Brief report: A reappraisal of clumsiness as a diagnostic feature of Asperger syndrome

Abstract

Asperger syndrome, first described by the Austrian physician Hans Asperger (1944), is an uncommon disorder whose clinical features overlap with those of autism (Kanner, 1943) and schizoid personality disorder (Wolff & Barlow, 1979;Wolff & Chick, 1980). Some authorities regard it as part of the "autistic spectrum" (Wing, 1981), while others have argued for the need to separate it from autism (Rutter, 1988;Tsai, 1991).One possible reason for the controversy surrounding the status of this syndrome is the lack of consensus about its clinical features. It is generally accepted that the core features of the syndrome consist of social isolation, odd and pedantic speech, poor nonverbal communication, and preoccupation with certain idiosyncratic interests (Wing, 1981). In addition, clumsiness has been proposed as one of the diagnostic criteria. Thus, based on the description of cases by Asperger, Wing (1981) noted that gross motor movements are clumsy and ill-coordinated in this syndrome. Most of the patients are said to be poor at games involving motor skills, and sometimes show impaired ability to write and draw. In a subsequent paper (Burgoine & Wing, 1983), she stated that "clumsy and ill-coordinated movements and

A preliminary study of right hemisphere cognitive deficits and impaired social judgments among young people with Asperger syndrome

“…We shall also examine performance on motor tasks requiting bimanual co-ordination. Whilst clumsiness may not be a major diagnostic feature of autism or of Asperger's syndrome (Ghaziuddin, 1992), it commonly occurs as an associated feature and, as Ghaziuddin suggests, requires further studies to investigate this problem in a systematic manner, particularly to develop an operational definition and standardised tests for clumsiness. We are optimistic that tasks requiring interhemispheric co-operation will help elucidate what constitutes this clumsiness*.…”

Validity and Neuropsychological Characterization of Asperger Syndrome: Convergence with Nonverbal Learning Disabilities Syndrome

“…It should be noted that four areas were found to be deficient for the great majority of subjects in both AS and HFA groups: three of these ("prosody", "social and emotional competence") are subsumed under the diagnostic definition of AS and autism, whereas one ("verbal content") is not. Of the remaining 18 areas, only deficits in "Gross Motor Skills" and "Fine Motor Skills" could possibly be subsumed under the diagnostic criterion for AS "motor clumsiness", although the latter has rarely been operationally defined or systematically described (Ghaziuddin, Tsai &: Ghaziuddin, 1992b). Therefore, with the possible exception of five items (gross and fine motor skills, prosody, and social and emotional competence), the remaining areas of neuropsychological characterization appeared to be independent of the initial psychiatric diagnostic assignment.…”

Brief report: A comparison of the diagnostic criteria for Asperger syndrome

“…Gillberg (1989) too proposed clumsiness as an essential diagnostic feature based on a study in which all the patients he diagnosed as AS were found to be clumsy. Although it may well be true that AS is usually associated with clumsiness, the fact remains that very few studies of Asperger syndrome have defined and assessed this symptom in a systematic manner (Ghaziuddin, Tsai, & Ghaziuddin, 1992). Thus, under the circumstances, the decision of the ICD-10 not to include clumsiness as an essential diagnostic feature seems justified.…”