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Asperger Syndrome and Autism: A Comparative Longitudinal Follow-Up Study More than 5 Years after Original Diagnosis

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Abstract

Prospective follow-up study of 70 males with Asperger syndrome (AS), and 70 males with autism more than 5 years after original diagnosis. Instruments used at follow-up included overall clinical assessment, the Diagnostic Interview for Social and Communication Disorders, Wechsler Intelligence Scales, Vineland Adaptive Behavior Scales, and Global Assessment of Functioning Scale. Specific outcome criteria were used. Outcome in AS was good in 27% of cases. However, 26% had a very restricted life, with no occupation/activity and no friends. Outcome in the autism group was significantly worse. Males with AS had worse outcomes than expected given normal to high IQ. However, outcome was considerably better than for the comparison group of individuals with autism.

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Notes

  1. A number of other instruments were used, but results from these will be presented in separate papers.

  2. Folk High School, is a Swedish form of school, with different educational levels ranging from Swedish High School equivalent to post High School education in specific fields mainly to acquire specific “non-academic” skills.

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Acknowledgments

This study was supported by the Linnéa & Josef Carlsson Foundation, the Wilhelm and Martina Lundgren Foundation, the Söderström-Königska Foundation, the Swedish Autism Foundation, the Göteborg Medical Society, the Petter Silverskiöld Memorial Foundation, grants from the State under the ALF (LUA) agreement, and by a grant from the Swedish Scientific Council (MRC grant: 2003–4581) for professor Gillberg. Both studies were approved by the Medical Ethical Committee of Göteborg University.

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Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Institute of Neuroscience and Physiology, Göteborg University, Göteborg, Kungsgatan 12, 411 19, Sweden

    Mats Cederlund, Bibbi Hagberg, Eva Billstedt, I. Carina Gillberg & Christopher Gillberg

  2. Queen Silvia´s Child- and Adolescent Hospital, Otterhällegatan, 12 A, 411 18, Göteborg, Sweden

    Mats Cederlund, Bibbi Hagberg, Eva Billstedt, I. Carina Gillberg & Christopher Gillberg

Authors
  1. Mats Cederlund
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  2. Bibbi Hagberg
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  3. Eva Billstedt
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  4. I. Carina Gillberg
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  5. Christopher Gillberg
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Corresponding author

Correspondence to Mats Cederlund.

Appendices

Appendix A: Diagnostic Criteria for Asperger Syndrome

Gillberg and Gillberg (1989) diagnostic criteria elaborated (Gillberg 1991)

  1. 1.

    Social impairment (extreme egocentricity) (at least two of the following)

    1. (a)

      inability to interact with peers

    2. (b)

      lack of desire to interact with peers

    3. (c)

      lack of appreciation of social cues

    4. (d)

      socially and emotionally inappropriate behaviour.

  2. 2.

    Narrow interest (at least one of the following)

    1. (a)

      exclusion of other activities

    2. (b)

      repetitive adherence

    3. (c)

      more rote than meaning.

  3. 3.

    Repetitive routines (at least one of the following)

    1. (a)

      on self, in aspects

    2. (b)

      on others.

  4. 4.

    Speech and language peculiarities (at least three of the following)

    1. (a)

      delayed development

    2. (b)

      superficially perfect expressive language

    3. (c)

      formal pedantic language

    4. (d)

      odd prosody, peculiar voice characteristics

    5. (e)

      impairment of comprehension, including misinterpretations of literal/implied meanings.

  5. 5.

    Non-verbal communication problems (at least one of the following):

    1. (a)

      limited use of gestures

    2. (b)

      clumsy/gauche body language

    3. (c)

      limited facial expression

    4. (d)

      inappropriate expression

    5. (e)

      peculiar, stiff gaze.

  6. 6.

    Motor clumsiness

    1. (a)

      poor performance on neuro-developmental examination.

Appendix B: DSM-IV (APA, 1994) Criteria for Autistic Disorder

Qualitative impairment in social interaction, as manifested by at least two of the following:

  1. (a)

    marked impairment in the use of multiple non-verbal behaviours such as eye-to-eye gaze, facial expression, body postures, and gesture to regulate social interaction

  2. (b)

    failure to develop peer relationships appropriate for developmental level

  3. (c)

    a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by lack of showing, bringing, or pointing out objects of interests to other people)

  4. (d)

    lack of social or emotional reciprocity

Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:

  1. (a)

    encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus

  2. (b)

    apparently inflexible adherence to specific, non-functional routines or rituals.

  3. (c)

    stereotyped and repetitive motor-mannerisms (hand- or finger-flapping or twisting or complex whole-body movements)

  4. (d)

    persistent preoccupation with parts of objects

The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning:

The is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years).

There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour (other than in social interaction), and curiosity about the environment in childhood.

Criteria are not met for another Pervasive Developmental Disorder or Schizophrenia.

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Cederlund, M., Hagberg, B., Billstedt, E. et al. Asperger Syndrome and Autism: A Comparative Longitudinal Follow-Up Study More than 5 Years after Original Diagnosis. J Autism Dev Disord 38, 72–85 (2008). https://doi.org/10.1007/s10803-007-0364-6

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  • DOI: https://doi.org/10.1007/s10803-007-0364-6

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