High-Functioning Autism / Asperger’s Syndrome

Autism: An Emerging National Epidemic

The past two decades have seen an alarming jump in autism diagnoses.  In 2009, the Centers for Disease Control and Prevention (CDC) reported that one in 110 children had a diagnosed autism spectrum disorder.  A report released in March 2012 by the CDC estimated that the current rate is closer to 1 in 88 children diagnosed with autism by age 8.  According to Autism Speaks, that figure of 1 in 88 is more children than are affected by diabetes, AIDS, cancer, cerebral palsy, cystic fibrosis, muscular dystrophy, and Down syndrome combined.

What is High-Functioning Autism (HFA)?

“Autism” and “autism spectrum disorder (ASD)” are general terms for a group of complex disorders of brain development.  Children with ASD may exhibit, to varying degrees, delays or impairment in multiple areas of development, including language, social-emotional, cognitive, and motor (i.e., poor motor coordination and problems with strength, speed and balance).  The autism spectrum contains numerous disorders which range from low-functioning autism to high-functioning autism (HFA) or Asperger’s Syndrome (AS).

The separation in the autism spectrum appears to be related to several characteristics.  In lower functioning autism, children tend to have a language delay or start talking later in life as well as a below average IQ.  These children are focused on their own private world.  Children with AS and HFA have average or above average IQ, start speaking within the expected age range, and are more aware of what they are unable to achieve socially.

There is much debate about how exactly to diagnose a child with HFA and AS.  Currently, HFA is not listed in the DSM-IV and the term seems to be more informal with no diagnostic criteria backing it.  Unfortunately, the newest DSM-V has removed all the diagnostic criteria for Asperger’s syndrome and has lumped it under the umbrella term “Autism Spectrum Disorder”.

For the Children’s Tomorrow Foundation, HFA and AS are nearly synonymous with each other and services will be provided to children with both forms of autism.  The Children’s Tomorrow Foundation will continue to include the DSM-IV’s diagnostic criteria for Asperger’s syndrome to communicate the differences between Asperger’s Syndrome and the rest of the autism spectrum.

What is Asperger’s Syndrome?

According to the Diagnostic and Statistic Manual of Mental Disorders (DSM-IV), a diagnosis for Asperger’s Syndrome is given when the criteria below are met:

(I) Qualitative impairment in social interaction, as manifested by at least two of the following:

  • (A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
  • (B) failure to develop peer relationships appropriate to developmental level
  • (C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
  • (D) lack of social or emotional reciprocity

(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:

  • (A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
  • (B) apparently inflexible adherence to specific, nonfunctional routines or rituals
  • (C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
  • (D) persistent preoccupation with parts of objects

(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.

(IV) 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)

(V) 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.

(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia