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I thought my 11-year-old nephew had Asperger’s Syndrome, but now my sister keeps referring to him as “Autistic.” When he was younger, he had frequent tantrums. But now he is a really great “quirky kiddo” who loves to tell his younger cousins all about bugs. Did he get worse, and I just don’t see it? Did something change? What is the difference between Autism Spectrum Disorder and Asperger’s Syndrome?
You have every right to be confused! The medical/psychological community has been confused about this for decades! So let's start at the beginning of the Autism/Asperger's story…
Autism was first described by an American child psychiatrist named Leo Kanner in 1943. He used this term to describe 11 children who were highly intelligent, extremely withdrawn and showed an inclination towards “an obsessive insistence on persistent sameness.” In 1944, an Austrian man named Dr. Hans Asperger also was noticing a pattern of social differences in several boys who were highly intelligent, struggled with social interaction and had specific obsessive interests. At first Autism was commonly described as “childhood schizophrenia,” but then “Autism” began to be diagnosed more and more in the 1950s and 1960s in the US. In 1980, “infantile autism” was listed in the DSM, the Diagnostic and Statistical Manual of Mental Disorders. The DSM is the “recipe book” for the field of psychology. Psychiatrists take the deficits/symptoms and then match these up to the deficits/symptoms associated with various diagnoses in the DSM. The goal here is to provide a patient with the most accurate diagnosis. At first “Autism” was the more common diagnosis in the US, because Kanner wrote his papers describing this disorder in English, and Asperger published in German. (In these pre-internet days, it could take a long while for things to get translated and widely distributed!). In 1994, Asperger’s Syndrome was added to the DSM and was then officially recognized as a diagnosis.
Over the past 20 years, language delay has emerged as the key differentiator between Autism and Asperger’s Syndromes. Autism was often characterized by a language delay before the age of 3 years, and Asperger’s syndrome was often used to describe children who were hyper-verbal. These children with Asperger’s Syndrome were often referred to as “little professors” or “walking encyclopedias” due to their high language skills but lack of social skills. However, once young children grew into their teen and older adult years, the differences between Asperger’s Syndrome and Higher Functioning Autism were very hard to determine unless you carefully examined the individual’s medical history. Then there were MANY arguments and debates between various practitioners and between the practitioners and parents. Does this child have Asperger’s? Does he really have Autism? If my child gets therapy and progresses, will his Autism switch to Asperger’s? Confused yet? So were we!
Just five months ago, in May 2014, the DSM came out with their 5th edition, the DSM-V. In this updated manual, the psychological community determined that Autism, Asperger’s, pervasive developmental disorder and childhood disintegrative disorder should be seen as existing on a spectrum rather than understood as separate diagnoses. Therefore, they placed all of these disorders under the umbrella term “Autism Spectrum Disorder” (or ASD). You will still hear the term “Asperger’s Syndrome” commonly used for/among individuals with high-functioning Autism. However, the medical community is now using the term ASD to describe all individuals on this spectrum rather than distinguishing between Autism or Asperger’s.
Does this clear up things a little bit? Is it still “as clear as mud”? I welcome any further questions/comments. I also recommend the resources below for further info.
Also, if you have a question you would like me to address in my Weekly Blog,
send it to share@ChildrensTherapyTEAM.com
History of Autism, Parents.com