Gillberg's Criteria For Asperger's (AS)

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JohnnyD017
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01 Nov 2009, 8:28 pm

hush6 wrote:

Isn't this thread supposed to be about discussing certain aspects of the crieteria and not just people clambering to tell everyone how many traits they have??? And who cares anyways, this criteria a joke imo.

You could also argue that the DSM4 criteria is a joke too and Ive heard some experts say that.

Things like depression could really mess up a diagnosis with this criteria, cos of the flat voice and lack of gestures. But same could be said for the DSM one, but its just easier to screw with this one if you assess somebody at the wrong time.

The narrow interest is an interesting one. Does a lack of narrow interest but with some of the other traits mark someone as borderline AS/NT? Could people far into the spectrum have a lack of narrow interest too? I havent heard of that happening before, though.

Asking people whats in the room, i dunno if that would work. You might be able to confirm SOME people on ASD that way but even people with AS will *probably* notice the people in the room first, unless they think its a trick question.

For those who dont know, rote learning is about repetition. Basically it means you're doing something cos its repetitive rather than enjoying it for what it is.

Sorry if I started the 'clambering'! I was trying to show that someone whod been pulled up by the DSM could get a totally different result out of this set of criteria. Some people like to compare themselves to each other too, can be interesting

hush6
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01 Nov 2009, 8:42 pm

I do think the DSM is a joke, maybe even worse than this list.

There is no crieteria that exists yet that is an accurate description of symptoms or reasons for symptoms experienced by people with AS. Right now it is just a shambles of very generalized observations that can be applied to almost anyone that isn't a social butterfly, anyone who has experienced trauma/neglect, anyone who is more driven by intellect and logic rather than emotion (but not on the spectrum)...

No list contains any trait that is SPECIFIC to having AS and applies to 100% of people on the spectrum. It is just a bunch of misinformed guesses.

Spokane_Girl

01 Nov 2009, 8:50 pm

No kidding. Even anorexics can meet the DSM AS criteria because well you only need to meet one thing in the second part and that is obsessions and all and their obsession be about their body and weight and food. It be in their routine too for work outs and all or else they get anxious if they don't do it. The first part you only need to meet two and they do have social problems because people can't stand them because they're so cranky. They might also avoid people too and not bother seeking enjoyments with others. Because of their new AS, it impairs them. No wonder some doctors have called anorexia the female AS :lol:

hush6
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01 Nov 2009, 9:00 pm

Some info and DSM for a separate disroder (I have removed the 'causes' part because I just want to show how close the symptoms are)

Quote:

"Reactive attachment disorder is broken into two types — inhibited and disinhibited. While some children have signs and symptoms of just one type, many children have both.

Inhibited type:
In inhibited reactive attachment disorder, children shun relationships and attachments to virtually everyone. This may happen when a baby never has the chance to develop an attachment to any caregiver.
Signs and symptoms of the inhibited type may include:
Resisting affection from parents or caregivers
Avoiding eye contact
Appearing to seek contact but then turning away
Difficulty being comforted
Preferring to play alone
Avoiding physical contact
Failing to initiate contact with others
Appearing to be on guard or wary
Engaging in self-soothing behavior

Quote:

DSM-IV 313.89: Reactive Attachment Disorder of Infancy or Early Childhood

* Beginning before age 5 and occurring in most situations, the patient’s social relatedness is markedly disturbed and developmentally inappropriate. This is shown by either of:
o Inhibitions. In most social situations, the child doesn’t interact in a socially appropriate way. This is shown by responses that are excessively inhibited, hypervigilant or ambivalent and contradictory. For example, the child responds to caregivers with frozen watchfulness or mixed approach-avoidance and resistance to comforting.
o Disinhibitions. The child’s attachments are diffuse, as shown by indiscriminate sociability with inability to form appropriate selective attachments. For example, the child is overly familiar with strangers or lacks selectivity in choosing attachment figures.
* This behavior is not explained solely by a developmental delay (such as Mental Retardation) and it does not fulfill criteria for Pervasive Developmental Disorder.

Specify type, based on predominant clinical presentation:

* Inhibited Type. Failure to interact predominates.
* Disinhibited Type. Indiscriminate sociability predominates.

Like AS, there is no specific criteria to diagnose adults with this disorder, but here is some words on what untreated childhood RAD turns into, sounds alot like what undiagnosed AS people turn into.

Quote:

Adult Attachment Disorder & Treatment

Unresolved childhood attachment issues leave an adult vulnerable to difficulties in forming secure adult relationships. Patterns of attachment continue through the life cycle and across generations. New relations are affected by the expectations developed in past relationships. There is a strong correlation between insecure adult attachment and marital dissatisfaction and negative marital interactions. If an adult does not feel safe with others, he/she will tend to be either rejecting of their partner or overly clingy.

Attachment problems are often handed down transgenerationally unless someone breaks the chain. As a parent, an insecurely attached adult may lack the ability to form a strong attachment to their child and provide the necessary attachment cues required for the healthy emotional development of the child thereby predisposing their child to a lifetime of relationship difficulties.

Depending on the genetic personality style of the individual and the early life events experienced, insecurely attached adults fall in one of two categories of insecure attachment:
AVOIDANT

Intense anger and loss
Hostile
Critical of others
Sensitive to blame
Lack of empathy
Views others as untrustworthy
Views others as undependable
Views self as unlovable or "too good" for others
Relationships feel either threatening to one's sense of control, not worth the effort, or both
Compulsive self-reliance
Passive withdrawal
Low levels of perceived support
Difficulty getting along with co-workers, often preferring to work alone
Work may provide a good excuse to avoid personal relations
Fear of closeness in relationships
Avoidance of intimacy
Unlikely to idealize the love relationship
Tendency toward Introjective depression (self critical)

ANXIOUS/AMBIVILENT
Compulsive Caregiving
Feel overinvolved and underappreciated
Rapid relationship breakups
Idealizing of others
Strong desire for partner to reciprocate in relationship
Desire for extensive contact and declarations of affections
Overinvests his/her emotions in a relationship
Perceives relationships as imbalanced
Relationship is idealized
Preoccupation with relationship
Dependence on relationship
Heavy reliance on partner
Views partner as desirable but unpredictable (sometimes available, sometimes not)
Perceives others as difficult to understand
Relationship is primary method by which one can experience a sense of security
Unlikely to view others as altruistic
Sensitive to rejection
Discomfort with anger
Extreme emotions
Jealous
Possessive
Views self as unlovable
Suicide attempts
Mood swings
Tendency toward anaclitic depression (dependent depression)

Skilpadde
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02 Nov 2009, 6:33 am

hush6 wrote:

Not one category relating to emotional development or a delay in emotional maturity. Until this becomes a part of the AS criteria (as it is a major reason we are 'impaired' socially - we are emotionally younger than our peers in spite of intelligence), I'll never fully relate to a list like that.

I'm not convinced about this. I had feelings like disappointment and humiliation at early age (2 1/2) when one supposedly only feel basic feelings.
Or did I misunderstand you?

How I fit Gillberg's criteria:
1 a, b and c and d
2 a and b, never c
3 a and somewhat b
4 e, some teachers have claimed also c
5 a and c, don’t know about b, d and e
6 Can be very clumsy

Not really sure what he means with these two:
1.(d) emotionally inappropriate behavior

4.Speech and language problems
(b) superficially perfect expressive language

Language is either perfect or not, how can it be superficially perfect?
And what is emotionally inappropriate? To not feel what is expected? Or something else?

AmberEyes
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02 Nov 2009, 7:03 am

Spokane_Girl wrote:

I would probably say "everything" to what is the first thing you see question or "the room" because he did say "first thing" not "what do you see."

I'm still trying to work out how this question could be phrased or presented.

Maybe it should be a more general:
'What do you see?'

But that would discount everything that the participant could hear, smell and taste if the question was taken literally. Unless each of the senses could be examined in turn.

'What do you hear?'

'What do you smell?'

etc.

The personality and tone of the questioner could also influence the response of the participant.

How do you see the world?

Isn't an easy question to phrase and can potentially be a leading question.

Should it be.

How do you experience the world?

People will say what they see first, first anyway, so maybe the word 'first' would be a redundant part of the question.

pandd
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02 Nov 2009, 11:14 am

hush6 wrote:

Well perhaps to someone who lacks the expertise to apply the criteria as it is intended. The criteria is not written with the lay person in mind, but rather for a specific audience who are assumed to bring to their reading particular understandings and expertise that necessarily preclude the interpretation you have arrived at.

Quote:

No list contains any trait that is SPECIFIC to having AS and applies to 100% of people on the spectrum.

This is actually not accurate either.

Quote:

It is just a bunch of misinformed guesses.

The criteria in the current DSM for AS are rudimentary, rough and raw; none of which is surprising given the state of information available when this text was last updated. None the less, they are not wholly inadequate, and are functional when appropriately applied by someone incorporating appropriate expertise.

buryuntime
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05 Nov 2009, 12:44 am

I hope in the next DSM sensory issues are a criteria.

Actually, I think it'd be interesting if we made up our own criteria that... didn't suck.

Wedge
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08 Nov 2009, 11:06 am

buryuntime wrote:

1. Why does it put more emphasis on Speech and Language rather than social interaction?

I guess I agree with Gillberg's diagnosis criteria. The explanations is this. In the DSM-IV one of the differences between autism and AS diagnosis is that autism involves a diagnostic criterion labled "Qualitative Impairments in Communication" consisting of 4 items. On the other hand, there is no criterion of impaired communication in AS the only criterion is that "there is no clinically significant general delay in language”. That way the DSM-IV omits some of the problems involved in communication and language first highlighted by Aspergers (1944). In fact, many professionals claim that while there is no language delay in AS their use of language is far from normal.
Acording to Asperger (1944) there was problems with pragmatics in his students (the context in which the language is used) which caused disturbed social interation. Asperger noticed oddities in their students language, describing his children as speaking like “little adults” in a pedantic manner using a large vocabulary. Later researchers also highlighted one-sidedness and lack of reciprocity in the communication of children with AS.
These aspects of Asperger's work are not included in the diagnostic criteria of DSM-IV and are correclty included in Gillberg's criteria. That is why I think Gillberg's criteria is a good one.

ASPartOfMe
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10 Aug 2014, 3:33 pm

vGILLBERG'S CRITERIA FOR ASPERGER'S DISORDER

A. Am I an Gillberg styled Aspie?

1.Severe impairment in reciprocal social interaction
(at least two of the following)
(a) inability to interact with peers:
Yes

(b) lack of desire to interact with peers:
Yes

(c) lack of appreciation of social cues:
Yes

(d) socially and emotionally inappropriate behavior:
Got a lot of that under control

I qualify for #1

2.All-absorbing narrow interest
(at least one of the following)
(a) exclusion of other activities:
Absolutely

(b) repetitive adherence:
Yes Yes did I say Yes?

(c) more rote than meaning:
Sometimes

I qualify for #2

3.Imposition of routines and interests
(at least one of the following)
(a) on self, in aspects of life
Absolutely

(b) on others:
Yes

I qualify for # 3

4.Speech and language problems
(at least three of the following)
(a) delayed development:
Don't know too long ago

(b) superficially perfect expressive language:
Probably
(c) formal, pedantic language:
Not so much anymore

(d) odd prosody, peculiar voice characteristics:
Yes. Mumble/unintelligible at times at times. Getting to be more of a problem as I interact more with older people with hearing problems.

(e) impairment of comprehension including misinterpretations of literal/implied meanings:
Yes

Probably fall short for number 4 see comment below

5.Non-verbal communication problems
(at least one of the following)
(a) limited use of gestures
Don't think so

(b) clumsy/gauche body language
Yes
(c) limited facial expression
Yes

(d) inappropriate expression
Yes

(e) peculiar, stiff gaze
Yes

Qualify for #5

6.Motor clumsiness: poor performance on neurodevelopmental examination
Yes

Qualify for 6
I may fall short of diagnosis because of number 4 or as because as with any criteria clinician.interpretation.

B. Comment
It is ironic I may fall short of diagnosis with this criteria because of #4 because I am glad unlike nearly everywhere else speech problems are recognized for aspergers. He just went overboard with this requiring you qualify for three when all other criteria requires 1 or 2. I am also glad unlike elsewhere motor clumsiness is recognized.

What I don't like is that there is not enough of a recognition of a spectrum. He should have required 4 or 5 of the 6 not all 6. And no mention of sensory or Executive Functioning. We do have to remember this came out in the relatively dark days of 1989.

Overall I like and feel closer to this criteria then the DSM. I feel a combination of this and the DSM were used the non savant/not very high functioning Autistics would not feel excluded from the Aspergers and Aspie nomenclature. This is how it should be. That it is not that way is a f*****g shame because this is closer to the traits Hans Asperger described. All of the above is not meant to suggest that people who are in long term marriages and have successful careers are not Autistic and do not face major difficulties.

_________________
“Self Acceptance is a process not a performance”
“You are autistic enough. And you always have been”

Professionally Identified and joined WP August 26, 2013
DSM 5: Autism Spectrum Disorder, DSM IV: Aspergers Moderate Severity.

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