Differential Diagnosis: Autism versus Aspergers

Autism and Asperger’s Disorder are diagnoses which both present with a hallmark feature of social impairment. There are several differences between Asperger's Childthe two diagnoses which help classify the two disorders.

Autism Diagnosis:

The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised (DSM-IV-TR), which is the diagnostic guidebook published by the American Psychiatric Association, indicates that there are three domains of diagnostic criteria for a diagnosis of Autism. Impairment with social relationships is the first domain which includes impaired nonverbal communication (poor eye contact and lack of gestures), poor peer relationships (lack of social interest when young to one-sided social interactions when older), poor joint attention (lack of pointing to show interest, not bringing items to show parents), and a lack of emotional reciprocity (failure of the child to notice parents and peers emotions). The second area is impairment in language which includes: language delay (not speaking at a year, or not speaking in sentences at two years), inability to carry on a give-and-take conversation, perseverative and repetitive language (repeating lines from television shows or the same thing over and over), and absent or delayed pretend play. The final area of Autism is repetitive behaviors which include: preoccupations or over-interest with favorite objects or topics that are unusual for the child’s age, routines and rituals that cause distress if interrupted, stereotypical movements (rocking, hand flapping, spinning), and interest in parts of objects (playing with only the wheels on a car). According to the DSM-IV, the main differential between the diagnoses of Autism (as described above) versus Asperger’s Disorder is that children with a diagnosis of Aspergers do not evidence impairment in language.

Asperger’s Diagnosis:

Neuropsychological studies have documented that children with Asperger’s Disorder often exhibit relative strength with regard to their verbal skills with deficits in their visual spatial and visual motor ability. Whereas children with Autism will often exhibit the opposite profile; strength with visual spatial and visual motor ability and weakness with verbal skills (Wolf, Fein, Akshoomoff, 2007).

Overall, the diagnoses of Autism and Asperger’s Disorder are quite similar in that they both feature impairment with social relationships and repetitive behaviors. The main exception between the two diagnoses is that children with Asperger’s do not exhibit the concern with language functioning.

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What Are Functional Assessments and the Four Main Functions of Behavior?

What are functional assessments?

Functional assessments are used to develop interventions for helping people change their behavior. A functional assessment is a procedure that is used to help identify what is reinforcing or

maintaining the behavior of concern. In order to generate a hypothesis about why an individual does something, a behavior analyst gathers information about the problem behavior (anything an individual does that is harmful or undesirable in some way). By observing the antecedents (what happened immediately before the behavior) and the consequences (what happened immediately after the behavior) of the problem behavior, behavior analysts can develop a probable cause for the behavior.

What is the function of behavior?

The function of behavior is the reason people behave in a certain way. People engage in millions of different behaviors each day, but the reasons for doing these different behaviors fall into four main categories.

The four main functions that maintain behaviors are:

  • Escape/Avoidance: The individual behaves in order to get out of doing something he/she does not want to do.
  • Attention Seeking: The individual behaves to get focused attention from parents, teachers, siblings, peers, or other people that are around them.
  • Seeking Access to Materials: The individual behaves in order to get a preferred item or participate in an enjoyable activity.
  • Sensory Stimulation: The individual behaves in a specific way because it feels good to them.

Once you have identified what function or functions are maintaining the behavior, you can start to implement an intervention that will help decrease the problem behavior and increase more appropriate behaviors.

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Basic Principles and Practices for Teaching Children With Autism New Skills

Teaching new skills to children with autism can be very difficult. It is important to first understand the fundamentals of behavior.

Behavior is an important part of teaching because in order to learn a new skill, a child must understand what response is desired and when. A child learns when a response is desired by experiencing a stimulus (i.e. item/request/instruction) and discrimination (Sd- discriminative stimulus).  A child simultaneously learns there is a desired response and discriminates that the response is only desired in the presence of the Sd. For example, if you are teaching a child to say “book” in the presence of a book, the Sd would be the book itself and the desired response would be saying “book.” That child will learn to say “book” only when that book is present. Later on, that child may begin saying “book” in the presence of new books, a pattern called generalization.

So, why is behavior important in teaching a new skill? It is important because a child’s response IS a behavior!

 Descriptions Of Behaviors:

Reflexive Behavior is our bodies’ natural reaction to environmental stimuli (e.g. blinking when someone blows in your eyes, or jerking your leg when someone hits your knee cap). These behaviors are called reflexes and occur without being learned. Read more