Asperger syndrome

Asperger's syndrome (AS) was a variant of autism and was classified as a neural and mental development disorder. In the DSM-5 and the ICD-11 (valid from 2022), the traditional autism subtypes (and thus Asperger's syndrome) have been abandoned altogether and all manifestations are now grouped together in a general spectrum of autistic disorders (autism spectrum disorders, ASD). The reason for this was the increasing recognition in science that a clear delineation of subtypes is not (yet) possible - and instead one should assume a smooth transition between mild and more severe forms of autism.

The main difference between Asperger's and other forms of autism is that, as a rule, language development is unimpaired and there is no reduction in intelligence.

Characteristics are peculiarities and difficulties in social interaction and communication as well as differences in perception and stimulus processing (this includes in particular sensory hypersensitivity and hyposensitivity and difficulties in stimulus filtering) as well as often unusual interests and talents.

The ability to recognise analogue forms of communication (gestures, facial expressions, eye contact) in other people, to evaluate them (mentalise them) or to send them out themselves is particularly impaired. The contact and communication behaviour of persons with Asperger's autism can thus appear strange and clumsy. Since their intelligence is normally developed in most cases, they are easily perceived as whimsical by those around them. Occasionally, Asperger's syndrome coincides with high or insular giftedness.

Asperger's syndrome is associated not only with impairments but also with strengths (for example in the areas of objective, non-emotional perception, introspection, attention or memory). Whether it should be classified as a disease or as a norm variant of human information processing is answered inconsistently by scientists and doctors as well as by Asperger's autistic people and their relatives. However, the basic condition for the diagnosis of Asperger's syndrome is that it leads to impairments in several areas of life (see criterion C in the DSM). Medically, it therefore has disease value and is currently classified as a mental disorder. The research community also disagrees on whether Asperger's syndrome should be seen as a qualitatively independent disorder or a weakened variant of early childhood autism.

Discovery of Asperger's Syndrome

Asperger's syndrome has been discussed in psychiatry since the mid-1920s. The earliest account is by the Russian child psychiatrist Grunya Sukhareva, who used the term "schizoid psychopathy" for it in 1926. The Austrian pediatrician Hans Asperger referred to it as "autistic psychopathy" in his habilitation thesis submitted in 1943.

Asperger's writing appeared at that time almost simultaneously with Leo Kanner's seminal paper on early childhood autism (1943). It is assumed that both authors initially had no knowledge of each other's work. Kanner's paper, published in the United States, immediately attracted international attention; the Austrian Asperger's essay was hardly known outside the German-speaking scientific community at the time, in the midst of World War II. An essay published in 1962 by two Dutch authors, which attempted a distinction between Asperger's "autistic psychopathy" and Kanner's autism, also initially met with little response.

The international research community did not take notice of Asperger's syndrome until after 1981, when British psychiatrist Lorna Wing continued Asperger's work and named the deviation, previously considered psychopathy, after Hans Asperger as a subset of the autism spectrum.

In the late 1980s, diagnostic criteria were then formulated by various parties, some of which differed considerably from one another. In 1992, Asperger's syndrome was included in the medical classification system ICD of the World Health Organization. In the Diagnostic and Statistical Manual of Mental Disorders (DSM), the classification system of the American Psychiatric Association, it was included from 1994 to 2013.

Related names

In the English-speaking world, early childhood autism was often distinguished between different forms. One of these was the so-called high-functioning autism (HFA). The authors of a study at the Yale Child Study Center suggested in 1995 that a distinction should be made between high-functioning autism and Asperger's syndrome. This distinction was reiterated in 2013 in a review paper by authors at the University of Freiburg. It is important to distinguish between high-functioning and low-functioning Asperger syndrome on the one hand, and between high-functioning and low-functioning early childhood autism on the other.

Previously, in 1991, Lorna Wing had proposed to describe autism as a transitional whole (continuum) of disorders of varying severity, in which HFA and Asperger's syndrome form mild manifestations. Today, authors sometimes speak of autism spectrum disorders (ASD).

Since the autism spectrum does not end with Asperger's syndrome, but extends far into normality - for example, into "completely normal" shyness or selfishness - the term Broader Autism Phenotype (BAP) was coined for manifestations with weakly pronounced autistic personality traits and behaviors. The term "autistic traits" corresponds most closely to this in German.