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Why Autism is Described as a Spectrum

We hear it all the time. “The Autism Spectrum,” but…what does it mean?

If you’ve asked yourself this same question, you’re not alone. Many parents of children with autism don’t hear the term for the first time until their child is diagnosed. Some even later than that. To understand the spectrum, first we need to understand how the diagnosis of autism has evolved over time.

The History of the Autism Diagnosis

Leo Kanner, a psychiatrist and physician initially described autism in 1943 as an emotional disturbance that had little to do with actual cognition. Shortly after, the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) described autism as a form of childhood schizophrenia.

In the 50s and 60s, autism was widely attributed to what was referred to as “refrigerator mothers,” mothers who were emotionally distant and cold to their children. This school of thought was disproved in the 60s and 70s as research at the time revealed that autism was biological, and rooted in early brain development.

The DSM-III, published in 1980, then altered the definition of autism, describing it as a developmental disorder, separate from schizophrenia, that was characterized by challenges in communication for children and atypical reactions to their environment. When the DSM-III was revised in 1987, it included pervasive developmental disorder-not otherwise specified (PDD-NOS), as an autism diagnosis. Though it never used the word “spectrum,” this addition contributed to the growing ideology that autism was more than just a singular condition with a very specific set of symptoms.

When was Autism First Described as a Spectrum?

Released in 1994, the DSM-IV was the first edition of the DSM to categorize autism as a spectrum. This version of the spectrum only listed 5 conditions: autism, PDD-NOS, Asperger’s syndrome childhood disintegrative disorder (CDD), and Rett’s syndrome. Though still limited in its definition, this change was a crucial stepping stone to the continuous spectrum we know today.

The DSM-5, the most recent edition of the DSM, added Autism Spectrum Disorder- which is characterized by “persistent impairment in reciprocal social communication and social interaction” and “restricted, repetitive patterns of behavior.” It also thrust the conceptualization of the continuous autism spectrum in to modern medicine.

So, What Does it All Mean?

Though the diagnosis has changed and morphed in the complicated process of medicinal research and theory, the idea behind autism as a continuous spectrum can be broken down in pretty simple terms.

The spectrum helps call to mind the unique ways that autism manifests itself in each individual. Though manuals like the DSM can categorize different diagnoses by generalities, autism is more complex than a list of symptoms. That is to say, no two individuals on the autism spectrum are exactly the same.

For many autism advocates, the spectrum has instead become a celebration of the colorful personalities and character traits of those with an autism diagnosis. Though many children with autism will face intellectual or behavioral challenges, many will demonstrate incredible attention to detail, creativity and intelligence in their lifetime, leading to happy, independent and fulfilled lives.

Dr. Stephen Shore, a professor of special education at Adelphi University- and an individual on the spectrum himself – once spoke the words “If you’ve met one person with autism, you’ve met one person with autism.” Those words have become a rallying cry, and a reminder of the uniqueness and individuality of each person on the spectrum.

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June 12, 2018

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