Asperger Syndrome or Autistic Disorder?

Abstract

The diagnosis of Asperger syndrome (AS) has been plagued with controversy and confusion since it was introduced into the psychiatric nomenclature, in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV; American Psychiatric Association [APA], 1994). This quandary has been portrayed in both the popular media, including newsmagazines and movies, and the scientific literature. Similarly, different views of the syndrome have emerged over the years as different diagnostic criteria were developed and investigated. Connotations that have become popular include high-functioning autism, adults with autism, eccentric people, and “nerds.” Confusion remains as to whether AS is in fact a separate diagnostic category, distinct from autistic disorder (AD), or is on a spectrum of social communication learning disability with autistic disorder. The latter question results directly from the significant overlap of diagnostic criteria for AS and AD in DSM-IV and its text revision ( DSM-IV-TR; APA, 2000). Klin, Volkmar, and Sparrow (2000) recently summarized the state of the science regarding Asperger's syndrome and its relationship to other disorders. The purpose of the present article is to provide a brief overview of the diagnostic concept of AS and to help clinicians with diagnostic decisions. Regardless of the diagnostic category, a significant number of children and adults with social communication learning disability require intervention.