The history of Asperger’s Syndrome
Asperger’s syndrome is named after Hans Asperger who in 1944 published descriptions of children with similar symptoms, characterising a disorder and he referred to the cluster of symptoms as autism. This was only one year after the work published by Leo Kanner (1943) who also described children with similar symptoms and also referred to the disorder as autism, this work then went on to become what we now recognise as autism. These two pieces of research occurred totally independent of each other.
It was English Psychiatrist Lorna Wing however, who first coined the term Asperger’s Syndrome in 1976 and who then went on to modify some of the descriptions for this syndrome. According to this early work, Asperger’s syndrome included the core features of autism (i.e., social and communication impairments and restricted and repetitive behaviour and interests), and (relative to autism) children with Asperger’s syndrome were considered to have milder symptoms, higher (though not necessarily normal) IQs, and more gross motor incoordination.
Asperger’s Disorder was first included in the American Diagnostic and Statistical Manual (DSM), in 1994. The most recent revision of the DSM, the fifth edition which came out in 2013 (DSM-5), saw Asperger’s Disorder removed and replaced by an umbrella diagnostic term Autism Spectrum Disorder. The DSM 5 notes that individuals with a well-established DSM–IV diagnosis of “Asperger’s disorder” “should be given the diagnosis of autism spectrum disorder.
In America, the DSM-5 is the primary reference manual used by clinician’s when making a diagnosis. In the United Kingdom, the International Classification of Disorder- 10th Edition (ICD-10) is the preferred tool used by clinicians when making a diagnosis. While Asperger’s Syndrome is still recognised in the ICD-10, a revised edition (ICD-11) is expected in 2018 and is anticipated that it will closely align with the DSM-5.
In Australia, both classification systems are recognised, however by in large in South Australia the DSM-5 is used when making a diagnosis. As such, since 2013, the diagnostic label of Asperger’s is not used, however it is still a term understood by the community.
Asperger’s Disorder (according to the DSM-IV)
The essential features of Asperger’s Disorder are severe and sustained impairment in social interaction and the development of restricted, repetitive patterns of behaviour, interest, and activity. The disturbance must clinically show significant impairment in social, occupational, and other important areas of functioning.
In contrast to Autistic Disorder, there are no clinically significant delays in language. In addition, there are no clinically significant delays in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour, and curiosity about the environment in childhood.
- Qualitative impairment in social interaction, as manifested by at least two of the following:
- Marked impairment in the use of multiple nonverbal behaviours such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction
- Failure to develop peer relationships appropriate to developmental level
- A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people)
- Lack of social or emotional reciprocity
- Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:
- Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
- Apparently inflexible adherence to specific, non-functional routines or rituals
- Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
- Persistent preoccupation with parts of objects
- The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
- 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)
- There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour (other than in social interaction), and curiosity about the environment in childhood.
- Criteria are not met for another specific Pervasive Developmental Disorder or Schizophrenia.