Aspergers Syndrome, High-Functioning Autism, and PDD:NOS

iStock_000012622375XSmallAsperger’s Syndrome (AS), High-Functioning Autism (HFA), and Pervasive Developmental Disorder: Not Otherwise Specified (PDDNOS) are disorders related to autism, a neurological developmental disorder characterized by impairment in social interactions, deficits in communications skills, and restricted and repetitive behaviors and interests. Examples of social difficulties include making poor eye contact, forming few peer relationships, demonstrating limited social reciprocity, and misreading or missing social cues. Examples of restricted and repetitive behaviors and interests include self-stimulatory behaviors (e.g., rocking and hand flapping), narrow and intense interests in a specific subject matter (e.g., preoccupations with trains or maps),  and the need to stick to rigid routines or rituals. Language difficulties in autism range from total mutism to idiosyncratic speech and verbal habits (e.g., repeating words and phrases, misusing pronouns). In contrast to those with other autistic disorders, individuals with AS present with typical, or even superior, language skills.

A part of the autism spectrum, AS, HFA, and PDDNOS share many characteristics with obsessive-compulsive spectrum disorders (OCSD). In particular, OCSD and autism are both defined in part by repetitive movements or habits. Some of the time, the repetitive movements or habits in autism are anxiety-related, indicating that they may be similar in nature to the anxiety-related repetitive rituals seen in OCSD. For this reason, some of the interventions used to treat repetitive behaviors in OCSD may be applied to repetitive behaviors seen in ASD.

Preliminary evidence supports the use of cognitive-behavioral therapy (CBT) for Asperger’s and other high-functioning variants of autism (e.g., HFA, PDDNOS). CBT for this population often includes assessing and altering maladaptive beliefs about the world, practicing social skills,  improving perspective-taking, role-playing, finding constructive uses for preoccupations and talents, and reducing impairing repetitive movements and habits.

Since CBT requires the patient to process his or her thoughts verbally and complete complex written assignments, the approach is appropriate for a minority of individuals on the autism spectrum. Thus, CBT Solutions of Baltimore provides services only to individuals with autism who are 18 years and older and fully verbal or close to fully verbal. The services are not appropriate for lower-functioning children or adults with autism, or young children in need of early intensive behavioral intervention. CBT Solutions of Baltimore does not provide Applied Behavior Analysis or treatment for individuals who have mild, severe, or profound intellectual disability. For information on resources for autism in the region, please consult Pathfinders for Autism.