Autism Spectrum Disorder (ASD) is a complex condition with many manifestations existing along a spectrum. This variation in manifestation means no two individuals experience autism the same way. Additionally, this diversity underscores the necessity of understanding different types and severities of autism.

The understanding of autism has evolved significantly in recent years, leading to the current classification as a spectrum disorder rather than as separate conditions such as Asperger Syndrome or PDD-NOS. The DSM-5 now classifies autism as a spectrum from mild to severe, encompassing previous subtypes under one diagnosis.

This approach uses severity levels to better describe the support needs of individuals with ASD, emphasizing personalized care and support tailored to each person’s unique needs.

What is Autism Spectrum Disorder?

Autism is a developmental condition marked by a wide range of social, communication, and behavioral challenges. The term “spectrum” in ASD highlights the vast diversity in abilities and symptoms experienced.

Where previously autism was defined as several discrete conditions, the new understanding is that these conditions are part of a spectrum of developmental issues that range based on the support required by that individual to live a fulfilling life.

How is Autism Defined?

Autism is defined through the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5). It represents a consensus among scientists and clinicians about the condition based on decades of research and clinical observation.

Where before autism was categorized as separate conditions, the DSM-5 criteria now emphasizes two core areas of deficit:

• Consistent impairments in social communication and social interaction across multiple contexts.
• Restricted, repetitive patterns of interests, activities, or behaviors.

Individuals who meet multiple criteria across both deficits may receive an Autism Diagnosis, indicating the diversity within the autism spectrum while also providing a means of categorizing severity by support required.

This new classification underscores the heterogeneity of autism: the fact that the same condition can encompass a diverse set of symptoms while providing a means for clinicians to assess and provide tailored support for individuals with autism.

Types and Classifications of Autism

With the introduction of the DSM-5 in 2013, conditions previously recognized as separate disorders were classified under the single umbrella of ASD. The purpose of this transition was to clear up misconceptions about what autism or its subtypes were by addressing the root causes of several conditions as a combination of genetic and environmental factors.

Understanding previous definitions is helpful in understanding the historical context and evolution of our understanding of autism. Recognizing classifications such as Asperger’s or Rett syndrome provides insight into the changing perspectives on neurodiversity and the complexities of autism.

This recognition also clarifies what people refer to when they use these terms today, even as the medical community has moved towards a more inclusive categorization in the DSM-5.

How Autism Was Previously Defined

Formerly, autism was not a spectrum disorder but a discrete condition with distinct subtypes that all shared similar characteristics.

Previous subtypes of Autism included:

• Autistic Disorder: Traditionally known as “classic” autism, this category represented individuals who exhibited significant language delays and communication challenges.
• Asperger Syndrome: This category identified individuals who did not have significant language delays but faced social and communicative problems. This term is still widely used and often is synonymous with “high-functioning autism” or “autism requiring support” (level 1).
• Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS): This category represented a catch-all for individuals who did not fully meet the criteria for autistic disorder but showed similar deficits in social interaction and restricted behaviors.
• Childhood Disintegrative Disorder: This category represents a rare condition where individuals develop normally until the age of 2-4, then experience significant developmental delays associated with autism.
• Rett Syndrome: This category represents a rare disorder that overlaps in symptoms with autism, but is now recognized as a distinct genetic condition.

DSM Classification Based on Severity of Autism

The understanding of autism as a condition influenced by both genetic and environmental factors marked a shift towards the spectrum model of autism. Early research into the causes of autism focused mainly on psychological factors, but as scientific methodologies advanced, a more complex picture emerged.

This evolution led to the recognition of autism as a spectrum disorder with a range of manifestations from mild to severe rather than a single condition with uniform characteristics. The shift to a spectrum-based model also reflects the idea that the interplay of genetic and environmental factors can result in a wide variety of outcomes, necessitating a personalized approach to diagnosis, treatment, and support.

Level 1: Requiring Support

Previously, individuals who might have been diagnosed with Aspergers or “high-functioning autism” now fall into this category. Level 1 support indicates individuals can communicate verbally but face challenges in social interaction, restricted interests, and repetitive behaviors.

Level 2: Requiring Substantial Support

This severity level is characterized by more noticeable difficulties in verbal and non-verbal social communication skills, and social impairments may be apparent even with support.

Level 3: Requiring Very Substantial Support

Individuals at this level of severity face severe challenges in verbal and non-verbal communication and social interaction, and typically exhibit more significant forms of repetitive behaviors and restrictive interests.

This category reflects what was previously known as “classic” autism, where individuals often require substantial, continuous support in their daily lives to ensure their safety and meet their basic needs.

Why Recognizing Different Types of Autism is Important

The transition to a severity-based classification underscores a more nuanced understanding of autism, focusing on the individual’s needs rather than fitting them into a narrowly defined category.

This transition reflects the ongoing trend in psychology and psychiatry towards more personalized care, recognizing the spectrum of autism as encompassing a wide range of abilities and challenges.

Additionally, this approach allows for a more tailored intervention strategy that can adapt as the individual grows and their needs change, promoting a better quality of life and independence.

Get Tailored Support With Start My Wellness

As our understanding of mental health issues and the support that they require evolves, the ability to provide tailored support and personalized strategies for individuals with autism is becoming more accessible than ever.

Start My Wellness understands this evolving landscape, where individualized care is paramount to improving quality of life and recognizing the unique skills and capabilities of those with autism. Our approach is rooted in the latest research and through a deep understanding of autism from decades of experience in psychiatric treatment.

Reach out today at (248)-514-4955 and meet our therapists to learn how we can support your needs and develop your unique strengths during your journey to wellness.

Sources

1. Start My Wellness: Early Signs of Autism Spectrum Disorder
2. Centers for Disease Control: Diagnostic Criteria for 299.00 Autism Spectrum Disorder
3. Iris Center: Comparison of the Diagnostic Criteria for Autism Spectrum Disorder Across DSM-5 and DSM-IV-TR
4. Verywell Health: What is a PDD-NOS Diagnosis?
5. Autism Speaks: Autism Severity Levels