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Tuesday, November 03, 2009

It is one of the most intriguing labels in psychiatry. Children with Asperger’s syndrome, a mild form of autism, are socially awkward and often physically clumsy, but many are verbal prodigies, speaking in complex sentences at early ages and acquiring expertise in some preferred topic — stegosaurs, clipper ships, interstate highways — that astonishes adults and bores their playmates to tears.

This once obscure diagnosis is increasingly common. Much of the growing prevalence of autism, which now affects about 1 percent of American children, according to federal data, can be attributed to Asperger’s and other mild forms of the disorder.

But no sooner has Asperger consciousness awakened than the disorder seems headed for psychiatric obsolescence. Though it officially joined the medical lexicon only in 1994, the experts who are revising psychiatry’s diagnostic manual propose to eliminate it from the new edition, due in 2012.

If they have their way, Asperger’s syndrome and another mild form of autism will be folded into a single diagnosis, autism spectrum disorder.

“Nobody has been able to show consistent differences between what clinicians diagnose as Asperger’s syndrome and what they diagnose as mild autistic disorder,” said Catherine Lord, director of the University of Michigan’s Autism and Communication Disorders Centers, a member of a group evaluating disorders for the manual.

Taking Asperger’s out of the manual, known as DSM-V for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, does not mean the term will disappear. “It’s just not a diagnostic term,” Lord said.

Recent books by people with Asperger’s give insights into the workings of some oddly beautiful minds. In “Look Me in the Eye,” John Elder Robison describes a painfully lonely childhood and an ability to look at a circuit design and imagine how it will transform sound — a talent he used to invent audio effects and exploding guitars for the band Kiss.

Not all people with Asperger’s have such abilities, and some who do suffer from anxiety and social limitations.

The change, if approved by the manual’s editors, is likely to be controversial. The Asperger’s diagnosis is used by insurers, state agencies and schools, not to mention people with the disorder.

People with Asperger’s and mild autism were divided on the prospect of losing the label. Temple Grandin, an animal scientist who is perhaps the best-known autistic American, said Asperger’s was too well-established to be discarded.

But some involved in the growing autism self-advocacy movement see things differently. “My identity is attached to being on the autism spectrum, not some superior Asperger’s identity,” said Ari Ne’eman, 21, who founded the Autistic Self-Advocacy Network. “I think the consolidation to one category of autism spectrum diagnosis will lead to better services.”

Source:   http://www.statesman.com/news/content/news/stories/nation/2009/11/03/1103asperger.html

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