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

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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.

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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.

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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.

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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

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