How to Test for Asperger's

Co-authored by Meredith Brinster, PhD

Last Updated: June 30, 2022 References Approved

Asperger's Syndrome, now called autism spectrum disorder level 1 in the DSM-V, affects a person's ability to communicate and socialize.^{[1]
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Expert Source

Meredith Brinster, PhD
Licensed Clinical Psychologist
Expert Interview. 23 July 2021.} People with Asperger's have medium to high IQs and may achieve great success in life, but they struggle with social awkwardness and limited nonverbal communication skills. The symptoms of Asperger's are shared by people with a range of other disorders, so it can be tricky to diagnose.

Part 1

Part 1 of 3:

Recognizing the Signs

1
Look for unusual nonverbal communication skills. Starting from early childhood, people with Asperger’s exhibit marked differences in the way they communicate. These differences are the most noticeable symptoms, especially during childhood, before they have been taught tools they can use to communicate more effectively. Look for the following differences in communication style:^{[2]
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- A tendency to avoid eye contact.
- Limited use of varying facial expressions, and/or monotone voice.
- Limited use of expressive body language, such as hand gestures and nodding.
2
Notice difficulties with receptive language. People with Asperger's often struggle with auditory processing, and may take longer to process spoken words. They may say "What?" or "Could you repeat that?" often, only to figure out what someone said while the person is in the middle of repeating themselves.
- Remembering large amounts of spoken words may be difficult, and the person may prefer to have written directions when it comes to things they need to do.
- Some people with Asperger's experience selective mutism, only talking when they feel comfortable.^{[3]
  X
  Trustworthy Source
  PubMed Central
  Journal archive from the U.S. National Institutes of Health
  Go to source} They may also find it difficult or impossible to speak during sensory overload, a meltdown, or in general.
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3
Determine if the person has trouble reading the social cues of others. A person with Asperger’s may have difficulty imagining how others feel, and difficulty picking up on nonverbal cues.^{[4]
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Expert Source

Meredith Brinster, PhD
Licensed Clinical Psychologist
Expert Interview. 23 July 2021.} They may be confused about facial expressions or body language that conveys happiness, sadness, fear, or pain. Here are some ways this difficulty might manifest itself:
- The person might not recognize when they have said something hurtful, or when they're making someone uncomfortable in a conversation.
- A child might play too rough, not realizing that pushing or other aggressive physical contact can be painful.
- The person constantly asks about people's feelings (e.g. "Are you sad?" "Are you sure that you're tired?") because they aren't sure how the other person feels. If the other person answers dishonestly, they may become very confused and try to seek an honest answer instead of letting it be.
- While they may not understand, they often care deeply. The person will act very surprised, sad, and apologetic when told that their actions were inappropriate. In most cases, they had no idea. They may feel worse than the person whose feelings were hurt.
4
Notice awkward or one-sided conversations. Individuals with Asperger's may not always know how to maintain a back-and-forth conversation, especially when it comes to subjects of interest to them, or moral topics like human rights. They might become so wound up in the subject matter that they miss signs that the person they're talking to has something to say or is bored with the conversation.^{[5]
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- Some people with Asperger’s realize that they monopolize conversations sometimes, and are thus afraid to talk about their interests at all. If someone is hesitant to talk about their favorite subject, and seems to expect the other person to get upset or bored with them, then they may be trying to suppress this impulse for fear of social repercussions.
5
See if the person has intense passions. Many people with Asperger's take a special, almost obsessive interest in a few subjects. For example, a person with Asperger’s who is interested in baseball might memorize the name and stats of every player on every Major League team. Other people with Asperger’s might love writing, writing novels and spouting nuanced writing advice from a young age. Later in life, these passions can develop into successful and enjoyable careers.^{[6]
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6
See if the person has trouble making friends. People with Asperger’s may have trouble making friends, since they have a hard time communicating effectively. Many people with Asperger’s want to make friends with others, but lack the social skills to do so. Their avoidance of eye contact and awkward conversation attempts can be misread as rudeness or being antisocial, when really they would like to get to know people better.
- Some people with Asperger’s, especially young children, may not demonstrate an interest in interacting with others. This usually changes as they age, and they develop the desire to get along and fit in with a group.
- People with Asperger's might end up with just a few close friends who really understand them, or they may surround themselves with acquaintances they don't connect with on a deep level.
- Autistic people are more likely to be bullied, and trust people who take advantage of them.
7
Notice the person's physical coordination. People with Asperger's often lack coordination skills, and may be a little clumsy. They might often trip or bump into walls and furniture. They may not excel at performing heavy physical activity or sports.^{[7]
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Notice sensory sensitivities. People with Asperger syndrome may have over- or under-sensitive senses. This can mean avoiding and being distressed by overwhelming sensory input, or seeking out sensory input when bored or under-stimulated.
- The person may make repetitive movements to help them cope. However, some people with Asperger syndrome learn to suppress these healthy movements for fear of seeming "odd."
9
Recognize difficulty coping. Life can be challenging for people with Asperger syndrome, and sometimes things might become too much to bear. The person may withdraw, or have uncontrollable crying episodes.
10
Identify developmental delays, including delays beyond childhood. Developmental delays may be subtle, but they can make it difficult as the person tries to become more independent. Kids and teens with Asperger syndrome might find growing up to be difficult and scary, because they cannot keep up with all the new demands. Consider if the person is late when it comes to things like learning to swim, learning to ride a bike, doing chores independently, and/or learning to drive.
- Some people with Asperger's syndrome may have atypical development, rather than developmental delays.^{[8]
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  Expert Source
  
  Meredith Brinster, PhD
  Licensed Clinical Psychologist
  Expert Interview. 23 July 2021.}
11
Recognize a need for additional quiet time. Keeping up with the demands of life can be a challenge for Asperger syndrome, and having "down time" is often important for relaxing and recovering from the events of the day.
- Students with Asperger syndrome may need to rest for a while after school.

Part 2

Part 2 of 3:

Confirming the Diagnosis

1
Read up on Asperger's Syndrome to help you make decisions. Medical and psychological researchers are still in the process of learning how to correctly diagnose the disorder, as well as how it should be treated. You are likely to see different doctors and therapists take different approaches to treatment, and that can be very confusing. Reading up on your own will help you better understand the varying approaches and make decisions as to which ones are best for you or your family member.
- Read things written by autistic people. There is a lot of misinformation about autism, and autistic people can offer the deepest insight about how it works and which treatments are the most effective. Read literature from autism-friendly organizations.
- Organizations like the National Autistic Society or MAAP publish up-to-date information about diagnosing, treating and living with Asperger's.
- Reading a book written by someone with Asperger's about that experience is a good way to get insight into the disorder. Try Nerdy, Shy, and Socially Inappropriate by Cynthia Kim or Loud Hands: Autistic People, Speaking, an anthology of essays by autistic writers.
2
Keep a diary of symptoms you observe. Everyone exhibits social awkwardness and some of the other symptoms of Asperger's from time to time, but if you keep a diary and take note of each instance, you'll start to pick up on patterns. If the person really does have Asperger's, you're likely to see the same symptoms happening again and again, not just once or twice.
- Write down detailed descriptions of what you observe. That way, you'll be able to give potential doctors and therapists as much information as possible to help get a correct diagnosis.
- Keep in mind that many symptoms of Asperger's are shared by other disorders, like OCD or ADHD. It's important to be open to the possibility that it's something else (or multiple things), so this person can receive the right kind of treatment.
3
Take an online test. There are several online tests designed to determine whether a person might have Asperger's. The test taker is asked a series of questions related to their social activities, favorite ways to spend time, and strengths and weaknesses to see if the common symptoms of Asperger's seem to be present.^{[9]
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- The results of an online test for Asperger's syndrome are in no way the same as a diagnosis. Rather, it's a way to determine whether further testing might be necessary. If the test reveals a tendency towards autism, you might want to make an appointment with the family doctor to find out more.
4
Get your family doctor's opinion. After you've taken an online test and you're reasonably sure that a disability is present, start by making an appointment with your general practitioner. Bring your symptom journal and share your concerns. The doctor will likely ask you a series of questions and ask you to elaborate on the specifics. If the doctor shares your feeling that Asperger's or another developmental disability might be at play, ask for a referral to a specialist.^{[10]
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FamilyDoctor.org
Family-focused medical advice site run by the American Academy of Family Doctors
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- Having that first conversation with a professional can be an intense experience. Thus far, you may have kept your concerns mostly private. Sharing them with a doctor might change everything. But whether the person you're concerned about is yourself or your child, you're doing the right thing by acting instead of ignoring what you've observed.
5
See a specialist for a full evaluation. Before the appointment, do research on the psychiatrist or psychologist to whom you are referred. Make sure the person specializes in working with the autism spectrum. The appointment will probably consist of an interview and a test with questions similar to the questions on the online tests. Once a diagnosis is given, the specialist will give recommendations as to how to proceed.^{[11]
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- During your meeting, don't be afraid to ask a lot of questions about the person's experience, diagnosis and treatment approach.
- If you aren't completely confident that the diagnosis is correct, seek a second opinion.

Part 3

Part 3 of 3:

Taking the Next Steps

1
Work with a team of professionals you trust. Dealing with Asperger's requires a multi-pronged approach with teachers, caretakers, physicians, and therapists. It's very important to get outside help from experienced and compassionate professionals. First and foremost, find a psychologist or therapist you connect with and trust – someone you'll be glad to have in your life for years to come as you work through the challenges that accompany autism.^{[12]
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Cleveland Clinic
Educational website from one of the world's leading hospitals
Go to source}
- If something feels off or uncomfortable after a few therapy sessions, don't hesitate to find someone who's a better match for you or your child. Trust is an important element when it comes to therapy.
- In addition to finding a trusted therapist, you might want the insight of specialized educators, nutritionists, and other professionals who can help you navigate the special needs of you or your child.
- Beware abusive and predatory specialists. Signs of a bad specialist include cruelty (restraint, yelling, withholding food), training the person to act non-autistic, and refusing to allow parents or guardians to witness therapy. They make false promises, like saying that they can "cure" autism, even though autism is lifelong. If the person hates or fears therapy, it needs to stop.
2
Seek out emotional support. Living as an autistic person can be challenging, and learning to cope can be a lifelong process. In addition to meeting with doctors and therapists to figure out the best course of treatment, consider seeking support from the Autism NOW, ASAN, or a local Asperger's support group. Find people you can call when you have questions, or when you just need someone to talk to who understands what you're going through.
- Do an online search for autism/Asperger support groups in your town. There may be one associated with the schools in your area.
- Consider attending a conference put on by the US Autism and Asperger's Association,^{[13]
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  Research source} ASAN, or another prominent group. You'll gain access to a wealth of resources, learn about cutting-edge treatment methodologies, and meet people with whom you might want to keep in touch.
- Join an organization run for and by autistic people, such as ASAN or the Autism Women's Network. You can meet other autistic people while making a positive difference in the world.
3
Organize your life to meet your unique needs. People with Asperger’s face more challenges than neurotypicals, especially in the arena of social interaction. However, people with Asperger’s can have full, wonderful relationships – many marry and have children – and highly successful careers. Being mindful of the person's unique needs, helping them overcome their setbacks and celebrating their strengths can give them the best chance to have a fulfilling life.
- One essential way to make life better for a person with Asperger's is to have a routine you stick to, since this can help them feel more secure. When you do have to switch things up, take the time to explain exactly why so the person understands.
- Modeling social skills for someone with Asperger's can help them learn by example. For example, you can teach the person to say hello and shake hands while making eye contact. The therapist you work with will give you the right tools to do this effectively.^{[14]
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- Celebrating the person's passion and allowing them to run with it is a good way to support someone with Asperger's. Nurture the person's interest and help them excel at it.
- Show the person that you love them and their autism too. The best gift to give a person with Asperger’s is accepting them for who they are.

Warnings

If people refuse to believe you, do not give up. Asperger's Syndrome is a neurological difference that should be diagnosed and supported accordingly, and consulting a medical advisor is vital.

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Asperger's syndrome may be coupled with other disabilities, including OCD, anxiety, epilepsy, depression, Attention Deficit Hyperactivity Disorder, etc. If you suspect you have any of these disorders, bring it to the attention of someone close, or a medical consultant.

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