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=== Differential diagnosis === Many children with AS are initially misdiagnosed with [[attention deficit hyperactivity disorder]] (ADHD).<ref name="McPart2006" /> Diagnosing adults is more challenging, as standard diagnostic criteria are designed for children and the expression of AS changes with age.<ref name=LehnhardtDiffDiag2013rev /><ref>{{cite journal | vauthors = Tantam D | title = The challenge of adolescents and adults with Asperger syndrome | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 12 | issue = 1 | pages = 143–63, vii–viii | date = January 2003 | pmid = 12512403 | doi = 10.1016/S1056-4993(02)00053-6}}</ref> Adult diagnosis requires painstaking clinical examination and thorough [[medical history]] gained from both the individual and other people who know the person, focusing on childhood behavior.<ref name="ASAdulthood">{{cite journal | vauthors = Roy M, Dillo W, Emrich HM, Ohlmeier MD | title = Asperger's syndrome in adulthood | journal = Deutsches Ärzteblatt International | volume = 106 | issue = 5 | pages = 59–64 | date = January 2009 | pmid = 19562011 | pmc = 2695286 | doi = 10.3238/arztebl.2009.0059}}</ref> Conditions that must be considered in a [[differential diagnosis]] along with ADHD include other ASDs, the [[schizophrenia spectrum]], [[personality disorder]]s, [[obsessive–compulsive disorder]], [[major depressive disorder]], [[semantic pragmatic disorder]], [[nonverbal learning disorder]], [[social anxiety disorder]],<ref name="Fitzgerald">{{cite journal|vauthors=Fitzgerald M, Corvin A|year=2001|url=http://apt.rcpsych.org/cgi/content/full/7/4/310|title=Diagnosis and differential diagnosis of Asperger syndrome|journal=Advances in Psychiatric Treatment |volume=7|issue=4|pages=310–18|url-status=live|archive-url=https://web.archive.org/web/20070910134556/http://apt.rcpsych.org/cgi/content/full/7/4/310|archive-date=10 September 2007|doi=10.1192/apt.7.4.310|doi-access=free}}</ref><ref name="LehnhardtDiffDiag2013rev">{{cite journal | vauthors = Lehnhardt FG, Gawronski A, Pfeiffer K, Kockler H, Schilbach L, Vogeley K | title = The investigation and differential diagnosis of Asperger syndrome in adults | journal = Deutsches Ärzteblatt International | volume = 110 | issue = 45 | pages = 755–63 | date = November 2013 | pmid = 24290364 | pmc = 3849991 | doi = 10.3238/arztebl.2013.0755}}</ref> [[Tourette syndrome]],<ref name="RapinTS" /> [[stereotypic movement disorder]], [[bipolar disorder]],<ref name="Foster">{{cite journal | vauthors = Foster B, King BH | title = Asperger syndrome: to be or not to be? | journal = Current Opinion in Pediatrics | volume = 15 | issue = 5 | pages = 491–94 | date = October 2003 | pmid = 14508298 | doi = 10.1097/00008480-200310000-00008 | s2cid = 21415556}}</ref> social-cognitive deficits due to brain damage from [[alcohol use disorder]],<ref name="pmid18412750">{{cite journal | vauthors = Uekermann J, Daum I | title = Social cognition in alcoholism: a link to prefrontal cortex dysfunction? | journal = Addiction | volume = 103 | issue = 5 | pages = 726–35 | date = May 2008 | pmid = 18412750 | doi = 10.1111/j.1360-0443.2008.02157.x}}</ref> and [[obsessive–compulsive personality disorder]] (OCPD).<ref name="Gillberg&Billstedt2000">{{cite journal | vauthors = Gillberg C, Billstedt E | title = Autism and Asperger syndrome: coexistence with other clinical disorders | journal = Acta Psychiatrica Scandinavica | volume = 102 | issue = 5 | pages = 321–30 | date = November 2000 | pmid = 11098802 | doi = 10.1034/j.1600-0447.2000.102005321.x | s2cid = 40070782}}</ref><ref name="Fitzgerald2001a">{{cite journal|vauthors=Fitzgerald M|s2cid=3814840|title=Diagnosis and differential diagnosis of Asperger syndrome|journal=Advances in Psychiatric Treatment|date=1 July 2001|volume=7|issue=4|pages=310–18|doi=10.1192/apt.7.4.310|doi-access=free}}</ref>
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