Asperger's Syndrome: What Happened to the Diagnosis?

Asperger's was removed from the DSM-5 in May 2013 because research showed clinicians could not reliably tell it apart from other forms of autism. The manual merged it into one diagnosis, autism spectrum disorder, with levels describing how much support a person needs. ICD-11 made the same change in 2022, so the term is no longer used in diagnosis.⁠^1,8,9,10

What was Asperger's syndrome, and what did it describe?

Introduced in the DSM-IV in 1994,⁠⁷ it described people with the social communication differences and restricted, repetitive interests seen in autism — but without a significant delay in language development or an intellectual disability. In practice it was applied to people who spoke on roughly the expected timeline, often had strong vocabularies, and whose difficulties centered on social interaction, sensory experience, change, and the unwritten rules other people seemed to absorb automatically.

Research on people diagnosed under those criteria fits that picture. In a 2005 study of 58 young people with a DSM-IV Asperger's diagnosis, all had mild autistic social difficulties, focused special interests, intelligence in the normal range, and an odd, often pedantic way of speaking.⁠¹⁵ In one comparison with high-functioning autism, the group diagnosed with Asperger's scored significantly higher on verbal and full-scale IQ.⁠¹⁶

The term entered wide use through Lorna Wing, who named it in 1981 after the Austrian pediatrician Hans Asperger, whose 1944 paper had described a similar group of children.⁠^17,18

Where did the name Asperger's come from?

Hans Asperger first used the label "autistic psychopaths" for a group of children in Vienna in 1938, several years before Leo Kanner's 1943 paper on autism. His full study appeared in 1944, after he submitted it to the University of Vienna in 1942 as his postdoctoral thesis, and it found little international recognition until the 1980s.⁠⁴ The 1944 paper presented four cases.⁠¹⁹

Lorna Wing's 1981 paper, "Asperger's syndrome: a clinical account," popularized the name. It described the condition's clinical features, course, causes, and management, and it argued for grouping the syndrome with early childhood autism in a wider set of conditions sharing differences in social interaction, communication, and imagination.⁠^17,4 That wider grouping is, in effect, the spectrum the DSM-5 adopted 32 years later.

Asperger was not the only person at his Vienna clinic describing these children. The staff physician Georg Frankl and the psychologist Anni Weiss had already published on similar cases before him; both were Jewish, and both were forced to leave Austria.⁠²⁰

What were the DSM-IV criteria for Asperger's disorder?

The DSM-IV offered four separate diagnoses on the autism spectrum: autistic disorder, Asperger's disorder, childhood disintegrative disorder, and a catch-all, pervasive developmental disorder not otherwise specified (PDD-NOS).⁠²¹ Asperger's disorder shared its two core requirements with autistic disorder and was separated from it mainly by what had not happened in early childhood.⁠⁷

That last rule mattered more than it looks. When researchers applied the DSM-IV criteria to the four cases Hans Asperger himself described in 1944, all four met the criteria for autistic disorder rather than Asperger's disorder.⁠¹⁹

Why was Asperger's removed from the DSM-5?

The DSM-5, published in May 2013, replaced the four DSM-IV diagnoses with one: autism spectrum disorder.⁠^1,21 The American Psychiatric Association gave two reasons. Researchers had found that the separate diagnoses were not applied consistently across clinics and treatment centers, and its Neurodevelopmental Work Group, led by Susan Swedo of the National Institute of Mental Health, judged that a single umbrella diagnosis would improve the diagnosis of autism without substantially changing the number of children diagnosed.⁠²¹

It wasn't reliable. After nineteen years, the evidence did not support Asperger's as a condition separable from autism without intellectual disability. Two clinicians assessing the same person could reach different labels. A distinction that depends on the assessor rather than the person isn't doing diagnostic work. One study made the problem concrete. Twelve university-based autism centers assessed 2,102 children: scores on standardized measures were similar across the sites, yet the subtype each child was given varied by site, because the centers weighted verbal IQ, language level, and core features differently.⁠⁸

The underlying model changed. The authors of that study concluded that their results supported moving from subgroups to dimensional descriptions of the core features, social affect and fixated, repetitive behaviors, recorded alongside language level and cognitive function.⁠⁸ Neuropsychology pointed the same way: once IQ was accounted for, people diagnosed with Asperger's and with high-functioning autism showed no significant differences in motor, visuospatial, or executive skills, which led the researchers to suggest that Asperger's might simply be "high-IQ autism."⁠¹⁶ Genetics showed overlap rather than boundaries: many of the genetic patterns associated with autism are also associated with numerous other psychological and psychiatric conditions.⁠²²

It created a service gap. This cuts against the assumption that the change was purely a loss. Some US states funded services for autism but not for Asperger's: a 2012 review of autism classification noted that in some states, people with Asperger's or PDD-NOS were not eligible for autism services or benefits, and argued that the data did not justify keeping the separate categories.⁠²² Folding them into one diagnosis removed that distinction for anyone diagnosed under the new criteria.

The change was contested at the time. A petition started in January 2012 by the Global and Regional Asperger Syndrome Partnership, asking the DSM-5 committee not to narrow the autism criteria, has gathered close to 9,000 signatures.⁠⁶ Its objection was to who would still qualify, rather than to the loss of the label itself. Those objections were serious and came largely from people who had built an identity and a community around the label.

Online, the debate ran both ways. In an analysis of 19 discussion threads in the online Asperger community, some members embraced the spectrum and coined a new identity, "spectrumite," while others were suspicious of the motives behind the change and worried about services and about the strong "aspie" identity.⁠²³

When did Asperger's stop being a diagnosis?

In the United States, in May 2013, when the DSM-5 replaced the DSM-IV; Asperger's disorder had been in the manual for 19 years.⁠^1,7 The international classification moved later. The World Health Assembly approved ICD-11 in May 2019, reporting under it began on January 1, 2022, and its autism spectrum disorder category takes in both the childhood autism and the Asperger syndrome of ICD-10.⁠¹⁰ The timeline below runs from the first use of the label in 1938 to ICD-11.

Did people diagnosed with Asperger's still qualify under the DSM-5?

Mostly, yes. Before publication, a study of 4,453 children with DSM-IV diagnoses on the autism spectrum found that the proposed DSM-5 criteria identified 91% of them using parent-report data alone.⁠²⁴ A later study that screened every 7- to 12-year-old in a South Korean community found that 92% of children with an Asperger's diagnosis met the DSM-5 autism criteria, compared with 99% of those with autistic disorder and 63% of those with PDD-NOS.⁠¹¹

The remaining 8% of the children with Asperger's met the criteria for social (pragmatic) communication disorder, a separate DSM-5 diagnosis for people with marked difficulties in social communication whose symptoms do not otherwise meet the criteria for autism spectrum disorder.⁠^11,9 The American Psychiatric Association's position was that anyone with a DSM-IV diagnosis on the autism spectrum should still meet the criteria for autism spectrum disorder or for another, more accurate DSM-5 diagnosis, while acknowledging that several other studies, using different methods, had been inconsistent in their findings.⁠²¹

For someone already diagnosed, the DSM-5 provides for the transfer directly: a well-established DSM-IV diagnosis of Asperger's disorder should be given the diagnosis of autism spectrum disorder.⁠⁹

Is Asperger's still in the ICD? What ICD-11 changed in 2022

ICD-11, the World Health Organization's classification, made the same move as the DSM-5. Its autism spectrum disorder category incorporates both childhood autism and Asperger syndrome from ICD-10, and it records the range of presentations with qualifiers for intellectual functioning and functional language rather than with subtypes.⁠¹⁰

It also dropped ICD-10's requirement for a history of delayed language, a change that partly reflects the end of Asperger syndrome: people with normal-range verbal intelligence typically do not have delayed language, and they now fall within the autism diagnosis. Two further changes matter to the people Asperger's once described. ICD-11 recognizes that some autistic people first show distress and clear social difficulty when social demands rise in adolescence or adulthood, and it adds persistent hypersensitivity or hyposensitivity to sensory input to the diagnostic requirements.⁠²⁵

Who was Hans Asperger, and why is the name controversial?

Some readers will encounter strong feelings about this word and won't know why. Here is the reason, stated plainly.

In April 2018, the historian Herwig Czech published a study in Molecular Autism⁠⁴ drawing on previously unexplored Vienna archives, including Asperger's personnel files and his clinical assessments of patients. Published the same year, the historian Edith Sheffer's book Asperger's Children: The Origins of Autism in Nazi Vienna⁠⁵ reached the same conclusion.⁠²⁰

Their findings: Asperger accommodated himself to the Nazi regime and was rewarded with career opportunities. He joined several organizations affiliated with the Nazi party (the NSDAP), though not the party itself. He publicly legitimized "race hygiene" policies, including forced sterilization. And he referred children to Am Spiegelgrund, a Vienna clinic where disabled children were systematically killed — including, as Czech documented, signing the transfer of a young child, Herta Schreiber, to that clinic in 1941, where she died.⁠⁴

Nearly 800 children died at Spiegelgrund between 1940 and 1945. Asperger examined Herta on June 27, 1941, two months before her third birthday, and wrote that permanent placement at Spiegelgrund "seems absolutely necessary." She was admitted on July 1 and died there on September 2, a day after her third birthday. The recorded cause was pneumonia, the most common cause of death at Spiegelgrund, where it was routinely induced with barbiturates.⁠⁴

When Molecular Autism published Czech's study, its editors wrote that when Lorna Wing coined the term in 1981, she, like the editors and the wider autism community, was unaware of Asperger's support for the Nazi program of compulsory sterilization and euthanasia.⁠²⁰ Czech notes that Wing's 1981 paper made no reference to the historical context of Asperger's work.⁠⁴

The two historians who uncovered the evidence disagree about what should follow. Sheffer has argued the term should be retired from use altogether.⁠⁵ Czech's own conclusion is narrower: that future use of the eponym "should reflect the troubling context of its origins in Nazi-era Vienna."⁠⁴ He has also written that he sees no reason to treat Asperger's scholarship as tainted in itself, and he called Sheffer's argument that the concept of autistic psychopathy was intrinsically tarnished by Nazi ideology "conceptually and methodologically weak."⁠²⁶ The journal's editors described his work as establishing "the necessary evidentiary framework for future discussion."⁠²⁰

Is the history of Hans Asperger still disputed?

Parts of it are. The anthropologist Dean Falk published a rebuttal arguing that it was highly unlikely Asperger knew of the killing program when he referred Herta Schreiber to Spiegelgrund.⁠²⁷ Czech replied in the same journal that her paper relied heavily on online translation software, contained mistranslations and basic factual errors, and should be retracted.⁠²⁶

In 2025, two researchers reviewed every document related to the Gugging Commission, which Czech and Sheffer had also cited. The commission's main task was to decide which children at the Gugging institution could attend an auxiliary school; some of the children it assessed were assigned to "Aktion Jekelius," which Czech and Sheffer read as a cover term for killing. The reviewers concluded that the documents give no indication that Asperger, a member of the Vienna delegation, knew of that action or its hidden murderous intent.⁠²⁸

At least one journal has stopped using the name: the editors and editorial board members of Pediatric Research have announced that they no longer publish any manuscript that refers to "Asperger Syndrome."⁠¹²

We're not going to adjudicate that here. The diagnosis was retired in 2013 for reasons entirely unrelated to this history. What the research means for people who still use the term as an identity is a question for them, and both positions are held by serious people.⁠¹²

What if I was diagnosed with Asperger's or identify with it?

Your diagnosis remains valid. Nobody was undiagnosed in 2013. No reassessment is required and existing support should not be affected by the terminology change alone. The DSM-5 says a well-established DSM-IV diagnosis of Asperger's disorder should be given the diagnosis of autism spectrum disorder.⁠⁹

Many people still use the term, and that's a personal choice. For people diagnosed before 2013, "Aspie" was often the first word that explained a lifetime of difference, and it came with a community. Losing an official category does not oblige anyone to abandon a self-description. Others have moved to "autistic" and prefer it — some because it's the current term, some because it avoids the subtype hierarchy the old system implied, some because of the historical research above. Both are reasonable, and this page isn't going to tell you which to use about yourself.

Research with people who had the diagnosis shows how personal the answer is. In an Australian interview study of 12 adults diagnosed with Asperger's under the DSM-IV, views on the change did not follow demographic lines; they tracked how far each person had come in integrating an Asperger's or an autistic identity.⁠¹³ In a UK survey of 3,470 people, including autistic adults, parents, and professionals, the most widely endorsed terms were "autism" and "on the autism spectrum"; "autistic" was endorsed by many autistic adults and family members but by fewer professionals, and no single description was accepted by everyone.⁠¹⁴

Where the term does cause practical difficulty: newer clinicians may not use it, some services require a current-framework diagnosis, and the word can complicate conversations with people who've read about the history. Worth knowing, not worth changing your identity over.

What is Asperger's called now?

Most people who received an Asperger's diagnosis would today be described as having autism spectrum disorder; the DSM-5 says a well-established DSM-IV diagnosis of Asperger's disorder should be given that diagnosis. The DSM-5 then records a support level for each of its two core areas, social communication and restricted, repetitive behavior, from level 1 (requiring support) to level 3 (requiring very substantial support), along with specifiers such as whether there is accompanying intellectual or language impairment.⁠⁹ Because the old Asperger's criteria ruled out early language delay and intellectual disability, someone who met them would usually be described today as autistic without accompanying intellectual or language impairment.⁠^7,9

A note on "high-functioning autism." The two terms were used almost interchangeably, and clinicians' inability to reliably separate them was part of what drove consolidation. “high-functioning” is also not a formal diagnosis, and carries its own significant problems — chiefly that it describes how well someone masks rather than what support they need, which is one route into autistic burnout.

The research backs that up. In a study of 2,225 children at the time of their autism diagnosis, IQ was a weak predictor of everyday adaptive skills, and in children without intellectual disability, adaptive scores fell well below IQ; the authors called "high-functioning autism" an inaccurate clinical descriptor when it is based on IQ alone.⁠²⁹ A 2022 review of the ICD-11 criteria makes a related point: some autistic people function well in many settings only through exceptional effort, so that their autistic characteristics are camouflaged. The diagnosis still applies, and camouflaging is commonly described as exhausting and is associated with a higher risk of anxiety and depression.⁠²⁵

What does level 1 autism mean?

Level 1 is the first of the DSM-5's three support levels, labeled "requiring support"; level 2 is "requiring substantial support" and level 3 is "requiring very substantial support."⁠⁹ Three points about it are often misunderstood.

• It is rated twice. Clinicians give one level for social communication and another for restricted, repetitive behavior, so the two can differ.⁠^9,30
• It describes support, not a type. The level is a rating of how much support a person needs, not a renamed version of the old types of autism.⁠⁹
• The boundaries are judgment calls. The DSM-5 describes the levels in words, but no quantitative method for telling them apart has been set, and in a study of 726 children and adolescents, groups with mild, moderate, and severe autism symptoms showed varying levels of adaptive and cognitive impairment.⁠³¹

In practice, the levels do track everyday functioning. In one developmental disabilities clinic, among 158 people diagnosed by licensed psychologists, roughly half were rated level 2 in each area, and higher levels went with lower adaptive skills and more severe autism scores.⁠³⁰

How do the DSM-5 and ICD-11 describe autism today?

The two manuals now agree on the diagnosis and differ mainly in how they record the variation within it.⁠^9,25,10

What are the signs of Asperger's in children and adults?

Asperger's is no longer diagnosed, so there is no current checklist for it. What people usually mean by it is autism in someone whose early language and thinking skills developed on time, which is what the DSM-IV criteria required.⁠⁷ The signs are therefore the signs of autism; what differs is how visible they are and when they begin to cause difficulty. The DSM-5 allows for that: symptoms must be present in early development but "may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life."⁠⁹

How do Asperger's traits show up in a child?

The CDC's list of autism signs includes social differences such as not noticing when others are hurt or upset by age 2 and not noticing other children and joining them in play by age 3, alongside behaviors such as getting upset by minor changes, having obsessive interests, needing to follow certain routines, and reacting unusually to the way things sound, smell, taste, look, or feel.⁠³²

In a child whose speech arrived on time, these differences can go unremarked until social demands outgrow what the child can manage, and some autistic people are not diagnosed until adolescence or adulthood.⁠^9,33 Focused special interests were universal in one DSM-IV Asperger's sample,⁠¹⁵ and one theory of why autistic attention concentrates this way is monotropism.

How do Asperger's traits show up in an adult?

The NHS describes common signs of autism in adults as finding it hard to talk to other people; spending more time alone than with others; finding facial expressions, gestures, or tone of voice hard to read; taking things literally; having fixed ways of doing things and getting distressed when routines change; repetitive movements such as rocking, hand-flapping, or finger-flicking, known as stimming; very focused specialist interests; and being very sensitive, or not sensitive at all, to light, sounds, smells, tastes, or textures.⁠³⁴

Autistic women, the NHS adds, may be more likely to copy how other people behave, appear to cope well in social situations, stay very quiet and hide their feelings in situations they find difficult, show fewer repetitive behaviors, and have a mental health condition such as anxiety, depression, or an eating disorder.⁠³⁴ For how these differences play out in everyday adult life and at work, see neurodivergent adults and autism at work.

Are sensory differences part of Asperger's and autism?

Both current diagnostic manuals — the DSM-5-TR⁠² and ICD-11 — include sensory features in their autism criteria: the DSM-5 added hyper- or hyporeactivity to sensory input in 2013, and ICD-11, effective 2022, includes sensory processing differences too.⁠³ Assessments carried out under older frameworks did not evaluate sensory processing, because it wasn't a criterion. For many people it is the most persistent daily factor, and it is a legitimate thing to raise with an occupational therapist.

The DSM-5 wording covers both directions: "hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment," with examples such as apparent indifference to pain or temperature, an adverse response to specific sounds or textures, excessive smelling or touching of objects, and visual fascination with lights or movement.⁠⁹ ICD-11 describes lifelong, strong, and persistent hypersensitivity or hyposensitivity to sensory stimuli, which can involve sounds, light, textures (especially of clothing and food), smells, and tastes; ICD-10, the classification that listed Asperger syndrome, did not treat unusual sensory processing as a core diagnostic feature.⁠²⁵

Sensory differences extend into adulthood. In a study of adults using the Adult/Adolescent Sensory Profile, a 60-item questionnaire about sensory experience in everyday life, 94.4% of the autistic group reported extreme levels of sensory processing in at least one of its four areas, and the patterns varied widely: different people reported very different, yet similarly severe, sensory difficulties.⁠³⁵ Sensory processing and autism covers the research in more depth, and occupational therapy for autism explains what an assessment and support can involve.

RelatedSensory processing differencessensory over-responsivitysensory tools for neurodivergent adultsfind an occupational therapist

Where can you get an autism assessment as an adult or for a child?

A new assessment today uses the autism spectrum disorder criteria; Asperger's is not one of the possible outcomes.⁠^1,10 Where to start depends on age and, for adults, on the country.

How do you get a child assessed?

Start with your child's pediatrician. The American Academy of Pediatrics recommends standardized autism screening at the 18- and 24-month well-child visits, with ongoing developmental surveillance in between.⁠³⁷ A screen is not a diagnosis. If screening or your own concerns point that way, a formal evaluation is done by one or more trained specialists, such as a developmental pediatrician, child psychologist, speech-language pathologist, or occupational therapist, who may observe your child, give a structured test, ask you questions, and have you fill out questionnaires.⁠³³

You do not need a doctor's referral to ask for help. In the US, each state runs its own early intervention program for young children, and a doctor's referral is not necessary to contact it; from age 3, you can call any local public elementary school, even one your child does not attend, to ask about an evaluation for preschool special education.⁠³⁸ For school-age children, the guide to IEPs and 504 plans explains how to request support at school.

By age 2, a diagnosis by an experienced professional can be considered reliable, but many children do not receive a final diagnosis until they are much older.⁠³³

How do adults get assessed?

In the US, the National Institute of Mental Health advises adults who wonder whether they are autistic to talk with a health care provider and ask for a referral for an evaluation; adults can be referred to a neuropsychologist, psychologist, or psychiatrist who has experience with autism. The evaluator asks about social interaction and communication, sensory issues, repetitive behaviors, and restricted interests, and the evaluation may include a conversation with family members about early development.⁠³⁶

In England, the NHS route starts with a GP, who can often refer adults to a local autism team. The team may ask you to fill in questionnaires, ask about your early life and your life at home, work, or college, and speak to someone who knew you as a child. Once a referral is accepted, it can take a few months or longer to get an assessment; in England you can choose which NHS service does it, which is called Right to Choose, or pay for an assessment outside the NHS.⁠³⁹

Because evaluators ask about early development, it can help to note what you remember of childhood and, if you can, to bring someone who knew you then. A self-check such as Do I have Asperger's? can help you organize what you have noticed before the appointment; a quiz describes patterns and cannot identify a condition.

Frequently Asked Questions

Sources

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Medical disclaimer. This page is for general educational purposes and does not constitute medical advice, diagnosis, or treatment. Diagnostic terminology changes over time; a diagnosis you or your child received remains valid. Always consult a qualified healthcare provider about your child.