Understanding Autism

The classification of autism and Asperger’s Syndrome

There are two main reference sources for the diagnosis of autism spectrum conditions
(and other developmental and intellectual disabilities, personality disorders and mental
health conditions). These are:

 The DSM-V (Diagnostic and Statistical Manual, 2014, American Psychiatric

Association)
 The ICD-10 (International Classification of Diseases, 2010, World Health
Organisation)

The DSM-V is predominant in the US, whilst the ICD-10 is more commonly used in Europe
and the rest of the world. The DSM-V initiated the removal of Asperger’s Syndrome as a
separate diagnosis (however it recommended that those with an existing diagnosis keep
it). The ICD-11, due out in 2019, will also remove the separate classification of Asperger’s
Syndrome.

Removing a diagnostic classification might impact on people’s understanding of what

autism is. It might also have implications where the diagnosis has become part of the
individual’s identity (for example, referring to oneself as an ‘aspie’) or social norms, such
as embracing autism as a positive difference rather than disability.

The argument for removing Asperger’s Syndrome as a separate diagnosis is, in part, that
whilst we are relatively skilled at diagnosing ‘autism vs not autism’ we have much less
confidence in our ability to differentiate further than that.

Previously Asperger’s Syndrome was differentiated from autism (in ICD-10) in terms of
developmental delays in speech and communication. For people meeting the criteria for
diagnosis of autism spectrum conditions, those with no delays in speech and
communication would have received a diagnosis of Asperger’s Syndrome and those with
these delays would have received a diagnosis of autism.

Also, we are not very sure about whether Asperger’s Syndrome is really different from
autism or whether any differences we see are just about individual differences between
people. Autism will look very different in for example:

 an autistic four year old boy who has an intellectual disability;

 a 13 year old autistic girl without an intellectual disability;
 an older autistic adult who has a high-paid job.

Clare L Melvin © University of Kent 2018

 Understanding Autism

Suggested links

You can read a brief overview about the ICD-11 and the upcoming eleventh revision on
this blog:

 https://greaterlondoncommunityofpractice.wordpress.com/2018/06/29/idd-in-
the-icd-11/

The NAS website is also a good place to keep an eye out for updates and changes

 http://www.autism.org.uk/about/diagnosis/criteria-changes.aspx

With regards to those who have a diagnosis, this link has quite an interesting take and
that despite the diminished used in medical forums, explains why the terms is likely to
remain:

 http://theconversation.com/what-happened-to-aspergers-syndrome-89836

This link gives a little more information about the changes in the DSM and ICD:

 https://spectrumnews.org/news/new-global-diagnostic-manual-mirrors-u-s-
autism-criteria/

Clare L Melvin © University of Kent 2018