What Is Asperger Syndrome? Understanding This Outdated Term For ASD
- For those experiencing suicidal thoughts, please contact the 988 Suicide & Crisis Lifeline at 988
- For those experiencing abuse, please contact the Domestic Violence Hotline at 1-800-799-SAFE (7233)
- For those experiencing substance use, please contact SAMHSA National Helpline at 1-800-662-HELP (4357)
Autism spectrum disorder (ASD) is a lifelong neurodevelopmental condition without a cure. In the past, this disorder was labeled either as autism or Asperger’s syndrome (also called Asperger syndrome). However, with the release of the 2013 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) by the American Psychiatric Association, autism spectrum disorder was instead labeled as a spectrum with three levels of support needs. Below, explore these levels in more detail, as well as the controversy and history behind the name “Asperger.” In addition, find out how to seek an autism diagnosis and symptom management support.
Asperger’s syndrome: A look at the term used in early editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM)
The term “Asperger’s syndrome” was first used in the 1980s to describe people with “high-functioning autism” or autism with lower support needs. British psychiatrist Dr. Lorna Wing, co-founder of the National Autistic Society, coined the term, citing the work of Hans Asperger, a scientist who noted differences between Autistic children when studying how they socialized and behaved. He noticed that some children were more capable of communicating socially and living independently. Because of his findings and social skills training efforts, he posited that there were several Autistic spectrum disorders and pervasive developmental disorders instead of one singular type of autism.
Why is “Asperger’s syndrome” no longer used? The historical controversy of labeling autism spectrum disorders
Although the term “Asperger’s syndrome” was used for many years as a diagnostic label for individuals with lower support needs than others with autism, the term is controversial. Although this work led to what society now understands as autism spectrum disorder, Hans Asperger’s work was highly controversial.
Asperger himself worked with the Nazis during the Holocaust, running experiments and studies on Autistic children. In his work, he reportedly said that Autistic children were unworthy of love and care from their families. Because of his work, many Autistic children were sent to a Nazi clinic to be studied. As a result, the children were murdered. This finding is often seen as controversial because some people don’t believe Hans Asperger knew that the Nazis would harm the children.
However, recent research suggests that Hans was aware he was sending the children to their deaths, and the clinic had been referred to as a “euthanasia” clinic when he first connected with it. There are also reports of Asperger’s racism and agreement with the Nazi party’s views on racial purity.
What if someone wants to identify with this label?
Because Asperger was associated with Nazism, the term “Asperger’s syndrome” is no longer used to describe individuals with autism who have lower support needs. However, some people continue to use this term because they don’t know the history behind it or find the term is the best fit for them. In other countries, this term is still widely used. Although identity labels are a personal choice, considering the history behind the term may be helpful when understanding why others might not appreciate the use of this label to describe autism. Instead of using “Asperger’s,” you might use the level system as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
Understanding autism spectrum disorder (ASD)
Autism spectrum disorder was labeled as a spectrum in the most recent edition of the DSM, partly because Asperger's research identified different presentations of the condition. However, many newer researchers have expanded on this research in ethical ways, moving away from the idea that some Autistic children are “better” or “worse” than others. The leveling system determines the level of support that Autistic children and adults require for optimal function.
Level one autism: Previously known as Asperger’s syndrome
Level one autism spectrum disorder is referred to as “requiring support.” People with this type of autism may have previously been identified with Asperger’s syndrome, which was considered a “milder” form of autism due to better communication and social skills. However, even though this is the lowest level of support needs, people with level one autism can still struggle significantly and require support in certain areas. Because autism is a spectrum, what one person on this level struggles with may be completely different from someone else’s struggles. For example, one person might be able to socialize well but struggle with rigid thinking and masking behaviors. Another might struggle to socialize but could be highly organized and able to maintain employment.
Level two autism
In the DSM-5, level two autism is referred to as “requiring substantial support.” Those with this level of autism typically have more noticeable difficulties in social interaction and independent living. They might struggle to hold a job, maintain relationships, and connect with others in society. Some people with level two autism struggle with verbal and nonverbal communication. They may have more rigid thought patterns and struggle significantly with sensory input and language development. As with the other levels, people on this level can have varied struggles, and not all people with level two autism have the same difficulties.
Level three autism
Level three autism is referred to as “requiring very substantial support.” Those categorized into this level usually have severe social deficits, difficulty with sensory input, and rigid, unmoving behaviors. They might be nonverbal, meaning they do not communicate through speech. Those on this level often require constant support and may never have jobs, relationships, or independent lives. As adults, they may live in a group home or clinical environment.
Understanding neurodiversity: A different way of viewing autism
Although autism is clinically organized into a level system, the levels themselves do not explain the full spectrum of Autistic individuals. Many people identify as “neurodivergent” as well as Autistic. The neurodiversity movement posits that all Autistic people are unique and that the spectrum can be as varied as an infinity symbol. For this reason, some people use the rainbow infinity symbol for autism awareness instead of the blue ribbon.
Within the neurodiversity movement, people may identify more as an “Autistic person” than “someone with autism.” Autism can be seen as an identity that might not be associated with disability or difficulties if society were to change to better accommodate Autistic individuals. Some may argue that autism would not be seen as a disability at all if society were fully open to accommodating the sensory, emotional, and structural needs of Autistic people. However, critics of this movement cite the difficulties of those living with “profound” autism or level three autism, who might not be able to share their voices in this conversation and could disagree. Some people believe that autism is disabling and would be disabling regardless of whether society changed.
The choice to identify with neurodivergence is a personal one. You don’t have to identify with this term if it doesn’t fit you. Overall, the idea of neurodiversity is about inclusion, equity, and understanding. Instead of judging Autistic children and adults for their natural stimming, personality traits, and unique interests, the theory of neurodiversity encourages society to accept the differences in how people’s minds work. Although many Autistic people struggle, studies also show that Autistic people tend to be more intelligent than “neurotypical” individuals in many areas, including decision-making, intentional focusing, sensory abilities, and synaptic functioning.
How to get a diagnosis for your child
If you’re seeking an autism diagnosis for your child, reach out to your child’s primary care pediatrician. They can potentially refer you to a testing provider that takes your insurance. You may also look into autism diagnostic centers in your area. A therapist may be able to offer an evaluation as well. An official assessment usually involves testing tools, interviews, and analyses. These tests can be expensive and often involve several appointments. You might be able to get funding for these tests in your area, especially if you’re struggling to pay for support for your child.
Many providers on BetterHelp now accept major insurance carriers. In many states, certain therapists on BetterHelp may be in-network with certain insurance plans. Coverage depends on your plan, provider, and availability.
When sessions are covered, members typically pay an average copay of about $19 per session. Check your in-network status on the BetterHelp site. Coverage varies by state and provider availability.
Getting an autism diagnosis as an adult based on the Diagnostic and Statistical Manual of Mental Disorders
Many people aren’t diagnosed with autism until adulthood because their needs may not have been recognized as autism during their childhood years. Autism has only been studied in adults, women, and girls more recently, so many people were left out of early autism research. Initially, autism was thought to be a disorder that primarily impacted young white boys, who were the only participants in early studies. For this reason, many women may enter adulthood wondering how to seek a diagnosis if they weren’t taken seriously in childhood or if their symptoms were overlooked.
Adults can receive autism diagnoses, and there are many testing tools psychologists can use to identify symptoms. The provider may ask about your childhood symptoms, as signs of autism in childhood are required for you to receive a diagnosis in adulthood. In addition, they may ask you how your symptoms impact your daily function in areas like socialization, work, and independent living.
How is autism treated?
Autism has no cure. Often, the best treatment recommended for autism is one that supports daily function in the child or adult client. Some people may require more support than others, which can look like more frequent therapy sessions. When seeking treatment, families often consider individual and group therapy, occupational support, family therapy, and long-term classes for supporting children with high support needs.
If you’re seeking therapy for your child, look into the ethical considerations of each type of therapy and study all options in depth before choosing. Some autism treatments may be harmful, potentially leading to symptoms of post-traumatic stress disorder (PTSD) in Autistic children. In addition, remember that autism is a spectrum. Even those within the same level can vary widely in needs. Some children respond well to frequent treatment, whereas others may become easily distressed in these environments.
Mental health support options
Caregivers and loved ones of children with autism, as well as Autistic adults, may also benefit from support. Therapy can be a helpful way to cope with symptoms of stress, anxiety, depression, and autism in daily life. One option that might be more accessible to those with limited time is online therapy through a platform like BetterHelp. With online therapy, you can attend sessions via phone, video, or live chat at any time that works for you. In addition, online therapy is often more cost-effective than in-person options.
Studies have found online therapy especially effective for Autistic adults and adolescents. For example, a 2021 study reported that online therapy could be an accessible treatment for adults with autism, potentially leading to less energy expenditure. Many participants in the study appreciated the text-based form of communication, which allowed them to receive accessible support and communicate more effectively without having to meet face-to-face.
Takeaway
How does a person with Asperger's behave as an adult?
Asperger’s syndrome is an outdated term that was previously used to refer to children with this social communication disorder. Asperger’s was meant to explain the differences between children diagnosed with autism spectrum conditions, as many children varied significantly in language skills and independent functioning ability in everyday life. Asperger’s is no longer used to describe any social communication disorders or autism spectrum disorder, as it has since been removed from the DSM due to the controversy behind the term and because “level one” of the autism spectrum may better explain ASD symptoms previously thought to have been Asperger’s syndrome.
What is it like to live with Asperger's?
People who live with a level of autism that might be considered “more high-functioning” can still have struggles related to autism that might not be as visible. For example, they may have severe sensory challenges or struggle with socializing, leading to a risk of being bullied or experiencing childhood trauma. In addition, they may appear more “neurotypical” to others, leading others to judge them more harshly for behavioral challenges or difficulty with nonverbal communication cues. They may also have repetitive behaviors, rigid expectations, and intense interests.
Many people with level one autism also struggle with self-injurious behaviors, which might cause them to be misdiagnosed with a condition like borderline personality disorder (BPD) by mental health experts, especially Autistic women. Some Autistic people might also frequently seek reassurance, struggle with communication, and misunderstand the intentions of others, leading them to potentially be at an increased risk of getting into abusive relationships. However, every person with ASD is different, so talk to a doctor or mental health professional to learn more.
Can a person with Asperger's lead a normal life?
Many people with level one autism spectrum disorder can lead a “normal” life or one that appears so, especially due to masking, a behavior meant to protect oneself from the social consequences of showcasing repetitive behavior patterns in public. People with level one autism are often able to be independent. However, they may still benefit from support from a therapist, psychiatrist, or autism specialist to lead a functional life. They may have more struggles that are “invisible,” meaning they happen outside of the public eye.
People with level one autism may also be more likely to accommodate themselves without help, such as by wearing earplugs in public to not be distressed by loud noises. They may be better able to determine verbal and nonverbal communication cues from others, potentially allowing them to have more relationships in their lives than a child or adult who has a higher level of autism. Still, many people with this type of autism may struggle to make friends or hold romantic relationships.
What do people with Asperger's struggle with?
Every person living with a mental health condition or childhood brain development disorder like autism has unique struggles determined by their unique environmental factors and unique biology. Some people struggle more with interpreting social cues, whereas others may exhibit more rigid and repetitive behavior. Still, all people with autism must have these symptoms to some capacity to be diagnosed.
In the past, the Asperger Syndrome Diagnostic Scale and Childhood Asperger Syndrome Test were used to diagnose Asperger’s syndrome. Now, the criteria in the DSM-5 are used to diagnose autism spectrum disorder and assign a support level based on one’s unique needs. These tests also look to rule out other developmental disorders, neurological disorders, and childhood disintegrative disorders, which can have similar symptoms to autism spectrum disorder.
What is the personality type of someone with Asperger's?
Every Autistic person is different. You can’t tell whether someone is Autistic based on a conversation with them alone. Many Autistic people are extroverted and social and enjoy making friends. In addition, not all Autistic people seem “socially awkward,” as many people have learned to mask certain traits to fit in better with others socially. You also cannot tell if someone is Autistic by looking at them. There is no “autism look.” Many Autistic people are conventionally attractive and are able to uphold conversations with strangers, even if they struggle or don’t interact in the same way as a non-Autistic person might.
What is the mind of someone with Asperger's?
Every person with autism spectrum disorder has different symptoms. You can’t know what’s going on in someone’s mind unless you ask them. Not all Autistic people have similar thought patterns or mental health struggles. If you know an Autistic person, ask them direct questions about themselves to learn more.
What happens when someone with Asperger's gets angry?
There is no one way that someone with autism spectrum disorder might act when angry, and there are limited studies on this subject. Some preliminary studies show that Autistic people might be more likely to ruminate on anger than others, which can show up as a build-up of anger-related thoughts that culminate in an “explosion.” In addition, Autistic people may struggle to understand their anger and label it. They might find anger overwhelming, which could lead to sensory overload more frequently.
What is the best therapy for Asperger's?
In general, organizations like the American Psychological Association (APA) and the World Health Organization (WHO) recommend therapy, medication, and outpatient support for Autistic individuals. Therapy options may include various forms of behavioral therapy, occupational therapy, art therapy, play therapy, narrative therapy, and animal-assisted therapy, among others. Medications are often used to treat co-occurring conditions like anxiety and depression. Antidepressants like selective serotonin reuptake inhibitors (SSRIs) may be helpful for some people.
How do you cope with Asperger's?
If you’ve been diagnosed with autism level one, you’re not alone. Millions of people have autism spectrum disorder. You may find ways to cope by meeting with a therapist. A mental health provider can look at your unique symptoms and personality traits and help you develop a plan for accommodating yourself and building a healthy, independent life in a way that works for you.
How do you calm down someone with Asperger's?
Helping someone with autism calm down from sensory overload or an emotional episode can be difficult, as each person is different. Some people don’t like being touched when they’re having an episode, whereas others may benefit from a heavy blanket or hug to calm down. Discuss with the person what makes them feel safe, if possible. If they aren’t verbal, you can learn more by paying close attention to their reactions to you. If they seem more distressed when you try to talk to them, ask questions, or touch them, avoid doing that.
- Previous Article
- Next Article