Good-bye to Asperger's
There’s a fairly arbitrary split between people diagnosed “Asperger” and high-functioning people diagnosed “Autism”. The big difference between these two categories is that the people with Asperger’s had speech before three (though it was probably unusual speech), and the people categorized Autism usually did not. In the HFA group, they almost universally catch on to speech by age five-after which they are, especially in the teen and adult years, functionally identical to Asperger’s.
The problem is that this difference in speech acquisition isn’t the only difference that you can find among people with HFA/Asperger’s. It’s just the only difference that people split the two groups apart by. There are other differences-significant ones-that do not fall along the lines of the HFA/Asperger’s split. For example, interest in socializing ranges from clumsy, insistent interaction to complete indifference within both categories. IQ ranges from borderline to genius in both groups. Adult prognosis ranges from “needs constant supervision” to “raising a family and holding a highly-paid job”. And while people diagnosed Autism tend to be more disabled on average, this could just be because stereotypes prompt Asperger’s as a diagnosis in an individual who fulfills Autism criteria-because the individual seems intelligent. (Asperger’s is stereotypically associated with intelligence.)
Asperger’s is obsolete as a diagnosis, and has been ever since we figured out that most people now diagnosed with Asperger’s are also diagnosable with DSM-IV Autistic Disorder-even more annoying because Autistic Disorder is supposed to take precedence. There’s no good reason to keep the label when it’s redundant and serves no purpose. The simpler the labeling system can be while keeping its meaning, the better.
It’s about time we got rid of the confusing Autism Spectrum, as it now is. When there’s enough diagnostic confusion that most people diagnosed Asperger’s could be diagnosed Autism, and when fully half the Pervasive Developmental Disorder diagnoses are PDD-NOS, something has to be done.
We’re just going to have to face it: Autism is a diagnosis with huge variations from individual to individual, and while knowing “autism” about somebody might tell you some things about them, you’re going to have to look at their specific case. Standardized treatment according to the diagnosis doesn’t cut it now, and it won’t be any more useful once they merge the spectrum; but at least we may be forced to consider each case individually, as we should’ve been doing all along.