Diagnosis and Treatment of AS

Diagnosis

Standard diagnostic criteria require impairment in social interaction, and repetitive and stereotyped behaviors and interests, without significant delay in language or cognitive development. Unlike the international standard,[6] U.S. criteria also require significant impairment in day-to-day functioning.[13] Other sets of diagnostic criteria have been proposed by Szatmari et al.[43] and by Gillberg and Gillberg.[44]

Diagnosis is most commonly made between the ages of four and eleven.[1] A comprehensive assessment involves a multidisciplinary team[2][4][45] that observes across multiple settings,[1] 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.[4] Delayed or mistaken diagnosis can be traumatic for individuals and families; for example, misdiagnosis can lead to medications that worsen behavior.[45] Many children with AS are initially misdiagnosed with attention-deficit hyperactivity disorder (ADHD).[1] Diagnosing adults is more challenging, as standard diagnostic criteria are designed for children and the expression of AS changes with age.[46] Conditions that must be considered in a differential diagnosis include other ASDs, the schizophrenia spectrum, ADHD, obsessive compulsive disorder, depression, semantic pragmatic disorder, nonverbal learning disorder,[45] Tourette syndrome,[17] stereotypic movement disorder and bipolar disorder.[26]

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