Autism vs ASD: What’s The Difference? Does It Matter?

Stumbling across this article could mean a few different things. More than likely, it means that you or someone close to you has been recently diagnosed with autism spectrum disorder (ASD). It could mean that someone close to you is currently being assessed, and you’re curious about what a diagnosis may mean. Or, you could be a student looking for answers to a discussion board question. Regardless of the reasoning, there is a lot of confusion around different terms in psychology and mental health, and Autism is no exception. This confusion is very much justified, and I hope to clarify everything a bit more so that families can understand the diagnosis better.

By far, the area where I see the most confusion is in explaining what autism spectrum disorder really is. It is a developmental disability that affects the way that people interact, communicate, and behave. This definition is well understood and accepted by most, but the confusion tends to be based on misunderstanding the spectrum nature of ASD and not knowing that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has undergone serious changes that no longer include various disorders. With that being said, the big question remains: Is there a difference between ‘autism’ and ‘autism spectrum disorder’? To that, my answer is yes there is, no there is not, there used to be, and kind of… but mostly no.

Diagnostic Criteria for Autism Spectrum Disorder (ASD)

To better understand autism spectrum disorder (ASD), it’s important to go over the official diagnostic criteria as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). The DSM, as the name states, is the book used in diagnosing mental disorders. It outlines all the diagnosis requirements, along with other relevant information about each disorder. People diagnosed with ASD must demonstrate persistent deficits across three different core areas:

  • Social Communication and Interaction: These usually include deficits in understanding and reciprocating social cues, difficulties in maintaining relationships, and struggles with nonverbal communication (eye contact, body language, ways that people communicate without using words).

  • Restricted and Repetitive Behaviors: This refers to engaging in things like repetitive movements or activities. This can look like literal repetitive movements like spinning or hand flapping, or look more like rigid adherence to routines or rituals, intense fixations on specific interests, or a serious resistance to change. These types of behaviors often serve various functions for individuals with ASD, from self-regulation to expressing preferences or reducing anxiety.

  • Sensory Sensitivities: Individuals with ASD may experience sensitivity to sensory stimuli. They can be hypersensitive to experiences and avoid them at all costs, or they can seek out incredibly intense sensory experiences because they are hyposensitive. For example, some individuals may enjoy intense pressure on their bodies, and others may become incredibly stressed when exposed to bright lights.

After a healthcare professional does an assessment and determines that these core areas have deficits, they will make an official diagnosis of autism spectrum disorder, which is also known as autism. The two terms can be used interchangeably. Autism spectrum disorder is the full and official diagnosis by healthcare providers, while autism is more of a shortened, less formal name. This is common with many different psychological and medical disorders. For example, someone with a bipolar disorder diagnosis may just say they have bipolar. Less of an official title, but the same disorder nonetheless.

The severity of these deficits can vary widely, ranging from mild to severe. This is where another large bit of confusion lies: Those with milder symptoms have autism. Those with severe symptoms have autism. Milder symptoms were once considered to be different diagnoses, as we will go into later. Because autism was once considered as something with more severe symptoms, those with lesser symptoms can easily be overlooked. There are hundreds of different ways that ASD can look in people, although many people still have preconceived notions as to what autism looks like. This leads to a much more rigid view of autism and a belief that symptoms must be more severe and visible for a diagnosis.

Understanding the Autism Spectrum

Autism vs asd is an outdated distinction

As mentioned above, the spectrum of autism is very wide. Not only do the various symptoms range in severity, but there are also completely different symptoms and behaviors that people with autism may or may not have. One person may struggle around loud noises and constantly flap their hands, while another might insist on lining their toys up in a particular order and not look at other people’s faces. They may have very little overlap in observable behaviors, but both are very much on the autism spectrum. Some people may have very few, if any, behaviors that are noticed by others, and others may have apparent symptoms and a clear need for support. Some may need little assistance to get by day to day, while others may heavily rely on support for activities of daily living, such as eating or getting dressed.

Levels of Functioning in Autism

This variation in support needs is the basis for the levels of functioning in autism. The levels help to give people a clearer understanding of the kind of support a person may need. Level 1 means that the individual has some basic support needs, while Level 3 indicates the need for the highest amount of support. It is important to note that support is required across all three levels.

Those with lower support needs still require support. In addition, those with lower support needs are still very much autistic. People often make the mistake of not recognizing autism in individuals who are better at masking it. Or, more commonly, people assume that those with lower support needs are not autistic but fall under another diagnosis. This is the most common mistake I have seen when it comes to people’s view of autism. ASD was not always the way it is now. It was once broken up into separate diagnoses, described below.

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Historical Context

DSM-IV to DSM-V Changes

As mentioned above, the Diagnostic and Statistical Manual of Mental Disorders is the definitive guide when it comes to recognizing and diagnosing psychological disorders. As such an important text, it is important that it is accurate and makes changes as we learn more about the mind. With that being said, it is an evolving piece of text that has, in the past, changed, removed, added, and modified many different disorders. In the previous version of the DSM (the DSM-IV), autism spectrum disorder was broken down into a few different diagnoses. It included Classic autism, Childhood disintegrative disorder, Asperger’s syndrome, and Pervasive developmental disorder not otherwise specified (PDD-NOS). Each of these diagnoses had its own diagnostic criteria and were all considered to be related but separate disorders.

In 2013, the DSM-V made changes and collapsed all of these separate disorders into autism spectrum disorder. The symptoms for each of these diagnoses are all explained by autism spectrum disorder and really only held differences when it came to the severity of those symptoms. So, someone who was once considered to have Asperger’s syndrome would now be called autism, even if their symptoms remained the same. Someone who had ‘classic autism’ would now fall under the autism spectrum along with those who were previously considered PDD-NOS. These changes aren’t well known outside of the world of psychology, so I’ve heard many people in recent years specify that their child or someone that they know has Asperger’s but not autism.

Collapsing these disorders into the autism umbrella has been extremely helpful and useful, on top of making the most sense. Firstly, having separate disorders that can be explained by one disorder ultimately splitting hairs. These discrete but heavily overlapping disorders made diagnosing more complex. Collapsing them into one disorder has helped create much more clarity and consistency in diagnosing and treatment.

Overall, it is more inclusive and recognizes neurodiversity. Recognizing a broader range of individuals under the ASD umbrella has led to more resources and support services being allocated to those who need them. Finally, it has helped to consolidate once-divided resources and research efforts, allowing for a more streamlined approach to understanding the spectrum and directing attention where it’s most needed.

Treatment and Support

ASD-treatment-support

Early Intervention and Therapies

Regardless of where an individual falls on the autism spectrum (or regardless of the previously recognized diagnosis that people choose to specify), early intervention can help lead to the best possible outcomes. Individuals on the spectrum may benefit from a wide variety of treatments and interventions including occupational therapy, speech therapy, physical therapy, applied behavior analysis (ABA), and more.

Each person’s autism will affect them differently, so the combination and intensity of these programs will vary depending on their unique needs. Even under the previously recognized diagnoses, these types of treatments and therapies were used for the best possible outcomes.

Advocacy and Acceptance

Promoting Awareness and Acceptance of Autism Spectrum Disorder

The misinformation and confusion around autism can be reduced with more awareness and acceptance of the spectrum nature of autism. Oftentimes, when people are quick to correct my mentioning of autism instead of Asperger syndrome, it’s rooted in an outdated perception of autism as a hierarchical construct. Despite the DSM changes, there is still a misconception that autism is inherently ‘more severe.’ This simply isn’t true, as we’ve mentioned that autism includes an incredibly wide range of symptoms.

Attempting to categorize individuals into separate boxes of ‘autism’ and ‘Asperger syndrome’ is not only outdated but also reductive and potentially harmful. It perpetuates the misconception that there is a clear dividing line between the functioning levels of individuals within the autism community, which fails to capture the complexity and diversity of experiences. In reality, autism is complex. It is complex but does not automatically mean that someone has extreme support needs or that they fit the box that may exist in people’s heads. Expanding our understanding of autism’s spectrum helps dismantle stereotypes and fosters genuine inclusion. Learning more about the disorder and how different it can look in people can seriously help dispel misconceptions and reduce the stigma.

Celebrating Neurodiversity

One of the most important things that people can do is to celebrate neurodiversity. There is no shame in autism spectrum disorder. Autistic people exist, love, hope, dream, achieve, eat, sleep, breathe, hurt, walk, dance, play, laugh, and create. Sometimes, people get stuck on the negative aspects of labels and, therefore, feel less inclined to use them to describe themselves or their loved ones. Autism isn’t something that someone should feel ashamed of. It’s a unique part of the beautiful tapestry of human diversity and should be treated as such.

Bottom Line: Autism vs ASD is an Outdated Distinction

With all of that being said, I will more definitively say that autism spectrum disorder and autism are the same. In the past, under the previous DSMs, there was much more of a distinction. This difference in classification was due to a lesser understanding of the disorder, which has been amended in the most recent version. Many of the previous disorders that people were diagnosed with now fall under the autism spectrum, and any distinctions made are more or less because many people aren’t aware of what autism can look like in people.

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