ABSTRACT
Diagnostic criteria for Asperger's Syndrome (ICD-10) or Asperger's Disorder (DSM-IV) do not mention anxiety. De®cits in reciprocal social interaction and restricted, repetitive and stereotyped patterns of behaviour are the hallmarks of this disorder as outlined in the diagnostic manuals. Yet every clinician working with children who have Asperger's Disorder knows that these children often become incapacitated by their anxiety. In fact, one world expert on autism spectrum disorders recently commented that anxiety was the primary dif®culty for people with these disorders. Prevalence studies have provided evidence that individuals with autism spectrum disorders are at an increased risk of anxiety disorder. One recent study has found that 14 per cent of their sample of children with autism (IQ > 70) met diagnostic criteria for an anxiety disorder, 51 per cent for a phobia, and 37 per cent for Obsessive-Compulsive Disorder (OCD) (Leyfer et al., 2006). Kim and colleagues (2000) found prevalence rates of 13 per cent over-anxious symptomology and 8 per cent for separation anxiety. This was in contrast to a 3 per cent rate in their normal control group. These researchers also found that the rates of anxiety symptoms were not signi®cantly different when children with Asperger's Disorder were compared to children with autism. This is important, as most studies have combined these two groups. Zandt and colleagues (2006) found that a sample of children with autism spectrum disorders had fewer compulsive and obsessive symptoms than a contrast group of children with OCD, but both groups had signi®cantly more OCD symptoms as compared to a normal control group. If we add to these ®gures children who don't have a diagnosed anxiety disorder, but whose functioning is affected by anxiety, the risk is of course even greater.
