Asperger syndrome and Autism Spectrum Disorder (ASD) have been used interchangeably over the years, creating a degree of confusion and ambiguity amongst the general public. The debate surrounding the use of these terms has been influenced not only by changing medical perspectives but also by historical controversies. This blog post aims to clarify the distinctions and commonalities between Asperger syndrome and Autism, based on the definitions provided by the International Classification of Diseases (ICD-10, ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-V).
Asperger syndrome vs autism: a historical overview
The term Asperger syndrome was named after Austrian paediatrician Hans Asperger. It was used to diagnose individuals who showed typical symptoms of autism but had no delay in language and cognitive development. However, recent revelations about Hans Asperger’s alleged involvement with Nazi eugenics programmes during World War II have led to resistance to using the eponymous title. recent research, particularly a study published in 2018 by medical historian Herwig Czech, has raised serious concerns about Asperger’s association with Nazi eugenics programs during World War II. The study suggested that Asperger actively cooperated with the Nazi regime and was involved in the Third Reich’s child euthanasia program.
From a broader perspective, such names attached to diagnoses can potentially distract from the core understanding of the conditions. For this reason, amongst others, psychiatric manuals have moved towards more descriptive and inclusive terminology.
Defining autism: ICD-10, ICD-11 and DSM-V
The ICD-10, ICD-11 and the DSM-V are widely used systems for diagnosing mental health disorders worldwide. The shift in how these manuals define autism is an important development.
According to the ICD-10, Asperger syndrome is considered a separate diagnosis from Autism, distinct mainly based on the absence of general delays in language or cognitive development.
On the other hand, the DSM-V, updated in 2013, no longer recognises Asperger syndrome as a separate diagnosis. Instead, it’s enveloped within the broader category of autism spectrum disorder. This change was made to provide a more flexible, dimensional approach that captures the wide variety of symptoms that individuals with these disorders can exhibit.
The most recent edition, ICD-11, which the NHS and British psychiatrists are moving towards adopting, follows a similar line to DSM-V. It does not recognise Asperger syndrome as a separate diagnosis, choosing instead to include it within autism spectrum disorder. This transition marks a significant step towards more inclusive diagnostic practices.
The importance of an inclusive diagnosis
The shift from separate diagnoses like Asperger syndrome to a more encompassing diagnosis like ASD is crucial for a number of reasons:
Fostering understanding
Grouping conditions under the umbrella term ASD helps people better understand that autism can manifest in various ways. It helps avoid the rigid categorical thinking that can result from using separate diagnostic labels.
Enhancing individualised care
The concept of the autism spectrum acknowledges that each individual with autism is unique, with their own strengths and challenges. This perspective is essential in tailoring individualised, person-centred care and interventions.
Promoting equality
The term ASD encourages equality by removing the hierarchical implications often associated with separate diagnostic labels. For instance, Asperger syndrome was sometimes wrongly perceived as a “milder” or “higher-functioning” form of autism, which could lead to misunderstandings and unequal treatment.
Moving forward: embracing the spectrum
In the light of these shifts in diagnostic criteria, it’s clear that subspecialist divisions like Asperger syndrome can sometimes do more harm than good. They risk fragmenting our understanding of autism and perpetuating stereotypes, rather than promoting acceptance and support for all individuals on the spectrum.
While the historical controversies surrounding Asperger syndrome have further complicated the issue, they offer an opportunity for us to reassess how we think about and categorise mental health disorders. This is an essential step towards a more inclusive, understanding society where people of all abilities are recognised and valued for who they are.
Conclusion
In conclusion, the essence of understanding autism lies not in subcategories, but in recognising the diverse experiences and needs of individuals on the spectrum. As we shift towards the adoption of ICD-11 and embrace broader, more inclusive diagnostic practices, we must look beyond the labels and see the person. The evolution of these diagnostic classifications encourages us to celebrate the rich tapestry of human diversity, placing the focus on understanding, acceptance, and tailored support for every individual with autism. This, after all, is the true meaning of an inclusive society.