Skip to main content
SpringerLink
Log in

Categorical and Dimensional Structure of Autism Spectrum Disorders: The Nosologic Validity of Asperger Syndrome

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

There is an ongoing debate whether a differentiation of autistic subtypes, especially between Asperger Syndrome (AS) and high-functioning-autism (HFA) is possible and if so, whether it is a categorical or dimensional one. The aim of this study was to examine the possible clustering of responses in different symptom domains without making any assumption concerning diagnostic appreciation. About 140 children and adolescents, incorporating 52 with a diagnosis of AS, 44 with HFA, 8 with atypical autism and 36 with other diagnoses, were examined. Our study does not support the thesis that autistic disorders are discrete phenotypes. On the contrary, it provides evidence that e.g. AS and autism are not qualitatively distinct disorders, but rather different quantitative manifestations of the same disorder.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Anderson, G. M. (2008). The potential role for emergence in autism. Autism Research, 1, 18–30.

    Article  PubMed  Google Scholar 

  • Asperger, H. (1944). Die „autistischen Psychopathen“im Kindesalter. Archiv für Psychiatrie und Nervenkrankheiten, 117, 76–136.

    Article  Google Scholar 

  • Baird, G., Simonoff, E., Pickles, A., Chandler, S., Loucas, T., Meldrum, D., et al. (2006). Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: The special needs and autism project (SNAP). Lancet, 368, 210–215.

    Article  PubMed  Google Scholar 

  • Baron-Cohen, S., Scott, F. J., Allison, C., Williams, J., Bolton, P., Matthews, F. E., et al. (2009). Prevalence of autism-spectrum conditions: UK school-based population study. British Journal of Psychiatry, 194, 500–509.

    Article  PubMed  Google Scholar 

  • Bennett, T., Szatmari, P., Bryson, S., Volden, J., Zwaigenbaum, L., Vaccarella, L., et al. (2008). Differentiating autism and asperger syndrome on the basis of language delay or impairment. Journal of Autism and Developmental Disorder, 38, 616–625.

    Article  Google Scholar 

  • Bölte, S., Rühl, D., Schmötzer, G., & Poustka, F. (2006). ADI-R diagnostisches interview für autismus—revidiert. Bern: Huber.

    Google Scholar 

  • Carter, A. S., Volkmar, F. R., & Sparrow, S. S. (1998). The vineland adaptive behavior scales: Supplementary norms for individuals with autism. Journal of Autism and Developmental Disorders, 28, 287–302.

    Article  PubMed  Google Scholar 

  • Constantino, J. N., Lajonchere, C., Lutz, M., Gray, T., Abbacchi, A., McKenna, K., et al. (2006). Autistic social impairment in the siblings of children with pervasive developmental disorders. American Journal of Psychiatry, 163, 294–296.

    Article  PubMed  Google Scholar 

  • Constantino, J. N., & Todd, R. D. (2003). Autistic traits in the general population: A twin study. Archives of General Psychiatry, 60, 524–530.

    Article  PubMed  Google Scholar 

  • Dawson, G., Webb, S., Schellenberg, G. D., Dager, S., Friedman, S., Aylward, E., et al. (2002). Defining the broader phenotype of autism: Genetic, brain, and behavioral perspective. Development and Psychopathology, 14, 581–611.

    Article  PubMed  Google Scholar 

  • Fimm, B., & Zimmermann, P. (2002). Testbatterie zur Aufmerksamkeitsprüfung (TAP) (Version 1.7). Herzogenrath : Psytest.

  • Fombonne, E. (2009). Epidemiology of pervasive developmental disorders. Paediatric Research, 65, 591–598.

    Article  Google Scholar 

  • Frith, U. (2004). Emmanuel miller lecture: Confusions and controversies about asperger syndrome. Journal of Child Psychology and Psychiatry, 45, 672–686.

    Article  PubMed  Google Scholar 

  • Gadow, K. D., DeVincent, C. J., Pomeroy, J., & Azizian, A. (2004). Psychiatric symptoms in preschool children with PDD and clinic and comparison samples. Journal of Autism and Developmental Disorders, 34, 379–393.

    Article  PubMed  Google Scholar 

  • Gadow, K. D., DeVincent, C. J., Pomeroy, J., & Azizian, A. (2005). Comparison of DSM-IV symptoms in elementary school-aged children with PDD versus clinic and community samples. Autism, 9, 392–415.

    Article  PubMed  Google Scholar 

  • Georgiades, S., Szatmari, P., Zwaigenbaum, L., Duku, E., Bryson, S., Roberts, W., et al. (2007). Structure of the autism symptom phenotype: A proposed multidimensional model. Journal of the American Academy of Child and Adolescent Psychiatry, 46(2), 188–196.

    Article  PubMed  Google Scholar 

  • Gillberg, C. (1998). Asperger syndrome and high-functioning autism. British Journal of Psychiatry, 172, 200–209.

    Article  PubMed  Google Scholar 

  • Gillberg, C., Gillberg, I. C., Rastam, M., & Wentz, E. (2001). The asperger syndrome (and high-functioning autism) diagnostic interview (ASDI): A preliminary study of a new structured clinical interview. Autism, 5, 57–66.

    Article  PubMed  Google Scholar 

  • Howlin, P. (2000). Outcome in adult life for more able individuals with autism or Asperger syndrome. Autism, 4, 63–83.

    Article  Google Scholar 

  • Howlin, P. (2003). Outcome in high-functioning adults with autism with and without early language delays: Implication for the differentiation between autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 33, 3–13.

    Article  PubMed  Google Scholar 

  • Kamp-Becker, I., Ghahreman, M., Smidt, J., & Remschmidt, H. (2009). Dimensional structure of the autism phenotype: Relations between early development and current presentation. Journal of Autism and Developmental Disorder, 39, 557–571.

    Article  Google Scholar 

  • Klin, A., & Jones, W. (2006). Attributing social and physical meaning to ambiguous visual displays in individuals with higher-functioning autism spectrum disorders. Brain and Cognition, 61(1), 40–53.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Klin, A., Saulnier, C. A., Sparrow, S. S., Cicchetti, D. V., Volkmar, F., & Lord, C. (2007). Social and communication abilities and disabilities in higher functioning individuals with autism spectrum disorders: The vineland and the ADOS. Journal of Autism and Developmental Disorders, 37, 748–759.

    Article  PubMed  Google Scholar 

  • Klin, A., Volkmar, F. R., & Sparrow, S. S. (2000). Introduction. In A. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome (pp. 1–21). New York: Guilford Press.

    Google Scholar 

  • Klin, A., Volkmar, F. R., Sparrow, S. S., Cicchetti, D. V., & Rourke, B. P. (1995). Validity and neuropsychological characterization of Asperger syndrome. Journal of Child-Psychology and Psychiatry, 36, 1127–1140.

    Article  PubMed  Google Scholar 

  • Kopra, K., von Wendt, L., Nieminen-von Wendt, T., & Paavonen, E. J. (2008). Comparison of diagnostic methods for asperger syndrome. Journal of Autism and Developmental Disorder, 38, 1567–1573.

    Article  Google Scholar 

  • Krueger, R. T., & Bezdjian, S. (2009). Enhancing research and treatment of mental disorders with dimensional concepts: Toward DSM-V and ICD-11. World Psychiatry, 8, 3–6.

    PubMed  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B., DiLavore, P. C., et al. (2000). The ADOS-G (autism diagnostic oberservation schedule-generic): A standard measure of social-communication deficits associated with autism spectrum disorders. Journal of Autism and Developmental Disorders, 30, 205–223.

    Article  PubMed  Google Scholar 

  • Lotspeich, L. J., Kwon, H., Schumann, C. M., Fryer, S. L., Goodlin-Jones, B. L., Buonocore, M. H., et al. (2004). Investigation of neuroanatomical differences between autism and Asperger syndrome. Archives of General Psychiatry, 61, 291–298.

    Article  PubMed  Google Scholar 

  • 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 Psychology and Psychiatry, 45, 421–434.

    Article  PubMed  Google Scholar 

  • Mayes, S. D., Calhoun, S. L., & Crites, D. L. (2001). Does DSM-IV Asperger’s disorder exist? Journal of Abnormal Child Psychology, 29, 263–271.

    Article  PubMed  Google Scholar 

  • McAlonan, G., Suckling, J., Wong, N., Cheung, V., Lienenkaemper, N., Cheung, C., et al. (2008). Distinct patterns of grey matter abnormality in high-functioning autism and Asperger’s syndrome. Journal of Child Psychology and Psychiatry, 49(12), 1287–1295.

    Article  PubMed  Google Scholar 

  • Ozonoff, S., Rogers, S. J., & Pennington, B. F. (1991). Asperger’s syndrome: Evidence of an empirical distinction form high-functioning autism. Journal of Child Psychology and Psychiatry, 32, 1107–1122.

    Article  PubMed  Google Scholar 

  • Posserud, M. B., Lundervold, A. J., & Gillberg, C. (2006). Autistic features in a total population of 7–9-year-old children assessed by the ASSQ (Autism Spectrum Screening Questionnaire). Journal of Child Psychology and Psychiatry and Allied Disciplines, 47, 167–175.

    Article  Google Scholar 

  • Prior, M., Eisenmajer, R., Leekam, S., Wing, L., Gould, J., Ong, B., et al. (1998). Are there subgroups within the autistic spectrum? A cluster analysis of a group of children with autistic spectrum disorders. Journal of Child Psychology and Psychiatry, 39, 893–902.

    Article  PubMed  Google Scholar 

  • Ring, H., Woodbury-Smith, M., Watson, P., Wheelwright, S., & Baron-Cohen, S. (2008). Clinical hetereogeneity among people with high functioning autism spectrum conditions: Evidence favouring a continuous severity gradient. Behavioural and Brain Functions, 4, 11.

    Article  Google Scholar 

  • Rühl, D., Bölte, S., Feineis-Mathews, S., & Poustka, F. (2004). Diagnostische Beobachtungsskala für Autistische Störungen. Bern: Huber.

    Google Scholar 

  • Rutter, M., Le Couteur, A., & Lord, C. (2003). Autism diagnostic interview-revised (ADI-R). Los Angeles: Western Psychological Services.

    Google Scholar 

  • Sanders, J. L. (2009). Qualitative or quantitative differences between Asperger′s disorder and autism? Historical considerations. Journal of Autism and Developmental Disorders, publishes online, June 2009.

  • Saulnier, C. A., & Klin, A. (2007). Brief report: Social and communication abilities and disabilities in higher functioning individuals with autism and asperger syndrome. Journal of Autism and Developmental Disorders, 37, 788–793.

    Article  PubMed  Google Scholar 

  • Skuse, D. H., Mandy, W., Steer, C., Miller, L., Goodman, R., Lawrence, K., et al. (2009). Social communication competence and functional adaptation in a general population of children: Preliminary evidence for sex-by-verbal IQ differential risk. Journal of the American Academy of Child and Adolescent Psychiatry, 48, 128–137.

    Article  PubMed  Google Scholar 

  • Sparrow, S., Balla, D., & Cicchetti, D. (1984). Vineland adaptive behavior scales (survey form). Circle Pines, MN: American Guidance Service.

    Google Scholar 

  • Szatmari, P. (2000). Perspectives on the classification of Asperger syndrome. In A. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome (pp. 403–417). New York: Guilford Press.

    Google Scholar 

  • Szatmari, P., Bartolucci, G., & Bremmer, R. (1989). Asperger’s syndrome and autism: Comparision of early history and outcome. Developmental Medicine and Child Neurology, 31, 709–720.

    Article  PubMed  Google Scholar 

  • Szatmari, P., Bryson, S. E., Streiner, D. L., Wilson, F., Archer, L., & Ryerse, C. (2000). Two-year outcome of preschool children with autism of Asperger’s disorder. American Journal of Psychiatry, 157, 1980–1987.

    Article  PubMed  Google Scholar 

  • Tewes, U. (1993). Hamburg-Wechsler-Intelligenztest für Erwachsene-Revision. Göttingen: Hogrefe.

  • Tewes, U., Rossmann, R., Schallberger, R. (Eds.) (1999). Hamburg-Wechsler-Intelligenztest für Kinder. Dritte Auflage. Bern: Huber.

  • Tonge, B. J., Brereton, A. V., Gray, K. M., & Einfeld, S. L. (1999). Behavioural and emotional disturbance in high-functioning autism and Asperger syndrome. Autism, 3, 117–130.

    Article  Google Scholar 

  • Virkud, Y. V., Todd, R. D., Abbacchi, A. M., Zhang, Y., & Constantino, J. N. (2009). Familial aggregation of quantitative autistic traits in multiplex versus simplex autism. American Journal of Medical Genetics, 150B, 328–334.

    Article  PubMed  Google Scholar 

  • Volkmar, F. R., & Klin, A. (2000). Diagnostic issues in asperger syndrome. In A. Klin, F. R. Volkmar, & S. S. Sparrow (Eds.), Asperger syndrome. New York: The Guilford Press.

    Google Scholar 

  • Volkmar, F. R., & Klin, A. (2005). Issues in the classification of autism and related conditions. In F. R. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (pp. 5–41). New York, NY: Wiley & Sons.

    Google Scholar 

  • Volkmar, F. R., State, M., & Klin, A. (2009). Autism and autism spectrum disorders: Diagnostic issues for the coming decade. Journal of Child Psychology and Psychiatry, 50, 108–115.

    Article  PubMed  Google Scholar 

  • Weisbrot, D. M., Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2005). The presentation of anxiety in children with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 15, 477–496.

    Article  PubMed  Google Scholar 

  • Witwer, A. N., & Lecavalier, L. (2008). Examining the vailidy of autism spectrum disorder subtypes. Journal of Autism and Developmental Disorders, 38, 1611–1624.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Dr. Becker is/has been involved in research/clinical trials with Eli Lilly and Shire, is on the advisory board of Eli Lilly/Germany, was on the speakers’ bureaus of Eli Lilly and Astra Zeneca and received conference attendance support from Shire and Eli Lilly. There is no conflict of interest for all other authors.

Author information

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry and Psychotherapy, Philipps-University Marburg, Hans-Sachs-Strasse 6, 35033, Marburg, Germany

    Inge Kamp-Becker, Judith Smidt, Mardjan Ghahreman, Monika Heinzel-Gutenbrunner, Katja Becker & Helmut Remschmidt

Authors
  1. Inge Kamp-Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Judith Smidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mardjan Ghahreman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Monika Heinzel-Gutenbrunner
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Katja Becker
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Helmut Remschmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Inge Kamp-Becker.

Appendix

Appendix

Neuropsychological Testing: For intellectual testing the German versions of the Wechsler Intelligence Scales were used (WISC-III; Tewes et al. 1999; WAIS-R; Tewes 1993). The emotion recognition was tested by a “facial emotion matching test” (candit.com: Facial Emotion Matching, parameters = number of correct answers, reaction time and detail mistakes (the false answer was made due to a detail like mouth or eyes)). Theory of Mind testing included the “Social Attribution Test” (Klin and Jones 2006, parameter = number of correct answers). Spatial perception was measured by a mental rotation test (candit.com: mental rotation, parameters = number of correct answers, reaction time). Executive functioning was tested by a test for cognitive flexibility (Wisconsin Card Sorting Test, parameter = perseveration score) and planning abilities (Tower of London test, parameters = amount of steps and reaction time). An attention test for divided attention (Fimm and Zimmermann 2002, dual task for visual and acoustic signals, parameters = mistakes, omissions, reaction time for visual and acoustic signals) was also undertaken.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kamp-Becker, I., Smidt, J., Ghahreman, M. et al. Categorical and Dimensional Structure of Autism Spectrum Disorders: The Nosologic Validity of Asperger Syndrome. J Autism Dev Disord 40, 921–929 (2010). https://doi.org/10.1007/s10803-010-0939-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-010-0939-5

Keywords

Search

Navigation