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DSM-IV
299.80 Asperger's Disorder
Qualitative impairment in social interaction, as manifested by
at least two of the following:
- marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze,
facial expression, body postures, and gestures to regulate social interaction
- failure to develop peer relationships appropriate to developmental level
- a lack of spontaneous seeking to share enjoyment, interests, or achievements with other
people(e.g., by a lack of showing, bringing, or pointing out objects of interest to other
people)
- lack of social or emotional reciprocity.
(B)
Restricted repetitive and stereotyped patterns of behavior, interests, and activities,
as manifested by at least one of the following:
- encompassing preoccupation with one or more stereotyped and restricted patterns of
interest that is abnormal either in intensity or focus
- apparently inflexible adherence to specific, non-functional routines or rituals
- stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting,
or complex whole-body movements)
- persistent preoccupation with parts of objects
(C)
The disturbance causes clinically significant impairment in social, occupational, or
other important areas of functioning.
(D)
There is no clinically significant general delay in language (e.g., single words used by
age 2 years, communicative phrases used by age 3 years)
(E)
There is no clinically significant delay in cognitive development or in the development
of age-appropriate self-help skills, adaptive behavior (other than in social interaction),
and curiosity about the environment in childhood.
(F)
Criteria are not met for another specific Pervasive Developmental Disorder or
Schizophrenia.
299.80 Pervasive Developmental Disorder Not Otherwise Specified
(Including Atypical Autism)
This category should be used when there is a severe and pervasive impairment in the
development of reciprocal social interaction or verbal and nonverbal communication skills,
or when stereotyped behavior, interests, and activities are present, but the criteria are
not met for a specific Pervasive Developmental Disorder, Schizophrenia, Schizotypal
Personality Disorder, or Avoidant Personality Disorder. For example, this category
includes atypical autism --- presentations that do not meet the criteria for
Autistic Disorder because of late age of onset, atypical symptomatology, or subthreshold
symptomatology, or all of these.
Associated Features and Disorders
Asperger's Disorder is sometimes observed in association with general medical
conditions that should be coded on Axis III. Various nonspecific neurological symptoms or
signs may be noted. Motor milestones may be delayed, and motor clumsiness is often
observed.
Prevalence
Information on the prevalence of Asperger's Disorder is limited, but it appears to be
more common in males.
Course
Asperger's Disorder appears to have a somewhat later onset than Autistic Disorder, or
at least to be recognized somewhat later. Motor delays or motor clumsiness may be noted in
the preschool period. Difficulties in social interaction may become more apparent in the
context of school. It is during this time that particular idiosyncratic or circumscribed
interests (e.g., a fascination with train schedules) may appear or be recognized as such.
As adults, individuals with the condition may have problems with empathy and modulation of
social interaction. This disorder apparently follows a continuous course and, in the vast
majority of cases, the duration is lifelong.
Familial Pattern
Although the available data are limited, there appears to be an increased frequency of
Asperger's Disorder among family members of individuals who have the disorder.
Differential Diagnosis
Asperger's Disorder is not diagnosed if criteria are met for another Pervasive
Developmental Disorder or for Schizophrenia. For the differential diagnosis
with Autistic Disorder, [see Autistic Disorder]. For the differential diagnosis
with Rett's Disorder, [see Rett's Disorder]. For the differential diagnosis with Childhood
Disintegrative Disorder, [see Childhood Disintegrative Disorder]. Asperger's Disorder
must also be distinguished from Obsessive-Compulsive Disorder and Schizoid
Personality Disorder. Asperger's Disorder and Obsessive-Compulsive Disorder share
repetitive and stereotyped patterns of behavior. In contrast to Obsessive-Compulsive
Disorder, Asperger's Disorder is characterized by a qualitative impairment in social
interaction and a more restricted pattern of interests and activities. In contrast to
Schizoid Personality Disorder, Asperger's Disorder is characterized by stereotyped
behaviors and interests and by more severely impaired social interaction.
299.80 Pervasive Developmental Disorder Not Otherwise
Specified (Including Atypical Autism)
This category should be used when there is a severe and pervasive impairment in the
development of reciprocal social interaction or verbal and nonverbal communication skills,
or when stereotyped behavior, interests, and activities are present, but the
criteria are
not met for a specific Pervasive Developmental Disorder,
Schizophrenia, Schizotypal
Personality Disorder, or Avoidant
Personality Disorder. For example, this category
includes atypical
autism"--presentations that do not meet the criteria for
Autistic
Disorder because of late age at onset, atypical
symptomatology, or subthreshold
symptomatology, or all of these.
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