Asperger's Syndrome: So Long, Farewell

In 1944 an Austrian pediatrician named Hans Asperger observed four children in his practice who had difficulty integrating socially. Their way of speakingwas either disjointed or overly formal and their all-absorbing interest in a single topic dominated their conversations. Dr. Asperger called the condition "autistic psychopathy" and he described it as a personality disorder marked by social isolation.

Dr. Asperger's observations were not widely known until 1981 when an English doctor named Lorna Wing published a series of case studies of children showing similar symptoms, which she called "Asperger's" syndrome. Asperger's Syndrome became a distinct disease and diagnosis in 1992 when it was included in the tenth published edition of the the World Health Organization's diagnostic manula, International Classification of Diseases (ICD-10). In 1994 it was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM IV), the American Psychiatric Association's diagnostic reference book.

According to Bryan King MD, one of the 13 members of the work group evaluating autism and other neurodevelopmental disorders for DSM V, Asperger's syndrome will be folded into a single broad diagnosis, autism spectrum disorder.

All interested parties will have an opportunity to weigh in on the proposed changes. The American Psychiatric Assocition is expected to post the working group'sfinal proposal on autism diagnostic criteria on the diagnostic manual's Web site in January, 2010 and invite comments from the public.

What is my point of view? I think that we are struggling to encapsulate a complicated constellation of symptoms. I would prefer if we took each individual and described their strengths and weaknesses. I know that this would present a problem for research funding, social service agencies and insurance companies. We need labels to have a short-hand way of describing a person's struggles. As long as we communicate that Autism Spectrum Disorders is an extremely wide barrel, then I can accept that. Getting rid of the diagnosis of Asperger's Syndrome may be a good thing. It is a vague diagnosis. Spectrum disorders are also vague, but at least the word spectrum conveys the messiness.

I thank Dr. Asperger for writing up his cases. His descriptions helped us to see variations in personality. Dr. Asperger's legacy can be continued on blogs. The internet gives us a wonderful opportunity to continue his efforts to describe what we see in our offices. From my point of view, that is his greatest contribution. I hope he will be remembered for that.

http://blog.shirahvollmermd.com/