Comparison of ICD-10 and Gillberg's criteria for Asperger syndrome

By Susan Leekam, Sarah Libby, Lorna Wing, Judith Gould, and Christopher Gillberg (2000). autism, 4, 11-28.

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In this study, algorithms designed for the Diagnostic Interview for Social and Communication Disorders (DISCO) were used to compare the ICD-10 criteria for Asperger syndrome with those suggested by Gillberg. Two hundred children and adults were studied, all of whom met the ICD-10 criteria for childhood autism or atypical autism. Only three (1 percent) met criteria for ICD-10 Asperger syndrome. In contrast, 91 (45 percent) met criteria for Asperger syndrome defined by Gillber, which more closely resemble Asperger's own descriptions. Results showed that the discrepancy in diagnosis was due to the ICD-10 requirement for 'normal' development of cognitive skills, language, curiosity, and self-help skills.

The results emphasise the differences between the two diagnostic systems. They also question the value of defining a separate subgroup and suggest that a dimensional view of the autistic spectrum is more appropriate than a categorical approach.

They also indicate that it is time to move away from potentially circular attempts to differentiate Asperger syndrome and autism. For the time being, in practive, the most useful indication of current needs and future prognosis is overall level of ability.