Asperger syndrome physical examination

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Physical Examination

  • Physical, emotional, and mental tests are done to rule out other causes and look more closely for signs of this syndrome. The team that will see your child includes a psychologist, neurologist, psychiatrist, speech therapist, and other professionals who are experts in diagnosing children with Asperger syndrome.
  • Standard diagnostic criteria require impairment in social interaction, and repetitive and stereotyped patterns of behavior, activities and interests, without significant delay in language or cognitive development. Unlike the international standard, U.S. criteria also require significant impairment in day-to-day functioning. Other sets of diagnostic criteria have been proposed by Szatmari et al.[1] and by Gillberg and Gillberg.[2]
  • Diagnosis is most commonly made between the ages of four and eleven. A comprehensive assessment involves a multidisciplinary team that observes across multiple settings,and includes neurological and genetic assessment as well as tests for cognition, psychomotor function, verbal and nonverbal strengths and weaknesses, style of learning, and skills for independent living. The current "gold standard" in diagnosing ASDs combines clinical judgment with the Autism Diagnostic Interview-Revised (ADI-R)—a semistructured parent interview—and the Autism Diagnostic Observation Schedule (ADOS)—a conversation and play-based interview with the child.[3] Delayed or mistaken diagnosis can be traumatic for individuals and families; for example, misdiagnosis can lead to medications that worsen behavior. Many children with AS are initially misdiagnosed with attention-deficit hyperactivity disorder (ADHD). Diagnosing adults is more challenging, as standard diagnostic criteria are designed for children and the expression of AS changes with age.[4]
  • Underdiagnosis and overdiagnosis are problems in marginal cases. The cost of screening and diagnosis and the challenge of obtaining payment can inhibit or delay diagnosis. Conversely, the increasing popularity of drug treatment options and the expansion of benefits has motivated providers to overdiagnose ASD.[5] There are indications AS has been diagnosed more frequently in recent years, partly as a residual diagnosis for children of normal intelligence who do not have autism but have social difficulties. There are questions about the external validity of the AS diagnosis, that is, it is unclear whether there is a practical benefit in distinguishing AS from HFA and from PDD-NOS;[6] the same child can receive different diagnoses depending on the screening tool.


References

  1. Szatmari P, Bremner R, Nagy J (1989). "Asperger's syndrome: a review of clinical features". Can J Psychiatry. 34 (6): 554–60. PMID 2766209.
  2. Gillberg IC, Gillberg C (1989). "Asperger syndrome—some epidemiological considerations: a research note". J Child Psychol Psychiatry. 30 (4): 631–8. doi:10.1111/j.1469-7610.1989.tb00275.x. PMID 2670981.
  3. Woodbury-Smith MR, Volkmar FR (2008). "Asperger syndrome". Eur Child Adolesc Psychiatry. doi:10.1007/s00787-008-0701-0. PMID 18563474.
  4. Tantam D (2003). "The challenge of adolescents and adults with Asperger syndrome". Child Adolesc Psychiatr Clin N Am. 12 (1): 143–63. doi:10.1016/S1056-4993(02)00053-6. PMID 12512403.
  5. Shattuck PT, Grosse SD (2007). "Issues related to the diagnosis and treatment of autism spectrum disorders". Ment Retard Dev Disabil Res Rev. 13 (2): 129–35. doi:10.1002/mrdd.20143. PMID 17563895.
  6. Klin A, Volkmar FR (2003). "Asperger syndrome: diagnosis and external validity". Child Adolesc Psychiatr Clin N Am. 12 (1): 1–13. doi:10.1016/S1056-4993(02)00052-4. PMID 12512395.





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