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Emanuel Miller lecture: Confusions and controversies about Asperger syndrome

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Frith, Uta·2004·Journal of Child Psychology and Psychiatry
DOI 10.1111/j.1469-7610.2004.00262.x
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Abstract

Background: Hans Asperger drew attention to individuals who show the core symptoms of autism in the presence of high verbal intelligence. Methods: A review of the literature explores current issues concerning the diagnosis and nature of Asperger syndrome. Results: The behavioural and neurophysiological evidence to date suggests that Asperger syndrome is a variant of autism typically occurring in high‐functioning individuals, and not a separate disorder. One of the problems of diagnosis is that the typical impairment of social communication may be difficult to identify in early childhood, and can be camouflaged in adulthood by compensatory learning. The range and nature of the social impairments in Asperger syndrome are still in need of investigation, but appear to be less severe than in autism. Experimental evidence suggests that individuals with Asperger syndrome may lack an intuitive theory of mind (mentalising), but may be able to acquire an explicit theory of mind. Brain imaging studies pinpoint a network that links medial prefrontal and temporal cortex as the neural substrate of intuitive mentalising. This network shows reduced activation and poor connectivity in Asperger syndrome. While some individuals with Asperger syndrome have written eloquently about their lives, their ability to talk about their own emotions appears to be impaired (alexithymia). This impairment may be linked to depression and anxiety, which is common in adulthood. Little is as yet known about the often considerable cognitive strengths in Asperger syndrome, or about the difficulties observed in higher‐level executive skills. Conclusions: Studies are needed that define the developmental course of the disorder and the nature of the strengths and weaknesses in both social and non‐social domains. This requires more sensitive assessment instruments than are currently available. Questions about the prevalence of Asperger syndrome, about associated and secondary features, and about optimal education and management, urgently call for such studies.

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  • Asperger syndrome can be considered the purest form of autism because it is unimpeded by the learning difficulties common to other parts of the autism spectrum.

    “Asperger syndrome might be considered to be the purest form of autism in the sense that it is unimpeded by the effects of learning difficulty common to other parts of the autism spectrum (Frith, 2004).”

    From Executive processes in Asperger syndrome: Patterns of performance in a multiple case series (2006) · cites this paper as Frith, 2004

  • Asperger syndrome might be considered the purest form of autism because it is unimpeded by the effects of learning difficulty.

    “First, Asperger syndrome might be considered to be the purest form of autism in the sense that it is unimpeded by the effects of learning dif- ficulty, for example (Frith, 2004).”

    From Executive processes in Asperger syndrome: Patterns of performance in a multiple case series (2006) · cites this paper as Frith, 2004

  • Frith (2004) suggested that much of the apparent variability in ToM test performance in adult samples may reflect the extent to which the task allows an individual to hack out a solution to a problem.

    “In a similar vein, Frith (2004) suggested that much of the apparent variability in ToM test performance that may be seen in adult samples may reflect the extent to which the task allows an individual to hack out a solution to a problem.”

    From Measuring Theory of Mind in Adults with Autism Spectrum Disorder (2017) · cites this paper as Frith (2004)

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  1. 14697610, 2004, 4, Downloaded from https://acamh.onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.2004.00262.x, Wiley Online Library on [28/12/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License
  2. Baron-Cohen, S., Tager-Flusberg, H., & Cohen, D. (2000). Understanding other minds: Perspectives from developmental neuroscience (2nd edn). Oxford: Oxford University Press.
  3. Beck, A.T., Steer, R., & Garbin, M. (1988). Psychometric properties of the Beck Depression Inventory: 25 years of research. Clinical Psychology Review , 8 , 77-100.
  4. Bowler, D. (1992). 'Theory of Mind' in Asperger syndrome. Journal of Child Psychology and Psychiatry , 33 , 877-893.
  5. Fitzgerald, M. (2002). Asperger's disorder and mathematicians of genius. Journal of Autism and Developmental Disorders , 32 , 59-60.
  6. Klin, A., Volkmar, F., & Sparrow, S. (Eds). (2000). Asperger syndrome . New York: Guilford Press.
  7. Prior, M.(Ed.). (2003). Asperger syndrome, behavioural and educational aspects . New York: Guilford Publications.
  8. Reitzel, J., & Szatmari, P. (2003). Learning difficulties in Asperger syndrome. In M. Prior (Ed.), Asperger syndrome, behavioural and educational aspects (pp. 35-54). New York: Guilford Publications.
  9. Wing, L. (2000). Past and future research on Asperger syndrome. In A. Klin, F. Volkmar, & S. Sparrow (Eds.), Asperger syndrome . New York: Guildford.
  10. 14697610, 2004, 4, Downloaded from https://acamh.onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.2004.00262.x, Wiley Online Library on [28/12/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

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Authors
Frith, U.
Venue
Journal of Child Psychology and Psychiatry
Publisher
Wiley
Published
2004-03-30
Volume
45
Issue
4
Pages
672-686
ISSN
  • 0021-9630 (ISSN-L)
  • 1469-7610
DOI
10.1111/j.1469-7610.2004.00262.x
OpenAlex
W2012309796
Cited by
439
References
92
Citations by year
2026: 4 · 2025: 4 · 2024: 12 · 2023: 5 · 2022: 10 · 2021: 12 · 2020: 18 · 2019: 10 · 2018: 17 · 2017: 22 · 2016: 22 · 2015: 21 · 2014: 23 · 2013: 32 · 2012: 30
FWCI
1.99
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Child Psychology and Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
Keywords
Asperger syndrome, autism spectrum disorder, high-functioning autism, theory of mind, mentalization, social communication deficits, alexithymia, anxiety and depression, executive function, compensatory learning, diagnostic classification, neuroimaging, medial prefrontal cortex, temporal cortex, emotional awareness
MeSH terms
Adolescent, Adult, Affective Symptoms, Anxiety, Child, Child Development, Child, Preschool, Cognition, Depression, Diagnosis, Differential, Humans, Infant, Infant, Newborn, Learning, Social Behavior, Temporal Lobe, Prefrontal Cortex, Mind-Body Relations, Metaphysical, Asperger Syndrome

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