Asperger’s Syndrome, until the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) used to be its own diagnosis. The term was synonymous with “high functioning autism.” Asperger’s syndrome, was different than other ASDs because people with Asperger’s have average or higher-than-average language and intelligence levels. It is no longer used by clinicians as a formal diagnosis. Instead, autism is diagnoses on a spectrum.

In 1944, Hans Asperger published a discussion in the German literature, of 4 boys with features that 37 years later were later named Asperger disorder by Lorna Wing. By 1994, Asperger’s was defined as “restricted repetitive patterns of behavior, interests, and activities and typically with average or above intellect.” Asperger’s original work was unrecognized in the US and Europe for 30 years, and he died in 1980.

Lorna Wing called attention to a group of children with classical symptoms of autism early in life, who developed fluent speech and wanted to communicate with others. These patients still had significant social skills difficulties. They lacked empathy, had little or no ability to form friendships, were naïve and inappropriate with one-sided interaction. They had pedantic and repetitive speech with poor nonverbal communication, showed intense interests in certain subjects, and were clumsy.

When the diagnosis of Asperger disorder was formulated, there was controversy as to whether it was a separate diagnosis or just a high-functioning version of autism. Some felt it was just a normal human difference.

DSM-5 looked at the various permutations in the autism spectrum and decided that due to the fluidity of the symptoms, it would be best to place all the types under the umbrella of autism spectrum disorder. Levels were designated regarding the need for services: level 3 was designated as needing the most intense services; level 2 requiring fewer services; and level 1 needing the least.

Now that ASD is diagnosed with “Levels” indicating the level of services needed, those who were previously diagnosed with Asperger’s would now, mostly likely, fall under Level 1 ASD.

According to Autism Speaks, those who are diagnosed with ASD (but who would previously have been diagnosed with Asperger’s) have a typical to strong verbal language skills and intellectual ability distinguish Asperger syndrome from other types of autism.

Additionally, Autism Speaks states the following;

Asperger syndrome generally involves:

• Difficulty with social interactions
• Restricted interests
• Desire for sameness
• Distinctive strengths
  
  

Strengths can include:

• Remarkable focus and persistence
• Aptitude for recognizing patterns
• Attention to detail
  
  

Challenges can include:

• Hypersensitivities (to lights, sounds, tastes, etc.)
• Difficulty with the give and take of conversation
• Difficulty with nonverbal conversation skills (distance, loudness, tone, etc.)
• Uncoordinated movements, or clumsiness
• Anxiety and depression
  
  

Characteristics of Asperger’s Syndrome

What distinguishes Asperger’s Disorder from classic autism are its less severe symptoms and the absence of language delays. Children with Asperger’s Disorder may be only mildly affected, and they frequently have good language and cognitive skills. To the untrained observer, a child with Asperger’s Disorder may just seem like a neurotypical child behaving differently.

Children with autism are frequently viewed as uninterested in others. This is not the case with Asperger’s Disorder. Individuals with Asperger’s Disorder usually want to fit in and have interaction with others, but often they don’t know how to do it. They may be socially awkward, not understand conventional social rules or show a lack of empathy. They may have limited eye contact, seem unengaged in a conversation and not understand the use of gestures or sarcasm.

Their interests in a particular subject may border on the obsessive. Children with Asperger’s Disorder often like to collect categories of things, such as rocks or bottle caps. They may be proficient in knowledge categories of information, such as baseball statistics or scientific names of dinosaurs. Often times kids with Asperger’s have excellent memorization skills but have difficulty grasping and conceptualizing abstract concepts.

One of the major differences between Asperger’s Disorder and autism is that, by definition, there is no speech delay in Asperger’s. In fact, children with Asperger’s Disorder frequently have good language skills; they simply use language in different ways. Speech patterns may be unusual, lack inflection or have a rhythmic nature, or may be formal, but too loud or high-pitched. Children with Asperger’s Disorder may not understand the subtleties of language, such as irony and humor, or they may not understand the give-and-take nature of a conversation.

Another distinction between Asperger’s Disorder and autism concerns cognitive ability. While some individuals with autism have intellectual disabilities, by definition, a person with Asperger’s Disorder cannot have a “clinically significant” cognitive delay, and most possess average to above-average intelligence.

While motor difficulties are not a specific criterion for Asperger’s, children with Asperger’s Disorder frequently have motor skill delays and may appear clumsy or awkward.

How is Asperger’s Syndrome Diagnosed?

According to Autism Society, “Diagnosis of Asperger’s Disorder has increased in recent years, although it is unclear whether it is more prevalent or more professionals are detecting it. When Asperger’s and autism were considered separate disorders under the DSM-IV, the symptoms for Asperger’s Disorder were the same as those listed for autism; however, children with Asperger’s do not have delays in the area of communication and language. In fact, to be diagnosed with Asperger’s, a child must have normal language development as well as normal intelligence. The DSM-IV criteria for Asperger’s specified that the individual must have ‘severe and sustained impairment in social interaction, and the development of restricted, repetitive patterns of behavior, interests and activities that must cause clinically significant impairment in social, occupational or other important areas of functioning.’”

The first step to diagnosis is an assessment, including a developmental history and observation. Early diagnosis is important as children with Asperger’s Disorder who are diagnosed and treated early in life have an increased chance of being successful in school and eventually living independently.

Evolution of Asperger’s Syndrome (autismspeaks.org)

1944: Austrian pediatrician Hans Asperger described four strikingly similar young patients. They had normal to high intelligence. But they lacked social skills and had extremely narrow interests. The children also shared a tendency to be clumsy.

1981: British psychiatrist Lorna Wing published a series of similar case studies. In it, she coined the term “Asperger syndrome.”

1994: Asperger syndrome listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-4).

2013: Asperger syndrome and other previously separate types of autism folded into one umbrella diagnosis of “autism spectrum disorder” in DSM-5.