Asperger's Syndrome to Autism Spectrum Disorder
As an autism spectrum disorder (ASD), Asperger's syndrome involved severe social impairments and restricted interests.1 How was it different, though, from what you might call “classic autism”? If you or someone you care about received a diagnosis of Asperger's syndrome, what does it mean?
In brief, a diagnosis of Asperger's syndrome was given to individuals who suffered no speech or cognitive delay as children, such that they were talking on time and have at least a "normal" IQ, but who nevertheless display a range of autistic-like behaviors and ways of taking in the world. The hallmarks of Asperger's included emersion in an all-consuming interest and a one-sided, self-focused social approach. 2
Descriptions provided over the years yielded a range of Asperger’s syndrome stereotypes: the absent-minded and socially out-of-it professor, the brilliant but geeky programmer with bad hygiene, the eccentric uncle who never married and lived alone amidst his extensive collection of ancient maps. There were kernels of truth in the stereotypes, but they could be misleading as well. Not everyone who was eccentric had Asperger's, and not everyone with Asperger's was a quirky genius. In reality, each person with Asperger's was differently-abled across several areas of challenge and giftedness, yielding a diverse group of individuals who faced some common issues.
Who was Asperger?
Autism and Asperger’s syndrome were first studied at nearly the same time, but on opposite sides of the Atlantic. Leo Kanner, who developed the first child psychiatric service at a U.S. hospital, described autism in 1943.3 Since he published in English, his work became widely known, the very basis of our modern concept of autism.4
Hans Asperger, an Austrian pediatrician who published only in German, was working during the same period with children who, although bright, spoke in a one-sided, lecturing fashion like “little professors” on topics in which they had an absorbing interest. The children were socially unaware, with little ability to form friendships or read others’ emotional states. They had difficulty with non-verbal communication, were prone to behavior problems, and appeared clumsy.5
Asperger’s seminal work remained virtually unknown until 1991 when it was translated into English.6 Shortly thereafter, Asperger’s syndrome was included for the first time in two psychiatric “bibles”: the Diagnostic and Statistical Manual - IV7 and the International Classification of Diseases -10.8 These provided the official criteria for diagnosis used by psychiatrists, as well as third party payers (meaning insurance companies), all over the world.
Asperger’s syndrome became a legitimate psychiatric diagnosis.
A Change of Name: Asperger's becomes autism spectrum disorder
However, in 2013 the American Psychiatric Association updated its Diagnostic and Statistical Manual and removed Asperger syndrome as a diagnosis separate from autism. Researchers found that Asperger's and other disorders under the larger autism umbrella "were not consistently applied across different clinics and treatment centers"13 Now all those disorders are called one name — "autism spectrum disorder." Some advocates and people with Asperger's say they will continue to use the term Asperger's, rather than autism spectrum disorder, nonetheless.
Aspects of Asperger’s Syndrome
The official diagnostic criteria for Asperger’s syndrome had often been criticized as being too narrow, failing to provide a meaningful picture of the disorder.9 Accounts provided by experts from Asperger himself onward, however, provide a more thorough description, and include the following:
- Autistic-Like Problems Interpreting and Interacting with the Social and Emotional World
- No Speech Delay, but Substantial Problems with Nonverbal Communication and the "Art of Conversation"
- At Least a "Normal" IQ
- Circumscribed Interests and Rigidity
- Clumsiness and Poor Motor Skills
Autism and Asperger's: Where’s the Line?
The removal of Asperger's syndrome from the psychiatric diagnostic manual in 2013 represented another step in the evolution of researchers' understanding and definition of the autism spectrum.10,11,12 Was Asperger's really a meaningful subtype of autism, characterized by some difference in genes or neurology? Or was it just “high IQ” autism? For researchers, this was an urgent question. For families, clinicians, and people with Asperger's themselves, what was most important in the here and now was an understanding of the breadth and complexity of the disorder. There is no doubt that this baffling profile of strengths and weaknesses exists, and that people with Asperger's may need substantial and lifelong help learning to use their gifts to offset their challenges.
- Redefinition: Autism, Asperger's, and the DSM-5
- For additional articles about Asperger's, see the list under Asperger Syndrome in the menu in the left column.
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington DC: Author.
- Klin, A., McPartland, J., & Volkmar, F. (2005). Asperger syndrome. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.88-125). Hoboken, NJ: John Wiley & Sons.
- Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217-250.
- Volkmar, F., & Klin, A. (2005). Issues in the classification of autism and related conditions. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.5-41). Hoboken, NJ: John Wiley & Sons. (pg. 6)
- Klin, A., McPartland, J., & Volkmar, F. (2005). Asperger syndrome. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.88-125). Hoboken, NJ: John Wiley & Sons. (pg. 89-90)
- Firth, U. (1991). Autism and Asperger Syndrome. Cambridge, UK: Cambridge University Press.
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., rev.). Washington DC: Author. (Pg. 84)
- World Health Organization. (1992). International classification of diseases: Diagnostic criteria for research (10th ed.). Geneva, Switzerland: Author.
- Klin, A., McPartland, J., & Volkmar, F. (2005). Asperger syndrome. In F. Volkmar et al. (Eds.), Handbook of Autism and Pervasive Developmental Disorders (pp.88-125). Hoboken, NJ: John Wiley & Sons. (pg.93)
- Bishop, D.V.M. (1989). Autism, Asperger’s syndrome and semantic-pragmatic disorder: Where are the boundaries? British Journal of Disorders of Communication, 24, 104-121.
- Klin, A., Pauls, D., Schultz, R., & Volkmar, F. (2005). Three diagnostic approaches to Asperger Syndrome: Implications for research. Journal of Autism and Developmental Disorders, 35(2), 221-234. Abstract
- Macintosh, K., & Dissanayake, C. (2006). Social skills and problem behaviours in school aged children with high-functioning autism and Asperger’s disorder. Journal of Autism and Developmental Disorders, 36, 1065-1076. Abstract
- Autism Spectrum Disorder. American Psychiatric Publishing. Retrieved on 11/14/2013 from http://www.dsm5.org/Documents/Autism%20Spectrum%20Disorder%20Fact%20Sheet.pdf