The adequacy of diagnostic criteria for Asperger's syndrome (AS) has been debated, and many in the field do not believe that AS warrants a discrete subgrouping, considering AS to differ from classic autism (AU) in more quantitative ways, while others have found evidence of qualitative distinctions supporting subgrouping within autism spectrum disorders. Differentiating AS from AU under the Diagnostic and Statistical Manual, 4th edition (DSM–IV; American Psychiatric Association [APA], 1994) and text revision (DSM–IV–TR; APA, 2000) guidelines has been challenging, given the overlap in criteria and hierarchical rules favoring AU if AS criteria is also met. The diagnostic difficulty is particularly acute in autism cases where cognitive development is normal ranged, commonly referred to as high functioning autism (HFA). Many clinicians and researchers have devised their own strategies for differentiating HFA from AS, relying on factors beyond the DSM–IV criteria thus creating further confusion. As the DSM–V proposed criteria abandons the subgrouping concept in favor of a single grouping of autism spectrum disorder with a continuum of severity, the validity of the AS diagnosis has been challenged. The current study seeks to follow others that have sought to better understand the factors beyond the DSM system that clinicians rely on to make a differential diagnosis in the autism spectrum under the DSM–IV. Neuroimaging studies have found differences in both brain function and grey and white matter differences between AS and HFA. There is also support for cognitive profile distinctions that correspond to the white matter model predictions of lower verbal intelligence for HFA and the reverse for AS. These findings suggest that it may be possible to infer these possible brain distinctions by examination of differences in cognitive profile patterns based upon Wechsler Intelligence Scale (Wechsler, 2003) verbal and performance differences. The present study explored this factor in clinician diagnostic opinion making through use of an experimental design using embedded manipulation of factors within a hypothetical case vignette presented in an e-mail survey format to experienced psychologists. Cognitive profile pattern did not make a significant difference in clinician's diagnosis in this study.
|Commitee:||Fossum, Thya A., Sarnoff, David|
|Department:||Harold Abel School of Social and Behavioral Sciences|
|School Location:||United States -- Minnesota|
|Source:||DAI-B 74/04(E), Dissertation Abstracts International|
|Subjects:||Educational psychology, Clinical psychology, Cognitive psychology|
|Keywords:||Asperger's syndrome, Autism, Cognitive profile, Diagnosis, Dsm-iv|
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