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Asperger Syndrome: Differential Diagnosis
Megan-Lynette Richmond, M.S., CCC-SLP and Susie S. Loraine, M.A., CCC-SLP
Asperger syndrome (AS) is a disorder in development characterized by social interaction difficulties and repetitive patterns of behavior and activities. Although AS is on the autism spectrum, it is different from other autism spectrum disorders (ASD)—autism, Rett syndrome, childhood disintegrative disorder, and pervasive development disorder-not otherwise specified (PDDNOS; “DSM-IV-TR®”, 2000, p. 74). As well, AS is often mistaken for other language and learning disabilities that do not fall under the autism spectrum.
AS shares many traits with other childhood disorders which makes it challenging to identify. This is why professionals use differential diagnosis—comparing signs and symptoms of different disorders to distinguish between them. The following chart pinpoints the differences that you may notice between AS and other (childhood) disorders.
Asperger Syndrome Autism
No significant language delay Significant language delay—difficulty understanding and using language
No significant delay in cognition—no mental retardation May or may not have cognitive delays—problems with thinking or mental retardation

Asperger Syndrome Speech/Language Disorders
Difficulty with social language and interaction Problems with understanding and using the structures of language, such as grammar, and/or sound production issues
More frequently occurs in males Not gender specific
IQ may be normal to above average Students may present with a wide range of IQ scores from low average to above average
Difficulty with motor (movement) planning; issues sequencing motor movements both gross—large muscles groups (running) and fine—small muscles groups (writing) No major motor movement issues
Unimaginative speech—speaking extensively on a favorite topic, such as a TV show Difficulty putting parts of sentences together for extensive discussion or writing

Asperger Syndrome Attention Deficit Hyperactivity Disorder (ADHD)
Attention problems may be because of social communication difficulty Attention problems due to lack of impulse control
Difficulty reading and interpreting body language and facial expressions Normal ability to read and interpret body language and facial expressions

Asperger Syndrome Obsessive-Compulsive Disorder (OCD)
Repetitive and limited interests Variety of interests and flexibility/shifts in focus
Significant social-interaction difficulties May have social-interaction difficulties
Often identified by the age of three Often identified at five years or older

Asperger Syndrome PDD-NOS
Language develops normally Delayed onset of language skills
Interest but difficulty with social communication Lack of or limited interest in social communication

Asperger Syndrome Schizophrenia
Often identified by the age of three Not identified until late teens to mid-30s
Poor coordination can persist throughout life Poor coordination may occur secondary to medication
Often normal verbal skills Disorganized speech and inconsistent language use (“DSM-IV-TR®”, 2000)

“DSM-IV-TR®” American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.) Washington, DC: Author.

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