Asperger’s syndrome (AS) and autism both come under the autism spectrum disorder (ASD). Both conditions can make social interaction challenging, but people with AS do not usually have problems with language and thinking.

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AS and autism can both affect a person’s behavior, social interactions, and relationships.

Historically, doctors diagnosed AS and autism separately. However, since 2013, both now combine under the umbrella diagnosis of ASD.

The American Psychiatric Association publishes a manual that practitioners use to diagnose mental health conditions. Its most recent edition, the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), incorporates AS into the diagnosis of ASD. Before this change, a mental health professional looked for specific criteria when diagnosing AS.

This article describes AS and autism in detail. It also explores ways that doctors diagnose ASD and some aspects of life with the diagnosis.

ASD is a group of neurodevelopmental conditions that can lead to challenges with social interactions, communication, and behavior.

The severity and characteristics of conditions that fall under the ASD umbrella can vary. There is a broad spectrum — one person’s experience of ASD may be very different from another’s.

Symptoms of autism spectrum disorder

Some characteristics of ASD include:

  • having difficulty with everyday conversations
  • sharing emotions or interests less often than peers
  • having difficulty responding to or understanding social cues
  • having difficulty understanding other people’s facial expressions or emotions
  • having delayed speech or language skills
  • having trouble developing or understanding relationships
  • doing repetitive actions, such as hand-flapping or rocking
  • becoming intensely interested in certain topics
  • speaking in atypical ways, such as in a singsong voice
  • having a significant need for predictable structure and order
  • becoming overwhelmed or angry in new situations
  • having a sensitivity to certain stimulants, such as being overwhelmed by loud noises or bright lights
  • experiencing intellectual delays

Healthcare professionals generally diagnose ASD in childhood, and about 1 in 68 children may have ASD.

AS first appeared in the DSM-4 in 1994. At the time, it was a separate diagnosis from autism. Many people with AS had no difficulties with language or cognitive skills, but they typically had trouble with social and communication skills.

Bringing AS under the umbrella of ASD in 2013 was met with some criticism. This partly concerned the fact that people with AS tend to have less explicit characteristics than autistic people.

A 2021 review observes that some people with a previous diagnosis of AS may not meet the criteria for ASD. If a person with AS loses their diagnosis, they may lose access to some support services. A person’s AS diagnosis can also be an important part of their identity.

A person with characteristics of AS may now receive a diagnosis of ASD because the condition falls under the broader classification of ASD.

Before the publication of the DSM-5 in 2013, the diagnostic criteria for AS in the DSM-4 included:

  • severe impairment in social interaction
  • repetitive patterns of behavior
  • intense or passionate interest in certain topics

The criteria also noted that a person with AS has “neurotypical” intelligence and language development, similar to those of someone without a developmental condition.

AS and autism are no longer considered different conditions. ASD is the name for a group of conditions, and AS is one of these. A person who might have received an AS diagnosis in the past may now receive a broader diagnosis of ASD.

Many people with an AS diagnosis consider this part of their identity. There can be an assumption that ASD is a significant disability, and a person who identifies as having AS may wish to avoid the ASD label due to associated ableist stigma.

The diagnostic criteria once recognized that people with AS have neurotypical language development and intelligence. An autistic person may also have neurotypical intelligence or experience mild or significant intellectual delays.

A person with AS may require less support than an autistic person, depending on the characteristics of their condition.

A 2016 study defines social anxiety disorder (SAD) as a mental health disorder where people have an intense fear of other people scrutinizing and assessing them negatively. As a result, they may excessively avoid social interactions.

ASD is a collection of neurodevelopment disorders that can cause difficulties with social interactions and communication.

According to the study, SAD and ASD have some overlapping symptoms. In both disorders, people may avoid making eye contact or keeping the gaze of another person.

The study found that autistic people may look toward another person more slowly, while a person with SAD may look away from another person more quickly.

Because doctors now consider AS to be a part of ASD, people with an AS diagnosis may now be able to access services for autistic people.

There is a consensus that AS and ASD are not conditions that require support services. An autistic person’s behavior may simply be different from what society expects.

However, a person may have trouble with certain aspects of their AS or ASD. For anyone who requires support, the following options may help:

Behavior and communication approaches

The Centers for Disease Control and Prevention (CDC) report that autistic children may benefit from approaches that provide:

  • structure
  • direction
  • organization
  • family participation

Some specific approaches that autistic people may find helpful include:

Applied behavior analysis

This is a form of support for autistic children that encourages helpful behaviors while discouraging unhelpful ones. There are many types, such as:

  • Positive behavior and support: This aims to identify the reason for a child’s particular challenging behavior and looks for ways to make a more appropriate behavior appealing to the child.
  • Pivotal response training: This aims to increase a child’s motivation to learn or communicate.
  • Early intensive behavioral intervention: This aims to help very young autistic children develop adaptive behaviors.
  • Discrete trial teaching: This aims to teach certain skills and behaviors in a controlled, step-by-step manner using positive feedback for encouragement.

Assistive technology

Autistic people can have trouble communicating, and some cannot communicate verbally. Assistive technology can help a person interact with others.

One example is a communication board with pictures or words on it that an autistic person can point to. Certain software on electronic devices, such as tablets, can help autistic people express themselves.

Occupational therapy

This can help an autistic person live as independently as possible. It may provide guidance about how to:

  • get dressed
  • prepare meals
  • bathe
  • communicate effectively

Speech therapy

This can help an autistic person improve their communication skills.

Dietary approaches

As the CDC notes, there is little evidence to support the use of dietary approaches for autistic children. Anyone interested in whether dietary changes may help support an autistic person should speak with a doctor first.

Medication

Some medications may help manage certain ASD characteristics, such as:

Since 2013, doctors have considered AS to fall within the broader classification of ASD. But a person with a diagnosis of AS may not identify as having ASD.

An autistic person does not necessarily require support, but various options are available for anyone who wants help managing elements of their ASD.