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Asperger's Disorder

by Tessa ten Tusscher, Ph.D.

Asperger’s Disorder (AD) is a developmental condition that is relatively rare, but frequently misdiagnosed. Children with this disorder usually have an average to above average intelligence, but have difficulty with social interactions, adherence to rules, and emotional sensitivity and reciprocity. AD is much more common in males. These deficits are often subtle and they can easily be missed in the classroom setting.

So what are the chief characteristics of this disorder? People with AD exhibit deficits in the following areas:

Social Interaction: Children with AD appear socially aloof, may have poor eye contact and, while wanting attention from their peers, do not have the skills to sustain positive interaction. Their major social deficit is an inability to understand the perspective of another person. This makes them seem to lack empathy.

Adherence to Rules: Children with AD need orderliness and structure. They may create their own rituals and insist that others adhere to their rules.

Language Development: During early childhood language development may be delayed. This is often followed by a "language burst" where children develop an extraordinarily broad vocabulary. However, they continue to have difficulty deriving the full meaning of both written and spoken language. This means that while it seems that they understand what is being said, they in fact miss subtle nuances of language.

Problem Solving: Children with AD appear to lack "common-sense." They have poor impulse control and deficits in planning, self-monitoring, and transitioning from one situation to another.

Motor Clumsiness: This is not an essential part of the syndrome and is usually seen in pre-school children. Motor clumsiness may extend into later development in children with AD.

AD is difficult to diagnose because many of these deficits are found in children with specific learning disabilities, obsessive-compulsive disorder, and autism. Diagnosis is further complicated because children frequently have co-existing disorders including tic disorders, Tourette’s, attention deficit/hyperactivity disorder, and mood disorders.

If a child is suspected of having AD, he or she should be referred to a neuropsychologist for evaluation. The neuropsychologist  will make the diagnosis by:

After a clear diagnosis is made, specific interventions can be developed to meet the academic, social, and emotional needs of the child. These include:

Teachers and parents of children with AD need education and support. Tony Atwood’s book, Asperger’s Syndrome: A Guide for Parents and Professionals, provides very useful and practical advice. 

There are also Web sites that have excellent information about Asperger’s Disease. On-line Asperger’s Syndrome and Support – OASIS – ( is a comprehensive and easy to navigate  site put together by a parent. Asperger’s Disorder Home Page ( has a lot of good information and links. 

Teachers, counselors, and health professionals  who would like information on diagnosis and how to develop academic or other interventions are welcome to contact the clinicians at BAPTA.

Dr. Tessa ten Tusscher is the founder and president of Bay Area Psychological Testing Associates. A clinical psychologist, she specializes in geriatric assessment and forensic consultation. Dr. ten Tusscher currently serves as the Training Director at the Institute on Aging, and supervises doctoral students’ research at the Wright Institute and CSPP. She has been a research psychologist and consultant to numerous agencies including UCSF/Mount Zion, Lakeside Medical Center, Elan Pharmaceuticals, and several large San Francisco law firms. Dr. ten Tusscher has taught extensively, both as a training psychologist, and at the University of California at Berkeley as a visiting scholar in sociology. She has provided expert testimony in a number of criminal and civil cases. Dr. ten Tusscher is on the Board of Directors of the San Francisco Psychological Association and is a past board member of the California Psychological Association.

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