Asperger's syndrome may disappear as a diagnosis under new
recommendations released Wednesday by the American Psychiatric
Asperger's, which is a milder and more high-functioning form of
autism, would be replaced by a single diagnosis of autism spectrum
disorder, with doctors indicating the severity. The same would go
for "pervasive developmental disorder, not otherwise specified," a
category for children who exhibit some symptoms of autism, but not
enough to warrant a diagnosis.
The proposed changes would appear in the fifth edition of the
Diagnostic and Statistical Manual of Mental Disorders, due out in
As autism has come to be viewed as a broad spectrum of
developmental disorders, many doctors see Asperger's as medical
hair-splitting. Its causes, symptoms and treatments are nearly
identical to mild forms of diagnosed autism.
"To me, the label is less important than the underlying
developmental issues and how to treat them," says Dr. Alan
Rosenblatt, a developmental pediatrician in Chicago.
Many practitioners say the change just reinforces what they've
known for years.
"From a scientific and clinical standpoint, the change is
certainly justified," says Dr. Geri Dawson, chief medical officer
with Autism Speaks, the country's largest autism advocacy group.
"It's time we start recognizing autism for what it is -- a broad
spectrum of disorders."
While the changes are being welcomed by doctors, it will likely
draw fire from some segments of the autism community. Many
celebrate their diagnoses.
"A whole culture has developed around the Asperger's label,"
says Rosenblatt, a member of Chicago Special Parent magazine's
advisory board. "And now, all of a sudden, an organized body of
medicine comes in and puts them back in the same ballpark as many
people who are much lower functioning."
In other cases, parents have embraced the Asperger's label
because they find it less stigmatizing than a diagnosis of
"I think this will be a very good temperature check" for gauging
public perceptions of autism, Dawson says. "It's important to be
sensitive to the fact that ... there are people who identify
strongly with this label."
What's in a name?
The change isn't merely cosmetic. The DSM serves as a bible for
mental health professionals, determining what disorders are worthy
of an official diagnosis and affecting how diseases are treated,
covered by insurance policies and in some cases, perceived by
For example, homosexuality appeared in the DSM as a mental
illness until 1973 and ADHD was added in 1987, both highly
And in this case, a streamlined diagnosis of autism may give
some children access to services that would have been out of reach
with an Asperger's diagnosis.
"By creating this broad category, it's likely to help some
people get access to services" that they otherwise would be denied,
In some states, she says, early intervention services and
specialized education programs require an official autism
Have an opinion? The American Psychiatric Association is
accepting public input online through April 20.
See more of Liz's stories here.
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