Journal of Autism and Developmental Disorders

, Volume 38, Issue 4, pp 616–625

Differentiating Autism and Asperger Syndrome on the Basis of Language Delay or Impairment

  • Terry Bennett
  • Peter Szatmari
  • Susan Bryson
  • Joanne Volden
  • Lonnie Zwaigenbaum
  • Liezanne Vaccarella
  • Eric Duku
  • Michael Boyle
Original Paper

Abstract

Asperger syndrome (AS) is differentiated from high-functioning autism (HFA) largely on a history of “language delay.” This study examined “specific language impairment” as a predictor of outcome. Language skills of 19 children with AS and 45 with HFA were assessed at 4–6 years of age (Time 1) and 2 years later (Time 2). Children’s symptoms and functional outcome scores were assessed every 2 years (Times 3, 4, and 5) until ages 15–17 years old. Regression analysis revealed that specific language impairment at time 2 more often accounted for the greatest variation in outcome scores in adolescence than the standard diagnosis of AS versus HFA based on history of language delay. Diagnostic implications are discussed.

Keywords

Autism Asperger syndrome Language impairment Outcomes 

References

  1. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders DSM-IV text revision (4th ed.). Washington DC: American Psychiatric Association.Google Scholar
  2. Chapman, R. S. (2000). Children’s language learning: An interactionist perspective. Journal of Child Psychology and Psychiatry, 41, 33–54.PubMedCrossRefGoogle Scholar
  3. Cook, R. J. (1987). PC-AGREE—Fortran program based on paper by Holman CDJ:Hamilton, ON.Google Scholar
  4. Fenson, L., Dale, P. S., Reznick, J. S., Bates, E., Thal, D. J., & Pethick, S. (1994). Variability in early communicative development. Monographs of the Society of Research in Child Development, 59, 1–173.Google Scholar
  5. Frith, U. (2004). Emmanuel Miller lecture: Confusions and controversies about Asperger syndrome. Journal of Child Psychology and Psychiatry, 45, 672–686.PubMedCrossRefGoogle Scholar
  6. Howlin, P. (2003). Outcome in high-functioning adults with autism with and without early language delays: Implications for the differentiation between autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 33, 3–13.PubMedCrossRefGoogle Scholar
  7. Karmiloff, K., & Karmiloff-Smith, A. (2001). Pathways to language from fetus to adolescent. Cambridge, Massachusetts and London, England: Harvard University Press.Google Scholar
  8. Kjelgaard, M. M., Tager-Flusberg, G. (2001). An investigation of language impairment in autism: Implications for genetic subgroups. Language and Cognitive Processes, 16, 287–308.PubMedCrossRefGoogle Scholar
  9. Klin, A., Pauls, D., Schultz, R., & Volkmar, F. (2005). Three diagnostic approaches to Asperger Syndrome: Implications for research. Journal of Autism and Developmental Disorders, 35, 221–234.PubMedCrossRefGoogle Scholar
  10. Krug, D. A., Arik, J. L., & Almond, P. (1980). Behavior checklist for identifying severely handicapped individuals with high levels of autistic behaviour. Journal of Child Psychology and Psychiatry, 21, 221–229.PubMedCrossRefGoogle Scholar
  11. Leung, A. K. C., & Kao, C. P. (1999). Evaluation and management of the child with speech delay. American Family Physician, 59, 3121–3128.PubMedGoogle Scholar
  12. Levine, M. N. (1986). Arthur adaptation of the Leiter international performance scale: A handbook. Montreal, QC: Institute of Psychological Research.Google Scholar
  13. Liss, M., Fein, D., Waterhouse, L., Allen, D., Dunn, M., Morris, R., & Rapin, I. (2001). Executive functioning in high-functioning children with autism. Journal of Child Psychology and Psychiatry, 42, 261–270.PubMedCrossRefGoogle Scholar
  14. Lord, C., Rutter, M., & LeCouteur, A. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685.PubMedCrossRefGoogle Scholar
  15. Macintosh, K. E., & Dissanayake, C. (2004). Annotation: The similarities and differences between autistic disorder and Asperger’s disorder: A review of the empirical evidence. Journal of Child Pscyhology and Psychiatry, 45, 421–434.CrossRefGoogle Scholar
  16. Mahler, M. S., & Furer, M. (1972). Child psychosis: A theoretical statement and its implications. Journal of Autism and Childhood Schizophrenia, 2, 213–218.PubMedCrossRefGoogle Scholar
  17. Majenemer, A., & Rosenblatt, B. (1994). Reliability of parental recall of developmental milestones. Pediatric Neurology, 10, 304–308.CrossRefGoogle Scholar
  18. McCormick, M. C., & Brooks-Gunn, J. (1999). Concurrent health status and maternal recall of events in infancy. Pediatrics, 104, 1176–1181.PubMedGoogle Scholar
  19. Nagy, J., & Szatmari, P. (1986). A chart review of schizotypal personality disorders in children. Journal of Autism and Developmental Disorders, 16, 351–367.PubMedCrossRefGoogle Scholar
  20. Newcomer, P. L., & Hammill, D. D. (1988). Testof Language Development-2. Toronto: Psycan.Google Scholar
  21. Schopler, E. (1996). Are autism and Asperger syndrome (AS) different labels or different disabilities?. Journal of Autism and Developmental Disorders, 26, 109–110.PubMedCrossRefGoogle Scholar
  22. Sparrow, S. S., Balla, D. D., & Chichetti, D. V. (1984). Vineland adaptive behavior scales (Survey Form). Circle Pines, MN: American Guidance Service.Google Scholar
  23. SPSS Inc. (2004). SPSS for Windows, Release 13.0.1. Chicago, IL.Google Scholar
  24. Ssucharewa, G. E., & Wolff, S. (1996). The first account of the syndrome Asperger described? Translation of a paper entitled “Die schizoiden Psychopathien im Kindesalter” by Dr. G. E. Swsucharewa; scientific assistant, which appeared in 1926 in the Monatsschrift fur Psychiatrie und Neurologie 60:235–261 European Child and Adolescent Psychiatry 5:119–132.Google Scholar
  25. Stein, M. T., Klin, A., & Miller, K. (2004). When Asperger’s syndrome and a nonverbal learning disability look alike. Journal of Developmental and Behavioral Pediatrics, 25, 58–64.CrossRefGoogle Scholar
  26. Szatmari, P., Bryson, S. E., Streiner, D. L., Wilson, F. J., Archer, L., & Ryerse, C. (2000). Two-year outcome of preschool children with autism or Asperger’s syndrome. American Journal of Psychiatry, 1576, 1980–1987.CrossRefGoogle Scholar
  27. Szatmari, P. (2000). The classification of autism, Asperger’s syndrome and pervasive developmental disorder. Canadian Journal of Psychiatry, 45, 731–738.Google Scholar
  28. Tager-Flusberg, H. (2004). Strategies for conducting research on language in autism. Journal of Autism and Developmental Disorders, 34, 75–80.PubMedCrossRefGoogle Scholar
  29. Thorndike, R. L., Hagn, E. P., & Sutter, J. M. (1985). Stanford-Binet Intelligence Scale (4th ed.). Chicago: Riverside.Google Scholar
  30. Toppelberg, C. O., & Shapiro, T. (2000). Language disorders: A 10-year research update review. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 143–152.PubMedCrossRefGoogle Scholar
  31. Volkmar, F. R., Cicchetti, D. V., Dykens, D., Sparrow, S. S., Leckman, J. F., & Cohen, D. J. (1988). An evaluation of the Autism Behavior Checklist. Journal of Autism and Developmental Disorders, 18, 81–98.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Terry Bennett
    • 1
  • Peter Szatmari
    • 1
    • 2
  • Susan Bryson
    • 3
  • Joanne Volden
    • 4
  • Lonnie Zwaigenbaum
    • 5
  • Liezanne Vaccarella
    • 1
  • Eric Duku
    • 1
  • Michael Boyle
    • 1
  1. 1.Department of Psychiatry and Behavioural NeurosciencesMcMaster UniversityHamiltonCanada
  2. 2.Offord Centre for Child StudiesHamiltonCanada
  3. 3.Department of Psychiatry, IWK Health CentreDalhousie UniversityHalifaxCanada
  4. 4.Speech Pathology and AudiologyUniversity of AlbertaEdmontonCanada
  5. 5.Department of PediatricsUniversity of AlbertaEdmontonCanada

Personalised recommendations