1. Asperger ’ s Disorder for the General Practitioner: Diagnosis, Misdiagnosis, and Missed Diagnosis Presented by Debra Moore, Ph.D. Fall Creek Counseling Associates www.sacramentopsychology.com

2. Could it be Asperger ’ s … ?

5. Diagnosis

11. DSM-IV (continued) C. The disturbance causes clinically significant impairment in social, occupational or other important areas of functioning. D. There is no clinically significant general delay in language (e.g., single words used by age 2 years, communicative phrases used by age 3 years)

12. DSM-IV (continued) E. No clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behavior (other than in social interaction), and curiosity about the environment in childhood. F. Criteria are not met for another specific PDD or Schizophrenia.

15. “ Aspies ” “ Neurotypicals ”

18. Asperger ’ s writings were basically ignored for almost 20 years. Then ……… ..

21. Missed Diagnosis

22. 3 important concepts Theory of Mind Central Coherence Executive Functioning

23. Theory of Mind (also called mentalizing) a specific cognitive capacity: the ability to understand that others have beliefs, desires and intentions that are different from one's own. thought to be hard wired.

30. Language Impairment in Asperger's phonology , the ability to handle speech sounds; syntax , the ability to operate rules of grammar; semantics , the ability to understand and create meaning, pragmatics , the ability to use language for the purpose of communication . This last ability, pragmatics , is universally a problem in Asperger's.

38. Missing the big picture Those with Asperger ’ s may use binoculars all the time, and isn ’ t interested in sharing the view with others.

50. Diagnostic Rating Scales for Asperger ’ s Disorder

55. Misdiagnosis

78. Avoidant : wants to go to the prom, but is too shy and nervous to ask anyone. If someone fixes him up with someone he is comfortable with, he ’ ll go and may have a good time. Schizoid : doesn ’ t particularly want to go and doesn ’ t ask anyone. Asperger ’ s : wants to go and asks the head cheerleader and doesn ’ t understand why she laughs at him.

83. The End