confusionAutism versus Asperger’s – Part One

The debate between professionals and the larger community regarding the use of the term Asperger’s has had quite an interesting and contested journey. Knowing a bit about this is helpful and thus the subject will be touched on here.  It is important to note that this is by no means a comprehensive exploration of the topic – that could be a separate article/book!

A Quick History Lesson

Asperger’s Syndrome is a relatively new diagnosis in the field of autism and the bigger field of psychiatric disorders.  Although Hans Asperger identified the “condition” in the 1940’s, his findings were not translated from German nor integrated into the international psychiatric nomenclature until much later.  His findings were separated from the English speaking world by both an ocean and a world war.

Though earliest mention of the features that we refer to now as Asperger’s Syndrome go back to the early 1900’s this information was not translated and subsequently effectively integrated into our knowledge base until the 1990’s when Asperger’s was added to the World Health Organizations International Classification of Diseases (ICD-10) in 1992..  In 1994 the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) included Asperger’s  as a distinct diagnosis.  Then in 2013 in the DSM-V Asperger’s was moved under the umbrella of Autism Spectrum Disorders.

The Higher End of the Spectrum

I choose to use the word Asperger’s when working with clients who are at the higher functioning end of the Autism Spectrum Disorders (ASD).  ASD is the term that the DSM-5  (Diagnostic Statistical Manual 5th Edition) instructs health providers to use when referencing everyone with features of autism no matter how severe or mild.  The DSM 5 effectively eliminated the term/diagnosis of Asperger’s Syndrome and merged the condition with Autism Spectrum Disorders. In everyday discussion, identification, and reference the term Asperger’s continues to be utilized.  In Europe the term Asperger’s has been retained and does continue to be part of the ICD 10 listing of medical conditions.

The belief was that there is no clear delineation between autism and Asperger’s and there was much overlap so merging the two was the scientific way to go. While this makes sense on a scientific level it poses some challenges in that the differences between a person with significant autism and often significant developmental delays couldn’t be more different than a person with a mild version of Asperger’s and either normal or incredibly high intelligence.

The Misperceptions about Autism

In working to both help people with Asperger’s (often late diagnosis) and getting them to see/own these issues the use of the word Autism works against acceptance and ownership.  Unfortunately but realistically society has a picture in mind when the term Autism is raised.  They/we picture a person who is nonverbal with severe delays in their development.  Not what one wants to identify with logically.