Doris Greenberg, MD, discusses the fine line between Asperger's Syndrome and Autism Spectrum Disorder.
Doris Greenberg, MD:
In the DSM-5 that's come out, all the various shades of autism have now been put together in one big basket, including those people who are called Asperger's syndrome.
There are many conflicts about this - because everybody is lumped together there is a lot of confusion. What do the people who have this and who've grown up thinking they have this, think about it? What does our society think about it? Are they really a separate group? Are they really just a part of the autism group? Or, is it just another way of being human?
There are different positions. It's been taken out of the DSM-5 but the category is still in the ICD-10, so it's still recognized around the world.
We have whole books written about Asperger's Syndrome. Lots of manuals and things about employing people with Asperger's disorder. And so it hasn't gone away. We opened a box - a pandora's box - and we can't close it now.
But i think the fact is that a lot of people who have autism aren't always the same way from the beginning to their adult years. I see an awful lot of children who come in very severely on the autism spectrum - not talking, lots of aloof behavior - who evolve and become people called Asperger's Syndrome.
On the other hand i see people who we did not think had any kind of autism, who as they grow up and you realize their quirky behaviors and their unusual ways of thinking, that they're on the spectrum. It's not a static diagnosis.
With all the research that's been done i tend to believe that it's the best thing for us to have people included within the autism spectrum so they can get the services they need, because the insurance companies, for example, won't let people get certain services unless they qualify as autism.
On the other hand, people with high functioning autism and Asperger's syndrome are not happy about being put into a group of very low functioning people - it's an insult to them. Speaking to them about this is very important.
Parents who used to come into my office where we'd make a diagnosis of autism - it was a grim day. People really threw up their hands and grieved. Not anymore. It just gives us an insight into the kinds of effective therapies that we can launch as soon as possible so we can get children back on the trajectory of development that they need to be on.
So, what do i think? What do I think, is that it's still ok to call people an Asperger's type of autism spectrum disorder - you know what kind of services they're gonna need.
What we call it is amorphous still. And from one institution to another, the diagnosis has been so muddy, that it makes a lot of sense if we're gonna do research to have a better way of categorizing people.