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Abstract | Summary
| Original Article
Annotation: The similarities and differences between autistic disorder and Asperger?s disorder: a review of the empirical evidence
Macintosh KE and Dissanayake C
Journal of Child Psychology and Psychiatry 2004; 45(3): 421-434
Bottom Line
Does the research literature support the theory that Asperger
syndrome is distinct from high functioning autism (HFA)?
- Previous research suggested that people with
Asperger syndrome had higher IQs and usually better language
use than people with autism.
- This study reviewed the current published studies
and concluded that there is no good evidence that Asperger
syndrome is different from HFA.
- The conclusion of this review is that people
with Asperger syndrome should be regarded as being on
the autism spectrum.
- Most of the studies have been surveys, not
the long-term studies needed to show if there are differences
in development and symptoms between groups of people,
so more research is definitely needed.
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Question: Does the research literature support the theory that Asperger?s disorder is distinct from high functioning autism?
Background: There continues to be some controversy over whether Asperger?s disorder (AD) is distinct from high functioning autism (HFA). Studies have looked at whether there are specific symptoms that differentiate Asperger?s disorder from autism. In medicine/psychiatry, the correct diagnosis (based on clusters of symptoms) is essential for successful therapy, but also to determine an individual?s likely future outcome. It is therefore important to know if these conditions have different symptoms, life course, or outcome in adulthood.
Data Sources: The authors searched the databases PsychINFO and MEDLINE, and looked at book chapters and the reference lists of papers found in their search. They also hand searched journals dated up to 2002.
Data Extraction: Not described.
Main results: The ?empirical sub-typing? studies did not provide much that was useful in determining whether there is a distinct difference between HFA and AD on symptoms. The comparative studies looked at different symptoms, including language and communication, cognitive functioning, motor skills, repetitive behaviours and restricted interests, social skills, cause of the conditions, age at appearance of symptoms, and prognosis. In each of these realms there was insufficient evidence to distinguish HFA from AD.
Conclusions: There is no clear evidence that HFA and AD are different conditions. According to this review, Asperger?s disorder should be regarded as being on the autism spectrum. One problem with the use of cluster analysis to resolve the question posed here is that there has been a failure to adequately match the study participants in the studies reviewed. If the participants are not matched for their developmental stages, that is, their mental age (MA) as compared to their chronological age (CA), then the conclusions drawn from the comparisons can be faulty. Symptoms alter with age and developmental stage, and this must be taken into account when trying to group people according to their symptoms.
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