Asperger's vs. Autism: Everything You Need to Know
However, in 2013, the DSM-5 started to group all forms of autism — including what clinicians used to consider Asperger’s syndrome — under the umbrella diagnosis of ASD.
This article explains how Asperger’s syndrome relates to ASD and the diagnosis of ASD.
Terminology for Asperger’s syndrome and ASD
Asperger’s syndrome is no longer a separate clinical condition. However, for the purposes of this article, we will continue to use the term “Asperger’s syndrome” to refer to the clinical presentations and descriptions of the type of ASD it used to represent.
This is because many people still choose to identify their condition as Asperger’s syndrome. Additionally, clinicians may still use the term due to the extensive research and diagnostic information available about this presentation of ASD.
Distinct information about Asperger’s syndrome may be useful to someone learning about ASD.
ASD refers to a group of neurological and developmental disorders. ASD may present as varying degrees of difference in social interaction and communication, and it may cause some repetitive and characteristic behaviors.
Autism is a “spectrum” disorder, as there is a lot of variation in how it can present in different people. This includes variation in the type and degree of characteristics an autistic person may present.
Clinicians also refer to it as a “developmental disorder,” as the symptoms typically appear during the first 2 years of life. However, both children and adults can experience ASD.
ASD does not affect everyone in the same way. Some autistic people do not experience many effects on their ability to perform the activities of daily life, whereas others may need substantial support.
Asperger’s syndrome was a classified developmental disorder that clinicians now consider ASD.
People who may once have received a diagnosis of Asperger’s syndrome may now receive a diagnosis of ASD.
Clinicians first described Asperger’s syndrome in the 1940s to describe differentiating behaviors similar to some of those of autistic people. Specifically, it was characterized by difficulties with social interaction and communication in people who had neurotypical development of intelligence and language.
Generally, people who had Asperger’s syndrome may have experienced differences in their understanding of social situations and certain forms of communication.
Although Asperger’s syndrome is no longer a unique condition, many people may still use the term to describe their particular form of ASD. Others may refer to the condition as “ASD without intellectual or language impairment.”
Differences between the characteristics that led to a diagnosis of Asperger’s syndrome, and other manifestations of ASD, are difficult to pinpoint.
Before the DSM-5 removed Asperger’s syndrome as a standalone condition, the DSM-IV outlined the previous clinically defined classification and distinction of Asperger’s syndrome.
As part of this classification, the DSM-IV specified criteria for Asperger’s syndrome that suggested that there may be some characteristics that Asperger’s syndrome and autism share and some characteristics that present differences in the two conditions.
These differences include people with Asperger’s syndrome not having any clinically significant delay in language or cognitive development, or in the development of self-help skills, appropriate to their age. Some autistic people may experience these delays.
Asperger’s syndrome vs. ‘high functioning’ autism
Some people believe that Asperger’s syndrome can present less “severe” symptoms than other cases of autism. Additionally, some may compare Asperger’s syndrome to autism, suggesting that it is a “milder” presentation of the condition or is similar to “high functioning” autism.
However, many people question the validity and appropriateness of comparing the severity of symptoms, especially according to functionality, as well as the measurement of certain functions to describe someone’s experience. These terms often do not consider many aspects of ASD and are poor predictors of the experiences and challenges that autistic people might have.
The researchers behind a 2020 investigation into the term “high functioning autism” and the clinical usefulness of measuring intelligence in ASD also suggest that the term is an inaccurate clinical descriptor.
ASD can present diversely, and differentiating disorders in this way may exclude the experiences and challenges of certain people. People who some may consider “high functioning” may have symptoms that are more socially acceptable or are better able to assimilate to avoid social stigma. Often, these perceived differences do not imply a less significant condition, only the ability to assimilate and “pass” as neurotypical.
The World Health Organization (WHO) notes that people with ASD often experience challenges that are not the result of their condition or symptoms but that are instead due to individually uncontrollable external factors, such as stigma and discrimination. This includes deprivation of health, education, and employment opportunities, as well as barriers to engaging and participating in communities.
As a result, having symptoms that some consider “less severe” does not preclude some autistic people from still having significantly affected experiences.
It is also important to recognize that every autistic person’s experiences and symptoms will be different, and each person may require different levels of support — from minimal to very substantial.
The WHO estimates that about 1 in 100 children experience ASD, though real figures may be much higher.
Although ASD can occur in all groups of people, symptoms of the disorder can vary, and others may perceive the symptoms of ASD differently.
Social symptoms are diverse
Standards and conventions of socializing and communication are often subjective and can vary across social groups.
Someone with ASD might experience differences in how they socialize and communicate. This makes considerations for the diversity of how ASD may present and the variations of social standards particularly important, as these factors can affect perceptions of a disorder and its diagnosis. This can ultimately affect the support that someone with ASD may receive and the treatment they receive from others.
Diagnostic bias may occur due to factors such as sex, race, nationality, age, and socioeconomic background, as well as other social and environmental factors.
Some believe that clinicians may underdiagnose ASD in certain groups due to the differences in the way its symptoms may present or be perceived, such as different symptoms that people may experience, stereotypes, and behavioral differences.
For example, a commonly accepted symptom of ASD is repetitive behaviors, but young children assigned female at birth may exhibit less repetitive behaviors than children assigned male at birth.
This can happen if the autistic person does not show any symptoms of neurodivergence that are particularly noticeable to caregivers, such as effects on intelligence or communication.
Symptoms of ASD can include:
- being very focused on a certain topic
- the need to follow a routine
- being upset by minor changes
- repetitive behaviors
- delayed skills in language, movement, cognition, or learning
- obsessive interests
- stimming, which are repetitive body movements or noises, such as flapping the hands or rocking
- hyperactive, impulsive, or inattentive behaviors
- anxiety, stress, or excessive worry
- particular sleeping or eating habits
- particular mood or emotional reactions, including to the ways things sound, smell, taste, look, or feel
Symptoms occur differently in each autistic person.
Some people may mistake ASD for other conditions due to similar symptoms and the variation of social and communication disorders. For example, conditions such as social anxiety disorder can present symptoms that coincide with those of ASD.
Similar symptoms can include avoiding eye contact, having difficulty being around unknown people, avoiding talking in social situations, and avoiding places with other people.
Although ASD and social anxiety disorder are two different conditions, many autistic people do experience social anxiety.
Additionally, according to one paper from 2021, autistic children may be more likely to experience other health conditions than the general population. These can include additional neurological, gastrointestinal, congenital, inflammatory, allergic, and sleep disorders.
There is currently no medical test to check for ASD or Asperger’s syndrome. To make a diagnosis, a doctor will look at the person’s behavior and developmental history.
The doctor may be able to diagnose ASD in someone from the age of 18 months, but the diagnosis is likely to be more reliable from the age of 24 months. However, some people may receive a diagnosis much later than this.
As the doctor will be asking about past behaviors, it can be a good idea to make a note of patterns and difficulties you notice so that it is easier to share them with your doctor.
Your doctor may refer you to a specialist such as a psychologist or a pediatrician if you are investigating a diagnosis for a child.
Asperger’s syndrome is an older name for a condition that clinicians now consider part of ASD.
Differences between what clinicians used to consider Asperger’s syndrome and autism are difficult to pinpoint. Typically, however, individuals with Asperger’s syndrome did not experience speech or cognitive delays, whereas some autistic people might.
Bias and other social factors may impact the perception of ASD and its characteristics. Diagnosis may help autistic individuals gain support.
People can have widely varying experiences and may choose different ways to describe and deal with their ASD.
Some autistic people who require substantial support for daily life may benefit from clinical treatments, while others may focus on eliminating the difficulties of ASD that result from social and environmental factors.