Asperger's Syndrome, which is characterized by advanced verbal skills and intelligence, repetitive and restrictive behaviors, and limited social abilities, will be removed from the latest revision of the Diagnostic and Statistical Manual for Mental Disorders (DSM). If you or your child has an Asperger's diagnosis, it's important to understand these changes, and how they may affect you.
Asperger's in the DSM-V
When neuropsychologist, psychiatrists, and other medical professional diagnosis someone with a disorder, they use the criteria outlined in the DSM. While previous version of the DSM included Asperger's as a disorder on the autism spectrum, the newest revision of this important manual will not include AS. Instead, all people on the autism spectrum, from those with very low functioning to those who would have been diagnosed with Asperger's Syndrome, will receive the new diagnosis of Autism Spectrum Disorder.
According to the Simons Foundation Autism Research Initiative, there are several reasons for subsuming the Asperger's Syndrome diagnosis into the larger umbrella of Autism Spectrum Disorder:
- One of the main criteria for an AS diagnosis under the previous DSM was that the individual have no language delay. The development team felt that it was too difficult to accurately measure whether children and adults had had any language delay. In addition, the language delay did not change the course of development for many individuals with high functioning autism, which by school age, was impossible to differentiate from Asperger's Disorder.
- In some ways, the diagnosis of AS contradicted the diagnostic criteria of Autistic Disorder (also known as classic autism). Because AS was always a subset of Autistic Disorder, this contradiction lead to some confusion among professionals diagnosing both disorders. This confusion lead to the Asperger's diagnosis being used too loosely and inconsistently to be meaningful.
- Recent research indicates that the Asperger's Syndrome and high functioning autism are not actually distinct disorders, so it is no longer practical to have a separate diagnosis.
Asperger's in the DSM-IV
In order to understand the changes to the Asperger's diagnosis, it's important to know how professionals defined the disorder in the past. According to the Autism Society, under the DSM-IV, an individual had to exhibit the following characteristics:
- Significant challenges with social interactions
- Restricted or limited interests, often very intense and focused, and repetitive behaviors
- No significant language delay
- No cognitive impairment
- Symptoms presenting a significant impairment in day-to-day functioning
How Changes to the Asperger's Syndrome Diagnosis Affect You
These changes to the diagnostic criteria may affect a number of people. Whether you're a parent, and individual, or a mental health professional, it's important to understand the impact of the DSM-V revision.
Previously Diagnosed Individuals
If you or your child already has a diagnosis of Asperger's, you may be wondering how these diagnostic changes will affect the services you receive or the way others perceive you. A study published in the Journal of American Child & Adolescent Psychiatry found that a significant number of people with an existing diagnosis of Asperger's Disorder could be excluded from the autism spectrum under the new diagnostic criteria. It remains to be seen whether individuals who currently have an Asperger's diagnosis will need to undergo a new assessment to continue receiving services.
If you have concerns about how these changes will affect you or your child, talk to your mental health provider, as well as your school special education team. You may need a new diagnosis to keep receiving medical services through your insurance company. However, if your child displays autism-like traits to a significant level, you may be able to keep the educational label of autism and continue receiving services through your school.
New Diagnoses
Those who have not yet been diagnosed with Asperger's may receive an autism spectrum disorder diagnosis instead. In fact, many mental health professionals have been using the diagnosis of high functioning autism instead of Asperger's in preparation for these changes.
Impact on Aspie Culture
Individuals with Asperger's, informally known as "Aspies," have a tight-knit, supportive culture of their own. Message boards like Wrong Planet help strengthen and support this culture and the individuals in it, and there is concern that those who lose the medical diagnosis of Asperger's may also lose the support of this community. The DSM Development Team stresses that labels like "Asperger-type" may continue to be used to describe people previously included on the autism spectrum, even if a medical diagnosis no longer applies.
May Not Be Understood for Years
It's important to remember that if you or your child has significant challenges with social or communication issues and repetitive behaviors, you should still pursue the services you need for success. The full impact of these changes to the Asperger's Syndrome diagnosis may not be understood for several years to come, but the positive affect of therapy is already well established.
