Subtyping the Autism Spectrum Disorder: Comparison of Children with High Functioning Autism and Asperger Syndrome.
Concetta de Giambattista, Patrizia Ventura, Paolo Trerotoli and 3 others
PMID 30043350WHAT IT FOUND
Children previously labelled Asperger syndrome or high-functioning autism looked similar in core autism features, but the Asperger group had higher IQ, more pedantic speech, and fewer language and school difficulties.
The old labels did not map cleanly onto DSM-5 severity levels.
Key findings
01The AS group had higher full-scale IQ than the HFA group (mean 114.1 vs 92.1), and all IQ sub-values were higher in AS.
02The clearest language and communication differences were late speech in HFA (32.5% AS vs 55.7% HFA) and pedantic speech in AS (56.3% vs 30.0%).
03Most children met DSM-5 ASD criteria (97.3%), but severity levels agreed only poorly with the old AS/HFA labels (Cohen's K = 0.42).
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
Single-centre study of children who already had a DSM-IV-TR diagnosis and average or above IQ, so it does not speak to newly diagnosed children or those with intellectual disability. The HFA group was mostly PDD-NOS (63 of 70), a heterogeneous label, and the paper says results may not extend to the broader ASD category. The AS and HFA groups differed in age (mean 11.5 vs 8.9 years) and IQ, so differences in language and school learning may be confounded by age or cognitive level. School learning results come from a subsample of 117 school-aged children, not all 150 participants. DSM-5 severity levels were compared with old diagnostic labels that served different purposes, and concordance was poor (Cohen's K = 0.42). The study compared many outcomes, so individual differences need to be weighed against the adjusted p-values and confidence intervals.
The easy way to misread this
Do not read these group differences as proof that Asperger syndrome and high-functioning autism are separate disorders. Many core features overlapped, and the DSM-5 severity classification agreed only poorly with the old labels.