636 CHAPTER 14
like to borrow that” not as a request to borrow the object but simply as an ex-
pressed wish. Table 14.6 lists the complete diagnostic criteria.
People with Asperger’s often avoid sustained eye contact, and don’t use
other nonverbal behaviors, such as facial expressions or body language, in nor-
mal ways (Criterion A1). And because they don’t understand social conventions,
their behavior can (inadvertently) communicate disinterest in others. Whereas
autism is characterized by an indifference to others, Asperger’s tends to involve
a lack of awareness of other people’s responses. For example, someone with
Asperger’s may continue talking about a topic long past the point at which
the listener’s interest has waned. The person with Asperger’s doesn’t notice—
doesn’t pick up on the social cues that indicate that the other person is no longer
listening.
To be diagnosed with Asperger’s, the individual must have symptoms that im-
pair the ability to function at school and care for himself or herself. Unlike those
with autism, however, children with Asperger’s develop in all areas (including lan-
guage) except social functioning. In fact, the disorder often isn’t diagnosed in early
childhood because all other areas of functioning are relatively normal. DSM-IV-TR
includes Asperger’s disorder in the category of pervasive developmental disorders in
order to group it with autism. However, Asperger’s does not involve pervasive defi cits.
Table 14.7 provides additional facts about this disorder.
Like people with autism, people with Asperger’s often develop an all-consuming
but narrow interest, spending large amounts of time on it, to the point of neglect-
ing other activities. Josh, described in Case 14.3, has a consuming passion about
directions.Table 14.6 • DSM-IV-TR Diagnostic Criteria for Asperger’s Disorder
A. Qualitative impairment in social interaction, as manifested by at least two of the following:
(1) marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial
expression, body postures, and gestures to regulate social interaction;
(2) failure to develop peer relationships appropriate to developmental level;
(3) a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
(e.g., by a lack of showing, bringing, or pointing out objects of interest to other people);
(4) lack of social or emotional reciprocity.B. Restricted repetitive and stereotyped patterns of behavior, interests, and activities, as mani-
fested by at least one of the following:
(1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest
that is abnormal either in intensity or focus;
(2) apparently infl exible adherence to specifi c, nonfunctional routines or rituals;
(3) stereotyped and repetitive motor mannerisms (e.g., hand or fi nger fl apping or twisting, or
complex whole-body movements);
(4) persistent preoccupation with parts of objects.C. The disturbance causes clinically signifi cant impairment in social, occupational, or other impor-
tant areas of functioning.D. There is no clinically signifi cant general delay in language (e.g., single words used by age 2
years, communicative phrases used by age 3 years).E. There is no clinically signifi cant 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.F. Criteria are not met for another specifi c Pervasive Developmental Disorder or Schizophrenia
[discussed in Chapter 12].Source: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Text Revision,
Fourth Edition, (Copyright 2000) American Psychiatric Association.