A synthesis and extension of the literature on the problems of Asperger\u27s syndrome as a distinct pervasive developmental disorder

For over 50 years, there has never been a consensus in the literature as to the diagnostic criteria for Asperger\u27s syndrome (AS). There is not even consensus as to the legitimacy of a separate category of AS as opposed to including the syndrome under autism (AU). Unfortunately, even the creation of diagnostic criteria in the DSM-IV, has not led to a general acceptance of one set of criteria nor the existence of AS as a separate developmental disorder. The end result of this situation is a field of literature that is confusing and contradictory in its conclusions concerning appropriate diagnosis criteria, etiology, prognosis, and treatment recommendations. Not surprisingly, it is very difficult for a practitioner to examine and compare the results of research studies that are based on differing criteria for diagnosis and different decision rules for placement into research categories. It is then difficult, if not impossible, to draw a clear scientifically and clinically based understanding of the diagnosis, treatment, and prognosis of a child who may have Asperger\u27s syndrome. This dissertation critically reviews both the pre- and post-DSM-IV literature concerning the prevalent views of appropriate diagnostic criteria for AS, the research trying to determine whether AS is a distinct disorder or simply a mild variant of AU, and research on treatments of choice and prognosis. In addition, I attempt to distill from the contradictory and inconsistent studies and clinical lore, a profile of AS that will be useful not only in the diagnosis and treatment of such children but also in furthering comprehensive research efforts in the identification and treatment of AS. Finally, based on the work of such prominent scholars as Meehl and Achenbach, I propose a change in methodology to repeated large population based studies using precise statistical techniques to examine the possibility of an AS taxon. Such an empirical approach would be very helpful in both moving past the present impasse in understanding and offering an empirical base for determining prognosis and appropriate treatment of those suspected of having Asperger\u27s syndrome