What’s The Difference Between Asperger’s & Autism?

In the last twenty years, the number of children diagnosed with autism has nearly tripled^[1]. This increase has been attributed to improved diagnostic tools, reduced stigma, increased access to specialized services, and our growing understanding of autism and related disorders. As more and more people receive this diagnosis, it becomes increasingly important to cultivate a deep understanding of the strengths and challenges associated with this condition.

You probably have heard of Asperger’s Syndrome, which many people recognize as being a form of “high-functioning” autism. Recently, the diagnosis of Asperger’s Syndrome (AS) was discontinued and replaced with that of Autism Spectrum Disorder (ASD).

To many people, it may seem like two interchangeable terminologies. However, a greater understanding of autism and why the change was made can be helpful in a variety of ways.

Each person with autism has their distinct qualities, showcases diverse strengths, and requires varying levels of support. It can be helpful to understand where AS falls on the autism spectrum.

Before the merging of Asperger’s syndrome into the broader category of autism spectrum disorders^[2] (ASD), there were some perceived differences between autism and AS. These differences were based on diagnostic criteria and characteristics described in DSM-IV.

Asperger’s syndrome was often considered a milder form of autism, characterized by average or above-average intelligence. Individuals diagnosed with AS had fewer significant delays in language and cognitive development compared to individuals with autism. 

People with Asperger’s syndrome typically exhibited intense interest in specific topics and demonstrated good language abilities, but they often struggled with social interactions and communication, particularly in understanding nonverbal cues and maintaining reciprocal conversations.

On the other hand, “classic” autism, or autistic disorder, typically presented with more severe symptoms across multiple domains, including social communication, repetitive behaviors, and sensory sensitivities. Individuals with classic autism often had significant language delays and intellectual disabilities, along with marked impairments in social interaction and communication skills.

It is important to note that these perceived distinctions were not always clear-cut, and there was considerable overlap and variability in individuals’ experiences within both diagnoses. The merging of Asperger’s syndrome into ASD in the DSM-5 aimed to address these complexities of autism, recognizing the wide range of abilities and challenges individuals may present across the autism spectrum.

The Difference Between Asperger’s Syndrome And Autism Spectrum Disorder

Social Struggles

Individuals with Asperger’s syndrome tend to have relatively intact language development and may possess an advanced vocabulary. They may struggle with pragmatic language skills, such as understanding sarcasm, figurative language, or the nuances of social communication. 

Those subtler difficulties can take a couple of different forms. A person with AS may have a hard time following the rhythm of conversation. They may inadvertently interrupt others or may have a hard time with sarcasm. They may have a difficult time with humor, as well. Personal space is also something they may have trouble with, either being too close or too far away.

Individuals with AS may also have distinctive ways of speaking, with odd inflections or speaking too loudly. They may also be too formal or informal, lacking an understanding of those contexts.

In classic autism, communication difficulties can range from delayed language development to nonverbal communication or a complete absence of speech. Echolalia, the repetition of words or phrases heard from others, is commonly observed in individuals with classic autism. It may be immediate (immediate echolalia) or delayed (delayed echolalia), serving different communicative purposes, or as a self-stimulatory behavior. 

Individuals with classic autism often have challenges with social pragmatics, which refers to the appropriate use of language in social contexts. They may struggle with understanding nonverbal cues, maintaining eye contact, and turn-taking. 

Due to the challenges in spoken communication, some individuals with classic autism may use alternative communication methods. These can include visual supports, augmentative and alternative communication (AAC) devices, or sign language to enhance their ability to communicate.

It’s important to remember that these communication deficits exist on a spectrum, and individuals with classic autism can have different levels of impairment or strengths in specific areas of communication.

For this reason, it is more appropriate to abandon the notion that Asperger’s syndrome and autistic disorder are two separate diagnoses. DSM-5 acknowledges the diverse range of experiences faced by individuals on the autism spectrum.

Restricted Interests

Both Asperger’s syndrome and classic autism may exhibit special interests. Individuals with Asperger’s syndrome have been thought to have focused interests that align with their cognitive abilities. They possess extensive knowledge about their interests. It may be a specific TV show or a video game. 

In classic autistic disorder, interests can be more restricted and may involve repetitive behaviors or fixations on specific parts of objects or patterns. They may focus on spinning wheels, flipping switches, or examining the little details of a toy. 

More recent research offers another possibility. The brain has a reward system that is part of the learning process. Do something ‘good’ and you get to feel good about it, encouraging you to do it again. Some evidence indicates that in people with ASD, this reward system is over-activated when they are pursuing their particular interests.  

Many people with ASD have restricted interests. To their caretakers or the people around them, it may seem like a good idea to make a consistent effort to expand their interest rather than encouraging their “fixation”. However, that’s not necessarily a good idea, as their interests can be an important coping mechanism. 

For some, engaging in activities involving their special interest is a way to relax and relieve anxiety. Taking advantage of these interests can also motivate a student with ASD at school to attempt tasks that are challenging or less preferred.

The overlap between autistic disorder and Asperger’s should now be fairly clear. Social struggles, difficulty with communication, and repetitive or restricted behaviors are commonly experienced by individuals with these two conditions. However, individuals previously classified under the outdated definitions of the Asperger’s syndrome diagnosis may experience these difficulties to a lesser extent.

What Is Autism Spectrum Disorder (ASD)?

Autism Spectrum Disorder (ASD) has been recognized as the official diagnosis by the DSM-5. Instead of using terms like autistic disorder or Asperger’s, it is more appropriate to use ASD. This inclusive term encompasses a variety of neurodevelopmental disorders that share common characteristics, such as difficulties in social communication and interaction, along with the presence of restricted and repetitive behaviors or interests.

We are also moving away from using the terms “high functioning” and “low functioning” to describe individuals on the autism spectrum. Instead, “high support needs” and “low support needs” are terms used to describe the level of assistance or support an individual requires to meet their daily living and functional requirements. 

• High support needs: This term refers to individuals who need significant assistance and support to navigate their daily lives. They may be diagnosed with severe to profound intellectual disability. Individuals in this “category” require extensive help with various aspects such as personal care, communication, mobility, and managing their physical and emotional well-being. 
• Low support needs: Individuals with low support needs require minimal assistance and support in their daily lives. They can typically manage their personal care, communication, mobility, and other activities independently or with minimal support. They may have a higher level of self-sufficiency and autonomy compared to individuals with high support needs.

What is Savant Syndrome?

Savant syndrome refers to a rare condition in which an individual with a developmental disorder demonstrates exceptional abilities or skills in a specific area. Several individuals with autism may exhibit remarkable talents in areas such as music, art, mathematics, or memory. However, not all individuals with this condition exhibit savant abilities. 

While savants may possess exceptional skills in one area, they typically have other areas of functioning that are more impaired or below average. For instance, being capable of performing complex mental calculations does not necessarily equate to overall higher intelligence or enhanced functioning in all aspects of life. Nevertheless, these skills make an individual unique and deserving of praise.

Common Comorbidities

Several conditions commonly co-occur with autism spectrum disorder (ASD).

• Intellectual Disability: Intellectual disability is commonly observed as a comorbidity in individuals with ASD. It is characterized by limitations in intellectual functioning including conceptual, social, practical, and self-care skills.
• Attention-Deficit/Hyperactivity Disorder (ADHD): ADHD is a neurodevelopmental disorder characterized by difficulties with attention, hyperactivity, and impulsivity.
• Anxiety Disorders: Anxiety disorders, such as generalized anxiety disorder, social anxiety disorder, or specific phobias, are prevalent comorbid conditions in individuals with ASD. These conditions may manifest as heightened levels of worry, fear, or avoidance.
• Depressive Disorders: Major depressive disorder and persistent depressive disorder are observed as comorbid conditions in individuals with ASD. Symptoms may include persistent sadness, loss of interest, changes in sleep and appetite, and low energy.
• Epilepsy: Epilepsy, a neurological disorder characterized by recurrent seizures, is seen more frequently in individuals with ASD compared to the general population.
• Sensory Processing Issues: Individuals with ASD may have heightened or diminished sensitivities to sensory stimuli, such as touch, sound, or light.
• Gastrointestinal (GI) Issues: Some individuals with ASD may experience gastroesophageal reflux disease (GERD), constipation, or inflammatory bowel disease.
• Sleep Disorders: Sleep problems, including difficulties with falling asleep, staying asleep, or having irregular sleep patterns, are also common comorbidities in individuals with ASD.

Conclusion

It’s unclear if these conditions are occurring more frequently or if we are just now starting to diagnose them more accurately. Either way, there are many people, both adults and children, who struggle with these problems. It is likely that you know somebody who faces these issues. You may even have someone in your family with ASD.

Some aspects of these conditions, particularly the struggles with social interactions, can have a huge impact on people’s lives. It can be particularly difficult if those around them don’t grasp the aspects of their behavior that are not entirely under their control, or the misunderstandings that can result.

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