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The Types and Terminology of Autism
by Robert Needlman, M.D., F.A.A.P.
reviewed by Christine Barry, Ph.D.
The terminology of autism can be confusing, in part because it has changed over the years, and in part because different professionals use the same terms to mean different things.
There are several subtypes that fall within the autistic spectrum of disorders. These disorders together are sometimes referred to as "autism" and sometimes as Pervasive Developmental Disorders (PDDs). PDD is a helpful term because it tells you that the conditions are pervasive (affecting multiple areas) and developmental (appearing in the course of development).
The subtypes of PDDs include:
- Autism or autistic disorder
- Asperger disorder
- Pervasive developmental disorder-not otherwise specified, also called atypical autism
- Childhood disintegrative disorder
- Rett disorder
At the risk of making what is already confusing even more so, here are some details about the different subtypes.- Autistic disorder. This is the main condition that typically goes by the name of "autism." The formal definition is spelled out in How is Autism Diagnosed. Unfortunately, many people use the word autism to refer to both the entire autism spectrum and the specific disorder. If you are confused by this, you are not alone!
Although autistic disorder is a diagnosis, it is a broad one. There are so many variations within the diagnosis that the label itself means little. It is much more helpful to describe each child's unique pattern of developmental strengths and weaknesses.
- Asperger disorder. This is a milder form of autism, often also referred to as high-functioning autism, in which the children have normal IQs and develop the ability to communicate verbally. However, their use of language is not completely normal. Their intonation is off, either sing-song or very flat; their social expressions often have a stilted or artificial quality; and they tend to miss verbal humor or irony. They also have difficulty understanding social cues, body language, and facial expressions. One of the most painful aspects of this condition is the great difficulty these children have making and keeping friends. Children with Asperger disorder tend to have obsessive or very narrow interests; they often fixate on a topic, and rigidly resist change.
- Pervasive Developmental Disorder--Not Otherwise Specified (PDD-NOS). This term is used for children who meet most, but not all, of the criteria for autism. Children with this disorder have basically the same pattern of strengths and weaknesses as children with autism, and benefit from the same interventions. The differences are subtle and mainly of interest to researchers.
- Childhood disintegrative disorder. This is a devastating, but thankfully very rare, disorder. I only mention it here for the sake of completeness and because the term tends to show up in writing about autism. As a practical matter, the likelihood that any given child will develop this disorder is minimal. Some time after their second birthdays, children with this disorder begin to lose milestones-usually speech, followed by fine-motor and social skills--and regress into an autistic pattern of disability. In some cases, the cause may be severe abnormal electrical (seizure) activity in the brain.
- Rett disorder (also called Rett syndrome). This rare disorder only affects girls. Like childhood disintegrative disorder, it leads to profound disability and is extremely rare. A distinctive feature is a compulsive hand-wringing movement that develops several months after the loss of developmental progress has become evident. The hand-wringing and relatively quick loss of developmental abilities are not likely to be confused with autism.
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Created December 21, 2000
Reviewed January 12, 2001
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