Childhood Asperger Syndrome Test (Self-Assessment)

Typically, by the time a child is three, a parent will start noticing behavioral differences when compared to other children, says John Carosso, PsyD, a child psychologist and certified school psychologist at Community Psychiatric Centers at the Autism Center of Pittsburgh, Pennsylvania. “They may see their child among other children and sense their child is different,” he says. “A child with Asperger’s tends to get into frequent conflicts with other children. They are very emotional compared to other kids and may have obsessions that other kids don’t have.”

If your child (any age) is having a very difficult time in a school setting or displaying explosive behavior at home, seek an evaluation, advises Eric Hollander, MD, director of the Autism and Obsessive-Compulsive Spectrum Program in the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center in New York City. Children with Asperger’s often have strong verbal skills yet deficits in non-verbal skills, he says.

“If your child is having trouble dressing herself by age five or problems with motor coordination, and difficulty drawing a box, you may want to look into getting her tested,” Dr. Hollander says. Other noticeable symptoms to look for include hand flapping, repetitive head banging, temper tantrums, and avoiding other children, he says.

Asperger’s is now considered a high-functioning type of autism spectrum disorder (ASD), explains Eric Hollander, MD, director of the Autism and Obsessive-Compulsive Spectrum Program in the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center in New York City. In fact, the most recent version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies Asperger’s under the umbrella term of an autism spectrum disorder rather than a diagnosis on its own, he says.

Your pediatrician or a social worker should be able to recognize that your child has a developmental delay, says Eric Hollander, MD, director of the Autism and Obsessive-Compulsive Spectrum Program in the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center in New York City. He or she will then most likely refer you to a specialist like a child psychiatrist, pediatric neurologist, or developmental neuropsychologist for an evaluation that includes various diagnostic tests. The parent may be interviewed about early childhood symptoms, Dr. Hollander says.

As part of your child’s comprehensive evaluation, you will be asked about early childhood symptoms and your child’s behavior will be observed, says Eric Hollander, MD, director of the Autism and Obsessive-Compulsive Spectrum Program in the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center in New York City. “This evaluation will be critical to make sure your child gets the appropriate support services such as specialized educational settings, occupational therapy, speech therapy, and social skills training,” he says.

You may also be referred to an autism diagnostic and treatment center. The nonprofit organizations Autism Speaks and ICare4Autism can connect you with resources and advocate for services at low or no cost to your family, Dr. Hollander says.

It’s a good idea for parents of children diagnosed with Asperger’s to seek counseling so they will be able to help their child learn to function, says John Carosso, PsyD, a child psychologist and certified school psychologist at Community Psychiatric Centers at the Autism Center of Pittsburgh, Pennsylvania. “It can also be helpful to get connected to a support group to help you, the parent,” he says.

Obsessive compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and social anxiety disorder (SAD) all can look similar to Asperger’s, says Eric Hollander, MD, director of the Autism and Obsessive-Compulsive Spectrum Program in the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center in New York City.

For example, a child with ADHD, due to distractibility, may display inconsistent eye contact and not be entirely responsive to directives. “So in that sense, a child with ADHD may appear similar to a child with Asperger’s but the underlying reasons for the issues are far different,” says John Carosso, PsyD, a child psychologist and certified school psychologist at Community Psychiatric Centers at the Autism Center of Pittsburgh, Pennsylvania. “So Asperger’s can be a challenging diagnosis to make.”

The milder the symptoms, the more chance that Asperger’s will be diagnosed later rather than sooner, says John Carosso, PsyD, a child psychologist and certified school psychologist at Community Psychiatric Centers at the Autism Center of Pittsburgh, Pennsylvania. “This is why you have teenagers and adults who have not been diagnosed,” he says.

Often, children with Asperger’s are very high-functioning, with good verbal skills, says Eric Hollander, MD, director of the Autism and Obsessive-Compulsive Spectrum Program in the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center in New York City. “They can be considered gifted children with great verbal skills, yet they may have a relative deficiency in the non-verbal skills area.”

If the symptoms are very mild and the concerns are addressed through treatment, your child’s symptoms may not be noticeable as they grow older and mature, says John Carosso, PsyD, a child psychologist and certified school psychologist at Community Psychiatric Centers at the Autism Center of Pittsburgh, Pennsylvania.

“As a child develops work-arounds and learns skills through social skills training, the deficits she has can be less noticeable and disruptive,” says Eric Hollander, MD, director of the Autism and Obsessive-Compulsive Spectrum Program in the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center in New York City. “Many children learn strategies that can help them, like having a note taker in school. And with these strategies and skill gains, a child can be part of mainstream education.”

The three characteristics a child with Asperger’s exhibits are social awkwardness, obsessiveness, and sensory issues, says John Carosso, PsyD, a child psychologist and certified school psychologist at Community Psychiatric Centers at the Autism Center of Pittsburgh, Pennsylvania. “They might be bossy, very physical, and lack empathy,” he says. “They may be aggressive. They want to be friendly with other children but they don’t know how.” Temper tantrums, self-injury, and aggression are other possible signs, as are language delays and the habit of avoiding eye gaze.

Look for deficits in social communication, repetitive behaviors, and rigidity, says Eric Hollander, MD, director of the Autism and Obsessive-Compulsive Spectrum Program in the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center in New York City. A child with Asperger’s may obsess over one item, always carrying it around, he says. “This also can interfere socially since this may be all the child talks about,” he says. “And they may be hypersensitive to clothing, sounds, touch, textures and smells.”

Additionally, Dr. Hollander says, because life is generally so difficult for these children, they may mishandle social situations. “These kids tend to be very emotional and are always having tantrums,” he says. “They are routine-oriented and very rule-oriented. They have the attitude: These are the rules and you stick with the rules.”