Asperger Syndrome: The Emerging Challenge to Special Education
Safran, Stephen P., Exceptional Children
"The child with low-functioning autism lives in a world of their own, but the child with Asperger Syndrome lives in our world but in their own way" (Van Krevelen, cited in Williams , p. 9)
Children with Asperger Syndrome (AS) have been described in the popular press as "Autism's Shadow" (Hayden, 1998) and as "Little professors who can't understand social cues" (O'Neil, 1999, p. 1). For 2 decades, AS has been a popular research topic in Europe and is currently receiving heightened exposure in American psychiatry (i.e., Klin, Volkmar, Sparrow, Cicchetti, & Rourke, 1995; Robertson, Tanguay, L'ecuyer, Sims, & Waltrip, 1999). Despite this burgeoning information base, with rare exception (see Marks et al., 1999), there has been scant attention paid to AS in the American special education literature. Further, referrals for special education services can be expected to sharply increase in the near future due to two reasons. First, AS has, for the first time, been included in the most recent edition of the Diagnostic and Statistical Manual IV of Mental Disorders (DSM-IV; American Psychiatric Association, 1994). Second, although prevalence rates vary, Ehlers and Gillberg's (1993) estimate of .71% of the general population in Sweden (.44% of girls, .91% of boys), several times higher than classic Kanner childhood autism, suggests a large, unserved student population in North America. Information is therefore desperately needed to assist educators in screening for those at risk for AS and to help plan effective interventions.
This article addresses issues related to AS by synthesizing the recent interdisciplinary and largely European literature related to identification issues and special education practices. Relevant scholarly citations were identified primarily through the ERIC and PSYCHINFO databases. This article also reports on and analyzes a series of critical topics, including the syndrome's history, definition, differential diagnosis from other Pervasive Developmental Disorders (PDDs), screening procedures and emerging educational interventions. In conclusion, implications for special education, including the role of diagnosis in programming and implications for practice are addressed.
HISTORY AND DEFINITION
In 1943, Leo Kanner published his now famous paper on "autistic disturbances of affective contact" (Gillberg, 1998). While the recognition of Kanner's autism spread throughout the world, a year later the Austrian psychiatrist Dr. Hans Asperger made a hauntingly similar, but completely separate discovery of what he termed "autistic psychopathy." This latter syndrome, apparently buried in the carnage of World War II, remained little known in the English-speaking world until 1981, when Dr. Lorna Wing of the United Kingdom reintroduced the condition as AS. Over the next 20 years, English language research on AS began to appear regularly in the United Kingdom and Scandinavia (Frith, 1991; Gillberg, 1998; Wing, 1998).
Throughout the 1980s and 1990s, various attempts were made to further define AS (American Psychiatric Association, 1994; Gillberg & Gillberg, 1989; World Health Organization, 1992). As with many "milder" psychiatric disorders, the debate continues over its symptomatology and whether it can be reliably distinguished from related disorders. In the medical and mental health communities, diagnostic legitimacy is confirmed internationally by the Tenth Revision of the International Classification of Diseases (ICD-10; World Health Organization, 1992), and in the United States by inclusion in the DSM-IV (American Psychiatric Association, 1994). Therefore, it was not until the mid-1990s that AS was accepted as a distinct childhood "mental disorder" in America. The late entry of this clinical diagnosis may provide some explanation about why so little has been written about AS in the special education literature.
Among the several definitions of AS, the DSM-IV (American Psychiatric Association, 1994) version is the most widely cited in the United States. …