Differentials
Other causes of disordered development/learning difficulties/intellectual disability, or another neurodevelopmental disorder
SIGNS / SYMPTOMS
Children or adults do not seem to the specialist to meet criteria for ASD and may have one of many other neurodevelopmental disorders underlying their difficulties.
In some children, a unifying diagnosis cannot be identified.
INVESTIGATIONS
The clinical history, standardized interviews, and observational tools help a clinician come to a conclusion.
Note that other causes of disordered development, such as intellectual or other neurodevelopmental disorders, may co-occur with ASD.
ADHD
SIGNS / SYMPTOMS
Children or adults have problems with attention and hyperactivity.
Children do not have the same degree of social communication difficulties as children with ASD.
The early developmental history is of hyperactivity rather than features of ASD.
ADHD and ASD may co-occur, but there may also be an overlap of symptoms between the two diagnoses. For example, children with ASD with delayed language may appear inattentive, even in the absence of ADHD. In addition, the focus on perseverative interests seen in ASD may present as distraction, which can mimic ADHD.[29]
INVESTIGATIONS
The clinical history, standardized interviews, and observational tools help a clinician come to a conclusion.
Note that ADHD may co-occur with ASD.[33]
Social (pragmatic) communication disorder
SIGNS / SYMPTOMS
Individuals show impairment in social communication and social interactions, but show no restricted and repetitive behavior or interests.[1]
INVESTIGATIONS
The clinical history, standardized interviews, and observational tools help a clinician come to a conclusion.
A diagnosis of social (pragmatic) communication disorder should be considered only if the developmental history fails to reveal any evidence of restricted/repetitive patterns of behavior, interests, or activities.[1]
Schizoid personality disorder
SIGNS / SYMPTOMS
Relatively later age of onset for schizoid disorder and the prominence of accompanying "pseudo-psychotic" symptoms of a persecutory, grandiose, or otherwise quasi-scientific nature.
INVESTIGATIONS
Clinical history and structured mental state examination to elicit signs of current mental state.
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