2.1 Definitions and diagnosis
There is now
'a high degree of consensus on the diagnostic criteria for autism and consistency in
the evidence on the validation of autism as a diagnostic category.'
(Rutter, 1996, p. 257).
Kanner (1943) first identified a condition in eleven cases that he felt had sufficient in
common, and were sufficiently different from other conditions, to merit a separate syndrome.
He referred to this disorder as a disorder of affective contact and identified criteria in terms
of interpersonal development, communication and imagination deficits that have largely
stood the test of time. Wing and Gould (1979) established the fact that the condition often ...view middle of the document...
Nevertheless, educational distinctions between the groups may not be valid
and Wing (1996) has maintained that autism and Asperger syndrome are more alike than
different. In practice, there is considerable overlap between people diagnosed as having
Asperger syndrome and/or as having 'high functioning autism'. There are, naturally,
differences arising from good general intellectual ability and good structural language skills.
The existence of motor disturbance, often in the form of dyspraxia, can be associated with
autistic spectrum disorders. The authors of this research consider that these features (ie
intellectual ability, language ability, motor difficulties) are best seen as individual
characteristics that need to be considered when determining individual needs, but which are
not helpfully ascribed to any particular diagnostic label.
Theoretical confusion and debate over differential diagnosis, plus the fact that diagnosis is
more difficult at the extreme ends of the intellectual range (Wing, 1996), means that it is
likely that many intellectually able children with autism or Asperger syndrome are
undiagnosed. This is also because definitions of special educational need stress 'learning
difficulties' and many of these children will not have difficulties in academic learning, at
least of the more easily recognisable kind. If, in addition, they are socially active rather than
withdrawn, their difficulties are more likely to be misinterpreted in terms of conduct
disorders or emotional difficulties, not associated with autism. The term 'mild autism' which
is sometimes used for such children, gives a misleading impression of the extent of the child's
difficulties and so the use of the term 'Asperger syndrome' for those of higher ability is likely
to help professionals and parents identify able children with autism and to provide more
appropriately for their education.
2.3 Range of labels
Because of difficulties in diagnosis, a range of descriptions might be used by professionals to
describe a child on the autistic spectrum. Such descriptions will include 'autistic tendencies',
'autistic features', 'Kanner's syndrome', 'Asperger syndrome', 'autistic behaviours', 'atypical
autism' and so on. Sometimes, one of the diagnostic features is emphasised ('semantic
pragmatic disorder', for example, or 'rigid and obsessional behaviour') and then it will be
necessary to look at the other two classifying features to determine whether this is an autistic
spectrum disorder or whether the difficulties are limited to that one area of functioning. It
must be remembered that autism is diagnosed by the existence of the full triad of
impairments and the particular manifestation of the triad will vary among individuals. There
are no behaviours per se that by their presence or absence indicate autism; it is the overall
pattern and the underlying difficulties that define autism. Bishop (1989) wrote a...