Sappok and colleagues mention a further aspect within the autism spectrum, which is socially and clinically of equal importance:
Persons with learning disabilities and comorbid autism are impaired in a particular way in their right to self-determination and participation in society, as well as in terms of access to adequate medical care. Especially their impairments in verbal and intellectual abilities make it difficult for those affected to describe their inner experiences in a precise and differentiated fashion. For this reason, the diagnostic evaluation depends even more on careful observation of behaviors and/or a history taken from persons close to the patient.
As for persons with high-functioning autism or Asperger syndrome, there is a grave lack of reliable diagnostic instruments, in order to identify hitherto undetected, affected adult persons and to enable them to have access to a therapeutic environment that is adapted to autism-specific ways of thinking, behaving, and perceiving. As early as in 2010, Sappok and colleagues published an article on autism in adults with mental handicaps that is very well worth reading (1). In a similar way to our own article, this article provides information on clinical particularities, comorbidities, differential diagnostic evaluations, and currently available psychodiagnostic approaches in this group of patients.
We also wish to point out the development of an S3 guideline “Autism disorders in childhood, adolescence, and adulthood” (2), which will consider the particular aspects of previously undetected autistic disorders in adults in the low-functioning and high-functioning range and that will hopefully provide momentum for the development of new diagnostic tools.
Footnotes
Conflict of interest statement
Dr. Lehnhardt has had meeting participation fees reimbursed by the Volkswagen Foundation.
References
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