more encompassing or longer in duration (at which point the interests become no longer appropriate)
  • Appears motivated by “fairness” and/or strong sense of justice, although that judgment, may not relate to right/wrong or morality.
  • Possible meltdowns will triggers that are difficult to identify or that appear insignificant.
  • Self-stimulatory behavior may be present with agitation (i.e. anxiety, excitement).
  • Boys suspected with AS appear more hyperactive, inattentive, and behaviorally inappropriate, whereas girls present as more shy, withdrawn, and socially appropriate until pressed.
  • Repetitive behaviors that may be highly non-fuctional

Daily Living/Adaptive Skills

  • Significant prompting needed to remind for completion of activities of personal hygiene (it is recognized that sensory and or fine-motor concerns may influence lack of completion).
  • Driving a vehicle may cause significant anxiety such that it inhibits the skill.

Language

  • Literal interpretation of language and poor use of figurative language.
  • May have poor use of humor or demonstrate a very dry or slapstick sense of humor.
  • May not utilize language flexibly.
  • May demonstrate echolalia, especially at younger ages (2-4), especially with videos, tv, movies.
  • May have demonstrated precocious language development – exceeding developmental milestones.
  • Language delay may also be present, specifically not meeting early milestones for language production and/or articulation errors.
  • May have vocal atypicalities: Breathing during words so that the word is broken up, noises that sound like tics, repetition of the start of sentences.

Sensory

  • Hypo- and hyper-sensitivities related to auditory, tactile, visual, and vestibular processing.
  • Restricted diet consisting of limited items with similar presentation (tastes may vary from bland, spicy, salty, sweet)
  • Reliance on certain fabrics for self-soothing, which can result in repetitive wardrobe

Motor

  • Gross-motor concerns: Clumsiness, lack of coordination
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4 Comments

Posted by on September 7, 2010 in ASD in the Grand Scheme

 

4 responses to “AS Criteria: A Dialogue, A Work In Progress

  1. Chris

    September 13, 2010 at 3:13 PM

    Great start. I would also add repetitiveness in daily activities, wearing your shirt inside out because you always have, (a comfort thing), a small menu consisting of bland foods, and something about coordination.

     
    • jholverstott

      September 14, 2010 at 4:44 PM

      Oh, yes, those are great additions! Consider those added!

       
  2. Emma Apple

    October 15, 2010 at 4:15 PM

    Difficulty with change in plans or routine and unpredictability.

     
  3. Tam

    October 15, 2010 at 10:30 PM

    “Poor organization of self and environment.”
    Can also be hyper-organized, everything has to be in it’s place or the world isn’t right. I used to “fix” the shelves at supermarkets, line up the books at libraries, etc. For me, certain things/places are in a constant state of chaos, and certain things/places have to be precisely organized. I think I realized it was impossible to keep everything organized, so I ‘allowed’ myself chaos in certain realms.

    You might add something like “poor sense of personal space” somewhere. I think a lot of us have trouble figuring out appropriate distances when talking with someone else, when we’re standing too close/”in someone’s face”, when we’re making the person think they have bad breath because we’re standing back too far… etc lol

    I don’t see anything on the list about the ‘special interests’ that usually get listed first – going on about trains, or whatever topic they’re obsessing on at the moment. I’m not sure whether it’s as prevalent as people usually make it out to be, just surprised not to see it on the list.

     

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