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.
A single diagnosis
If they have their way, Asperger's syndrome and another mild form of autism — pervasive developmental disorder not otherwise specified — 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 neurodevelopmental 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. “We don't want to say that no one can ever use this word,” Lord said. “It's just not a diagnostic term.”
But 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.