Is the term Asperger's still used?

The word comes from the name of Hans Asperger, an Austrian paediatrician who practised in Vienna in the middle of the twentieth century. It entered international use much later: the British psychiatrist Lorna Wing proposed the eponym in a paper published in 1981 in Psychological Medicine.

The classifications that preceded the current revisions, the tenth revision of the international classification of diseases and the fourth edition of the American Psychiatric Association manual, kept it as a separate category alongside autism and two further entries. In everyday use it mostly described autistic people with no language delay and no accompanying intellectual disability.

That nuance explains a good deal of what followed. Many adults were given the term at a time when autism was still described first and foremost as a childhood picture with severe language difficulties. For them the word was a way in, and it stayed attached to a recognition they had waited a long time for.

The DSM-5, published on 22 May 2013, brought four categories from the previous edition, Asperger's syndrome among them, under a single heading: autism spectrum disorder. The fact sheet published by the manual's publisher gives the reason accepted at the time: researchers had found that the separate categories were not being applied the same way from one centre to another.

The change was argued over, and it was argued over with numbers. Kristine Kulage, Arlene Smaldone and Elizabeth Cohn published a systematic review and meta-analysis in 2014 covering fourteen studies that compared the two sets of criteria. Every one of them reported a fall in the number of people retained under the new criteria, ranging from 7.3% to 68.4%, for a pooled fall of 31% across the spectrum.

The World Health Organization classification followed. Its eleventh revision, adopted at the World Health Assembly in May 2019 and taken up by member states from 2022, brings under one category what the previous revision called childhood autism and Asperger's syndrome. The synthesis paper published by that revision's authors in 2019 states it in those words.

A second reason, this one historical, was added after 2013. In 2018 the medical historian Herwig Czech published an archival study in Molecular Autism on Hans Asperger's activity in Vienna under National Socialism. It documents his membership of organisations tied to the regime, his public support for forced sterilisation measures, and his part in transferring children to an institution where they were killed.

The neutral term today is autism spectrum disorder, and in ordinary speech autistic person or person on the autism spectrum. That is what this site uses, including in the title of its questionnaire.

• Instead of Asperger's syndrome: autism spectrum disorder, or autism without accompanying intellectual disability when the precision helps.
• Instead of mild Asperger's or a bit autistic: describe the concrete support needs, area by area.
• When speaking about someone: use the words that person uses about themselves.
• When speaking about yourself: no word needs justifying to anyone.

One worry comes up again and again: does removing the category cancel what someone was told fifteen years ago? No. The publisher's fact sheet on the DSM-5 states that anyone falling under one of the four former categories meets the criteria for autism spectrum disorder in the new manual, or those of another more accurate category. The vocabulary changed; what had been described did not.

Three reasons, none of them illegitimate. First habit: thousands of people grew up with this word, and it appears in their paperwork and their conversations. Then online search, where queries containing it remain among the most typed on the subject, which keeps the pages using it alive. Finally identity, which is the strongest reason of the three.

A survey published in 2016 in the journal Autism asked 3,470 people in the United Kingdom, autistic adults, parents, family, friends and professionals, which terms should be used. Autistic adults placed Asperger's syndrome and the shorthand Aspie among the terms they liked most, while parents, professionals and family clearly rejected the second. The authors conclude that no single term is universally accepted.

The United Kingdom's national autism charity describes the same situation on its page about the term, updated in June 2023: some people who were given it go on using it about themselves, others have dropped it, either because it no longer appears in the classifications or because of the archival work on Hans Asperger. Both positions coexist, and both hold up.

The query is still typed, and the pages answering it generally offer a self-observation questionnaire. It is worth knowing what that covers: there is no questionnaire specific to Asperger's syndrome, because the category no longer exists in the classifications. What circulates under that name is a questionnaire about autistic traits in adulthood, whatever its title says.

Brain Quiz publishes a self-observation questionnaire on autistic traits in adults: 28 concrete situations, four axes, an immediate result with no account. Its items were written for this site from the literature, no published scale is reproduced in it, and its thresholds have never been calibrated on a population. It can neither confirm nor rule out a disorder: it helps put words on things before raising them with a health professional. The link is at the foot of this page.