Aspergers vs. The Autistic Spectrum

There have been three proposals that the DSM-IV-TR diagnosis of Asperger’s Syndrome be replaced and merged into part of the Autism Spectrum Disorder in the DSM-V.

The rationale for this transition is that Asperger’s Syndrome, although presently separated from the more static ‘Autistic Disorder’ of the DSM-IV-TR, would have significant overlap with High Functioning Autistic on the Autism Spectrum. Presently, Asperger’s and Autistic Disorder have 3 overlapping criteria:

1)     Marked impairment in social interaction, as manifested by at least 2 of the following: impairments of nonverbal behaviors/body language, failure to develop peer relationships, a lack of spontaneous seeking of interests with other people, and lack of social/emotional reciprocity.

2)     Restricted and repetitive & stereotyped behavior patterns, manifested by preoccupation with abnormal intensity or focus, inflexible adherence to nonfunctional routines or rituals, stereotyped motor mannerisms, persistent preoccupation with parts of objects.

3) The disturbance is not better accounted for by other Pervasive Disintegrative Disorder Rett’s Disorder, Schizophrenia.

Asperger’s Syndrome Criteria also specifies that there is:

1) There is no clinically significant general delay in language (E.G. single words used by age 2 years, communicative phrases used by age 3 years)

2) There is no clinically significant delay in cognitive development or in the development of age-appropriate self help skills, adaptive behavior (other than in social interaction) and curiosity about the environment in childhood.

In many cases, the difference in diagnosis between high functioning Autism Disorder and Asperger’s is slight, and relies on the provider’s understanding and familiarity with each diagnosis. There also is substantial doubt as to whether the separation in criteria is relevant to the diagnosis; several studies have demonstrated that the difference in language or developmental delay in Autistic and Asperger’s Syndrome children has generally disappeared by early adolescence.  Although children with Aspergers are more frequently diagnosed in early school years and autistic children are usually diagnosed in early childhood and infancy,  recent research suggests that the symptoms of Asperger’s may simply be more subtle, and consequently overlooked or easily adapted to at home. This suggests that the differences between High-Functioning Autism and Asperger’s Syndrome are very small. In adolescence, the Intelligence Quotient (I.Q) of individuals with High Functioning Autism and Asperger’s Syndrome are relatively similar.

Although the academic setting may look to further differentiate between Autism and Aspergers, the distinction is not yet clear, and the purpose of the DSM-V is not to further academic study. Instead,  the DSM-V Task Force has decided to review and uphold the proposals to merge Aspbergers with the high functioning portion of the more comprehensive Autism Spectrum Disorder, in order to facilitate the clinicians ability to diagnose based on the needs and differences the individual (usually a child) will face compared to others of the same age.

In addition, with the elimination of Asperger’s from the DSM-V, there will be more children who qualify for governmental assistance for Autism. In some areas, a diagnosis of autism is required for governmental funds and assistance for individuals and families. The diagnosis-dependent access to support may have encouraged clinicians to diagnoses Autistic Disorder, rather than the more accurate but less useful criteria of Asperger’s Syndrome.

Although the debate continues as to whether the diagnoses of Asperger’s Syndrome can be empirically differentiated from high functioning Autistic Disorder, the removal of Asperger’s Syndrome from the DSM-V may not be the end of Asperger’s.

Kaland, N. (2011). Brief Report: should Asperger syndrome be excluded from the forthcoming DSM-V?. Elsevier Ltd., Retrieved fromhttp://ees.elsevier.com/RASD/default.asp

Janet Greider

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