What Everybody Ought To Know About Types of Autism

Does autism ever confuse you?  I mean, autism, autism spectrum disorder, Aspergers, and all the other terms people use?

What if I could clear up the confusion for you?

Read on to understand the different types of autism and a new development.

types of autismTypes of Autism

Autism

Autism is a neurological condition characterized by difficulty communicating, language delay, repetitive behaviors, and restricted interests.

It is diagnosed by age 3.

Aspergers

Aspergers is a neurological condition which, like autism, also includes difficulties in social interaction and restricted interests.  It’s usually diagnosed between the ages of 2 and 6 years of age.  What makes Aspergers different is that both the cognitive and languages remain intact from birth forward.

Regressive Autism Disorder/Child Disintegrative Disorder

These two types of autism have been listed separately, but they seem very similar.  In both types of autism, the child develops normally, but then suddenly regresses and develops autism characteristics.

Regressive Autism accounts for 20-30% of all people with autism.

The main difference between regressive autism disorder and child disintegrative disorder is the age at which the child starts “losing” regular developmental abilities.  With regressive autism disorder, the child suddenly regresses around two years old.  In child disintegrative disorder, the loss of language, social, and/or motor skills can happen anywhere between 3 and 10 years old.

Rett Syndrome

This is a developmental disorder of the neurological system affecting a main part of the central nervous system, known as ‘grey matter.’  The condition mainly occurs in girls.  Children with Rett syndrome start developing normally, but begin to lose their communication and social skills between 1 and 4 years old.   Feet, hands, and head size are typically smaller than average, and hand movements become repetitive.

Pervasive Developmental Disorder

People with this condition may have many characteristics in common with autism and/or Aspergers, but may not meet the full criteria needed for a pure autism or Aspergers diagnosis.

Understanding DSM-V and the Definition of Autism: Types of Autism Merged Into Autism Spectrum Disorders

The Diagnostic and Statistical Manual represents the United States’ psychiatry community ways of systematizing and diagnosing mental conditions.  While the future of categorizing mental conditions is moving toward a brain biology based understanding, neuroscience for autism is still young enough that this manual represents the best efforts to describe mental conditions.

The DSM-V has changed as researchers continue to study and learn about the nature of autism.  As researchers studied the different types of autism, they concluded that there were many more similarities between them than differences.

Here’s the definition of Autism Spectrum Disorders, encompassing all sub-types of autism under one term:

People with ASD [Austim Spectrum Disorders] tend to have communication deficits, such as responding inappropriately in conversations, misreading nonverbal interactions, or having difficulty building friendships appropriate to their age. In addition, people with ASD may be overly dependent on routines, highly sensitive to changes in their environment, or intensely focused on inappropriate items. Again, the symptoms of people with ASD will fall on a continuum, with some individuals showing mild symptoms and others having much more severe symptomsAutism Spectrum Disorder, American Psychiatric Publishing

Types of Autism Remain Distinct Outside of the United States

Since the DSM-V is a United States publication, it mainly affects Americans.  The World Health Organization, the directing and coordinating authority for health within the United Nations, uses the ICD-10 (International Classification of Diseases).   This classification system recognizes the types of autism.

Social Communication Disorder

The DSM-5 has created a new classification for people who have “significant problems using verbal and nonverbal communication for social purposes, leading to impairments in their ability to effectively communicate, participate socially, keep up social relationships, or otherwise perform academically or occupationally.”  Social (Pragmatic) Communication Disorder, American Psychiatric Publishing.

Social Communication Disorder Characteristics

  • Persistent difficulty with verbal and nonverbal communication that cannot be explained by low cognitive ability
  • Symptoms include – difficulty acquiring and using spoken and written language, and problems with inappropriate responses in conversation
  • The condition limits effective communication, social relationships, academic achievement, or occupational performance.
  • Symptoms must be present in early childhood even if not recognized until later when speech, language, or communication demands exceed their abilities.

The challenge with this new classification is that legislation, funding, and school services/insurance services are just learning about this.  I hope there will be fair services available to these people.

Concerns

While I appreciate efforts to revise the current understandings of the autism spectrum, I share some of John Elder Robison’s concerns, as expressed in his article, How Will the DSM V Changes in Autism Affect People?

Money, Money, Money

Many insurers, bureaucrats, and schools allocate most of the money for the more severe cases of autism.  I share concern that those who are “higher functioning” may receive less support, because of how subjective the levels of severity are defined.

Since this blog speaks mainly to high functioning autism and Aspergers people, I share Mr. Robison’s concern with how subjectively insurers and schools may interpret the 3 different severity levels of Autism Spectrum Disorder.

  • Level 1: “Requiring Support”
  • Level 2: “Requiring Substantial Support”
  • Level 3: “Requiring Very Substantial Support”

Here’s how Level 1, “requiring support” [which would apply to high functioning autism and Aspegers] is defined [quoted from John Robison’s article]:

  1. Without supports in place, deficits in social communication cause noticeable impairments.  Has difficulty initiating social interactions and demonstrates clear examples of atypical or unsuccessful responses to social overtures of others.   May appear to have decreased interest in social interactions.
  2. Rituals and repetitive behaviors (RRB’s) cause significant interference with functioning in one or more contexts.   Resists attempts by others to interrupt RRB’s or to be redirected from fixated interest.

Too many insurers or school personnel can easily interpret a person as being higher functioning than even this level of support.  “May appear” leaves a lot of room for interpretation, and could leave some children and adults without services.

The Solution: Speak Up!

I urge all of you to speak up before your government officials, school boards, and elsewhere to make sure they know that a change in diagnostic wording does not in any way change our need for support.  Even if the diagnostic codes numbers change, their obligation to provide educational, social, medical and therapeutic services should remain unchanged.

If the government chooses to require people to obtain a new diagnosis to suit the new DSM, I absolutely feel it is their agencies’ responsibility to pay for same, and continue services until obtained.

John Elder Robison

References Cited:

Understanding Autism — The Basics, f rom WebMD

What do you think about the different types of autism?  Do you prefer the new autism spectrum disorders definition?  Or do you prefer distinct subtypes?  I look forward to hearing your comments.

photo credit: the author of this picture is unknown, but thank you to BubblesMakeHimSmile.com for letting me use this photo.

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