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Asperger Syndrome: Differential Diagnosis
by Megan-Lynette Richmond, M.S., CCC-SLP and Susie S. Loraine, M.A., CCC-SLP
Asperger syndrome (AS) is a disorder in development characterized by social interaction difficulties and repetitive patterns of behavior and activities. Although AS is on the autism spectrum, it is different from other autism spectrum disorders (ASD)—autism, Rett syndrome, childhood disintegrative disorder, and pervasive development disorder-not otherwise specified (PDDNOS; "DSM-IV-TR®", 2000, p. 74). As well, AS is often mistaken for other language and learning disabilities that do not fall under the autism spectrum.
AS shares many traits with other childhood disorders which makes it challenging to identify. This is why professionals use differential diagnosis —comparing signs and symptoms of different disorders to distinguish between them. The following chart pinpoints the differences that you may notice between AS and other (childhood) disorders.
Asperger SyndromeAutism
No significant language delaySignificant language delay - difficulty understanding and using language
No significant delay in cognition - no mental retardationMay or may not have cognative delays - problems with thinking or mental retardation
Asperger SyndromeSpeech/Language Disorders
Difficulty with social language and interactionProblems with understanding and using the structures of language, such as grammar, and/or sould production issues.
More frequently occurs in malesNot gender specific
IQ may be normal to above averageStudents may present with a wide range of IQ scores from low average to above average
Difficulty with motor (movement) planning; issues sequencing motor movements both gross - large muscles groups (running) and fine - amall muscle groups (writing)No major motor movement issues
Unimaginative speech - speaking extensively on a favorite topic, such as a TV showDifficulty putting parts of sentences together for extensive discussion or writing
Asperger SyndromeAttention Deficit Hyperactivity Disorder (ADHD)
Attention problems may be because of social communication difficultyAttention problems due to lack of impulse control
Difficulty reading and interpreting body language and facial expressionsNormal ability to read and interpret body language and facial expressions
Asperger SyndromeObsessive-Compulsive Disorder (OCD)
Repetitive and limited interestsVariety of interests and flexibility/shifts in focus
Significant social-interaction difficultiesMay have social-interaction difficulties
Often identified by the age of threeOften identified at five years or older
Asperger SyndromePDD-NOS
Language develops normallyDelayed onset of language skills
Interest but difficulty with social communicationLack of or limited interest in social communication
Asperger SyndromeSchizophrenia
Often identified by the age of threeNot identified until late teens to mid-30s
Poor coordination can persist throughout lifePoor coordination may occur secondary to medication
Often normal verbal skillsDisorganized speech and inconsistent language use ("DSM-IV-TR®", 2000)
"DSM-IV-TR®" American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.) Washington, DC: Author.

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