5 ms·

A Concise History of Asperger Syndrome (2015)

53 points by lainon 9y ago

zero_intp 9y ago
As a high functioning non-normative, I have found kinship with many of those diagnosed with Asperger's. The full isolation of the Autistic have generally had little parity with the challenges I have faced. The blithe dismissal by the writers of the DSM-V of an entire developmental process has led me to dismiss the entire psychological profession as self-serving.
- Angostura 9y ago
  Sorry, I'm having trouble understanding what you are saying. Are you concerned by the way that's Aspergers has been rolled into the autistic spectrum?
  - goodells 9y ago
    The person you're replying to may be referring to the fact that DSM-5's diagnostic criteria for Autism Spectrum Disorder exclude a large number of people who would formerly have qualified as having Aspberger's Syndrome. TFA also talks about how some prefer to keep the AS label vs. ASD.
    - zero_intp 9y ago
      Thank you
- jcrben 9y ago
  If someone is high-functioning, why is a diagnosis necessary? Why pathologize personality? I think that was part of what the removal of Asperger's was about. It's unclear if there was any effective therapy for what many don't even regard as a disorder or disability. There are many personality traits which might be uncomfortable in various situations, but aren't classified as medical disorders. It doesn't mean they aren't worth exploring as part of self-discovery. With that said, there are some captured into this category who really do need help, which is what the ASD spectrum diagnosis can capture.
  - emmab 9y ago
    I'm high functioning but still have sensory processing disorder related to ASD which makes it hard to function in very sensory overwhelming environments. I also had a lot of difficulties relating to socialization growing up related to ASD, even if they are less relevant now that I'm an adult.
    - jcrben 9y ago
      Hopefully we get better at spotting sensory disorders and perhaps someday "sensory processing disorder" will be a recognized diagnosis with specific evidence-based treatment. From the article: "field trials showed that DSM-5 ASD has improved specificity at the cost of excluding more cognitively able individuals, including up to 75% of those previously diagnosed with AS". Also from the article: "there is evidence that patients, families, education professionals, and health professionals connote AS with positive features and associate Autism with strange behavior, learning disability and family dysfunction". Autism correlates with various things and I imagine that these would involve different therapy. For example, the number thrown around is that 1/3 are nonverbal and do not develop functional speech in adulthood (https://en.wikipedia.org/w/index.php?title=Autism&oldid=799627286#cite_note-36 https://en.wikipedia.org/w/index.php?title=Autism&oldid=7996...). In children, about half engage in self-harm (http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2788.2003.00507.x/full http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2788.2003....) or physical aggression (http://www.sciencedirect.com/science/article/pii/S1750946712001456 http://www.sciencedirect.com/science/article/pii/S1750946712...). See also (not necessarily endorsing): http://nymag.com/news/features/autism-spectrum-2012-11/ http://nymag.com/news/features/autism-spectrum-2012-11/ https://www.newyorker.com/tech/elements/the-no-label-movement https://www.newyorker.com/tech/elements/the-no-label-movemen... https://en.wikipedia.org/wiki/Rosenhan_experiment https://en.wikipedia.org/wiki/Rosenhan_experiment
  - zero_intp 9y ago
    To get to high functioning, engage in a significant amount of social counseling. High functioning does not mean working the same as everyone else.
  - mmusson 9y ago
- louithethrid 9y ago
  The brain-shamans have done a lot of damage during the last centurie: https://de.wikipedia.org/wiki/Lobotomie https://de.wikipedia.org/wiki/Lobotomie They are kept around, so that worser pseudo science can not fill the gap.
j9461701 9y ago
> ... a peculiar, fascinating physical appearance, with “finely boned features,” of “almost aristocratic appearance” Is this referencing the mild physical androgyny observed in many Asperger patients, or just Hans Asperger suffering from a small sample size? I've never seen this symptom described elsewhere before. Regardless, an interesting overview of the state of the field. I had no idea physical clumsiness was so central to the diagnosis in so many systems and for so many years. Poor social skill, need for sameness, but bad motor skills was never something I considered so core to being an Aspie.
- jcrben 9y ago
  It sounds like old-school 1940s-era science. Seems like you might be taking it too seriously.
  - tyingq 9y ago
    It's just one study, but seems to be in the same rough space, and fairly recent: http://www.dailymail.co.uk/health/article-2051749/Autism-Wider-eyes-broader-mouth-Scientists-identify-subtle-distinct-facial-characteristics-children-developmental-disorder.html http://www.dailymail.co.uk/health/article-2051749/Autism-Wid...
    - DanBC 9y ago
      You can't trust anything the daily fucking mail says. For example, from the article you link to: > Some scientists however believe there has been an actual rise in autism cases due to environmental factors. The MMR vaccine has been cited as a possible cause however a link has yet to be confirmed. This is bollocks, and we knew it was bollocks before 2011 (when this article was published). The GMC hearing; the Lancet retractions, and Wakefield being struck off all happened in 2010.
      - tyingq 9y ago
        The article publisher wasn't the interesting part. Other publications reported on the study.
stefantalpalaru 9y ago
> The entry of autism and Asperger syndrome (AS) into the history of psychopathology was marked by extraordinary coincidences. Both disorders were first described by Kanner (1943) and Asperger (1944), respectively. Both were Austrian-born physicians and, though unaware of each other’s writings, both used the term “autistic” to describe a unique group of children who shared features of impaired social interaction and restricted, repetitive behaviors and interests. "Unaware" my ass. Georg Frankl - Asperger’s chief diagnostician - emigrated from Vienna to the US in 1937. One year later, he met and started working with Kanner in Baltimore. Kanner was a fellow Austrian Jew emigrant, like Frankl, but with an earlier start - he left Berlin (where he worked as a cardiologist) in 1924 for America where he switched to paediatrics and psychiatry. What's more, the first diagnoses of "infantile autism" in Baltimore came from Frankl. Kanner took Asperger's theories through his chief diagnostician, made a mess of them with some silly psychoanalysis-inspired "refrigerator mother" explanation, and published them before Asperger had a chance. This silly conflict prevented psychiatric progress for decades. Only recently Asperger's take on the pathology became accepted by the scientific community. His "continuum" is our "spectrum" and his name has been purged from the nomenclature, but he has been - nonetheless - vindicated. More details: https://www.theatlantic.com/health/archive/2015/08/autism-history-aspergers-kanner-psychiatry/398903/ https://www.theatlantic.com/health/archive/2015/08/autism-hi... P.S.: there's also Grunya Efimovna Sukhareva - the Ukrainian/Soviet scientist whose 1926 work on autism has been thoroughly ignored: https://www.ncbi.nlm.nih.gov/pubmed/25826582 https://www.ncbi.nlm.nih.gov/pubmed/25826582

53 points by lainon 9y ago

As a high functioning non-normative, I have found kinship with many of those diagnosed with Asperger's. The full isolation of the Autistic have generally had little parity with the challenges I have faced. The blithe dismissal by the writers of the DSM-V of an entire developmental process has led me to dismiss the entire psychological profession as self-serving.

Angostura 9y ago
Sorry, I'm having trouble understanding what you are saying. Are you concerned by the way that's Aspergers has been rolled into the autistic spectrum?
- goodells 9y ago
  The person you're replying to may be referring to the fact that DSM-5's diagnostic criteria for Autism Spectrum Disorder exclude a large number of people who would formerly have qualified as having Aspberger's Syndrome. TFA also talks about how some prefer to keep the AS label vs. ASD.
  - zero_intp 9y ago
    Thank you
jcrben 9y ago
If someone is high-functioning, why is a diagnosis necessary? Why pathologize personality? I think that was part of what the removal of Asperger's was about. It's unclear if there was any effective therapy for what many don't even regard as a disorder or disability. There are many personality traits which might be uncomfortable in various situations, but aren't classified as medical disorders. It doesn't mean they aren't worth exploring as part of self-discovery. With that said, there are some captured into this category who really do need help, which is what the ASD spectrum diagnosis can capture.
- emmab 9y ago
  I'm high functioning but still have sensory processing disorder related to ASD which makes it hard to function in very sensory overwhelming environments. I also had a lot of difficulties relating to socialization growing up related to ASD, even if they are less relevant now that I'm an adult.
  - jcrben 9y ago
    Hopefully we get better at spotting sensory disorders and perhaps someday "sensory processing disorder" will be a recognized diagnosis with specific evidence-based treatment. From the article: "field trials showed that DSM-5 ASD has improved specificity at the cost of excluding more cognitively able individuals, including up to 75% of those previously diagnosed with AS". Also from the article: "there is evidence that patients, families, education professionals, and health professionals connote AS with positive features and associate Autism with strange behavior, learning disability and family dysfunction". Autism correlates with various things and I imagine that these would involve different therapy. For example, the number thrown around is that 1/3 are nonverbal and do not develop functional speech in adulthood (https://en.wikipedia.org/w/index.php?title=Autism&oldid=799627286#cite_note-36 https://en.wikipedia.org/w/index.php?title=Autism&oldid=7996...). In children, about half engage in self-harm (http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2788.2003.00507.x/full http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2788.2003....) or physical aggression (http://www.sciencedirect.com/science/article/pii/S1750946712001456 http://www.sciencedirect.com/science/article/pii/S1750946712...). See also (not necessarily endorsing): http://nymag.com/news/features/autism-spectrum-2012-11/ http://nymag.com/news/features/autism-spectrum-2012-11/ https://www.newyorker.com/tech/elements/the-no-label-movement https://www.newyorker.com/tech/elements/the-no-label-movemen... https://en.wikipedia.org/wiki/Rosenhan_experiment https://en.wikipedia.org/wiki/Rosenhan_experiment
- zero_intp 9y ago
  To get to high functioning, engage in a significant amount of social counseling. High functioning does not mean working the same as everyone else.
- mmusson 9y ago
louithethrid 9y ago
The brain-shamans have done a lot of damage during the last centurie: https://de.wikipedia.org/wiki/Lobotomie https://de.wikipedia.org/wiki/Lobotomie They are kept around, so that worser pseudo science can not fill the gap.

j9461701 9y ago

> ... a peculiar, fascinating physical appearance, with “finely boned features,” of “almost aristocratic appearance” Is this referencing the mild physical androgyny observed in many Asperger patients, or just Hans Asperger suffering from a small sample size? I've never seen this symptom described elsewhere before. Regardless, an interesting overview of the state of the field. I had no idea physical clumsiness was so central to the diagnosis in so many systems and for so many years. Poor social skill, need for sameness, but bad motor skills was never something I considered so core to being an Aspie.

jcrben 9y ago
It sounds like old-school 1940s-era science. Seems like you might be taking it too seriously.
- tyingq 9y ago
  It's just one study, but seems to be in the same rough space, and fairly recent: http://www.dailymail.co.uk/health/article-2051749/Autism-Wider-eyes-broader-mouth-Scientists-identify-subtle-distinct-facial-characteristics-children-developmental-disorder.html http://www.dailymail.co.uk/health/article-2051749/Autism-Wid...
  - DanBC 9y ago
    You can't trust anything the daily fucking mail says. For example, from the article you link to: > Some scientists however believe there has been an actual rise in autism cases due to environmental factors. The MMR vaccine has been cited as a possible cause however a link has yet to be confirmed. This is bollocks, and we knew it was bollocks before 2011 (when this article was published). The GMC hearing; the Lancet retractions, and Wakefield being struck off all happened in 2010.
    - tyingq 9y ago
      The article publisher wasn't the interesting part. Other publications reported on the study.

stefantalpalaru 9y ago

> The entry of autism and Asperger syndrome (AS) into the history of psychopathology was marked by extraordinary coincidences. Both disorders were first described by Kanner (1943) and Asperger (1944), respectively. Both were Austrian-born physicians and, though unaware of each other’s writings, both used the term “autistic” to describe a unique group of children who shared features of impaired social interaction and restricted, repetitive behaviors and interests. "Unaware" my ass. Georg Frankl - Asperger’s chief diagnostician - emigrated from Vienna to the US in 1937. One year later, he met and started working with Kanner in Baltimore. Kanner was a fellow Austrian Jew emigrant, like Frankl, but with an earlier start - he left Berlin (where he worked as a cardiologist) in 1924 for America where he switched to paediatrics and psychiatry. What's more, the first diagnoses of "infantile autism" in Baltimore came from Frankl. Kanner took Asperger's theories through his chief diagnostician, made a mess of them with some silly psychoanalysis-inspired "refrigerator mother" explanation, and published them before Asperger had a chance. This silly conflict prevented psychiatric progress for decades. Only recently Asperger's take on the pathology became accepted by the scientific community. His "continuum" is our "spectrum" and his name has been purged from the nomenclature, but he has been - nonetheless - vindicated. More details: https://www.theatlantic.com/health/archive/2015/08/autism-history-aspergers-kanner-psychiatry/398903/ https://www.theatlantic.com/health/archive/2015/08/autism-hi... P.S.: there's also Grunya Efimovna Sukhareva - the Ukrainian/Soviet scientist whose 1926 work on autism has been thoroughly ignored: https://www.ncbi.nlm.nih.gov/pubmed/25826582 https://www.ncbi.nlm.nih.gov/pubmed/25826582