rscn4338Back when the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) was released in 2013, I did a post where I asked this question and concluded that it was at least still with us in the ICD-10 (International Classification of Diseases) used by the World Health Organization.

The DSM-5 dropped ‘Asperger syndrome’, incorporating all aspects of autism under the term ‘Autism Spectrum Disorder'(ASD). The ICD-10 continued to recognize Asperger’s, but over the years it has had revisions and it appears that it turned its back on Asperger’s well before the new OCD-11 was adopted by most countries this year. For some time even the ICD-10 has used the term Autism Spectrum Disorder.

Incidentally, according to the USA’s Center for Disease Control, the ICD-10 is only used in the USA to categorize “mortality and morbidity” statistics. This is apparently because the World Health Organization insists on it. However, if you read any of it, you soon find it to be a full disease categorization. A good description of this situation and the ICD-11 is in the CDC comment on the new ICD-11 (which the USA will not implement until 2025).

Anyway, if you use the ICD-11’s ‘A-Z’ index and choose autism, you now get Autism Spectrum Disorder, which it explains at great length. There is not the slightest mention of Asperger’s. However, oddly enough, if you put “Asperger’s” into the index search, you get this:

6A02.0 Autism spectrum disorder without disorder of intellectual development and with mild or no impairment of functional language

Parent: 6A02 Autism Spectrum Disorder

This is a bit amusing – ASD which only arrived in 2013 apparently gave birth to the term Asperger’s syndrome which has been in use over 30 years. But at least Asperger’s is acknowledged to exist, even if it has been tucked into a closet.

I understand the argument for putting all aspects of autism onto a spectrum, but this is problematic when autism appears to have different causes, the most common one being genetic inheritance. The British research psychologist Simon Baron-Cohen has argued that Asperger’s is the basic condition, the genetic part of autism transferred through our DNA, while those aspects involving increased disability are usually the result of damage to that initial condition.

To me, Simon Baron-Cohen has been advancing the understanding of autism, while the removal of Asperger’s from the DSM-5 and the ICD-11 feels like a backward step, especially when those two catalogues talk always of disorder. The term ‘syndrome’ used with Asperger’s acknowledged at least the possibility that autism is a natural condition, not a disease

One reason I remain fond of the Asperger term is Hans Asperger himself, who along with Leo Kanner coined the term ‘autism’ in the 1940s. Kanner was talking disorder from the beginning, while Asperger was always open-minded about it. He was fond of his autistic children, who he liked to call ‘little professors’. Look at what he wrote as early as 1938:

Where it is about logical thinking, where the issue is meeting their special interests, they are ahead, surprise their teachers with their clever answers; where it is about more or less mechanical learning by heart, where concentrated learning is demanded (copying, spelling, methods of arithmetic) these ‘clever’ children fail in a severe kind of way, so that they are often on the brink of failing their exams.

This quote is taken from psychologist Tony Attwood’s 2007 book, The Complete Guide to Asperger Syndrome. In the book, Attwood says of his own counseling of autistic patients he judged to be in this category,

I usually say to the child, “Congratulations, you have Asperger’s Syndrome”, and explain that this means he or she is not mad, bad, or defective, but has a different way of thinking.

Before writing any more about this, I must see what Attwood’s take is on the demotion of Asperger’s.

 

PS – the ICD-11 website:   ICD-11 (who.int)

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s