This is from the book Asperger Syndrome A Practical Guide for Teachers
by Val Cumine, Julia Leach and Gill Stevenson
David Fulton Publishers London
ISBN 1-85346-499-6
Differential Diagnosis
Differential diagnosis is the process of deciding what the condition is and what it isn't. It involves comparing the child's behavior with behavior typical of other disorders which could account for the same symptoms.
Jonathon Green (1990), a child and adolescent psychiatrist who has researched the nature of Asperger syndrome, outlines several areas for differential diagnosis. He points out that the differential diagnosis of children who may have Asperger syndrome involves considering alternative conditions in which some of the features are similar to those of the triad of impairments.
These include the following:
The triad of impairments referred to above are
1. impaired social interaction
2. impaired social communication
3. impaired play and lack of flexible thinking
combine to define autism, and not present in this particular combination in other groups."
Ordinary insensitivity ......
Emotional Disorder.....
Dyspraxia - Children with Asperger syndrome are often clumsy, with poorly developed fine-motor and eye-hand coordination skills. Conversely, some children with severe dyspraxia also experience marked social problems. Therefore, differential diagnosis can be difficult in some cases, particularly
with younger children. However, the distinction is important because children whose problems are fundamentally associated with dyspraxia will respond more readily to social-skills-based intervention because of a relatively intact ability to form social relationships. They are also less rigid and obsessional in their interests than children with Asperger syndrome. In
terms of educational intervention, there will be areas of similarity, but the priorities will be different.
Language Disorder - The borders of developmental language disorders and autism can be difficult to define. When children are able to compensate for language difficulties by using gesture, facial expression, mime, and signs, it will be clear
that the source of difficulty is language-based. However, as Rutter (1978) observed, some children present a mixed picture. Social, communication and behavioral difficulties may be observed in young children with severe receptive language disorders as well as in young children with autism spectrum disorders. Collaboration between professionals involved in assessment.....is essential. As the child reaches school age, the picture is usually becoming clearer.
Attention Deficit Hyperactivity Disorder (ADHD) - Young children with ADHD will evidence many behaviors which may also be
present in Asperger syndrome, for example: not seeming to listen when spoken to directly; not following through on instructions; experiencing difficulty organising tasks and activities; talking excessively; interrupting and being easily distracted. Occasionally, young children of five or six years of age with Asperger syndrome may initially be diagnosed as having ADHD,.....If however, social difficulties remain and are
resistant to change, the differential diagnosis of Asperger syndrome may need to be considered.
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