Help understanding diagnosis criteria - examples

[ThomasL]

I'm almost positive I have Asperger's or a some similar disorder, but I'm confused about the following diagnostic criteria:

 

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

 

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

 

* apparently inflexible adherence to specific, nonfunctional routines or rituals

 

I was hoping some of you would be kind enough to provide some clarification and/or examples (either from your own life or other people with AS, or just in general).

[Tally]

Hi Thomas, and welcome to the forum.

 

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

This is basically a really complicated way of saying you have a "special interest" or obsession that is more intense than normal people's hobbies. For example, a person who likes cats might enjoy spending time with their cat and sometimes mention their cat in conversation. Whereas a person with a special interest in cats might talk about them all the time, spend a fortune on books about cats, and have difficulty making conversation on other topics

 

It's a difficult one, because many people who become leading experts in their field have an all-encompassing interest. Not all of them have Asperger's! But it certainly seems to be something that is almost universal in Asperger's.

 

apparently inflexible adherence to specific, nonfunctional routines or rituals

This is the OCD-type symptoms that many people with Asperger's have. For example, most people take the same route when they go to the shops, because they know it is the quickest route. If there was a road closure, it could be quite annoying if you had to take a longer route. A person with Asperger's though, might get very upset and struggle to cope with needing to take a different route. They might struggle to calm down, look at a map, and select the second best route.

[coolblue]

Both these characteristics can be the result of difficulties with switching the focus of attention, rather than an active preference for a particular activity.

 

All the diagnostic criteria for autistic spectrum disorders are related to frontal lobe function, which is why the 'executive function' model was suggested. Having difficulty changing the focus of attention, or finding having to do it irritating or distressing, rather than feeling passionate about growing chrysanthemums or rock-climbing, or whatever, would be the thing to look for.

 

cb

[justine1]

Hi Thomas, and welcome to the forum.

 

 

This is basically a really complicated way of saying you have a "special interest" or obsession that is more intense than normal people's hobbies. For example, a person who likes cats might enjoy spending time with their cat and sometimes mention their cat in conversation. Whereas a person with a special interest in cats might talk about them all the time, spend a fortune on books about cats, and have difficulty making conversation on other topics

 

It's a difficult one, because many people who become leading experts in their field have an all-encompassing interest. Not all of them have Asperger's! But it certainly seems to be something that is almost universal in Asperger's.

 

 

This is the OCD-type symptoms that many people with Asperger's have. For example, most people take the same route when they go to the shops, because they know it is the quickest route. If there was a road closure, it could be quite annoying if you had to take a longer route. A person with Asperger's though, might get very upset and struggle to cope with needing to take a different route. They might struggle to calm down, look at a map, and select the second best route.

Tally sums it up perfectly My son has an obsession with spongebob,I know lots of kids the same age who also like spongbob however my son is able to remember word for word what each charactor is going to say for every single episode.He has clothes,games,bag,lunchbox and his whole room is decorated with spongebob.

 

He also has an obsession with an online game called superbrawl he can do all the sound effects and acts it out repititevly,he even starts from scratch when he has made an error.The movements are almost like rocking back and forth, the whole thing can be very distracting and annoying to others, for us its "normal" part of our day.

[ThomasL]

Thanks guys, for the replies and for the kind welcome.

 

Do you know if these criteria primarily apply to children, and are not necessarily so apparent in adults with Asperger's?

 

Also, are these same criteria necessary for similar conditions, such as HFA, PDD-NOS, etc.?

 

Finally, is it possible (or even common) to have such symptoms and not be aware of them, even when trying to think of some? That would make sense to me, but I'm not entirely sure...

 

The thing is, EVERY other criteria and characteristic seems to fit perfectly - I'm even an INTP, and an atheist/agnostic (not quite sure which), etc., which I'm delighted to see are common among people with Asperger's... finally a group of like-minded people!

 

Actually, I'm pretty sure I have "special interests" (certain academic subject areas that I have a long-standing interest in); I'm just not so sure about the "nonfunctional routines or rituals". Would bruxism (the habitual, purposeless clenching and grinding of the teeth, esp. unconsciously and during sleep) qualify as a nonfunctional routine or ritual?

[coolblue]

Hi Thomas

 

There used to be a full list of criteria for developmental disorders online, but it's vanished. This was the best I could find:

 

http://www.psychologynet.org/dsm.html

 

It's important to remember that what the Diagnostic and Statistical Manual of Mental Disorders does is to group patients according to their symptoms and give each group a label. The diagnostic criteria listed do not lead to a diagnosis in the sense that measles is a diagnosis, where we can identify the exact cause of the symptoms. It's the equivalent of describing all once-common childhood illnesses as 'childhood rash disease' and lumping together measles, german measles, chicken pox etc. under the same umbrella heading because they all involve a fever, a sore throat and a rash.

 

It could be that some people meet the criteria for Asperger syndrome because they have one underlying factor in their brain development that has caused their symptoms, or because several different factors have happened to coincide to produce a similar range of behaviours. Some people could have exactly the same brain development issue or coinciding factors and not get a diagnosis of AS because these factors did not lead to a *significant* impairment of social interaction or communication or, as possibly in your case, to noticeable restricted or repetitive behaviours.

 

It's also important to remember that the impairments listed in the diagnostic criteria apply to the entire population; everybody has some impairment in social interaction, communication or repetitive behaviour. We're talking about a 'diagnosis' that is essentially deciding whether or not someone falls within the normal range in terms of behaviour, which is pretty subjective. Because the definitions of the diagnostic criteria are so broad, there's plenty of scope for differences of opinion about whether any given individual falls into one category or another. So I wouldn't set too much store by the finer points.

 

If you feel having a diagnosis might be helpful, then find out about getting a diagnosis; otherwise, see yourself as one of the wide variety of unique individuals that make up the human race.

[justine1]

Thanks guys, for the replies and for the kind welcome.

 

Do you know if these criteria primarily apply to children, and are not necessarily so apparent in adults with Asperger's?

 

Also, are these same criteria necessary for similar conditions, such as HFA, PDD-NOS, etc.?

 

Finally, is it possible (or even common) to have such symptoms and not be aware of them, even when trying to think of some? That would make sense to me, but I'm not entirely sure...

 

The thing is, EVERY other criteria and characteristic seems to fit perfectly - I'm even an INTP, and an atheist/agnostic (not quite sure which), etc., which I'm delighted to see are common among people with Asperger's... finally a group of like-minded people!

 

Actually, I'm pretty sure I have "special interests" (certain academic subject areas that I have a long-standing interest in); I'm just not so sure about the "nonfunctional routines or rituals". Would bruxism (the habitual, purposeless clenching and grinding of the teeth, esp. unconsciously and during sleep) qualify as a nonfunctional routine or ritual?

Hi

The diagnostic criteria remains the same when diagnosing children and adults.The difference is that adults who are not diagnosed through childhood

are more likely to copy what others around them are doing so as to "fit in." Certain behaviours are frowned upon by society and so if a child is told not to do X they will eventually cease to do it.For my son his rocking and noises he makes are comparable to when someone needs to burp or when someone has hiccups, he can try his best to control it but it will eventually come out.

 

However there will always be noticeble differences between an adult NT and adult ASD person, its true you may not see them yourself others close to you may point things out and a professional qualified to diagnosis ASD's will be able to pick up on all the signs.

If you have family members who can recall more about your childhood that should help you more,you could show them the diagnostic criteria and maybe make notes about things they recall and compare to what other people are experiencing with their ASD kids, though bearing in mind everyone is different NT or ASD.

 

I have no ASD but I grind my teeth something terrible, more so when I am stressed/anxious.

[trekster]

Thanks guys, for the replies and for the kind welcome.

 

Do you know if these criteria primarily apply to children, and are not necessarily so apparent in adults with Asperger's?

 

Also, are these same criteria necessary for similar conditions, such as HFA, PDD-NOS, etc.?

 

This criterion can be applied to children or adults. The AQ test is a questionnaire designed to point out the possibility of some

autistic spectrum disorder.

 

PDD-NOS has been used in 2 different ways, 1st before the Asperger criterion was well known, and 2nd it means

"we know you are on the spectrum somewhere but we cant decide where". It could be in the same category as "autistic traits".

i think the autistic disorder criterion are slightly different to the Asperger criterion. If you can speak then probably

the asperger criterion would be used to assess you.

 

Finally, is it possible (or even common) to have such symptoms and not be aware of them, even when trying to think of some? That would make sense to me, but I'm not entirely sure...

 

Yes if you aren't aware that others dont have the symptoms you have, hard to define them under a name such as Aspergers.

Especially since you cannot tell by looking at someone that they have aspergers (unless you know what to look for).

 

The thing is, EVERY other criteria and characteristic seems to fit perfectly - I'm even an INTP, and an atheist/agnostic (not quite sure which), etc., which I'm delighted to see are common among people with Asperger's... finally a group of like-minded people!

 

Actually, I'm pretty sure I have "special interests" (certain academic subject areas that I have a long-standing interest in); I'm just not so sure about the "non-functional routines or rituals". Would bruxism (the habitual, purposeless clenching and grinding of the teeth, esp. unconsciously and during sleep) qualify as a non-functional routine or ritual?

 

If bruxism was a repetitive routine that served no purpose *to someone else* then yes. The problem with calling it a "non-functional routine" is that it isnt clear to literally minded folk that it means "non-functional to the autistic/asperger".

[Tally]

Would bruxism (the habitual, purposeless clenching and grinding of the teeth, esp. unconsciously and during sleep) qualify as a nonfunctional routine or ritual?

Not if you are doing in unconsciously, no. The routines and rituals are things you consciously choose to do. There may be a very strong compulsion, but it's something you physically could stop yourself from doing and are aware of doing. It could be things like feeling like you need to store your clothing separately by colour - not just because it makes it easier to find things, but because you feel uncomfortable if they are out of place. It could also include things like flicking light switches several times before it feels right, or checking things a lot.

 

They may serve a purpose in terms of helping to control anxiety, but they can also get in the way of day to day activities. For example, if you need to check you have locked the door a lot of times, it might make you late to appointments.