HISTORY OF ASPERGER'S
SYNDROME
The history of Asperger syndrome, an Autism Spectrum Disorder (ASD), is brief; Asperger syndrome is a relatively new
diagnosis
in the field of autism,[1] named in honor of Hans Asperger (1906–80),
an Austrian psychiatrist and pediatrician. An English psychiatrist,
Lorna Wing popularized the term "Asperger's syndrome"
in a 1981 publication; the first book in English on Asperger syndrome
was written by Uta Frith in 1991 and the condition was subsequently
recognized in formal diagnostic manuals later in the 1990s.[1]
Asperger and Kanner
Asperger was the director of the University Children's
Clinic in Vienna, spending most of his professional life in Vienna
and publishing largely in German.[1] In 1944, Asperger described
in the paper "'Autistic psychopathy' in childhood"[2]
four children in his practice[3] who had difficulty in integrating
themselves socially. Although their intelligence appeared normal,
the children lacked nonverbal communication skills, failed to demonstrate
empathy with their peers, and were physically clumsy. Their speaking
was either disjointed or overly formal, and their all-absorbing
interest in a single topic dominated their conversations. Asperger
called the condition "autistic psychopathy" and described
it as primarily marked by social isolation.[4] Asperger called his
young patients "little professors",[2] and believed the
individuals he described would be capable of exceptional achievement
and original thought later in life.[3]
Two subtypes of autism were described between
1943 and 1944 by two Austrian researchers working independently—Asperger
and Austrian-born child psychiatrist Leo Kanner (1894–1981). Kanner
emigrated to the United States in 1924;[1] he described a similar
syndrome in 1943, known as "classic autism" or "Kannerian
autism", characterized by significant cognitive and communicative
deficiencies, including delayed or absent language development.[5]
Kanner's descriptions were influenced by the developmental approach
of Arnold Gesell, while Asperger was influenced by accounts of schizophrenia
and personality disorders.[6] Asperger's frame of reference was
Eugen Bleuler's typology, which Gillberg described as "out
of keeping with current diagnostic manuals", adding that Asperger's
desriptions are "penetrating but not sufficiently systematic".[7]
Asperger was unaware of Kanner's description published a year before
his;[6] the two researchers were separated by an ocean and a raging
war, and Asperger's descriptions were ignored in the United States.[3]
During his lifetime, Asperger's work, in German, remained largely
unknown outside the German-speaking world.[1]
Coinage
According to Ishikawa and Ichihashi in the Japanese
Journal of Clinical Medicine, the first author to use the term Asperger's
syndrome in the English-language literature was the German physician,
Gerhard Bosch.[8] Between 1951 and 1962, Bosch worked as a psychiatrist
at Frankfurt University. In 1962, he published a monograph detailing
five case histories of individuals with PDD[9] that was translated
to English eight years later,[10] becoming one of the first to establish
German research on autism, and attracting attention outside the
German-speaking world.[11]
Lorna Wing is credited with widely popularizing
the term "Asperger's syndrome" in the English-speaking
medical community in her 1981 publication[12] of a series of case
studies of children showing similar symptoms.[1] Wing also placed
Asperger's syndrome on the autism spectrum, although Asperger was uncomfortable characterizing
his patient on the continuum of autism spectrum disorders.[3]
She chose "Asperger's syndrome" as a neutral term to avoid
the misunderstanding equated by the term autistic psychopathy with
sociopathic behavior.[13] Wing's publication effectively introduced
the diagnostic concept into American psychiatry and renamed the
condition as Asperger's;[14] however, her accounts blurred some
of the distinctions between Asperger's and Kanner's descriptions
because she included some mildly retarded children and some children
who presented with language delays early in life.[6]
Early studies
The first systematic studies appeared in the late
1980s in publications by Tantam (1988) in the UK, Gillberg and Gilbert
in Sweden (1989), and Szatmari, Bartolucci and Bremmer (1989) in
North America.[1] The diagnostic criteria for Asperger's syndrome were outlined by
Gillberg and Gillberg in 1989; Szatmari also proposed criteria in
1989.[13] Asperger's work became more widely available in English
when Uta Frith, an early researcher of Kannerian autism, translated
his original paper in 1991.[1] Asperger's syndrome became a distinct diagnosis in
1992, when it was included in the 10th published edition of the
World Health Organization’s diagnostic manual, International Classification
of Diseases (ICD-10); in 1994, it was added to the fourth edition
of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
as Asperger's Disorder.[4]
Contemporary
Less than two decades after the widespread introduction
of Asperger's syndrome to English-speaking audiences, there are
hundreds of books, articles and websites describing it; prevalence
estimates have increased dramatically for Autism Spectrum Disorder, with Asperger's syndrome
recognized as an important subgroup.[1] However, questions remain
concerning many aspects of Asperger's syndrome; whether it should
be a separate condition from high-functioning
autism is a fundamental issue requiring further study.[3] The
diagnostic validity of Asperger syndrome is tentative, there is
little consensus among clinical researchers about the usage of the
term "Asperger's syndrome", and there are questions about
the empirical validation of the DSM-IV and ICD-10 criteria.[6] It
is likely that the definition of the condition will change as new
studies emerge[6] and it will eventually be understood as a multifactorial
heterogeneous neurodevelopmental disorder involving a catalyst that
results in prenatal or perinatal changes in brain structures.[3]
References
1 Baron-Cohen S, Klin A (2006). "What's so
special about Asperger Syndrome?" (PDF). Brain and cognition
61 (1): 1–4. doi:10.1016/j.bandc.2006.02.002. PMID 16563588.
2 Asperger H; tr. and annot. Frith U [1944] (1991). "'Autistic
psychopathy' in childhood", in Frith U: Autism and Asperger
syndrome. Cambridge University Press, 37–92. ISBN 052138608X.
3 Baskin JH, Sperber M, Price BH (2006). "Asperger syndrome
revisited". Rev Neurol Dis 3 (1): 1–7. PMID 16596080.
4 National Institute of Neurological Disorders and Stroke (NINDS)
(July 31, 2007). Asperger Syndrome Fact Sheet. Retrieved 24 August
2007.
5 Kanner L (1943). "Autistic disturbances of affective contact".
Nerv Child 2: 217–50. Reprint (1968) Acta Paedopsychiatr 35 (4):
100–36. PMID 4880460.
6 Klin A (2006). "Autism and Asperger syndrome: an overview".
Rev Bras Psiquiatr 28 (Suppl 1): S3–S11. PMID 16791390.
7 Ehlers S, Gillberg C. "The epidemiology of Asperger's syndrome:
a total population study." J Child Psychol Psychiatry. 1993
Nov;34(8):1327–50. PMID 8294522 Full Text.
8 Ishikawa G, Ichihashi K (2007). "[Autistic psychopathy or
pervasive developmental disorder: how has Asperger's syndrome changed
in the past sixty years?]" (in Japanese). Nippon Rinsho 65
(3): 409–18. PMID 17354550.
9 (German) Bosch G (1962). Der frühkindliche Autismus - eine klinische
und phänomenologisch-anthropologische. Untersuchung am Leitfaden
der Sprache. Berlin: Springer.
10 Bosch G (1970). Infantile autism – a clinical and phenomenological
anthropological investigation taking language as the guide. Berlin:
Springer.
11 Bölte S, Bosch G. "Bosch’s Cases: a 40 years follow-up of
patients with infantile autism and Asperger syndrome" (PDF).
Journal of Psychiatry. Retrieved on 2007-08-20.
^ Wing L (1981). "Asperger's syndrome: a clinical account".
Psychological medicine 11 (1): 115–29. PMID 7208735. Retrieved on
2007-08-15.
12 Mattila ML, Kielinen M, Jussila K, et al (2007). "An epidemiological
and diagnostic study of Asperger syndrome according to four sets
of diagnostic criteria". Journal of the American Academy of
Child and Adolescent Psychiatry 46 (5): 636–46. doi:10.1097/chi.0b013e318033ff42.
PMID 17450055.
13 McPartland J, Klin A (2006). "Asperger's syndrome".
Adolesc Med Clin 17 (3): 771–88. doi:10.1016/j.admecli.2006.06.010.
PMID 17030291.
Click here to go to the
home page to view the full range of autism fact sheets at www.autism-help.org
This autism fact sheet is licensed under the GNU
Free Documentation. It is derivative of an autism-related articles
at http://en.wikipedia.org |
