Some people are born with traits, behaviors, and communication patterns that differ from the average person. Over time, we’ve used different terms to describe them, as our understanding of these traits evolved. Most people recognize the term autism, though even that label is now outdated. Experts now use the umbrella diagnosis of autism spectrum disorder (ASD) to cover a range of similar conditions, like autism and Asperger’s syndrome. What were once separate diagnoses now fall under ASD.
At its core, ASD is a neurodevelopmental disorder that affects how a person behaves, interacts, learns, and thinks. As an umbrella diagnosis, symptoms can vary a lot from person to person. And there’s still much we don’t know about ASD and related conditions.
Though the terminology has changed, there were historical differences between autism and Asperger’s. Many people were diagnosed with these conditions before they became outdated. Understanding the history of autism and Asperger’s helps explain why both are now considered part of ASD.
The term “autism” was first used by Swiss psychiatrist Eugen Bleuler when describing schizophrenia. At the time, schizophrenia was a broader diagnosis, and children with autism were often misdiagnosed with schizophrenia. For Bleuler, autism meant withdrawing from reality.
Years later, physician Leo Kanner used the term for children with a “powerful desire for aloneness” and a need for “sameness.” He noted poor social skills, developmental struggles, and restricted interests but saw autism as different from schizophrenia.
Around the same time, Hans Asperger observed similar symptoms but without the same social and learning difficulties. Experts later named this Asperger’s syndrome. Over time, autism and Asperger’s were seen as related, with Asperger’s viewed as a “less severe” form of autism. By 2015, both terms became outdated in the DSM-5, and in 2021, the ICD followed suit. Today, the term ASD covers both.
While classic autism and Asperger’s were very similar, they had clear diagnostic differences. Both required specific behavioral symptoms. For autism, the ICD-10 required impaired development in social communication, relationships, or play before the age of three. Children needed to show at least six other symptoms related to social interactions, communication, or behavioral patterns. Autism cases were often classified as high-functioning or low-functioning, depending on intellectual abilities. Asperger’s, on the other hand, didn’t require significant delays in language or cognitive development. The DSM-IV-TR added a requirement for significant impairment in daily life.
One key difference between autism and Asperger’s is language development. Children with autism typically babbled less and had fewer varied sounds. As they grew, they used fewer words and combinations. Most people with Asperger’s didn’t experience the same delays. However, some people with language issues were still diagnosed with Asperger’s because of healthy cognitive development.
Issues with social interaction are common across conditions that now fall under ASD, including autism and Asperger’s. People with both conditions often struggle with eye contact, facial expressions, and posture. Those with autism are more likely to be nonverbal or repeat phrases. Much of this comes from missing social cues that others pick up easily.
Many compare social interactions to a game where they don’t know the rules. But since ASD is so varied, every person’s experience with social interaction can be different.
Classic autism often involves cognitive delays, while people with Asperger’s typically develop at a normal rate. In fact, children with Asperger’s often had a sophisticated vocabulary and excelled in logic-based subjects like math or science. However, they might struggle with figurative or metaphorical language.
Autism, on the other hand, usually involved poorer cognitive development, though some individuals had “splinter skills” like perfect recall or extreme talent in music or math.
Both autism and Asperger’s came with unique sensory symptoms. People with these conditions were often highly sensitive to sights and sounds, picking up on details others wouldn’t notice. But this also meant bright lights and loud noises could be overwhelming. People with autism were often more sensitive to textures, touch, or smells, which could be distressing.
Many viewed Asperger’s as a “less serious” form of autism, but that’s an oversimplified view of two complex conditions. Just as someone with autism can live a fulfilling life without major struggles, someone with Asperger’s might face significant challenges.
Ultimately, how someone functions depends on their specific symptoms, upbringing, support, and other factors. While those with autism might need more help due to cognitive issues, that’s not always the case.
Another reason autism and Asperger’s now fall under ASD is that both conditions might require unique educational approaches. There’s no one-size-fits-all method for people with ASD.
Some might need to learn in dimmer rooms to avoid sensory overload, while others might need help to understand figurative language. These conditions are complex and require tailored strategies.
Both autism and Asperger’s have been associated with a “lack” of emotions, but that’s not entirely accurate. Studies show that people with either condition can feel emotions, but they might have trouble expressing them.
Many people with Asperger’s also have alexithymia, meaning they struggle to identify or describe their emotions. Autism, especially in its classic form, was often linked to emotional outbursts and aggression, while Asperger’s typically wasn’t.
Classic autism, with its more noticeable behaviors, was diagnosed more frequently than Asperger’s, especially since autism’s definition has shifted over time. Asperger’s was newer, less understood, and subtler, leading to fewer diagnoses.
Both conditions were likely underdiagnosed, and many adults didn’t receive a diagnosis until much later in life, if at all. Today, more resources are available for adults with ASD, though it can still be hard to detect, especially as adults may have learned to mask their symptoms.
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