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Thread: Evolution of Asperger's Syndrome Diagnosis

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    Default Evolution of Asperger's Syndrome Diagnosis

    In 1926, Russian neurologist Ewa Ssucharewa wrote “Die Schizoiden Psychopathien im Kindesalter“. Some academics who study Asperger’s Syndrome have concluded that this paper describes a group children that resemble children currently given an Asperger’s Syndrome diagnosis.

    Link to Translation of “Die Schizoiden Psychopathien im Kindesalter”


    In 1943, Austrian pediatrician Hans Asperger wrote “Die ‘Autistichen Psychophathien’ im Kindesalter“.

    Hans Asperger Biography

    Link to “Die ‘Autistichen Pschophathien’ im Kindesalter”



    In 1964, child psychiatrist Sula Wolff had an unpublished paper entitled "Schizoid personality disorder in childhood" read at the Sixth International Congress of Psychotherapy. She did not formally publish on the topic until 1979; her first published paper on the topic was entitled "Schizoid Personality in Childhood: A Comparative Study of Schizoid, Autistic and Normal Children". In this paper, Wolff identified her 'schizoid children' with Hans Asperger's 'autistic psychopaths'. Thereafter, she published regularly on the topic of 'schizoid disorder of childhood'. In 1995, she wrote a comprehensive treatment of ‘schizoid Disorder of chilhood’ entitled Loners: The Life Path of Unusual Children. Critically, her book was highly regarded. However, it seems that ultimately, her lifelong work on ‘schizoid disorder of childhood’ would be ignored by mainstream psychiatric academia with favor going to an ‘autism spectrum’ approach.

    Sula Wolff Biography


    Link to Beyond Asperger Syndrome

    Link to Wolff Schizoid Disorder of Childhood Criteria


    In 1980, the American Psychiatric Association included 'Schizoid Disorder of Childhood or Adolescence' in the DSM III. I believe the category was largely based on Sula Wolff's work .

    Link to DSM III description of 'Schizoid Disorder of Childhood or Adolescence'




    In 1981, English psychiatrist Lorna Wing wrote a paper entitled “Asperger syndrome: a clinical account“. This paper ultimately accomplished three things: (i) it coined the terminology ‘Asperger Syndrome‘ [which we henceforth refer to as AS], (ii) it popularized Hans Asperger's work with respect to mainstream psychiatric academia, and (iii) it proposed that the psychiatric condition that Asperger and Wolff were describing is a mild sort of autism (i.e., on the high-functioning end of the 'autism spectrum').

    Lorna Wing Biography

    Link to “Asperger syndrome: a clinical account”


    In DSM III R (1987), 'Schizoid Disorder of Childhood or Adolescence' was removed as a category. It is listed in the Index; however, the Index says SEE PERVASIVE DEVELOPMENTAL DISORDER NOS. This detail illustrates that by this time, Lorna Wing's view that AS belongs to an 'autism spectrum' had attracted a following in psychiatric academia.


    In 1989, Swedish child pyschiatrist Christopher Gillberg published the first set of diagnostic criteria for AS.

    Christopher Gillberg Biography

    Link to Gillberg Asperger Syndrome Criteria


    In 1986, child psychiatrist Peter Szatmari began a study of 'schizotypal children'. He eventually disposed of this terminology and replaced it with 'Asperger Disorder' since, at the time, there was a great deal of enthusiasm among the psychiatric academics to study the condition called AS by Lorna Wing. In 1989, Szatmari published a set of diagnostic criteria for AS.

    Peter Szatmari Biography

    Link to "A Chart Review of Schizotypal Personality Disorder in Children"

    Link to Szatmari Asperger Disorder Criteria


    [Note that Szatmari’s criteria for Asperger’s Disorder are more reminiscent of ‘Schizoid Disorder of Childhood’ than the current standardized criteria for Asperger’s Disorder.]


    In 1992, The World Health Organization included 'Asperger's Disorder' in the ICD-10 under the Pervasive Developmental Disorder section.

    Link to ICD-10 Asperger Disorder Criteria

    Note that this category includes 'autistic psychopathy' [as described by Hans Asperger] and 'schizoid disorder of childhood' [as described by Sula Wolff].


    In 1994, The American Psychiatric Association included 'Asperger's Disorder' in DSM IV under the Pervasive Developmental Disorder section.

    Link to DSM IV TR Asperger Disorder Criteria



    The ICD-10 and DSM IV became the standards for AS diagnosis in Europe and the USA, respectively. Note that the AS categories‘ descriptions were made comparable to the descriptions for 'Autistic Disorder' [henceforth referred to as AD]. A result was that the standardized AS categories, while overlapping with the old ‘autistic psychopathy‘/‘schizoid disorder of childhood’ category, differ significantly from the ‘autistic psychopathy‘/‘schizoid disorder of childhood’ category . A primary difference is that the standardized AS categories identify only the more functionally impaired persons. Also, while the description of ‘autistic psychopathy‘/‘schizoid disorder of childhood’ mention symptomology similar to schizophrenia [including mild disorganized behavior, 'schizophrenic eccentricity', and unusual fantasies], descriptions of AS ignore these symptoms altogether.


    Since the popularization of AS among psychiatric academia, it has been regarded by mainstream psychiatric academia as a branch off of the 'autism tree'; however, psychiatric academics have been divided on the issue of whether or not AS, as defined in ICD-10 and DSM-IV, is a valid category. Apparently, the reason for AS being given its own category in ICD-10 and DSM IV is so research into AS could proceed unbridled; the primary question to be answered by AS researchers was ‘Is the AS category valid?’ In particular, researchers have been comparing AS to high-functioning AD [henceforth referred to as HFA]. Researchers have focused on the accuracy of the diagnostic criteria for each group and fine differences between the two groups. Besides the obvious normal language development/late language development criterion difference, researchers have concluded that the AS and AD standardized criteria fail to adequately distinguish between the AS group and HFA group. However, neuropsychological research suggests that the groups have different cognitive profiles. Also, some research using the Rorschach test suggests that [compared to the HFA group] the AS group tends towards more disorganized thinking, more eccentricity, more introspection, more introversion, and tends to be much more imaginative. But since the diagnostic criteria for standardized AS categories essentially fail to differentiate it from AD, psychiatric academics are in general agreement that modifications are necessary for the standardized AS categories.


    The American Psychiatric Association intends to publish DSM V in 2013. The Pervasive Developmental Disorder section will undergo a major upheaval. In particular, all Pervasive Developmental Disorders [from DSM IV] will be subsumed by a single Autism Spectrum Disorder category. For details, see the links below.


    Autism Spectrum Criteria


    Questions About Asperger's Disorder Revision --> Then go to RATIONALE.

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    Children diagnosed with Asperger's Syndrome have no speech delays unlike children with autism. A person with Asperger's Syndrome can be supported to find ways of adapting to the challenges of their diagnosis. As per me providing social skills training to these children would be best, as this will help to learn about how to establish, maintain and repair friendship situations.

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    So schizoid personality disorder, autistic psychopathy, and Asperger's Syndrome are 3 different names for the same condition?

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    Quote Originally Posted by Robert View Post
    So schizoid personality disorder, autistic psychopathy, and Asperger's Syndrome are 3 different names for the same condition?
    The diagnostic category of Asperger's Disorder evolved from the the work on Autistic Psychopathy (used by Hans Asperger in 1943) and Schizoid Personality Disorder in Childhood (used by Ewa Ssucharewa in 1926, Sula Wolff in 1964, in DSM III in 1980). It was originally conceived of as a disorder of personality, but in the 1980s, the psychiatric establishment decided that they would like to group it alongside Autistic Disorder, and they endeavored to place it under a new `Autism Spectrum' umbrella. This diagnosis no longer exists under the DSM V taxonomy.

    According to the ICD 10, Autistic Psychopathy and Schizoid Disorder in Childhood are synonyms for Asperger's Disorder. See the link below.
    ICD 10 Asperger's Disorder Criteria

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