“After learning hearing so much about the chat rooms, my space, FaceBook and other sites kids frequent today I became concerned with my child on the computer for hours at a time. Purchasing PC Tattletale put my mind at ease. I now know who my child chats with, what they say and of course the web sites he visits.”
“Although I have good kids, I know they are susceptible to influences from others and sometimes don't use good judgment in what the post on the internet. This way I can keep an eye on everything to make sure they are safe and not getting involved in anything questionable.”
‘As a parent it is our responsibility to teach our kids about internet safety. But, I do also understand that some kids don't realize the true consequences of the harm that can happen when they talk to strangers or view harmful material online. By using this monitoring software I am able to see if my kids are at risk to any predators online. I looked into several other programs and so far PC Tattletale has the best features.”
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‘As moms and dads we have the right to know exactly what our kids are doing on the internet. It's nothing different than getting to know their friends and find out what they are doing. The internet is great but also can be very dangerous, and PC Tattletale has helped me understand my child's way of thinking and also be on the watch out mode for friends that I don't want her hanging out with.”
“Being a single mother, it gives me an extra set of eyes to protect my kids. I know there are a lot of moms and dads that would be surprised what their kids are doing. I was and I'm glad I was able to put a stop to it by using PC Tattletale.”
‘I always wanted to know what my child did online - but I felt it was an invasion of his space. But after a Dr. Phil show where he said I had an obligation to know so I bought the program and boy am I glad I did!’
“I am one of the computer experts in my Church and I have received many inquiries regarding how to monitor child activities. I did some research and selected your product because it looked like it would do what others in my Church are looking for. It does and I am now recommending it to others. I also am considering holding some educational sessions to help them install and use your software effectively. The screen captures feature has given me great insight into usage of the family PC. We home school and this feature has helped us to discover and correct times when some of our kids were "playing games" during school time instead of actively doing their school work.”
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“I believe even the most trusted teenager needs to be monitored. A mother should always be one step ahead of their child/kids. It makes it a lot easy to tackle a situation, than a problem.”
“I believe in the adage "trust, yet verify" and that is exactly what this software allows me to do. I feel better knowing that as of yet my childs relationships with older teens are above board. They are not trying to persuade her to do things that I feel are inappropriate. I know that if an inappropriate situation should arise, I will be able to protect my child from her own naivety.”
“I bought the program, for the concern of my grandchilds, aged 13 & 15. When at my house, they spend a lot of time on myspace.com, and other questionable web sites, which greatly concern me. For my own peace of mind, (with my childs consent), I decided to purchase this program, to monitor them. I think it's a wonderful program, and I’m thrilled to be able to know who they are chatting with and who they are emailing. My child and I are quite happy with the results.”
“I consider monitoring my kids's activities on the computer to have saved one of my kids lives or from being abducted. My 2nd oldest child, when she was 13, (She turned 14 in April) had a chat with someone in a kid's chat room. He wrote to her that he was around 16 years old and in High School. He also lied about his location. After a while he wrote her a personal e-mail with things that a 13 year old shouldn't have read but made it sound like he wanted to be her boyfriend, etc. After doing some research on the computer myself, I found out this guy was 32 years old and lived in the same city as us! I was in shock and I admit, Upset!”
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‘I feel that there is too much pornography on the internet, and way too easy to access. I therefore decided to try out your product to ensure all kinds of unsuited material would be inaccessible from our personal computer. The program was good at preventing the material reaching our PC too.”
“I have not been able to find another program that has all of the features this one has. My favorite is the screen recording, but I use them all. We've told our child over and over that the 16-yr-old girl talking to him on the internet may very well be a 50-yr-old man, looking for little boys who are gullible enough to believe him. With this program, there may still be a chance for someone to contact him once, but with me checking the recordings every day, I can end it before something bad happens.”
‘I like the fact that it is hidden and only I can access it and see all that goes on the computer and Internet It’s a great program!’
“I like using the PC Tattletale because I feel more at ease knowing that I will be seeing whatever my child sees and I will be able to help him should he need help. The scary part is that I have learned that there are a lot more predators than I first realized!’
“I purchased this software just in time. The insight the documentation provided allowed me to know what was going on and reference it thru possible other methods of access. I turned my child's attitude around just in time before she could have back strongly influenced by the wrong crowd of people. PC Tattletale offered great insight into what my child was thinking and feeling - rather than what she was telling me.”
“I told my kids I was putting tattletale on our computer. Knowing that I am monitoring has worked well. Before PC Tattletale I found them on sites I didn't approve of occasionally, but with PC Tattletale they stay away from those sites. PC tattletale has made me feel much more comfortable with my kids being online. I don't feel like they are going to be the targets of the many bad things that I know can happen on the net.”
“I tried many different programs and they either didn't work or were very difficult to install. PC Tattletale was extremely easy to install and worked right away. PC Tattletale has given me peace of mind. I no longer have to worry if there is something or someone trying to hurt my kids.”
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“I was a computer consultant starting in 1997, and was going to many homes in the Atlanta area, and saw how many kids were just given free rein on the 'net, simply because moms and dads were unaware of HOW to see or monitor what they were doing. I saw horrible stuff that parents had no idea about. Already, I've told at least 20 or so people about PC Tattletale PC monitoring software in about 2 years.”
“I was concerned about my 15 y.o. child and who he was spending time with and what they were like. Turns out that many of them are dealing drugs and committing crimes. If I had not downloaded PC Tattletale I never would have known what my sons and his friends were up to. He has since stopped hanging with these kids who now have all been arrested on several occasions. My child is now spending his spare time in an organized sport that he is really enjoying while his ex friends are spending time reporting to a probation officer.”
“It gives you a sense of security in knowing that you are taking care of your kids while they are online. I loved the fact that it was so simple to use. I can't believe that it kept track of all the information.”
“It has helped me keep an eye on where he goes and I can also check MySpace sites by following where he has been. It just makes me feel more at ease knowing that I can see everything that goes on.”
“It is good to see what the kids are up to and if they are listening to the rules of the computer use and respecting your request. I like that I can see everything that is going on and what is being said in the chats and emails. My husband had a very ugly divorce and his ex is very bitter and with held access to his kids for over 5-years, now that the child has come to live with us we need to be able to monitor what is going on, because the child did not come without many issues.”
“My child does not know about the PC Tattletale program. Seeing where she goes, and says online helps me with "stories" and the "hypothetical scenarios" to teach her the importance of not abusing the internet or accessing inappropriate web sites.”
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“My wife and I felt like we were in the dark with our child's life and the people that she hung around. We caught her lying about things she was doing and places she was going. So now since she basically lives on the computer, we know exactly what's going on at all times. PC Tattletale is the only way you're going to know what is going on all of the time. It's amazing all of the small details that get left out when talking to your child directly. It has helped build a trust. Our child knows that in order to use the computer, she has to have it monitored which has helped tremendously.”
“PC Tattletale has enabled me to give them more freedom on the web and teaches them to use their good judgment in selecting what they do online. They know they will be held accountable for their actions, and if they get into something they shouldn't then PC tattletale is there as a safety net to allow me to protect them from something that might harm them.”
“PC Tattletale has helped me keep an eye on where he goes and I can also check people's MySpace sites by following where he has been.”
“PC Tattletale has helped me to understand how my child is using the computer and the extent of their relationships online. I learned something very unexpected. It helped me to understand how my child thinks while doing homework. I was able to see how many times during the course of doing homework they got distracted by instant messages, music videos and web surfing. No wonder very little homework was getting done!”
“PC Tattletale is the best parental control I have ever seen; with the added benefit that it also records activity so I can see where my kids are going and what they are doing. If I don't watch my kids and correct them when they are wrong then they will think that their actions have no consequences.”
“PC Tattletale just makes me feel more at ease knowing that I can see everything that goes on MySpace is very popular among teens and the more I go through the many teens that display drugs and tell all I wonder where all the parents are. I have found a lot of information concerning my child’s friends and plans, so I think every mother should have a copy on the computer and find out what their child is doing.”
“PC Tattletale keeps you informed on what your kids deal with at school and helps you to understand situations and also provides material to discuss with them. I love being able to easily read their emails and chatting. It has brought up situations to discuss with our child regarding the use of bad language, the issues dealt with at school with friends, etc. I love it. Also, it is very easy to use.”
“Thanks pc tattletale for saving my child from going down the right path. Had I not downloaded your software I would never have know the extent of his friend’s illegal activity. Thanks for helping me be a better mother.”
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“The installation and interface were very smooth and easy to use and geared more towards home/family use rather than office/employer/employee like comparable software. The single license for two computers was an awesome bonus. Especially compared to some other software in this category. When I accidentally downloaded and installed an older version of the software, I was notified by you and informed that I had the wrong version. The notification also included the links I needed to get the correct one and instructions necessary to remove and reinstall the software.”
“The latest information about FaceBook, MySpace, etc in addition to the publicity about chat rooms and unmonitored IM among kids and others who pose as kids made my wife and me decide we need to monitor much more closely. PC Tattletale had everything we wanted. We need to mandate accountability in our kids and they need to know that the internet is not a private site--that everything they do and say is monitored by someone, and it might as well be their moms and dads catching them before something wrong happens. It is easy to use and monitors our kids's every move. This will let us keep our kids safe, teach them important lessons so they don't fall, and also let them learn that honesty and morality are always better than sneaking around accompanied by borderline behavior.”
“There is simply no time for naivety in our society. With all of the temptations placed upon our kid's via the internet, we can't just assume that they're not succumbing to that temptation. We must put our kids 1st, at all cost... and if they lose a little privacy as part of that cost, so be it!”
“You can see everything that happen on pc and give the mother the opportunity to speak with kids (or block) if necessary. This software just give me more peace of mind. I also think this software is affordable - especially with the fact that you can monitor 2 pc's!”
“You might be surprised at what you find out is not what you expected. Thanks so much.”
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PC Tattletale: Parental Control and Internet Monitoring Tool
PC Tattletale offers a complete Internet Monitoring and Parental Control Software solution, that's unmatched in the industry. PC Tattletale Parental control software contains all the PC monitoring tools you'll need to keep your Aspergers child safe - in a single easy to use software suite!
Your purchase of one (1) PC Tattletale registration key lets you use the software on TWO computers at NO extra charge! Also, they give you a 7 day FREE trial, so it’s all too confusing – just don’t order it!
Check out these features:
1. Advanced Keystroke Logger - Records all keystrokes including passwords, "hidden characters" and true keystrokes too - including MySpace.Com and FaceBook.Com account passwords.
2. Email Monitoring - PC Tattletale captures both in AND outbound mail, records Outlook and Outlook Express, AOL Email, Eudora, SMTP/POP3 Email, MS Exchange Email, Hotmail, Yahoo Email, MSN System Email and Google Gmail. PC Tattletale can even send you copies of your youngster's emails in REAL TIME so you'll know what's going on even if you're at the office!
3. PC Tattletale captures the name of each software program that your youngster used, when that program was started and how long the program was active.
4. PC Tattletale makes it easy to keep tabs on what your youngster is doing on MySpace.com and other social networking web sites. Using the powerful screen capture and key stroke recording technology, PC Tattletale makes it easy for you to see exactly what they post on their MySpace.com account, what their password is, what they are say when they use My Space to chat, instant message and much more!
5. PC Tattletale solves the problem of helping you stay on top of what your youngster does when you're not there to watch over their shoulder. And it gives you the tools to invisibly monitor your youngster and help keep them safe on the Internet.
6. Powerful Chat Recorder - Records all chat sessions and Instant messages - Captures both sides of ANY Chat conversation or Instant Message, including: AOL Chat Rooms and Instant Messenger, AOL Triton ICQ Chats, MSN Messenger, Yahoo Messenger, AIM, Trillain chat and even MySpace.com!
7. Screen Shots Captures - PC Tattletale's "DVD like" controls and playback makes it as simple as clicking the “PLAY” button to watch EVERYTHING your youngster did when they were online! PC Tattletale even separates the screen captures by user and date. This means you can focus only on the youngster you want to watch. You save time by zeroing in on suspicious activity. Works with Internet Explorer and Fire Fox too!
8. The special "Stealth Technology" -- Once installed PC Tattletale will not appear in the Windows Start Menu, Desktop, Task Manager, Program Files Folders, or even the Add/Remove programs menu because PC Tattletale is TOTALLY invisible to the user.
9. URL Specific Web Filtering and keyword blocking -- Specify any web site that you want blocked. If your youngster tries to go to a web site that contains that keyword, PC Tattletale displays a "404 Page not found error," leaving them wondering why they can't get into blocked site.
The company guarantees that if PC Tattletale Parental Control and PC Monitoring Software doesn't give you a window into your child's/teen’s online world, and the peace of mind to know exactly what they see, where they go and who they talk to, then they will issue you a complete 100% refund!
I have used this software since 2006. I highly recommend it! This is like having a trusted babysitter watching over your Aspergers child's shoulder and reporting to you - in real time - exactly what's he is doing online!
You've got absolutely nothing to lose to try it!!
Mark Hutten, M.A.
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What is important to know before my Aspergers teenage son turns 18?
Question
What is important to know before my Aspergers teenage son turns 18?
Answer
Stepping into adulthood can be a confusing and difficult time for the Aspergers (high functioning autistic) teen. However, it does not have to be. Many teens with Aspergers are fairly well adjusted after years of living with the associated symptoms and adapting to better fit into their environment.
Here are a few areas that can cause problems for the teenager with Aspergers:
Here are a few areas that can cause problems for the teenager with Aspergers:
- Employment
- Independent living skills
- Post secondary education
- Relationships and social skills
- Self-care issues
Moms and dads can help their Aspergers teen prepare for life as an adult by making sure he has the right amount of support. Support can come from many sources. Parents, teachers, school advisors or counselors, medical professionals, therapists, friends, and support group members cover most, if not all, of the basic areas of life.
Some geographical areas offer support for the Aspergers teen through government agencies. With a qualifying diagnosis, your teenager may be able to receive health insurance coverage, housing assistance, various therapies, vocational training, and career counseling, just to name a few possibilities. Check with your local government or disability services office to learn more about availability in your area.
It might help if you make a list of the skills you would like to see developing in your Aspergers teen. By making this list, you will be able to see his strengths and weakness and help determine a plan for his immediate future.
Here is a sample list:
Here is a sample list:
- Social skills and relationships-- Does he have the ability to relate to others and communicate, verbally and non-verbally? Should he continue with social skills classes or perhaps find a home program?
- Self-care-- Does he have good personal hygiene? Does he understand the importance of regular medical care and keeping track of his medications?
- Coping skills-- Can he handle the anxiety, emotions, and frustration often brought on by change? Should he begin cognitive therapy to help with his emotions?
- Career and college choices-- Has he chosen a path based on his special interests and talents? What colleges are grabbing his interests? Do these schools offer disability support services?
- Basic living skills-- Does he understand the importance of housekeeping, budgeting, and grocery shopping?
Moving into adulthood does not have to be daunting for your teenager with Aspergers. Teens can develop the necessary skills for college, career, and independent living with the right support.
Discipline for Defiant Aspergers Teens
Aspergers Meltdowns versus Temper Tantrums
One of the most misunderstood Aspergers (high functioning autism) behaviors is the meltdown. Frequently, it is the result of some sort of overwhelming stimulation of which cause is often a mystery to moms and dads and teachers. They can come on suddenly and catch everyone by surprise. Aspergers kids tend to suffer from sensory overload issues that can create meltdowns. Kids who have neurological disorders other than Aspergers can suffer from meltdowns, too. Unlike tantrums, these kids are expressing a need to withdraw and slowly collect themselves at their own pace.
Kids who have tantrums are looking for attention. They have the ability to understand that they are trying to manipulate the behavior of the others, caregivers and/or peers. This perspective taking or "theory of mind" is totally foreign to the Aspergers youngster who has NO clue that others cannot "read" their mind or feelings innately. This inability to understand other human beings think different thoughts and have different perspectives from them is an eternal cause of frustration.
Tantrums—
A tantrum is very straightforward. A youngster does not get his or her own way and, as grandma would say, "pitches a fit." This is not to discount the tantrum. They are not fun for anyone. Tantrums have several qualities that distinguish them from meltdowns.
- A youngster having a tantrum will look occasionally to see if his or her behavior is getting a reaction.
- A youngster in the middle of a tantrum will take precautions to be sure they won't get hurt.
- A youngster who throws a tantrum will attempt to use the social situation to his or her benefit.
- A tantrum is thrown to achieve a specific goal and once the goal is met, things return to normal.
- A tantrum will give you the feeling that the youngster is in control, although he would like you to think he is not.
- When the situation is resolved, the tantrum will end as suddenly as it began.
FACT:
If you feel like you are being manipulated by a tantrum, you are right. You are. A tantrum is nothing more than a power play by a person not mature enough to play a subtle game of internal politics. Hold your ground and remember who is in charge.
A tantrum in a youngster who is not Aspergers is simple to handle. Moms and dads simply ignore the behavior and refuse to give the youngster what he is demanding. Tantrums usually result when a youngster makes a request to have or do something that the parent denies. Upon hearing the parent's "no," the tantrum is used as a last-ditch effort.
The qualities of a tantrum vary from child to child When kids decide this is the way they are going to handle a given situation, each youngster's style will dictate how the tantrum appears. Some kids will throw themselves on the floor, screaming and kicking. Others will hold their breath, thinking that his "threat" on their life will cause moms and dads to bend. Some kids will be extremely vocal and repeatedly yell, "I hate you," for the world to hear. A few kids will attempt bribery or blackmail, and although these are quieter methods, this is just as much of a tantrum as screaming. Of course, there are the very few kids who pull out all the stops and use all the methods in a tantrum.
Effective parenting -- whether a youngster has Aspergers or not -- is learning that you are in control, not the youngster. This is not a popularity contest. You are not there to wait on your youngster and indulge her every whim. Buying her every toy she wants isn't going to make her any happier than if you say no. There is no easy way out of this parenting experience. Sometimes you just have to dig in and let the tantrum roar.
Meltdowns—
If the tantrum is straightforward, the meltdown is every known form of manipulation, anger, and loss of control that the youngster can muster up to demonstrate. The problem is that the loss of control soon overtakes the youngster. He needs you to recognize this behavior and rein him back in, as he is unable to do so. A youngster with Aspergers in the middle of a meltdown desperately needs help to gain control.
- A youngster in a meltdown has no interest or involvement in the social situation.
- A youngster in the middle of a meltdown does not consider her own safety.
- A meltdown conveys the feeling that no one is in control.
- A meltdown usually occurs because a specific want has not been permitted and after that point has been reached, nothing can satisfy the youngster until the situation is over.
- During a meltdown, a youngster with Aspergers does not look, nor care, if those around him are reacting to his behavior.
- Meltdowns will usually continue as though they are moving under their own power and wind down slowly.
Unlike tantrums, meltdowns can leave even experienced moms and dads at their wit's end, unsure of what to do. When you think of a tantrum, the classic image of a youngster lying on the floor with kicking feet, swinging arms, and a lot of screaming is probably what comes to mind. This is not even close to a meltdown. A meltdown is best defined by saying it is a total loss of behavioral control. It is loud, risky at times, frustrating, and exhausting.
Meltdowns may be preceded by "silent seizures." This is not always the case, so don't panic, but observe your youngster after she begins experiencing meltdowns. Does the meltdown have a brief period before onset where your youngster "spaces out"? Does she seem like she had a few minutes of time when she was totally uninvolved with her environment? If you notice this trend, speak to your physician. This may be the only manifestation of a seizure that you will be aware of.
When your youngster launches into a meltdown, remove him from any areas that could harm him or he could harm. Glass shelving and doors may become the target of an angry foot, and avoiding injury is the top priority during a meltdown.
Another cause of a meltdown can be other health issues. One example is a youngster who suffers from migraines. A migraine may hit a youngster suddenly, and the pain is so totally debilitating that his behavior may spiral downward quickly, resulting in a meltdown. Watch for telltale signs such as sensitivity to light, holding the head, and being unusually sensitive to sound. If a youngster has other health conditions, and having Aspergers does not preclude this possibility, behavior will be affected.
==> How to Prevent Meltdowns and Tantrums in Children with Aspergers and High Functioning Autism
The Diagnosis of Aspergers
Aspergers (AS) is one of the pervasive developmental disorders (PDD) which is a family of congenital conditions characterized by marked social impairment, communication difficulties, play and imagination deficits, and a range of repetitive behaviors or interests 1. The prototypical PDD is autism, which was first described by Leo Kanner at Johns Hopkins in 1943 2. Autism occurs in 1 out of every 1000 births 3, is a neurobiologic disorder with a strong genetic component (a 2%–5% recurrence rate in siblings, which is a 50 fold increase relative to the general population) 4, and some as yet tentative biologic markers involving brain structure (e.g., some people may have larger brains) and brain function (e.g., the typical brain specialization to recognize faces is not present) 5.
Approximately 70% of people with autism have a degree of mental retardation, and the typical cognitive profile includes great variability of skills (e.g., usually higher level nonverbal problem-solving skills and lower level language and conceptual skills) 6. Universally, there is a considerable discrepancy between a person's cognitive potential (i.e., IQ) and their ability to meet the demands of everyday life (or adaptive skills) 7. The diagnosis of autism is entirely behavioral and is made through clinical examination of a youngster's history and current presentation in the areas of social, communicative, and play/imagination behaviors 8. In the past decade, there has been progress in research of the biologic origins of autism, particularly in the areas of genetics and brain function, but there is no biologic test as yet (e.g., through blood analysis) to identify people with this condition 9.
In 1944, Hans Asperger, an Austrian pediatrician with an interest in special education, described four kids who had difficulty integrating socially into groups 10. Unaware of Kanner's description of early infantile autism published just the year before, Asperger called the condition he described “autistic psychopathy,” indicating a stable personality disorder marked by social isolation. Despite preserved intellectual skills, the kids showed marked paucity of nonverbal communication involving gestures and affective tone of voice, poor empathy and a tendency to intellectualize emotions, an inclination to engage in long-winded, one-sided, sometimes incoherent and rather formalistic speech (he called them “little professors”), all-absorbing interests involving unusual topics that dominated their conversation, and motoric clumsiness. Unlike Kanner's patients, these kids were not as withdrawn or aloof.
They also developed, sometimes precociously, highly grammatic speech, and in fact could not be diagnosed in the first years of life. Discarding the possibility of a psychogenetic origin, Asperger highlighted the familial nature of the condition, and even hypothesized that the personality traits were primarily male-transmitted. Asperger's work, originally published in German, became widely known to the English speaking world only in 1981, when Lorna Wing published a series of cases showing similar symptoms 11. Her codification of the condition she called Aspergers blurred somewhat the differences between Kanner's and Asperger's descriptions, as she included a small number of girls and mildly mentally retarded kids, and some kids who had presented with some language delays in their first years of life. Since then, several studies have attempted to validate Aspergers as distinct from autism without mental retardation, although comparability of findings has been difficult because of the lack of consensual diagnostic criteria for the condition 12. Although ASPERGERS was first granted official recognition in ICD-10 13, and appears as Asperger disorder in DSM-IV 1, its nosologic status is still uncertain.
Clinical features—
The diagnosis of ASPERGERS requires the demonstration of qualitative impairments in social interaction and restricted patterns of interest, criteria that are identical to autism. In contrast to autism, there are no criteria in the cluster of language and communication symptoms, and onset criteria differ in that there should be no clinically significant delay in language acquisition, cognitive, and self-help skills. Those symptoms result in significant impairment in social and occupational functioning 1.
In some contrast to the social presentation in autism, people with ASPERGERS find themselves socially isolated but are not usually withdrawn in the presence of other people, typically approaching others but in an inappropriate or eccentric fashion. For example, they may engage the interlocutor, usually an adult, in one-sided conversation characterized by long-winded, pedantic speech about a favorite and often unusual and narrow topic. They may express interest in friendships and in meeting people, but their wishes are invariably thwarted by their awkward approaches and insensitivity to the other person's feelings, intentions, and nonliteral and implied communications (e.g., signs of boredom, haste to leave, and need for privacy).
Chronically frustrated by their repeated failures to engage others and form friendships, some people with Aspergers develop symptoms of a mood disorder that may require treatment, including medication. They also may react inappropriately to or fail to interpret the valence of the context of the affective interaction, often conveying a sense of insensitivity, formality, or disregard for the other person's emotional expressions. They may be able to describe correctly, in a cognitive and often formalistic fashion, other people's emotions, expected intentions, and social conventions; however, they are unable to act on this knowledge in an intuitive and spontaneous fashion, thus losing the tempo of the interaction. Their poor intuition and lack of spontaneous adaptation are accompanied by marked reliance on formalistic rules of behavior and rigid social conventions. This presentation is largely responsible for the impression of social naiveté and behavioral rigidity that is so forcefully conveyed by these people 12.
Although significant abnormalities of speech are not typical of people with ASPERGERS, there are at least three aspects of these individuals' communication patterns that are of clinical interest 14. First, speech may be marked by poor prosody, although inflection and intonation may not be as rigid and monotonic as in autism. They often exhibit a constricted range of intonation patterns that is used with little regard to the communicative function of the utterance (assertions of fact, humorous remarks). Rate of speech may be unusual (e.g., too fast) or may lack in fluency (e.g., jerky speech), and often there is poor modulation of volume (e.g., voice is too loud despite physical proximity to the conversational partner). The latter feature may be particularly noticeable in the context of a lack of adjustment to the given social setting (e.g., in a library, in a noisy crowd). Second, speech often may be tangential and circumstantial, conveying a sense of looseness of associations and incoherence.
Even though in a small number of cases this symptom may be an indicator of a possible thought disorder, the lack of contingency in speech is a result of the one-sided, egocentric conversational style (e.g., unrelenting monologues about the names, codes, and attributes of innumerable TV stations in the country), failure to provide the background for comments and to clearly demarcate changes in topic, and failure to suppress the vocal output accompanying internal thoughts. Third, the communication style of people with ASPERGERS is often characterized by marked verbosity. The youngster or adult may talk incessantly, usually about a favorite subject, often in complete disregard as to whether the listener might be interested, engaged, or attempting to interject a comment, or change the subject of conversation. Despite such long-winded monologues, the person may never come to a point or conclusion. Attempts by the interlocutor to elaborate on issues of content or logic, or to shift the interchange to related topics, are often unsuccessful.
People with ASPERGERS typically amass a large amount of factual information about a topic in an intense fashion 12. The actual topic may change from time to time, but often dominates the content of social exchange. Frequently the entire family may be immersed in the subject for long periods of time. This behavior is peculiar in the sense that oftentimes extraordinary amounts of factual information are learned about very circumscribed topics (e.g., snakes, names of stars, TV guides, deep fat fryers, weather information, personal information on members of congress) without a genuine understanding of the broader phenomena involved. This symptom may not always be easily recognized in childhood because strong interests in certain topics, such as dinosaurs or fashionable fictional characters, are ubiquitous. In younger and older kids, however, typically the special interests interfere with learning in general because they absorb so much of the youngster's attention and motivation, and also interfere with the youngster's ability to engage in more reciprocal forms of conversation with others.
People with ASPERGERS may have a history of delayed acquisition of motor skills, such as pedaling a bike, catching a ball, opening jars, and climbing outdoor play equipment. They are often visibly awkward and poorly coordinated and may exhibit stilted or bouncy gait patterns and odd posture. Neuropsychologically there may be a pattern of relative strengths in auditory and verbal skills and rote learning, and significant deficits in visual-motor and visual-perceptual skills and conceptual learning 15. Many kids exhibit high levels of activity in early childhood, and the commonest reported comorbid symptoms in adolescence and young adulthood are anxiety and particularly depression 16.
Clinical assessment—
ASPERGERS, like the other pervasive developmental disorders, involves delays and deviant patterns of behavior in multiple areas of functioning. To thoroughly evaluate all relevant domains, different areas of expertise, including overall developmental functioning, neuropsychologic features, and behavioral status are required. Hence the clinical assessment of people with this disorder is most effectively conducted by an experienced interdisciplinary team. In most cases, a comprehensive interdisciplinary assessment involves the following components: a thorough developmental and health history, psychological and communication assessments, and a diagnostic examination including differential diagnosis 17.
Further consultation regarding behavioral management, motor disabilities, possible neurologic concerns, psychopharmacology, and assessment related to advanced studies or vocational training also may be needed. Given the prevailing difficulties in the definition of ASPERGERS and the great heterogeneity of the condition, it is crucial that the aim of the clinical assessment be a comprehensive and detailed profile of the individual's assets, deficits, and challenges, rather than simply a diagnostic label. Effective educational and treatment programs can only be devised on the basis of such a profile, given the need to address specific deficits while capitalizing on the person's various resources and strengths.
The psychologic assessment aims at establishing the overall level of intellectual functioning, profiles of psychomotor functioning, verbal and nonverbal cognitive strengths and weaknesses, style of learning, and independent living skills. At a minimum, the psychologic assessment should include assessments of intelligence and adaptive functioning, although the assessment of more detailed neuropsychologic skills can be of great help to further delineate the youngster's profiles of strengths and deficits (e.g., organizational skills). A description of results should include not only quantified information but also a judgment as to how representative the youngster's performance was during the assessment procedure and a description of the conditions that are likely to foster optimal and diminished performance. For example, the youngster's responses to the amount of structure imposed by the adult, the optimal pace for presentation of tasks, successful strategies to facilitate learning from modeling and demonstrations, effective ways of containing off-task and maladaptive behaviors such as cognitive and behavioral rigidity (e.g., perseverations, perfectionism, ritualized behavior), distractibility (e.g., difficulty inhibiting irrelevant responses, tangentiality), and anxiety are all important observations that can be extremely useful for designing an appropriate intervention program.
Within the psychological assessment, particular attention should be placed on adaptive functioning, which refers to capacities for personal and social self-sufficiency in real-life situations. The importance of this component of the clinical assessment cannot be overemphasized. Its aim is to obtain a measure of the youngster's typical patterns of functioning in familiar and representative environments such as the home and school that may contrast markedly with the demonstrated level of performance and presentation in the clinic. It provides the clinician with an essential indicator of the extent to which the youngster is able to use his or her potential (as measured in the assessment) in the process of adaptation to environmental demands. A large discrepancy between intellectual level and adaptive level signifies that a priority should be made of instruction within the context of naturally occurring situations to foster and facilitate the use of skills to enhance quality of life.
The communication assessment should examine nonverbal forms of communication (e.g., gaze, gestures), nonliteral language (e.g., metaphor, irony, absurdities, and humor), suprasegmental aspects of speech (e.g., patterns of inflection, stress and volume modulation), pragmatics (e.g., turn-taking, sensitivity to cues provided by the interlocutor), and content, coherence, and contingency of conversation. Particular attention should be given to perseveration on circumscribed topics, metalinguistic skills (e.g., understanding of the language of mental states including intentions, emotions, and beliefs), reciprocity, and rules of conversation.
The diagnostic assessment should integrate information obtained in all components of the comprehensive evaluation, with a special emphasis on developmental history and current symptomatology. It should include observations of the youngster during more and less structured periods. This effort should take advantage of observations in all settings, including the clinic's reception area (e.g., contacts with other kids or with family members), the halls (e.g., how the youngster interacts initially with the examiners), and in the testing room during breaks, periods of silence, or otherwise unstructured situations.
Often the youngster's disability is much more apparent during such periods in which the youngster is not given any instruction and has no adult-imposed expectation as to how to behave. Specific areas for observation and inquiry include the patient's patterns of special interest and leisure time, social and affective presentation, quality of attachment to family members, development of peer relationships and friendships, capacities for self-awareness, perspective-taking and level of insight into social and behavioral problems, typical reactions in novel situations, and ability to intuit other person's feelings and infer other person's intentions and beliefs.
Problem behaviors that are likely to interfere with remedial programming should be noted (e.g., anxiety, temper tantrums). The kid’s ability to understand ambiguous nonliteral communications (particularly teasing and sarcasm) should be further examined, particularly in regard to the youngster's patterns of response (e.g., misunderstandings of such communications may elicit aggressive behaviors). Other areas of observation involve the presence of obsessions or compulsions, ritualized behaviors, depression and panic attacks, integrity of thought, and reality testing.
Treatment—
As in autism, treatment of ASPERGERS is essentially supportive and symptomatic, and to a great extent, overlaps with the treatment guidelines applicable to people with autism unaccompanied by mental retardation 18. One initial difficulty encountered by families is proving eligibility for special services. As people with ASPERGERS are often verbal and some of them do well academically (at least in some areas), educational authorities might judge that the deficits—primarily social and communicative—are not within the scope of educational intervention. In fact, these two aspects should be the core of any educational intervention and curriculum for people with this condition. With regard to learning strategies, skills, concepts, appropriate procedures, cognitive strategies, and behavioral norms may be more effectively taught in an explicit and rote fashion using a parts-to-whole verbal instruction approach, where the verbal steps are in the correct sequence for the behavior to be effective. Additional guidelines should be derived from the individual's neuropsychologic profile of assets and deficits. The acquisition of self-sufficiency skills in all areas of functioning should be a priority.
The tendency of people with ASPERGERS to rely on rigid rules and routines can be used to foster positive habits and enhance the person's quality of life and that of family members. Specific problem-solving strategies, usually following a verbal algorithm, may be taught for handling the requirements of frequently occurring, troublesome situations (e.g., involving novelty, intense social demands, or frustration). Training is usually necessary for recognizing situations as troublesome and for selecting the best available learned strategy to use in such situations. Social and communication skills are best taught by a communication specialist with an interest in pragmatics in speech in the context of individual and small group therapy. Communication therapy should include appropriate nonverbal behaviors (e.g., the use of gaze for social interaction, monitoring and patterning of inflection of voice), verbal decoding of nonverbal behaviors of others, social awareness, perspective-taking skills, and correct interpretation of ambiguous communications (e.g., nonliteral language).
Often, grown-ups with ASPERGERS fail to meet entry requirements for jobs in their area of training (e.g., college degree) or fail to maintain a job because of their poor interview skills, social disabilities, eccentricities, or anxiety attacks. It is important, therefore, that they are trained for and placed in jobs for which they are not neuropsychologically impaired, and in which they will enjoy a certain degree of support and shelter. It is also preferable that the job does not involve intensive social demands, time pressure, or the need to quickly improvise or generate solutions to novel situations. The little experience available with self-support groups suggests that people with ASPERGERS enjoy the opportunity to meet others with similar problems and may develop relationships around an activity or subject of shared interest. Special interests may be used as a way of creating social opportunities through hobby groups. Supportive psychotherapy and pharmacologic interventions may be helpful in dealing with feelings of despondency, frustration, and anxiety, although a more direct, problem-solving focus is believed to be more beneficial than an insight-oriented approach.
External validity—
Although ASPERGERS was first described more than 50 years ago 10, it was not until 1994 that is was included in DSM-IV 1 as one of the PDDs. Inclusion in the DSM-IV followed limited evidence that it could be differentiated from autism unaccompanied by mental retardation, or higher functioning autism (HFA) 19. As noted, however, its nosologic status remains unclear, in part because of the adoption of varying diagnostic schemes in the research literature 12. Although the advent of the DSM-IV definition was intended to create a consensual diagnostic starting point for research, it has been consistently criticized as overly narrow 20, 21, rendering the diagnostic assignment of ASPERGERS improbable or even “virtually impossible” 22, 23.
The introduction of ASPERGERS in DSM-IV and ICD-10 24 was prompted by the recognition that autism is a clinically heterogeneous disorder and that the characterization of subtypes of PDD might help behavioral and biologic research by allowing the identification of clinically more homogeneous groups 25, 26, 27. Although this effort has been successful for some PDD conditions (e.g., Rett syndrome) 28, it has not been the case in ASPERGERS. Published reports have modified DSM-IV or ICD-10 criteria 15, 29, treated ASPERGERS and HFA interchangeably 16, 17, 30, 31, or used unique investigator-defined criteria 32, making it difficult to compare studies. Only two studies 33, 34 have systematically compared different diagnostic schemes. These two studies generally revealed that different nosologic schemes result in the assignment of different diagnoses to the same patients, raising the important issue of how to compare studies using different definitions of ASPERGERS.
These studies, however, did not consider the question of the usefulness of a given diagnostic concept relative to important predictions that may have practical value to research (e.g., differences in neuropsychologic or neurobiologic findings between ASPERGERS and HFA), or clinical practice (e.g., differences in treatment efficacy, comorbid symptomatology, or outcome as a function of the given diagnostic assignment) 35. To summarize, the state of discussions on the nosologic status of ASPERGERS is, therefore, extremely problematic, given that studies cannot be necessarily compared because of the adoption of different diagnostic definitions, and there has been no comparison across different diagnostic schemes with regard to the relative usefulness of each of the schemes. And yet, the absence of a consensual or validated definition has not deterred the upsurge of research publications on the syndrome nor the apparently marked increased in the use of the diagnosis in clinical and educational settings 36.
It is apparent from this brief discussion of the external validity of ASPERGERS that studies comparing the usefulness of different diagnostic schemes is badly needed. This agenda for research is needed for several reasons.
First, there is a need to gauge the extent to which available research data obtained using different diagnostic systems are comparable.
Second, despite the upsurge in research and clinical interest in ASPERGERS, the absence of a validated definition prevents the development of standardized instrumentation that could enhance reliability of diagnostic assignment and make possible cross-site collaborations that are essential to behavioral and biological research.
Third, there are indications that the DSM-IV definition is being ignored in clinical practice 23, with the term being used as synonymous to higher functioning autism (HFA) (i.e., autism unaccompanied by mental retardation) or, maybe even more commonly, to PDD-NOS 12, creating a rift between DSM-IV and research and clinical practice, thus confusing and alienating investigators, clinicians, and parents alike.
And fourth, the scientifically interesting question as to whether or not there are qualitative discontinuities among the PDDs, or alternatively, whether the PDDs should be considered along a dimensional continuum (and what this dimension should be) is left unresolved without some resolution of the validity of the ASPERGERS diagnosis.
Several lines of research could serve the purpose of assessing the usefulness of different diagnostic schemes. First, learning profiles of assets and deficits are of great importance in educational treatment planning for people with PDDs 6, particularly in people with normative IQs 17. Neuropsychologic research of ASPERGERS is extremely equivocal to date. In 1995, the authors' group 15 documented considerable differences between people with HFA and ASPERGERS. Specifically, people with ASPERGERS showed a profile of assets and deficits consistent with a nonverbal learning disability (NLD) 37.
NLD is characterized by strengths in verbally mediated skills (e.g., vocabulary, rote knowledge, verbal memory, verbal output) and deficits in nonverbal skills (e.g., visual–spatial problem solving, visual–motor coordination). People with HFA exhibited the opposite profile. Such “double dissociation” has been shown to be one of the most powerful external validators of specific subtypes of syndromes 38. These findings have been supported by several studies focused on IQ profiles 39, 40, 41, although several other studies have failed to replicate them 42, 43. As noted, however, direct comparison across studies is not possible because different diagnostic schemes were used in them.
A second potential area of validation research in ASPERGERS could use patterns of comorbidity. Research on the psychiatric difficulties associated with the PDDs is of great importance for treatment planning, given that these symptoms may have the potential for being extremely debilitating (e.g., limiting the effectiveness of educational interventions and posing further limitations on the individual's ability to use his or her internal coping resources). Documentation of these difficulties can lead to psychopharmacologic approaches that can greatly alleviate such symptoms, thus making the student more available to other forms of intervention (e.g., educational see Towbin, this issue). ASPERGERS has been associated with a host of comorbid conditions, including schizophrenia 44, 45, Tourette syndrome 46, and attentional, affective, and obsessional disorders 47, 48. More recent research has emphasized anxiety, mood, and obsessional disorders to be particularly prevalent in this population 49, 50. As stated previously, however, there has been no attempt to study patterns of comorbidity that may be specific to HFA and AS, with most studies using the two diagnoses interchangeably.
A third potential line of research for external validation studies of ASPERGERS relates to the aggregation of social and other psychiatric disorders in family relatives. Research into patterns of genetic liability associated with the PDDs has been one of the most active areas of investigation in autism and related conditions 4. Studies have consistently shown higher rates of social disabilities or difficulties in family members of people with autism 51, 52, and of other psychiatric symptoms including anxiety, mood, and obsessional disorders 53, 54. None of these studies, however, has made the attempt to assess the usefulness of separating families of probands with HFA from those of probands with ASPERGERS.
The available data on the familiality of ASPERGERS are essentially limited to a handful of case reports and some preliminary studies 55, 56. Many case reports have been consistent with Asperger's original observation 10 of similar traits in family members, particularly fathers or male relatives 57, 58, 59. Whether or not variants of autism such as ASPERGERS might reflect greater or lower genetic liability could be of great significance in elucidating mechanisms involved in producing the marked heterogeneity among PDDs. Such studies, however, cannot be conducted without standardized diagnostic procedures, which, in turn, depend on some initial consensus as to the criteria for the definition of ASPERGERS.
To avoid insularity among research groups (i.e., each one adopting its own diagnostic scheme) and to advance the field from its current stalemate, one approach might be to simultaneously compare different diagnostic schemes and assess each one on the basis of independent factors of clinical or research significance. Such research is not yet available.
Future directions for research and clinical service—
The current state of affairs in nosologic research of ASPERGERS, with little available evidence to point to a distinction between this concept and HFA, PDD-NOS, and other similar diagnostic entities 12, has prompted many investigators to derive premature conclusions. For example, some have treated ASPERGERS as different from other conditions, whereas others have treated it as the same as other conditions. The more typical approach is to see ASPERGERS within the spectrum of PDDs, maybe indicating some half point between autism and normalcy. The authors' discussion suggests that either position is unwarranted at present.
Those who view ASPERGERS as different from other disorders have the onus to document in what ways ASPERGERS is unique among the social disabilities. This task requires comparison of extant diagnostic schemes. Those who view ASPERGERS as within the spectrum of social disabilities have the onus to define what this spectrum consists of. This task requires isolation of specific psychologic (e.g., IQ, language functions, metacognitive skills) or neurobiologic (e.g., genetic liabilities, neurostructure, or neurofunction findings) that can quantify the social disability spectrum and predict social outcome. Both of these programmatic research areas are still in their incipience.
It is nevertheless crucial to separate this research discussion from the areas of clinical practice and provision of services dedicated to people with ASPERGERS and their families. The unavoidable confusion conveyed to parents and advocates inherent in the fragility of the validity status of ASPERGERS is sufficiently harmful to justify a concerted effort on the part of clinicians and advocates to adhere to some unequivocal principles so that the needs of their clients are properly addressed.
First, whether or not there is controversy over the fine-grained distinctions between ASPERGERS and other conditions, and despite some literature and great media coverage over some famous people exhibiting or not exhibiting this condition, the vast majority of kids, adolescents, and grown-ups with ASPERGERS require a comprehensive package of treatments. Equivocating about these individuals' needs on the basis of the poor scientific status of the diagnostic concept is unjustified.
Second, adequate educational programs should not be based on a diagnostic label and generalizations associated with it, but on individualized profiles of assets and deficits that can be accomplished only through thorough evaluations involving psychologic, communication, and psychiatric assessments.
And third, the notion that ASPERGERS is simply a “milder” form of autism, regardless of whether or not this statement is scientifically justified, should be well contextualized in that, whereas “mild” is a term comparing people with this condition with those with prototypical autism and a degree of mental retardation, it is certainly not “mild” when considering these people' great difficulties in meeting the demands of everyday life. In other words, eligibility for services should be fiercely advocated.
Treatment should focus on those areas of greatest challenges, those that are known to deleteriously impact on these individuals' capacity for independent living, vocational satisfaction, and better social adjustment. These include socialization skills in general (e.g., social reciprocity and social communication), adaptive skills (e.g., “street smarts,” how to function in the community, how to fend for oneself in potentially inhospitable environments), organizational skills (e.g., how to perform complex tasks and anticipate problems), a cognitive–behavioral, and sometimes psychopharmacologic plan to alleviate anxiety and depression when these emerge, and sympathetic mental health and educational professionals who strive to build on these individuals' unique assets to compensate for their deficits and to create more positive social experiences.
References—
[1]. [1] American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edition. Text revision, DSM-IV-TR. Washington, DC: Author. 2000.
[2]. [2] Kanner L. Autistic disturbances of affective contact. Nervous Child. 1943;2:217–253.
[3]. [3] Fombonne E. The epidemiology of autism: a review. Psychol Med. 1999;29:769–786. MEDLINE | CrossRef
[4]. [4] Rutter M. Genetic studies of autism: from the 1970s into the millennium. J Child Psychol Psychiatry. 2000;28:3–14.
[5]. [5] Schultz RT, Romanski LM, Tsatsanis KD. Neurofunctional models of autistic disorder and Asperger syndrome: clues from neuroimaging. In: Klin A, Volkmar F, Sparrow S editor. Asperger syndrome. New York, NY: Guilford Press; 2000;p. 172–209.
[6]. [6] Klin A, Carter A, Volkmar FR, Cohen DJ, Marans WD, Sparrow SS. Assessment issues in children with autism. In: Cohen DJ, Volkmar FR editor. Handbook of autism and pervasive developmental disorders. 2nd edition. New York, NY: Wiley; 1997;p. 411–418.
[7]. [7] Gillham JE, Carter AS, Volkmar FR, Sparrow SS. Toward a developmental operational definition of autism. J Autism Dev Disord. 2000;30(4):269–278. MEDLINE | CrossRef
[8]. [8] Lord C. Diagnostic instruments in autism spectrum disorders. In: Cohen DJ, Volkmar FR editor. Handbook of autism and pervasive developmental disorders. 2nd edition. New York, NY: Wiley; 1997;p. 460–483.
[9]. [9] Bailey A, Phillips W, Rutter M. Autism: towards an integration of clinical, genetic, neuropsychological, and neurobiological perspectives. J Child Psychol Psychiatry. 1996;37(1):89–126. MEDLINE | CrossRef
[10]. [10] Asperger H. Die ‘Autistischen Psychopathen’ im Kindesalter. Arch Psychiatr Nervenkr. 1944;117:76–136. CrossRef
[11]. [11] Wing L. Asperger's syndrome: a clinical account. Psychol Med. 1981;11:115–129. MEDLINE | CrossRef
[12]. [12] Volkmar FR, Klin A. Diagnostic issues in Asperger syndrome. In: Klin A, Volkmar FR, Sparrow SS editor. Asperger syndrome. New York, NY: Guilford Press; 2000;p. 25–71.
[13]. [13] World Health Organization . The ICD-10 classification of mental and behavioral disorders. Geneva: Author; 1992;.
[14]. [14] Klin A, Volkmar FR. Asperger syndrome. In: Cohen DJ, Volkmar FR editor. Handbook of autism and pervasive developmental disorders. New York, NY: Wiley & Sons; 1997;p. 94–122.
[15]. [15] Klin A, Volkmar FR, Sparrow SS, Cicchetti DV, Rourke BP. Validity and neuropsychological characterization of Asperger syndrome. J Child Psychol Psychiatry. 1995;36:1127–1140. MEDLINE | CrossRef
[16]. [16] Martin A, Patzer DK, Volkmar FR. Psychopharmacological treatment of higher-functioning pervasive developmental disorders. In: Klin A, Volkmar FR, Sparrow SS editor. Asperger syndrome. New York, NY: Guilford Press; 2000;p. 210–230.
[17]. [17] Klin A, Sparrow SS, Marans WD, Carter A, Volkmar FR. Assessment issues in children and adolescents with Asperger syndrome. In: Klin A, Volkmar FR, Sparrow SS editor. Asperger syndrome. New York, NY: Guilford Press; 2000;p. 309–339.
[18]. [18] Klin A, Volkmar FR. Treatment and intervention guidelines for individuals with Asperger syndrome. In: Klin A, Volkmar FR, Sparrow SS editor. Asperger syndrome. New York, NY: Guilford Press; 2000;p. 340–366.
[19]. [19] Volkmar FR, Klin A, Siegel B, Szatmari P, Lord C, Campbell M, et al. DSM-IV Autism/Pervasive Developmental Disorder Field Trial. Am J Psychiatry. 1994;151:1361–1367.
[20]. [20] Eisenmajer R, Prior M, Leekam S, Wing L, Gould J, Welham M, et al. Comparison of clinical symptoms in autism and Asperger's disorder. J Am Acad Child Adolesc Psychiatry. 1996;35:1523–1531. Abstract | Full-Text PDF (786 KB) | CrossRef
[21]. [21] Szatmari P, Archer L, Fisman S, Streiner DL, Wilson F. Asperger's syndrome and autism: differences in behavior, cognition, and adaptive functioning. J Am Acad Child Adolesc Psychiatry. 1995;34:1662–1671. Abstract | Full-Text PDF (977 KB) | CrossRef
[22]. [22] Miller J, Ozonoff S. The external validity of Asperger disorder: lack of evidence from the domain of neuropsychology. J Abnorm Psychol. 2000;109:227–238. CrossRef
[23]. [23] Mayes SD, Calhoun SL, Crites DL. Does DSM-IV Asperger's disorder exist?. J Abnorm Child Psychol. 2001;29:263–271. MEDLINE | CrossRef
[24]. [24] World Health Organization . The ICD-10 classification of mental and behavioral disorders. Geneva: Author; 1992;.
[25]. [25] Rutter M. The Emanuel Miller Memorial Lecture 1998. Autism: two-way interplay between research and clinical work. J Child Psychol Psychiatry. 1999;40:169–188. MEDLINE | CrossRef
[26]. [26] Bailey A, Palferman S, Heavey L, Le Couteur A. Autism: the phenotype in relatives. J Autism Dev Disord. 1998;28:369–392. MEDLINE | CrossRef
[27]. [27] Volkmar FR, Klin A, Cohen DJ. Diagnosis and classification of autism and related conditions: consensus and issues. In: Cohen DJ, Volkmar FR editor. Handbook of autism and pervasive developmental disorders. New York, NY: Wiley; 1997;p. 5–40.
[28]. [28] Gura T. Gene defect linked to Rett syndrome. Science. 1999;286(5437):27. MEDLINE | CrossRef
[29]. [29] Ozonoff S, Rogers S, Pennington B. Asperger's syndrome: evidence of an empirical distinction. J Child Psychol Psychiatry. 1991;32:1107–1122. MEDLINE | CrossRef
[30]. [30] Gillberg C, Gillberg C, Rastam M, Wentz E. The Asperger Syndrome (and high-functioning autism) Diagnostic Interview (ASDI): a preliminary study of a new structured clinical interview. Autism. 2001;5:57–66. MEDLINE | CrossRef
[31]. [31] Howlin P. Outcome in adult life for more able individuals with autism or Asperger syndrome. Autism. 2000;4:63–83. CrossRef
[32]. [32] Gillberg C. Asperger syndrome and high-functioning autism. Br J Psychiatry. 1998;172:200–209. MEDLINE | CrossRef
[33]. [33] Ghaziuddin M, Tsai LY, Ghaziuddin N. A comparison of the diagnostic criteria for Asperger syndrome [brief report]. J Autism Dev Disord. 1992;22(4):643–649. MEDLINE | CrossRef
[34]. [34] Leekam S, Libby S, Wing L, Gould J, Gillberg C. Comparison of ICD-10 and Gillberg's criteria for Asperger syndrome. Autism. 2000;4:11–28. CrossRef
[35]. [35] Szatmary P. Perspectives on the classification of Asperger syndrome. In: Klin A, Volkmar FR, Sparrow SS editor. Asperger syndrome. New York, NY: Guilford Press; 2000;p. 403–417.
[36]. [36] In: Klin A, Volkmar FR, Sparrow SS editor. Asperger syndrome. New York, NY: Guilford Press; 2000;.
[37]. [37] Rourke B. Nonverbal learning disabilities: the syndrome and the model. New York, NY: Guilford Press; 1989;.
[38]. [38] Fletcher JM. External validation of learning disability typologies. In: Rourke PB editors. Neuropsychology of learning disabilities: essentials of subtype analysis. New York, NY: Guilford Press; 1985;p. 187–211.
[39]. [39] Ehlers S, Nyden A, Gillberg C, Dahlgren Sandberg A. Asperger syndrome, autism and attention disorders: a comparative study of the cognitive profiles of 120 children. J Child Psychol Psychiatry. 1997;38(2):207–217. MEDLINE | CrossRef
[40]. [40] Lincoln A, Courchesne E, Allen M, Hanson E, Ene M. Neurobiology of Asperger syndrome: seven case studies and quantitative magnetic resonance imaging findings. In: Schopler E, Mesibov G, Kunce LJ editor. Asperger syndrome or high-functioning autism?. New York, NY: Plenum; 1998;p. 145–166.
[41]. [41] Lincoln AJ, Allen M, Kilman A. The assessment and interpretation of intellectual abilities in people with autism. In: Schopler E, Mesibov G editor. Learning and cognition in autism. New York, NY: Plenum; 1995;p. 89–117.
[42]. [42] Szatmari P, Archer L, Fisman S, Streiner DL, Wilson F. Asperger's syndrome and autism: differences in behavior, cognition, and adaptive functioning. J Am Acad Child Adolesc Psychiatry. 1995;34:1662–1671. Abstract | Full-Text PDF (977 KB) | CrossRef
[43]. [43] Ozonoff S. Neuropsychological function and the external validity of Asperger syndrome. In: Klin A, Volkmar FR, Sparrow SS editor. Asperger syndrome. New York, NY: Guilford Press; 2000;p. 72–96.
[44]. [44] Clarke DJ, Little Johns CS, Corbett JA, Joseph S. Pervasive developmental disorders and psychoses in adult life. Br J Psychiatry. 1989;155:692–699. MEDLINE
[45]. [45] Tantam D. Asperger's syndrome [annotation]. J Child Psychol Psychiatry. 1988;29:245–255. MEDLINE | CrossRef
[46]. [46] Kerbeshian J, Burd L. Asperger's syndrome and Tourette syndrome: the case of the pinball wizard. Br J Psychiatry. 1986;148:731–736. MEDLINE | CrossRef
[47]. [47] Ghaziuddin M, Tsai L, Ghaziuddin N. Comorbidity of autistic disorder in children and adolescents. Eur Child Adolesc Psychiatry. 1992;1(4):209–213. CrossRef
[48]. [48] Thomsen PH. Obsessive-compulsive disorder in children and adolescents: a 6–22-year follow-up study: clinical descriptions of the course and continuity of obsessive-compulsive symptomatology. Eur Child Adolesc Psychiatry. 1994;3:82–96. CrossRef
[49]. [49] Kim J, Szatmari P, Bryson S, Streiner DL, Wilson FJ. The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism. 2000;4:117–132. CrossRef
[50]. [50] Green J, Gilchrist A, Burton D, Cox A. Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorder. J Autism Dev Disord. 2000;30:279–293. MEDLINE | CrossRef
[51]. [51] Piven J, Palmer P, Jacobi D, Childress D, Arndt S. The broader autism phenotype: evidence from a family study of multiple-incidence autism families. Am J Psychiatry. 1997;154:185–190.
[52]. [52] Murphy M, Bolton PF, Pickles A, Fombonne E, Piven J, Rutter M. Personality traits of the relatives of autistic probands. Psychol Med. 2000;30:1411–1424. MEDLINE | CrossRef
[53]. [53] Piven J, Palmer P. Psychiatric disorder and the broad autism phenotype: evidence from a family study of multiple-incidence autism families. Am J Psychiatry. 1999;156:557–563.
[54]. [54] Bolton PF, Pickles A, Murphy M, Rutter M. Autism, affective and other psychiatric disorders: patterns of familial aggregation. Psychol Med. 1998;28(2):385–395. MEDLINE | CrossRef
[55]. [55] Folstein SE, Santangelo SL. Does Asperger syndrome aggregate in families?. In: Klin A, Volkmar FR, Sparrow SS editor. Asperger syndrome. New York, NY: Guilford Press; 2000;p. 159–171.
[56]. [56] Volkmar FR, Klin A, Pauls D. Nosological and genetic aspects of Asperger syndrome. J Autism Dev Disord. 1998;28:457–463. MEDLINE | CrossRef
[57]. [57] Bowman EP. Asperger's syndrome and autism: the case for a connection. Br J Psychiatry. 1988;152:377–382. MEDLINE | CrossRef
[58]. [58] DeLong GR, Dwyer JT. Correlation of family history with specific autistic subgroups: Asperger's syndrome and bipolar affective disease. J Autism Dev Disord. 1988;18(4):593–600. MEDLINE | CrossRef
[59]. [59] Gillberg C, Gillberg IC, Steffenburg S. Siblings and parents of children with autism: a controlled population-based study. Dev Med Child Neurol. 1992;34:389–398. MEDLINE
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