Autism vs. Aspergers: Exploring the Distinctions and Similarities

Understanding Autism Spectrum

To grasp the distinctions and similarities between autism and Asperger's syndrome, it is essential to have a comprehensive understanding of the autism spectrum. This section explores the historical perspectives and the changes introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Historical Perspectives

In the past, doctors diagnosed Asperger's syndrome (AS) and autism as separate conditions. However, since 2013, both have been combined under the umbrella diagnosis of Autism Spectrum Disorder (ASD). This shift in diagnostic classification aimed to provide a more comprehensive understanding of the diverse range of symptoms and characteristics within the spectrum.

DSM-5 Changes

Before the publication of the DSM-5 in 2013, the diagnostic criteria for Asperger's syndrome (AS) in the DSM-4 included significant difficulties in social interactions and relationships, repetitive behaviors or interests, clinically significant impairment in social, occupational, or other important areas of functioning, and neurotypical intelligence and language development similar to those without a developmental condition [1].

The merging of Asperger's syndrome into the broader Autism Spectrum Disorder (ASD) umbrella in 2013 was met with criticism. This change was due to the fact that people with AS tend to have less explicit characteristics than individuals on the autism spectrum. Some individuals with a previous AS diagnosis may not meet the criteria for ASD, which could result in a loss of access to support services and potentially impact their sense of identity.

Asperger's syndrome is now considered part of the autism spectrum disorder (ASD). The diagnostic criteria for Asperger's were introduced into the DSM in 1994, but as of 2013, it is no longer diagnosed as a separate condition [2].

Understanding the historical perspectives and the changes in diagnostic criteria provides a foundation for exploring the differences and similarities between autism and Asperger's syndrome in the subsequent sections.

Asperger's vs. Autism

When exploring the distinctions and similarities between Asperger's and autism, it's important to understand the differentiation factors and diagnostic criteria that were historically used. However, it's essential to note that since 2013, the diagnostic criteria have changed, and Asperger's is no longer diagnosed as a separate condition, but rather falls under the umbrella diagnosis of Autism Spectrum Disorder (ASD).

Differentiation Factors

Historically, doctors differentiated Asperger's syndrome (AS) from high-functioning autism (HFA) based largely on a history of "language delay". The term "Asperger's" was used to describe individuals with neurotypical intelligence and language development similar to those without a developmental condition, but significant difficulties in social interactions and relationships, as well as repetitive behaviors or interests. Some individuals with Asperger's tend to have less explicit characteristics than those with autism, which can influence the level of support they require [1].

Diagnostic Criteria

Before the publication of the DSM-5 in 2013, the diagnostic criteria for Asperger's syndrome in the DSM-4 included significant difficulties in social interactions and relationships, repetitive behaviors or interests, clinically significant impairment in social, occupational, or other important areas of functioning, and neurotypical intelligence and language development similar to those without a developmental condition. However, with the merging of Asperger's syndrome into the broader ASD umbrella, a separate diagnosis of Asperger's is no longer given, and individuals with the characteristics previously associated with Asperger's now receive a diagnosis of ASD.

It's important to acknowledge that the merging of Asperger's into the broader ASD diagnosis has been met with criticism. Some individuals with a previous Asperger's diagnosis may not meet the criteria for ASD, potentially resulting in a loss of access to support services and a potential loss of identity [1]. However, the shift in diagnosis allows for a more comprehensive understanding of the spectrum and the individual needs of those within it.

Understanding the differentiation factors and diagnostic criteria between Asperger's and autism provides insight into the historical perspectives of these conditions. However, it's crucial to recognize the changes in diagnostic approaches and the current understanding that places both conditions under the broader umbrella of ASD.

Evolution of Diagnosis

Over time, the diagnosis and understanding of autism and Asperger's syndrome have evolved, leading to changes in how these conditions are classified and diagnosed. Prior to 2013, there were distinct distinctions between autism and Asperger's. However, since then, both conditions have been combined under the umbrella diagnosis of Autism Spectrum Disorder (ASD).

Pre-2013 Distinctions

Before 2013, doctors diagnosed Asperger's syndrome (AS) and autism as separate conditions. The diagnostic criteria for Asperger's syndrome in the DSM-4 included significant difficulties in social interactions and relationships, repetitive behaviors or interests, clinically significant impairment in social, occupational, or other important areas of functioning, and neurotypical intelligence and language development similar to those without a developmental condition.

Post-2013 Changes

In 2013, the publication of the DSM-5 brought about significant changes in the diagnosis of autism and Asperger's. As a result, Asperger's syndrome is no longer considered a stand-alone diagnosis but is now part of the broader Autism Spectrum Disorder (ASD). This merging of Asperger's syndrome into the ASD umbrella has been met with some criticism. People with Asperger's tend to have less explicit characteristics compared to individuals with autism. The concern is that individuals with a previous Asperger's diagnosis may not meet the criteria for ASD, potentially leading to a loss of support services and an impact on their identity.

The shift in diagnosis has been made to provide a more comprehensive understanding of the spectrum of autism-related conditions and to ensure that individuals receive appropriate support and interventions.

The changes in diagnostic criteria reflect an evolving understanding of autism and Asperger's. The focus now is on assessing individuals based on a range of symptoms and characteristics associated with ASD, rather than categorizing them into specific subtypes. This approach acknowledges the diverse nature of autism and the need for individualized support and interventions.

It is important to note that the changes in diagnosis do not diminish the unique experiences and challenges faced by individuals with Asperger's or autism. The goal is to provide a more inclusive and comprehensive framework for understanding and supporting individuals across the autism spectrum.

Treatment Approaches

When it comes to addressing autism spectrum disorders (ASD), a comprehensive treatment approach is essential. This typically involves a combination of therapies and, in some cases, medication. By utilizing these approaches, individuals with ASD can enhance their quality of life and develop skills to navigate social interactions and daily challenges.

Therapies for ASD

Therapy plays a crucial role in the treatment of ASD, focusing on improving communication skills, social interactions, and adaptive behaviors. Some of the most common therapies used for ASD include:

Social Skills Training: This therapy aims to enhance social interactions and communication skills. It helps individuals with ASD learn how to engage in conversations, interpret nonverbal cues, and develop appropriate social behaviors.
Speech-Language Therapy: This therapy focuses on improving language and communication skills. It can help individuals with ASD develop speech, improve articulation, and enhance nonverbal communication.
Cognitive Behavioral Therapy (CBT): CBT assists individuals with ASD in managing challenging behaviors and emotions. It helps them identify and modify negative thought patterns, develop coping strategies, and improve problem-solving skills.
Applied Behavior Analysis (ABA): ABA is a structured therapy that focuses on reinforcing positive behaviors and reducing problematic ones. It helps individuals with ASD develop functional skills, improve communication, and reduce repetitive behaviors.

Medication Considerations

Medication is not always necessary for individuals with ASD, but in some cases, it can be beneficial in managing associated symptoms like depression, anxiety, or attention deficits. Medication should be prescribed by a qualified healthcare professional, and the decision to use medication should be made on an individual basis, taking into account the specific needs and circumstances of each person.

It's important to note that medication does not target the core symptoms of ASD but rather helps individuals manage certain challenges that may arise. Common medications prescribed for individuals with ASD may include:

Selective Serotonin Reuptake Inhibitors (SSRIs): These medications are commonly used to manage symptoms of anxiety, depression, and obsessive-compulsive behaviors in individuals with ASD.
Stimulants: Stimulant medications, such as methylphenidate, may be prescribed to individuals with ASD who also have significant attention deficits or hyperactivity.
Antipsychotics: Antipsychotic medications can be used to manage severe behavioral issues, aggression, or self-injurious behaviors in individuals with ASD.

It's important to remember that medication should always be used in conjunction with other therapeutic interventions and under the guidance of a healthcare professional who specializes in ASD.

By combining various therapies and, if necessary, utilizing medication, individuals with ASD can receive comprehensive support to address their unique challenges and maximize their potential for personal growth and development. The specific treatment approach may vary based on the individual's needs, and it's important to regularly reassess and adjust the treatment plan as required.

Neurophysiological Variances

Understanding the neurophysiological variances between autism spectrum disorder (ASD) and Asperger's syndrome (ASP) can shed light on the distinctions and similarities between these conditions.

EEG Coherence Studies

EEG coherence studies have been conducted to explore possible neurophysiological differences between ASD and ASP. EEG coherence is a measure of brain connectivity, and it has provided insights into the unique characteristics of these conditions.

Research using EEG coherence-based DFA (discriminant function analysis) rules has successfully classified individuals as either controls or ASD. Interestingly, when ASP subjects are included in the analysis, 96.2% of them are classified as ASD. However, when ASP subjects are directly compared to ASD subjects using new DFA rules, 92.3% of ASP subjects are identified as separate from the ASD population.

The findings suggest that while the ASP population falls closer to ASD than controls within a control-ASD dichotomy, it is distinctly separate when directly compared to ASD. This indicates that the ASP population constitutes a neurophysiologically identifiable entity within the higher functioning tail of the ASD population distribution.

Specifically, the ASP population shows more reduction of left lateral anterior-posterior coherence compared to the ASD group. On the other hand, the ASP group demonstrates markedly increased left mid-temporal to central parietal-occipital coherence. These differences may correspond to variations in visual-spatial functioning and right hemispheric characteristics observed in individuals with ASP.

Brain Connectivity Findings

The distribution characteristics of the ASP population demonstrate that the ASP sample distribution is Gaussian normal and falls within the limits of a normal population. While the ASP population falls on the lower end of the ASD population distribution, it does not represent a completely distinct clinical entity.

These neurophysiological variances identified through EEG coherence studies contribute to our understanding of the differences between ASD and ASP. They highlight the unique brain connectivity patterns in individuals with ASP and provide evidence for the neurophysiological basis of these conditions. Further research is needed to deepen our understanding of the underlying mechanisms and how they relate to the behavioral characteristics observed in individuals with ASD and ASP.

Behavioral Characteristics

When it comes to understanding autism spectrum disorder (ASD), it's essential to explore the behavioral characteristics that individuals with ASD may exhibit. Two notable areas of behavior that are often observed in individuals with ASD are sensory sensitivities and emotional expression.

Sensory Sensitivities

Many individuals with ASD have extreme sensitivity to normal stimuli such as sounds, lights, textures, and more. These stimuli can be overwhelming, confusing, or even painful for them. Even seemingly harmless stimuli like the uniform of a police officer can cause discomfort [5].

These sensory sensitivities can lead to unique behaviors as individuals with ASD attempt to cope with or communicate their needs. They may display unusual mannerisms, such as loud repetitive vocalizations, hand flapping, or self-stimulatory behaviors like biting their arms. These behaviors may intensify with agitation, discomfort, confusion, or fear.

Emotional Expression

Individuals with ASD may exhibit emotions that do not fit the situation or appear out of sync with their surroundings. For example, they may repeatedly giggle when not amused or seem extremely distressed even when being consoled. These atypical emotional expressions can be challenging to understand for those unfamiliar with ASD.

Moreover, individuals with ASD may seem unaware of their surroundings, even in potentially dangerous conditions. For instance, they may walk or stand in the street seemingly unconcerned about passing cars. This lack of awareness can be attributed to the challenges they face in processing and responding to environmental cues [5].

These behavioral characteristics in individuals with ASD can manifest or increase in intensity when they are upset, frustrated, scared, or anxious. It's important to approach and interact with individuals with ASD with patience and understanding, recognizing that their behaviors may be a means of communication or a way to cope with sensory overload [5].

By recognizing and understanding these behavioral characteristics, we can create a more inclusive and supportive environment for individuals with ASD.