Asperger syndrome (a specific autism spectrum disorder): Clinical features and diagnosis in children and adolescents
- L Erik von Hahn, MD
L Erik von Hahn, MD
- Associate Professor of Pediatrics
- Tufts University School of Medicine
- Section Editors
- Carolyn Bridgemohan, MD
Carolyn Bridgemohan, MD
- Section Editor — Developmental and Behavioral Pediatrics
- Assistant Professor of Pediatrics
- Harvard Medical School
- Marc C Patterson, MD, FRACP
Marc C Patterson, MD, FRACP
- Section Editor — Pediatric Neurology
- Professor of Neurology, Pediatrics, and Medical Genetics
- Chair, Division of Child and Adolescent Neurology
- Mayo Clinic College of Medicine
The American Psychiatric Association recognized Asperger disorder (also called Asperger syndrome) as a specific entity by publishing diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) in 1994 . A modest literature on Asperger disorder has emerged since then, though there are no specific clinical features that establish Asperger disorder as distinct from the autism spectrum as a whole [2-4] and its status as a separate entity is uncertain. In the DSM-5, published in 2013, Asperger disorder is encompassed within the diagnosis of autism spectrum disorder . In contrast, Asperger syndrome remains a distinct entity in the International Classification of Diseases, 10th Revision (ICD-10) .
This topic review summarizes the modest literature that describes Asperger syndrome as a separate entity. The terms “Asperger syndrome” and “autism spectrum disorder” (ASD) will be used interchangeably to acknowledge the two classification systems. Most of the information in this topic review will apply to children with ASD of Level 1 severity who do not have intellectual impairment, but may have language impairment. This approach is consistent with research that shows that subtypes of autism differ primarily on the basis of IQ [7,8]. (See 'Terminology' below and "Autism spectrum disorder: Diagnosis", section on 'Diagnostic criteria'.)
The clinical features and diagnosis of Asperger syndrome will be reviewed here. The management and prognosis are discussed separately. (See "Asperger syndrome (a specific autism spectrum disorder): Management and prognosis in children and adolescents".)
Asperger syndrome is considered to be an "autism spectrum disorder" (ASD). ASD is a neurodevelopmental disorder that has diverse etiologies. It is characterized by a constellation of symptoms that includes deficits in reciprocal social interaction, social communication, and restricted and repetitive behavior (including stereotyped interests and activities) [5,6,9]. (See "Autism spectrum disorder: Diagnosis", section on 'Diagnostic criteria'.)
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- CLINICAL FEATURES
- Early features
- Core features
- - Social skills
- Language skills
- - Behavioral features
- Other features
- - Clumsiness
- - School performance
- Associated conditions
- DIAGNOSTIC APPROACH
- Role of the primary care provider
- Multidisciplinary evaluation
- DIFFERENTIAL DIAGNOSIS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS