Definition & Diagnosis


Asperger syndrome is defined in section 299.80 of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as

1. Qualitative impairment in social interaction, as manifested by at least two of the following:
-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.
-Failure to develop peer relationships appropriate to developmental level.
-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).-
A lack of social or emotional reciprocity.

2. 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 in either intensity or focus.
- Apparently inflexible adherence to specific, nonfunctional 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.

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

4. There is no clinically significant general delay in language (e.g., single words used by age two years, communicative phrases used by age three years).

5. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills or adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.

6. Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.



Please read the DSM cautionary statement. The diagnostic criteria of the Diagnostic and Statistical Manual are criticized for being vague and subjective; a condition that one psychologist might define as a significant impairment might be defined by another psychologist as merely insignificant.

In A Guide to Asperger Syndrome (Cambridge: Cambridge University Press, 2002), Christopher Gillberg also criticizes the "no significant delay" clauses of the DSM, and to a lesser extent some of the others, and argues that the clauses represent a misunderstanding or oversimplification of the syndrome. He states that although there may well be significant delay in some areas of language development, it is often combined with exceptionally high functioning in other language-related areas, and he argues that this combination superficially resembles but is in reality very different from normal development in language and adaptive behavior.

Partly because of Asperger syndrome's recent appearance in the DSM and partly because of differences of opinion such as Gillberg's, at least three other, slightly different sets of diagnostic criteria are used in the field besides the DSM-IV definition. One is due to Gillberg himself and his wife and is also endorsed by Attwood; among other differences, this definition emphasizes the linguistic peculiarities, which go unmentioned in the DSM-IV criteria. Another definition is due to a team of Canadian researchers and is often called the Szatmari definition, after the first listed author of the paper in which these criteria first appeared. Both of these definitions were first published in 1989. The third is the ICD-10 definition; this one is similar to the DSM-IV version, and Gillberg criticizes it in much the same manner as he does the DSM-IV version.

Gillberg's criteria are as follows (All six criteria must be met for confirmation of diagnosis; however, self-diagnosis is not recommended):

1. Severe impairment in reciprocal social interaction (at least two of the following)
- inability to interact with peers
- lack of desire to interact with peers
- lack of appreciation of social cues
- socially and emotionally inappropriate behavior

2. All-absorbing narrow interest (at least one of the following)
- exclusion of other activities
- repetitive adherence
- more rote than meaning

3. Imposition of routines and interests(at least one of the following)
- on self, in aspects of life
- on others

4. Speech and language problems(at least three of the following)
- delayed development
- superficially perfect expressive language
- formal, pedantic language
- odd prosody, peculiar voice characteristics
- impairment of comprehension including misinterpretations of literal/implied meanings

5. Non-verbal communication problems(at least one of the following)
- limited use of gestures
- clumsy/gauche body language
- limited facial expression
- inappropriate expression
- peculiar, stiff gaze
- Motor clumsiness: poor performance on neurodevelopmental examination

For ICD-10, the phrase Asperger's syndrome is synonymous with Autistic psychopathy and Schizoid disorder of childhood