Asperger Syndrome and the Difficulties of Diagnosing and Treating Related Conditions

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In the April issue of Exceptional Parent (EP) magazine, readers of the military section met Jose Cotto, 13-year-old son of Captains Ada and Victor Cotto of Fort Benning, Georgia ("Building Life Skills for Children with Asperger Syndrome," by Eileen G. Pollack, MA, and Dennis C. Russo, PhD, ABPP). Before being diagnosed with Asperger syndrome, Jose had been misdiagnosed with anger management issues and attention deficit hyperactivity disorder (ADHD). An accurate diagnosis and effective treatment for his symptoms have made a world of difference--helping him control his temper, focus his attention, and improve his communication skills. Once angry and isolated, Jose has made significant academic progress as well as many new friends. Yet there is much to be done for children with a diagnosis of Asperger syndrome.

Not all children and adolescents with Asperger syndrome are as fortunate as Jose. Misdiagnosis is common. So is a lack of understanding that Asperger syndrome is often accompanied by other disorders. Estimates vary, but as many as 40 percent of individuals with Asperger's also have another condition. This secondary condition is referred to as a "co-occurring" disorder. Many co-occurring disorders are psychiatric in nature and require attention from parents, teachers, and professionals. The most common co-occurring disorders are ADHD, obsessive-compulsive disorder (OCD), and mood disorders such as depression and anxiety.

Diagnosing co-occurring disorders in children with Asperger's can be challenging (see sidebar). These youngsters may have difficulties with communication, self-expression, and social interactions, and may be unable to easily share or describe their feelings. Diagnosis is also challenging because Asperger's and some of these other disorders share common characteristics. Unless a thorough evaluation is conducted, it can be difficult to distinguish between the disorders or to identify co-occurring conditions.

A proper diagnosis of a single or co-occurring disorder should be made by a qualified professional such as a pediatrician, psychiatrist, or psychologist. This specialist will provide a diagnosis based on direct observations of the child's behavior, interactions …