고기능자폐증과 아스퍼거장애 비교 연구

Abstract

There is remarkable similarity and overlap between high-functioning autism (HFA) and Asperger's disorder (AS), with core impairments in socialization, communication, and imagination being recognized as fundamental and universal in both conditions. As a result, there has been a long-standing controversy over the distinction between these disorders. The purpose of this study was to make a comparison between HFA and AS by using a case study research method, focusing on three research questions: (1) Is there any simililarities between HFA and AS? (2) Is there any differences between HFA and AS? (3) Are HFA and AS distinguishable? HFA and AS were comparatively examined in terms of such characteristics as social interaction, communication, restricted/repetitive/stereotyped patterns of behavior/interests/activities, intelligence, motor function, and comorbidity. For this investigation, three different methods were employed including diagnostic tests, semistructured interviews, and anecdotal records of two HFA-diagnosed children(1 male, 1 female; mean age 10.0 years; mean full-scale IQ 98.5) and two AS-diagnosed children(2 male; mean age 10.4 years; mean full-scale IQ 95.5). The results were follows: First, there were no differences between HFA children and AS children in qualitative impairment of reciprocal social interaction, restricted/repetitive/stereotyped patterns of behavior/interests/activities, ADHD, full scale IQ, and motor function. Second, there were some different clinical features between HFA children and AS children. Children with HFA suffered from a clinically significant general delay in language by age 3 years, but those with AS did not. Children with HFA demonstrated more impaired communication abilities than those with AS. Children with AS had a tendency for pedantic speech pattern but children with HFA did not. Children with HFA had an aloof and passive type, but those with AS had an active but odd type in their social impairments. Children with HFA showed a tendency toward stereotyped behavior, but childen with AS had a tendency toward all absorbing interests. Children with AS exhibited higher scores in verbal IQ than in performance IQ and those with HFA showed the opposite pattern, Third, this study proposed such distinctive clinical features between children with HFA and those with AS as follows: precedent and early onset of language development delay (by 3 years vs later), the distinctive level of communication impairment (severe vs mild), the pedantic speech (existing or not), the type of social impairments (aloof and passive vs active but odd), stereotyped behavior vs tendency of all absorbing interests, and the whether verbal IQ is higher than performance IQ or not. The conclusion was that it is desirable to maintain the distinction between HFA and AS for the time being, and related research should be conducted continuously. Along with the conclusion, several suggestions were presented for future related research.