Asperger’s syndrome: history of a diagnosis that no longer exists

February 18 of each year is International Asperger’s Syndrome Day: in reality, starting from 2013, this condition it is no longer considered a distinct diagnosis from autism and the picture corresponding to it is part of disorders of the autism spectrum. Although it still remains an important identity issueL’existence of Asperger’s syndrome as a diagnostic entity has been rather briefarousing great interest and conflicting opinions both in the scientific community and beyond. Let’s see how the perception of him has changed over the years and what the current situation is.

As reports the World Health Organization (WHO), disorders of the autism spectrum belong to neurodevelopmental disorders and are a diverse group of conditions characterized by a certain degree of difficulty in social interaction and communication, along with other characteristics such as atypical patterns of activities and behaviors. The Autistic people’s abilities and needs vary and they can evolve over time: While some autistic people can live independently and may require a mild level of support, others may require a high level of support, even lifelong. Speaking of numbers, second the Ministry of Health, in recent years international epidemiological studies have reported a increase generalization of the prevalence of spectrum disordersprobably to be referred to, among other factors, a greater training of doctors, an increased knowledge of the general population and the changes in diagnostic criteriaincluding the one that involved Asperger’s syndrome ten years ago.

Brief history of a diagnostic entity

Let’s take a step back. As it reports the Higher Institute of Healththe syndrome is named by the Austrian physician Hans Aspergerwho in 1944 described a group of children displaying particular behaviors in social interaction, communication skills, and narrow and absorbing interests. Because Asperger wrote in German, his work did not become known in the English-speaking scientific world until British psychiatrist Lorna Wing used the name “Asperger’s syndrome” in a item published in 1981 in the scientific journal Psychological medicineproposing the term to refer to a group of 34 people between 5 and 35 years old who responded to features originally described by the Austrian doctor. While the number of publications on the “new” syndrome grew exponentially – reports a item of 2015 published in the magazine Frontiers in Psychology which briefly traces its history – within the scientific community the idea quickly made its way that autism and Asperger’s syndrome were different entitiesmainly due to the fact that Asperger people had good cognitive and linguistic skills, in addition to the fact that for several researchers the so-called impairment in social interaction differed qualitatively between the two conditions.

All this leads, in 1994, to the first (and only) appearance of Asperger’s syndrome in the fourth edition of Diagnostic and statistical manual of mental disorders (the American Psychiatric Association Reference Manual on Psychiatric Conditions and Disorders), Dsm-IVas a subcategory of pervasive developmental disorders, distinguishing it fromautism due to the absence of intellectual disability and functional impairment of language. As anticipated, the new diagnostic entity does not have a long life: the introduction of Asperger’s syndrome as a distinct diagnosis, the authors of the 2015 article continue, was surrounded by controversy from the beginning, showing numerous contradictions in its definition and in his diagnostic criteria.

The new diagnosis

In light of all this, not even twenty years after its introduction in the DSM-IV, the DSM-5 working group dedicated to neurodevelopmental disorders concludes that there is insufficient evidence to support a distinction significant between autism and Asperger’s syndrome, sanctioning the disappearance of the latter in the DSM-5. In particular, the new document, published in 2013, introduces i autism spectrum disorders, which include the diagnostic criteria of autism and concurrent conditions, according to which the diagnosis is autism with (or without) intellectual disabilitywhich in turn can have various degrees, and/or with (or without) functional impairment of language (with varying degrees); furthermore, the DSM-5 also defines i support levels which can need a person on the spectrum, from a level 1 (mild support need) to a level 3 (high support need). WHO has also eliminated Asperger’s syndrome from its International classification of diseases and related problems, inserting in the new 2022 edition, theICD-11autism spectrum disorders.