Is There More Than One Autism Spectrum Disorder?

There Were Different Autisms; Now There Are Just Different Names

Autism is a "spectrum disorder," meaning you can be a little autistic or very autistic. Until May 2013, there were five "official" autism spectrum diagnoses,but the diagnoses within the autism spectrum weren't clearly named, nor were the symptoms always the same even within the same diagnosis. What's worse, terms like "severe autism", "mild autism", and "high functioning autism" aren't true diagnoses at all - they're just descriptive terms to help parents and teachers better understand a child's status on the autism spectrum.

Today, with the DSM-5, there is just one "autism spectrum disorder" -- and everyone is lumped under that single diagnosis. But that doesn't mean we've stopped using the older or informal terms! Welcome to the complex world of many autisms.

What Is the Autism Spectrum?

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The "autism spectrum" describes a set of developmental delays and disorders which affect social and communication skills and, to a greater or lesser degree, motor and language skills. It is such a broad diagnosis that it can include people with high IQ's and mental retardation - and people with autism can be chatty or silent, affectionate or cold, methodical or disorganized.

Until May 2013, official diagnoses within the autism spectrum included autistic disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS), Asperger syndrome, Childhood Disintegrative Disorder, and Rett Syndrome. Today, there is just one Autism Spectrum Disorder, with three levels of severity -- but many therapists, clinicians, parents, and organizations continue to use terms like PDD-NOS and Asperger syndrome.

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What Are Pervasive Developmental Disorders?

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"Pervasive Developmental Disorder" is a formal term that means exactly the same thing as "autism spectrum disorder." You may hear this term from an evaluator or doctor, but you will rarely hear it in a school or therapist's office.

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What Is Asperger Syndrome?

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Asperger syndrome describes individuals at the highest-functioning end of the autism spectrum. The term -- and the diagnosis -- was removed from the diagnostic manual in 2013, but virtually everyone in the autism community continues to use it because of its usefulness in describing a very specific group of people. People with Asperger syndrome generally develop spoken language in the same way as typically developing children, but have a tough time with social communication. These difficulties that become more obvious as they get older and social expectations rise.; Because people with Asperger syndrome are often very intelligent - but "quirky" - the disorder is sometimes nicknamed "geek syndrome" or "little professor syndrome."

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What Is Mild Autism?

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The term "mild autism" is not an official diagnosis. It's simply a more descriptive term than "Asperger syndrome" or "autism." Generally speaking, when people use the term mild autism they are referring to individuals whose symptoms fit an autism spectrum diagnosis, but who has strong verbal skills and few behavioral issues. Those individuals may, however, have significant problems with social communication. They may also have problems coping with too much sensory input (loud noise, bright lights, etc.).

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What Is High Functioning Autism?

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Like "mild" autism, high functioning autism (sometimes shortened to HFA) is a made-up term that's become more and more commonly used. At one point (before 2013), the term was used to distinguish "autism" from "Asperger syndrome." The official distinction made by practitioners before 2013 was that people with HFA had or have speech delays while people with Asperger Syndrome have normal speech development. Of course, these days there IS no Asperger syndrome... making the distinction moot.

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What Is PDD-NOS?

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"Pervasive Developmental Disorder Not Otherwise Specified" is a mouthful of words that, until 2013, were used to describe individuals who didn't fully fit the criteria for other specific diagnoses but are nevertheless autistic. Because there is no easy way to define the symptoms of PDD-NOS, which may range from very mild to very severe, the diagnostic category no longer exists, though a new diagnosis, Social Communication Disorder, may become a similar "catchall" category. 

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What Is Severe Autism?

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Severe autism is not an official diagnosis; instead, it is a descriptive term along with profound autism, low functioning autism, and classic autism. People with "severe autism" are often non-verbal and intellectually disabled, and may have very challenging behaviors.

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What Is Rett Syndrome?

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Rett syndrome is a genetic disorder that affects only girls. It is the only one of the former autism spectrum disorders that can be diagnosed medically (so far) -- and as of May 2013, it is no longer included in the Autism Spectrum. Girls with Rett syndrome develop severe symptoms including the hallmark social communication challenges of autism. In addition, Rett syndrome can profoundly impair girls' ability to use their hands usefully.

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What Is the Broad Autism Phenotype?

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The broad autism phenotype includes those people with the merest touch of autism. This is sometimes described as having "shadow symptoms." Such mild symptoms, which are recognizable but which do not impair daily functioning, are common among family members of people with full-blown autism. Is this really autism? Or just a personality type? As with many issues related to autism, it depends on who you ask.

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Autism Terms Aren't Always Helpful

While some autism-related terms are descriptive, they're not always terribly helpful. That's because each and every individual on the autism spectrum is unique. Even if you think you know what a term means, it's always important to learn more about a particular individual's strengths and challenges.

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