diagnose
autism spectrum disorder includes several disorders that were diagnosed separately before 2013. the boundaries between these diseases are not always clear and can be confusing to all those involved.
autism spectrum disorder is a diagnostic label for a broad category of neurodevelopmental disorders.
these types used to be diagnosed separately based on differences in symptoms and intensity:
- autism
- Asperger's syndrome
- UNSPECIFIED PERVASIVE DEVELOPMENTAL DISORDERS (PDD-NOS)
IN 2013, THE DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM-5) REVISED THESE CLASSIFICATIONS. ALL TYPES OF AUTISM ARE NOW COMBINED INTO A SINGLE DIAGNOSIS OF AUTISM SPECTRUM DISORDER (ASD).
the change in terminology reflects a newer diagnosis. but the previous terminology wasn't completely eliminated in the conversation.
SOME MEDICAL PROFESSIONALS, PARENTS, OR PEOPLE WITH AUTISM THEMSELVES MAY USE TERMS LIKE ASPERGER'S SYNDROME OR PDD, BUT THEY ARE NO LONGER THE OFFICIAL DIAGNOSIS IN THE U.S. CLASSIFICATION SYSTEM.
let's take a closer look at some of the terms you might hear about autism and how they adapt to changing circumstances.
what are the symptoms of autism?
the most obvious symptoms often involve communication and interaction with others.
people with autism may have different ways of learning, thinking, and solving problems. intellectually, people with autism range from severe challenges to gifted.
everyone is different. some people will have a lot of symptoms, and some people will only have some symptoms. signs of autism in children 3 or 4 years of age may differ from those of adolescents or adults. some people with autism may be able to "mask" (or hide) their symptoms.
general signs of autism may include:
- do not respond to their names
- avoid eye contact or show no awareness when others speak
- do not understand sharing or rotating
- don't look at the items they show
- does not point or does not respond to points
- difficulty understanding facial expressions
- repeat a word or phrase
- perform repetitive actions (stimulation)
- it is difficult to express the need
- prefer single-player games, or can't play "pretend" games
- difficulty adapting to changes or emotional breakdowns
- exhibits hypersensitivity to sounds, smells, tastes, vision, or touch
- you need to organize a physical environment
- speech and language skills are sluggish, or lack gestures
- lose skills you've learned before
among older children and adults, you may also notice:
- difficulty reading body language, facial expressions, and other social cues
- there is no sarcasm, teasing, or rhetoric
- speak monotonously
- difficulty building relationships
autism type terminology is no longer used today
when autism is classified by type, the boundaries between the different types of autism can be blurred. diagnosing was and is still complicated, and often stressful for families.
If you or your child was diagnosed before the DSM-5 change, you may still be using the older term (i.e. Asperger's). Never mind. If helpful, your doctor may continue to use these terms.
Asperger's syndrome
Asperger's syndrome is at the mild end. people with Asperger's syndrome are generally considered "high functioning," their intelligence is above average, and there is no speech delay. some people with autism object to the terms "high function" or "low function".
signs and symptoms include:
- social interaction disorder
- difficulty reading facial expressions, body language, and social cues
- don't understand irony, metaphor, or humor
- exhibit awkward body language, stand too close, or speak too loudly
- lack of eye contact
- repeat the same behavior and activity
NOTE THAT ALL OF THE ABOVE AND BELOW SYMPTOMS ALSO APPLY TO ASD. THE MAIN DIFFERENCE BETWEEN ASPERGER'S SYNDROME AND AUTISM IS THAT ASPERGER'S SYNDROME HAS MILD SYMPTOMS AND NO LANGUAGE DELAY.
children labeled Asperger'swith may have more subtle differences, and they often have strong language and cognitive skills.
for others, these can be interpreted as signs of rudeness, so building friendships can be challenging. other signs include:
- clumsy
- bad handwriting
- a narrow range of interests or a focus on a single interest
- repeat the behavior
- regular and strict rules are required
- it's easy to get upset when things don't go as planned
UNSPECIFIED PERVASIVE DEVELOPMENTAL DISORDERS (PDD-NOS)
PDD-NOS IS DIAGNOSED WHEN THE DEVELOPMENTAL DISORDER DOES NOT FULLY MEET THE CRITERIA FOR AUTISM, ASPERGER'S SYNDROME, LÄTTER SYNDROME, OR DISINTEGRATION DISORDER IN CHILDREN.
PDD-NOS IS ALSO KNOWN AS "ATYPICAL AUTISM."
SIGNS OF PDD-NOS INCLUDE:
- social behavior deficits
- skills development is uneven
- speech and language dysplasia
- difficulty accepting change
- unusual responses to taste, sight, hearing, smell, or touch
- repetitive or ritualized behavior
- highly restricted and focused interest
THESE SYMPTOMS CAN NOW APPLY TO ASD.
autism
autism is considered the more serious end. you may see more pronounced symptoms early on. these include:
- the challenge of social interaction
- communication issues
- repeat the behavior
other signs include:
- tantrums or "breakdowns"
- sleep and eating disorders
children at severe extremes may prefer to play alone and have difficulty interacting with their peers. they need a high level of support.
disintegrating disorders in children
children with the disease reach normal developmental milestones in the first few years. after that, the skills acquired drop rapidly, including:
- language and communication
- social skills, gaming, and self-care skills
- motor skills, as well as bowel and bladder control
disintegrating disorder in children is at a serious end.
why doctors no longer use this term
the spectrum illustrates broad developmental delay and symptom severity.
ASD INCLUDES PEOPLE WITH SOME MILD AUTISM CHARACTERISTICS, AS WELL AS PEOPLE WHO NEED HELP WITH DAILY FUNCTIONING. IT REPRESENTS EACH LEVEL OF INTELLIGENCE, AS WELL AS DIFFERENT LEVELS OF COMMUNICATION AND SOCIAL SKILLS.
the difference between one type and another can be subtle and difficult to determine.
you may have heard other terms for types of autism
terms such as "mild" or "highly functional" are not official diagnoses. some people find these terms useful, but many in the autism community don't find them useful or accurate, largely because of the range of abilities that people with autism may have.
you may also have heard of the three "levels" of autism, with level 1 being the most mildmildest and level 3 the most severe.
high-functioning autism
high-functioning autism describes "mild" autism, or "grade 1" on the spectrum.
Asperger's syndrome is often described as high-functioning autism. symptoms are present, but the need for support is minimal.
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extensive autism phenotype
the broad autism phenotype is a rarely used term.
it is often described as an undiagnosed "autistic feature". symptoms are mild and have no clinical significance for diagnosis.
researchers point out that this sometimes happens in relatives of people with autism.
severe autism
severe autism is sometimes referred to as "grade 3.". people with severe autism need help with their day-to-day operations.
care or a high level of support may be required throughout the lifecycle.
is tech syndrome autism?
Rett syndrome or Rett disorder is also known as "autism- dementia-ataxia-loss of purposeful hand use syndrome."
but it is not included in the autism spectrum. this is a brain disease caused by a genetic mutation.
classic tech syndrome usually affects girls who exhibit typical development in the first few months. then, symptoms begin to appear, involving the following issues:
- language and communication
- learn
- harmonize
eventually, affected children may experience repetitive hand movements. other symptoms include:
- slow growth or small head
- spit
- uncommon eye movements, staring or blinking
- cold limbs
- sleep disorders
- irritability
- abnormal breathing
- seizures
- curvature of the spine
how to get an autism diagnosis
if you think your child may have symptoms of autism, talk to their pediatrician or primary care physician. they can refer you to the right specialist, such as:
- developmental pediatrician
- pediatric neurologist
- psychiatrist or psychologist
you can also request an assessment from a public early childhood assistance center in your state. it is free and you do not need a doctor's referral or diagnosis. your local public school district can also help.
there is no medical test that can diagnose autism spectrum disorder. doctors can make a diagnosis through a comprehensive behavioral assessment and developmental screening.
some people on the spectrum need minimal support. others need a lot. either way, early intervention is associated with long-term positive effects.
Conclusion:
diagnoses of autism spectrum disorder include several disorders that were diagnosed separately before 2013. the boundaries between these diseases are not always clear and can be confusing to all those involved.
the scope covers a wide range of symptoms and severity. the evolution of the spectrum and the changing terminology should help make things easier to understand.
regardless of the variances across the entire range, people with autism can learn skills that can last a lifetime.