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What happened to Asperger’s syndrome?

AGXStarseed

Well-Known Member
(Not written by me)

I often get asked “Does my child have Asperger’s?” in my clinical work. Or, “Do I have Asperger’s?”

These are challenging questions to answer. They have stimulated much debate among clinicians, researchers, and those who have identify with the term over the past several years.

Asperger’s Disorder (more commonly referred to as Asperger’s syndrome) is linked to the work of Hans Asperger, an Austrian physician who published his initial work in German in 1944.

He described children who presented with strong vocabulary and language skills in conjunction with a range of symptoms: Odd social use of language and tone of voice, social isolation from peers, repetitive behaviours, strong interests in unusual topics, and a desire to maintain structure and routine in their lives.

Much of the English-speaking world remained unaware of Asperger’s work until 1991 when it was translated and brought to the attention of clinicians by English psychiatrist Lorna Wing.

Although this description is similar to that of autism, Asperger’s account differed in that speech was less commonly delayed, motor clumsiness was more common, onset of symptoms occurred later, and his initial cases were all male.


A ‘pervasive developmental disorder’
Asperger’s syndrome made its official appearance when the World Health Organization (WHO) published the initial version of the International Classification of Diseases (ICD), 10th edition.

Subsequently, the American Psychiatric Association (APA) included it in the newly defined category of Pervasive Developmental Disorders (PDDs) alongside Autistic Disorder and other similar diagnostic terms in 2000, which brought more widespread clinical attention and an appreciation that not only males can be affected.

Interestingly, the APA reportedly included Asperger’s in an effort to prompt researchers to identify potentially distinct subgroups of autism— so that assessment and treatment could be refined and targeted.

These efforts yielded variable results, and the general research consensus is that clinicians applied diagnostic criteria inconsistently and that individuals with Asperger’s and autism are more similar than different.


Replaced by ‘Autism Spectrum Disorder’
As a result of this inconsistent application and similarities among the PDDs, the APA removed the clinical term from use and replaced it with a broad Autism Spectrum Disorder (ASD) term — encompassing several previous distinct disorders — when they published their most recent diagnostic manual in 2013.

However, the WHO continues to use the term, at least until they release the ICD 11th edition in 2019, which is reported to also use ASD in place of previous diagnostic terms.

It is this recent transition in clinical terminology that has stimulated substantial debate.

Should Asperger’s syndrome have been removed from use and replaced by the broad ASD term?

Scientists, clinicians and those living with Asperger’s have disagreed, sometimes quite strongly, on this topic. There was initial evidence that the new APA framework would result in a substantial number of individuals with Asperger’s syndrome no longer meeting criteria for a clinical diagnosis. And there are concerns this could have a negative impact on their financial support and services, which are dependent on a diagnosis.

However, the APA states that individuals who had a diagnosis under the previous framework should not lose their diagnosis. And research has supported the grouping of previous clinical labels under the broader ASD term.


‘Aspies’ identify with clinical label
Despite these views, Asperger’s syndrome has become societally popular, with characters in movies such as The Accountant and television shows such as Community being portrayed as either having the condition or displaying traits commonly associated with it.

An interesting social phenomenon also began to occur in the early 2010s, in which those with Asperger’s began to personally identify with their clinical label — referring to themselves as “Aspies” or other similar terms that represent their unique attributes and characteristics.

Indeed, it is this personal identification that has led to some of the more personal or emotional responses to the changes in diagnostic terminology, with Aspies often rejecting the term ASD.

In the end, it appears as though Asperger’s has faded from clinical use, while remaining a popular term to describe a certain type of individual.

Given that the term was initially introduced in an effort to determine if it truly differs from other clinical descriptions, it is interesting to observe and reflect upon society’s adoption and integration of it.


Asperger’s unique characteristics
Many clinicians will even admit (if only privately) that they understand the unique characteristics demonstrated by someone with Asperger’s.

As for how I respond to parents, I try to describe the current clinical framework and how it has evolved over time.

I tell them that I appreciate the unique attributes commonly associated with the Asperger’s term and I suggest that if their child’s behaviour seems to align with that description, then they or their child may feel more comfortable thinking about things in that way.

I also work with families to understand how people can often personally identify with clinical terms (for example “an autistic person” as opposed to “a person with autism”) as there is concerted effort from the ASD community to use such person-first language.

In the end, the term that clinicians, families or individuals use is a matter of personal preference. One thing is certain though, Asperger’s is here to stay, even if the diagnosis isn’t.


Source: What happened to Asperger's syndrome?
 
I like that; because when I say "Asperger’s" people understand so much more!

I would tend to agree. However domestically speaking I'd be remiss to point out that mass murderer Adam Lanza has made the term somewhat infamous, particularly with the media.

Often wondering what poorly-informed Neurotypicals may be thinking the moment they hear that term. Does it help them to understand, or does it close them off to considering much of anything based on the violent actions of a few?

To emphasize Neurodiversity rather than perceptions of neuro-deviancy.
 
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Personally I'm glad they got rid of the term. It just creates divides which do not exist. Sure we may be treated better if we use the word aspergers, but surely that's wrong and shouldn't as such?

I was so relieved when I got the diagnosis of "autism" and not "aspergers". I wrote a blog post on this exact topic a while back if anyones interested in my 2cents.

The Problem with “Asperger’s”
 
I wrote a blog post on this exact topic a while back if anyones interested in my 2cents.

You make good points. And it's not like I don't say "I'm on the spectrum," either. But if I say I have autism, it can get ugly; people think all kinds of weird things, because I am high functioning.

Yes, we need education, not ignorance, but in the meantime, we have to make our way in the world.
 
One of the things I like about the Spectrum concept is the semi-acknowledgement of my own thoughts: which is that autism is just something that happens, and it can happen along with other things.

For the longest time self-harming behaviors were considered part of autism -- and now research is indicating that it is more a part of actual brain damage combined with low intelligence. It doesn't have to anything to do with autism, per se. Likewise, intellect strength is not part of autism so much as autism is expressed differently according to the person's challenges and strengths. How can anyone say autism is "non-verbal" or "emotionless" when we have people on the spectrum who are quite verbal and expressive?

I don't think the mental health conditions so many of us deal with are necessarily part of autism either; how well could we cope if we had been understood more, helped more, treated better?

We don't know.
 
For the longest time self-harming behaviors were considered part of autism -- and now research is indicating that it is more a part of actual brain damage combined with low intelligence

I think self-harming behaviors are a function of distress relative to coping resources, for humans in general (autistic or not). Sensory processing differences can add complications, too, in terms of varying sensitivity to pain and differences in body awareness. (Of course, brain damage and/or intellectual disability could add lots of distress and compromise coping resources or involve extreme sensory processing differences, so I'm not disputing a correlation between self-harm and brain damage/intellectual disability. Plus, of course, I'm not an expert.....)

I have (supposedly, according to standardized testing) high intelligence with no brain damage, and I have self-harming behaviors. When I was young and going through an extremely stressful time in adolescence they were quite bad, too -- I had frequent meltdowns and was basically covered in bruises all the time.

I agree with you, though.

Sometimes it all leaves me wondering what exactly autism is, where the boundary lines are eventually going to be drawn -- if autism will disappear entirely as a clinical entity and be replaced by tons of more specific things to describe the various neurological differences that lead to atypical cognitive/sensory/information processing and in turn to the symptoms that we today call "autism".
 
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The best term in my mind would be Aspergers Autism.
Like most of us, I think there should be a way to convey
to the NTs what you are talking about instantly.
Everyone knows the word autism and unfortunately
due to lack of knowledge many have one certain idea that comes to mind when they hear the word.
Low intellect with strange behavioural actions.

Due a lot in part to the movies and entertainment industry
Aspergers has been presented to the majority and they now have a set of ideas regarding people with it.
While it is a part of the spectrum it is not the cut and dry
idea of what the word autism has brought to mind in the past.
That's why I combine the two words so people may understand better if they think of a mix between them.

As far as media perhaps bringing the negative idea of
being the mass killer types, well, that's the media and unfortunate.
But, it would take more knowledge on that subject also.
IMO this is a mix of mental illnesses and personality disorders usually. Such as one on the spectrum with a co-mordity of sociopathy for example.
 

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