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Definition from Merriam-Webster Dictionary
Co-Morbid- existing simultaneously with and usually independently of another medical condition. |
There are many conditions that can be co-morbid with autism spectrum disorder.
Persons with Asperger Syndrome (A.S.) show marked deficiencies in social skills.
Diagnostic Criteria for 299.80 Asperger's Disorder
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The following is from Diagnostic and Statistical Manual of Mental Disorders: DSM IV
(I) Qualitative impairment in social interaction, as manifested by at least two of the following:
(A) marked impairments in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body posture, and gestures to regulate social interaction
(B) failure to develop peer relationships appropriate to developmental level
(C) a lack of spontaneous seeking to share enjoyment, interest or achievements with other people, (e.g.. by a lack of showing, bringing, or pointing out objects of interest to other people)
(D) lack of social or emotional reciprocity
(II) Restricted repetitive & stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
(A) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
(B) apparently inflexible adherence to specific, nonfunctional routines or rituals
(C) stereotyped and repetitive motor mannerisms (e.g. hand or finger flapping or twisting, or complex whole-body movements)
(D) persistent preoccupation with parts of objects
(III) The disturbance causes clinically significant impairments in social, occupational, or other important areas of functioning.
(IV) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)
(V) There is no clinically significant delay in cognitive development or in the development of age-appropriate self help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.
(VI) Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia."
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REFERENCES
Most patients presenting in clinical settings with AS have other co morbid psychiatric disorders. Ghaziuddin M, Weidmer-Mikhail E, Ghaziuddin N. "Co morbidity of Asperger syndrome: a preliminary report." J Intellect Disabil Res 42 ( Pt 4):279-83 PMID 9786442
Children are likely to present with attention-deficit hyperactivity disorder (ADHD), while depression is a common diagnosis in adolescents and adults. Ghaziuddin M, Weidmer-Mikhail E, Ghaziuddin N. "Co morbidity of Asperger syndrome: a preliminary report." J Intellect Disabil Res 42 ( Pt 4):279-83 PMID 9786442
Bipolar disorder, or manic-depression, is itself co morbid with a number of conditions, including autism. Autism includes some symptoms commonly found in mood and anxiety disorders. McElroy SL (2004). "Diagnosing and treating co morbid (complicated) bipolar disorder". The Journal of clinical psychiatry 65 Suppl 15: 35–44. PMID 15554795. Towbin KE, Pradella A, Gorrindo T, Pine DS, Leibenluft E (2005). "Autism spectrum traits in children with mood and anxiety disorders". Journal of child and adolescent psychopharmacology
Some children with autism also have gastrointestinal (GI) symptoms, but there is a lack of published rigorous data to support the theory that autistic children have more or different GI symptoms than usual. It has been claimed that up to fifty percent of children with autism experience persistent gastrointestinal tract problems, ranging from mild to moderate degrees of inflammation in both the upper and lower intestinal tract. Encopresis, University of Iowa Health Care, Center for Disabilities and Development, accessed August 17, 2006
Studies conducted by the Yale Child-Study Group suggest that up to 80% of children who meet the criteria for AD also have NVLD. While there are no studies on overlap in the other direction, most likely children with the more severe forms of NVLD also have AD. - David Dinklage, PhD, is Director of Neuropsychology and Co-Director of Training in Child Psychology at Cambridge Hospital in Massachusetts. He is also an Instructor in Psychology at the Harvard Medical School, and carries on a private clinical practice in Belmont, Massachusetts.
Research indicates people with AS may be far more likely to have the associated conditions. Stoddart, K. P. (Editor) (2005). "Children, Youth and Adults with Asperger Syndrome: Integrating Multiple Perspectives". London: Jessica Kingsley Publishers. ISBN 1-84310-268-4, p. 44.
People with AS symptoms may frequently be diagnosed with clinical depression, oppositional defiant disorder, antisocial personality disorder, Tourette syndrome, ADHD, general anxiety disorder, bipolar disorder, obsessive compulsive disorder or obsessive-compulsive personality disorder. Gillberg C, Billstedt E. "Autism and Asperger syndrome: coexistence with other clinical disorders." Acta Psychiatry Scand. 2000 Nov;102(5):321-30. PMID 11098802 Dysgraphia, dyspraxia, dyslexia or dyscalculia may also be diagnosed.AS-IF.org. Asperger Syndrome Information and features: Overlap. Retrieved 6 July 2006.
Some people with AS experience varying degrees of sensory overload and are extremely sensitive to touch, smells, sounds, tastes, and sights. Aquilla P, Yack E, Sutton S. "Sensory and motor differences for individuals with Asperger Syndrome: Occupational therapy assessment and intervention" in Stoddart, Kevin P. (Editor) (2005), p. 198.
In some cases, people with AS may have an odd way of walking, and may display compulsive finger, hand, arm or leg movements, including tics and stims. Jankovic J, Mejia NI. "Tics associated with other disorders". Adv Neurol. 2006;99:61-8. PMID 16536352 Mejia NI, Jankovic J. Secondary tics and tourettism. Rev Bras Psiquiatr. 2005;27(1):11-7. PMID 15867978
ASD is also associated with epilepsy, with variations in risk of epilepsy due to age, cognitive level, and type of language disorder. Tuchman R, Rapin I (2002). "Epilepsy in autism". Lancet Neurol 1 (6): 352–8. DOI:10.1016/S1474-4422(02)00160-6. P
When you speak about hyperlexia, you must talk about language learning disorder. When you talk about them both, you need to address autism. More recently, when you talk about hyperlexia, you need to think about the nonverbal learning disorders as well. When you talk about hyperlexia and nonverbal learning disorders, you must talk about Asperger's syndrome. When you talk about all of these, you always need to consider that Attention Deficit Disorder may be a coexisting trait. Lynn Richmann is professor and directory of the division of pediatric psychology at the University of Iowa College of Medicine. He directs the Pediatric Learning Disorders Clinic. This article is adapted from his presentation at the conference on hyperlexia held in Oak Brook Illinois, October, 1996
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