‘Asperger syndrome’, often referred to as Asperger’s, is a term that has become increasingly less common in discussions about autism. For many years, it was used to describe a specific profile within autism. However, it’s no longer officially recognized as a separate diagnosis. Understanding when did Asperger’s stop being a diagnosis requires looking at changes in diagnostic manuals and a deeper understanding of autism itself, along with the controversial history associated with the term.
The Diagnostic Shift: From Asperger Syndrome to Autism Spectrum Disorder
Historically, Asperger syndrome was used to diagnose individuals on the autism spectrum who were considered to have higher cognitive functioning and strong language skills compared to those with classic autism, and crucially, without a learning disability diagnosis. This distinction, however, began to be seen as less clear-cut and less helpful over time. The diagnostic landscape shifted significantly with revisions to key diagnostic manuals.
The turning point for the term ‘Asperger syndrome’ came with the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. This manual, published by the American Psychiatric Association, is highly influential in mental health diagnoses worldwide. In DSM-5, Asperger syndrome was removed as a distinct diagnosis and was incorporated under the umbrella term of ‘Autism Spectrum Disorder’ (ASD). This change reflected a growing consensus within the medical and scientific community that the features previously categorized as Asperger syndrome were better understood as part of a broader autism spectrum.
Following suit, the World Health Organization’s International Classification of Diseases, 11th Revision (ICD-11), also ceased to recognize Asperger syndrome as a separate diagnosis when it was endorsed in 2019 and came into effect in January 2022. ICD-11 also integrates what was previously known as Asperger syndrome into Autism Spectrum Disorder.
Alt: Dr. Lorna Wing, a key figure in autism research, speaking at a conference, highlighting her pioneering work on the autism spectrum.
The History of Asperger Syndrome and Hans Asperger’s Controversy
The term ‘Asperger syndrome’ gained prominence in the 1980s, largely due to the work of British psychiatrist Dr. Lorna Wing. Dr. Wing, a co-founder of the National Autistic Society, drew upon the earlier work of Austrian psychiatrist Hans Asperger from the 1940s. Asperger had described children with patterns of behavior that today we recognize as autism, but who had typical language development. Wing’s work popularized the concept of an autism spectrum, referencing Asperger’s observations to illustrate the wide variation within autism.
However, while the spectrum concept remains invaluable, the reliance on Hans Asperger’s work has become deeply problematic. Recent research has brought to light disturbing aspects of Hans Asperger’s history, particularly his involvement during the Nazi regime. Investigations revealed that Asperger cooperated with the Nazis and, shockingly, played a role in sending autistic children to a clinic in Nazi Germany where they were likely murdered as part of the regime’s eugenics programs. His descriptions of some autistic children as having less ‘worth’ contributed to this horrific outcome.
Alt: A historical image from Nazi Germany, representing the regime during Hans Asperger’s time and the context of his controversial actions.
This dark history has further fueled the move away from the term ‘Asperger syndrome’. For many, continuing to use a diagnostic label associated with someone complicit in Nazi atrocities is ethically untenable.
Why the Change Matters and What It Means Today
The discontinuation of Asperger syndrome as a diagnosis signifies a shift in understanding and classifying autism. It underscores the view that autism is a spectrum, with a vast range of presentations, rather than distinct subtypes. While officially, Asperger’s stopped being a diagnosis with the DSM-5 in 2013 and ICD-11 in 2019, the impact is ongoing.
It’s important to acknowledge that some individuals who were previously diagnosed with Asperger syndrome still identify with this term. For some, it represents a significant part of their identity and personal history. However, the professional and medical consensus has moved towards Autism Spectrum Disorder. This change is driven by a more nuanced understanding of autism and a reckoning with the troubling history of Hans Asperger. The focus now is on recognizing and supporting the diverse needs of all individuals on the autism spectrum under a unified diagnostic framework.
In conclusion, Asperger syndrome ceased to be an official diagnosis with the publication of DSM-5 in 2013 and ICD-11 in 2019. This change reflects both advancements in our understanding of the autism spectrum and a necessary ethical consideration of the term’s historical baggage. The shift towards Autism Spectrum Disorder aims to be more inclusive, accurate, and respectful.
