The symptoms of Asperger's remain the same. The diagnosis procedure hasn't changed either. But experts realized that they could serve their patients more effectively with a name and diagnosis change.
Between 1994 and 2013, people could walk into a doctor's office, undergo testing, and walk out with a diagnosis of Asperger's syndrome. Now, if those same people went to the same offices and had the same tests, they would emerge with a diagnosis of autism spectrum disorder (ASD).
The word spectrum in ASD is deliberate. There is one disease, but it comes in many forms with different severity levels.
It's best not to think about Asperger's vs. autism. Instead, think about an individual's habits, preferences, and challenges. Insights gleaned there could lead to effective therapies.
The History of Asperger's
Chances are, people with Asperger's have always been active in society, but we didn't give their characteristics a name until the 1940s. As soon as the term was applied, people wanted to change it.
Autism Speaks explains the Asperger's timeline like this:
- Early description: In 1944, an Austrian pediatrician described four patients with poor social skills, narrow interests, and clumsiness.
- Later interest: In 1981, a British psychiatrist published case studies under the heading "Asperger syndrome," named after the pediatrician from the 1940s.
- Formal acceptance: In 1994, Asperger syndrome was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).
- Name change: In 2013, the term Asperger syndrome was removed from the DSM-5 and replaced with autism spectrum disorder.
The National Autistic Society in the UK explains that all people with autism share common traits. They typically struggle with social interactions, for example, and they tend to have very narrow interests. But some people have more difficulties than others.
When researchers looked at Asperger's vs. autism, they saw many similarities. In fact, so-called "high-functioning" autistic people, who still have symptoms but can often compensate to better fit with the world around them, are almost indistinguishable from people with Asperger's.
The research supports the idea that these are not two separate disorders. Instead, they represent one disorder that manifests differently, with varying levels of severity. The name change represents that point of view.
Asperger’s vs. Autism Symptoms
ASD encompasses many people who display a variety of symptoms, but they can all be grouped into categories.
Autism symptoms include:
- Communication difficulties. Some people with autism don't talk at all. People with Asperger's tend to have good language skills, but they may not understand nonverbal language.
- Social dysfunction. Some children with autism seem disinterested in other people. People with Asperger's often want to connect with others, but they can't seem to make a connection.
- Limited interests. Some people with autism like only one thing or a series of things, and they may like to talk about only those things. This is more pronounced in people with Asperger's.
- Cognitive problems. Some people with ASD score low on intelligence tests. Some people with Asperger's score very high.
People at the very impaired end of the autism spectrum often need around-the-clock care. They may not be able to tackle daily tasks, including using the bathroom or cooking, and their employment opportunities are minimal.
People with Asperger's are often able to succeed in mainstream jobs, experts say. Some enjoy thoughtful, intellectually challenging careers like laboratory work or computer programming. Others thrive in research settings, and they set up home offices to do their job.
Despite many strengths, people with Asperger's may need encouragement and support to live independently. They may forget to tackle everyday tasks, such as washing their clothes or buying groceries. They may not have a robust circle of friends who can support them if they fall ill or lose their jobs. Informal caregivers can fill the gap and ensure that these people live full and rewarding lives.
It's critical to understand that people with ASD are individuals. They have their own habits, hopes, dreams, and preferences. Lists like this can blur their individuality and make it hard to see the person behind the label.
Meeting one person with autism doesn't mean you understand everyone with the diagnosis. An open mind is critical.
People with Asperger's are often adept at explaining who they are and what they need. People who fall elsewhere on the autism spectrum may like to do the same, if given the chance.
How Is Asperger's Diagnosed?
Doctors use interviews to diagnose ASD. When all the results are in, your doctor uses the information to determine where you fall on the spectrum.
Experts say an ASD screening might include an assessment of your:
- Social skills. Questions about current relationships, interactions with authority figures, and feelings about others are expected. Sometimes, outsiders like family members or teachers also answer questions to give experts a deeper understanding.
- Physical health. Underlying issues could blur your ASD symptoms. For example, kids with profound hearing loss may seem as though they are uncommunicative, but when that problem is addressed, they can chat with their peers with ease. A full health panel helps doctors rule out issues like this.
- Mental health. Asperger's and other autism disorders often spark depression, anxiety, and hyperactivity. These problems can limit recovery.
Asperger's is difficult to diagnose, and it's common for doctors to use multiple interviews to spot the disorder. People with Asperger's are intelligent and often quite social. Some mask their symptoms, so the issues are harder to see. Multiple interviews, held over a long period, can help doctors identify issues that might remain hidden in one quick chat.
Some people with presumed Asperger's don't move through the diagnosis process. They think of their habits and traits as innate parts of their personalities. They can't imagine a life without these characteristics, and they choose not to identify or address them.
This is a valid choice, but it's not the right one for everyone. Autism spectrum disorder is a protected disability, and people with the diagnosis can access critical help.
They may have protections against job loss, for example, and they may be able to request modifications to their work so they can succeed despite ASD. Without a diagnosis, those protections aren’t available.
Asperger’s vs. Autism: Does Treatment Differ?
ASD therapies aim to help people build vital skills so they can succeed in the world around them. Each person with autism is different, with core strengths and some limitations. Therapy is always tailored, and it always varies from one person to the next.
Someone with severe autism and an inability to speak obviously needs different interventions than someone with Asperger's who can talk well, reason, and make most decisions. While the specifics are very different, the mode of treatment between these two people doesn't differ.
Applied behavior analysis (ABA) therapy is the primary form of treatment for people with autism. Therapists meet with their clients one on one to:
- Discuss goals. What skills elude the person? What's one key lesson that could make the person's life better?
- Explain the process. Professionals describe what they are doing both to their client and to the client’s family. Practicing lessons outside of therapy is critical. The more everyone understands how the process works, the better.
- Set a treatment schedule. ABA is intense, and most people spend hours each week in therapy. Many ABA providers work within the client’s home, and others hold appointments in their office or in the community.
When ABA begins, therapists and technicians break one large task into component parts. Then, they run drills to help the person master those concepts. A child with autism might need to learn how to brush teeth, for example. A child with Asperger's might need to learn how to make eye contact with peers. The lessons are different, but the approach of therapy is the same.
Experts say some people with Asperger's benefit from other forms of therapy, including physical therapy to ease clumsiness or occupational therapy to relieve sensory overload. Some people use ABA alone.
Autism spectrum disorder can't be cured. Disease eradication isn't the goal of treatment.
Instead, professionals use their skills to help people understand their tendencies and develop mechanisms to live with them. For many families touched by autism, the therapy is critical.
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