AS and average to above average IQ

Could you please comment on the subject of the diagnosis of AS and it's association with a child having an average to above average IQ. My fourteen year old son was recently diagnosed PDD-NOS and the primary reason for not being diagnoses AS was his less than average IQ (Full Scale IQ = 51). Although his IQ places him in the mild metal retardation range, he is far from retarded, functions very well [actually], is social and ironically, has an almost a politician like social side/interest despite his typical lacking ASD social skills. He is spot on AS according to everything I have read - the exception is his IQ. I am curious to know if the children referenced here on IAN with dx of AS have higher than average IQ's and what, if anything, is being consider with regard to DSM-IV diagnostic criteria... not "just" because of my child, but the considerable varying attributes of all our children. Thank you!

Hi MonsterJamKidsDad.

You were asking about why a child who seems to fit the Asperger's profile was given a diagnosis of PDD-NOS based on his IQ.

In brief, according to the DSM-IV (which provides the guidelines for making psychiatric and developmental diagnoses), having no cognitive and no speech delay are two of the elements that are supposed to determine who should be given an Asperger's diagnosis as opposed to some other ASD diagnosis. PDD-NOS is often given when a child doesn't quite meet the criteria for "classic" autism or "classic" Asperger's as described in the DSM-IV. That can be frustrating if you come to feel that your child looks a lot like the descriptions you have read of people with Asperger's, and Asperger's would be a meaningful identity that helped make your child's whole set of challenges and gifts understandable. (Actually, as long as it works, and the information you get by reading books and articles on Asperger's is helpful, you should just keep on reading!)

In practice, out in the community, things don't always go "by the book," which is quite old now, and I have certainly met people who had an Asperger's diagnosis even when they had suffered a speech delay as a child or had a less than "normal" IQ. Looking at one subsample of 836 children with autism or Asperger's participating in IAN, for example, I found that 74% of children with Asperger's had phrase speech by the age of 3 compared with 26% of children with autism. Still, there were some children with Asperger's who did NOT have phrase speech by three. Likewise, I found that, of the 364 in my sample who reported an IQ and/or a mental retardation diagnosis, 13% of the children with Asperger's had an IQ of 85 or lower.

In any case, when the DMS-IV is revised to become the DSM-V, they are planning to eliminate Asperger's as a diagnosis and replace all of the ASDs with just "Autism Spectrum Disorder." People will then also be given a "severity" level based on social/communication difficulties and restricted/repetitive behaviors and interests.

You can see the draft criteria and explanations here: http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=94#

(Be sure to look at all the tabs leading from that page.)

When/if the Asperger's category is eliminated, everyone using that label will be challenged to adapt to a new way of thinking and naming that set of characteristics, from families to clinicians to teachers to researchers to individuals with Asperger's themselves.