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©2013 UpToDate ® Print Email Differential diagnosis of Asperger disorder Condition Features that may help to distinguish the condition from Asperger disorder Pervasive developmental disorders Autistic disorder Significant abnormalities in language, play, and cognitive skills; onset before age three years High-functioning autism (HFA) Significant abnormalities in language, play, and cognitive skills; onset of symptoms before age three years, but diagnosis may be made later than for autistic disorder. The difference between HFA and Asperger disorder is an area of controversy. Pervasive developmental disorder not otherwise specified Some, but not all, of the criteria for autistic disorder are present (may have late age of presentation, or atypical or subthreshold symptoms; or may meet only two of the three criteria for autistic disorder) Rett disorder Female predominance; head growth deceleration; loss of skills Childhood disintegrative disorder Marked intellectual disability and language impairment Other disorders Attention deficit hyperactivity disorder* Lack of impairment in social interaction; lack of restricted patterns of behavior; normal pragmatic language skills Schizophrenia* Hallucinations; delusions; disorganized speech Selective mutism Lack of impairment in social interaction; normal ability for communication in some settings; lack of restricted patterns of behavior and stereotypies Language disorder (expressive or mixed receptive-expressive) Normal social skills; lack of restricted patterns of behavior; lack of stereotypies; onset before age three years Nonverbal learning disorder* Less impairment in social skills and pragmatic language than for individuals on the autism spectrum; verbal skills typically stronger than nonverbal skills; do not show the same repetitive behaviors and restricted interests Obsessive compulsive disorder* Normal social skills; normal pragmatic language; restricted/repetitive behaviors are a source of anxiety rather than a pleasure (as they are in autistic disorder or Asperger disorder) Social phobia/anxiety* Lack of pervasive impairments in social development; lack of circumscribed interests; subjective distress about social interactions and about specific situations Normal social awkwardness Normal age-appropriate interests and hobbies; normal pragmatic language skills * May occur comorbidly with Asperger disorder. Data from:

Social phobia/anxiety* Lack of pervasive impairments in social development; lack of circumscribed interests; subjective distress about social interactions and about specific situations Normal social awkwardness Normal age-appropriate interests and hobbies; normal pragmatic language skills * May occur comorbidly with Asperger disorder. Data from: Asperger's disorder. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR®). American Psychiatric Association, Arlington, VA 2000. p.80. Johnson CP, Myers SM. Autism spectrum disorders. In: Developmental-Behavioral Pediatrics. Evidence and Practice. Wolraich ML, Drotar DD, Dworkin PH, Perrin EC (Eds). Mosby Elsevier, Philadelphia 2008. p.519.