If Asperger syndrome is effectively synonymous with social and interpersonal issues, then isn’t it right to remove it from the autism spectrum, and from the Diagnostic and Statistical Manual of Mental Disorders? The manual, known as D.S.M., is published by the American Psychiatric Association, which covers all mental health disorders for both children and adults.
That’s the argument Dr. Paul Steinberg makes in the Opinion pages, in a thoughtful article that’s respectful of the real needs behind many an autism diagnosis: “major problems with receptive language (the ability to comprehend sounds and words) and with expressive language,” and, commonly, language delays. “Aspies,” he says, have a social disability, but one that requires social skills coaching, not a diagnosis that may lead to “lower self-esteem and poorer social development” in children “inappropriately placed in school environments with truly autistic children.”
His words are punctuated by another Opinion piece, this one from the novelist Benjamin Nugent, headlined “I Had Asperger Syndrome. Briefly.” It relates how his mother, a psychology professor and Asperger specialist, concluded with the help of a colleague that her son had from the syndrome that she studied (a lesson to any psychologist parent). She included him in an educational video she produced at the time, “Understanding Asperger’s.”
Mr. Nugent has forgiven his mother and says that at the time she labeled him an “Aspie,” he did indeed meet the criteria set by the D.S.M. (the same criteria under consideration for change). But Asperger syndrome is supposed to be a “continuous and lifelong disorder,” and his symptoms (an intense focus on one activity combined with a social awkwardness that left him largely friendless amid other children annoyed by his affectations) disappeared once he reached New York and found a group of peers and a career that interested him.
When the American Psychiatric Association announced that it was considering redefining autism in a more restrictive way, I wrote, here, that I feared it would affect children’s lives, and not for the better. In the comments, many of you agreed — your children had experienced a need for services that might not be available without a diagnosis.
But both Mr. Nugent and Dr. Steinberg raise the other side of the argument. “Under the rules in place today, any nerd, any withdrawn, bookish kid, can have Asperger syndrome,” Mr. Nugent writes. “The definition should be narrowed. I don’t want a kid with mild autism to go untreated. But I don’t want a school psychologist to give a clumsy, lonely teenager a description of his mind that isn’t true.”