{"id":15178,"date":"2022-06-09T11:38:19","date_gmt":"2022-06-09T16:38:19","guid":{"rendered":"https:\/\/last-drum.flywheelsites.com\/?p=15178"},"modified":"2024-09-11T10:07:16","modified_gmt":"2024-09-11T15:07:16","slug":"defining-degrees-of-autism-the-controversy-and-a-suggested-solution","status":"publish","type":"post","link":"https:\/\/autism.org\/defining-degrees-of-autism-the-controversy-and-a-suggested-solution\/","title":{"rendered":"Editorial – Defining Degrees of Autism: The Controversy and a Suggested Solution"},"content":{"rendered":"

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This editorial originally appeared in ARI\u2019s Autism Research Review International \u2013 <\/em>now available online. Visit the ARRI Online to continue reading this issue and more.<\/span><\/p>\n<\/div>

<\/i>Visit the ARRI Online<\/span><\/a><\/div>
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\"\"Over the years, a number of broad terms have been used to describe individuals with autism spectrum disorders (ASD). In general, these terms have focused on levels of functioning, intelligence, severity, and verbalization.<\/p>\n

While these terms are widely used in the research literature as well as in the autism community, many people have raised concerns about their simplistic nature and their reliance on ill-defined criteria. In this editorial, I suggest a simpler and more accurate system for classifying individuals with ASD.<\/p>\n<\/div>

\"Autism<\/span><\/div>
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A brief history of ASD terminology<\/strong><\/p>\n

Initially, autism was referred to as infantile autism <\/em>or Kanner\u2019s syndrome<\/em>. Later, terms such as classical autism<\/em> and autistic-like <\/em>were used. The former term described individuals who exhibited most of the symptoms and behaviors described in Kanner\u2019s 1943 seminal paper1<\/sup>, while the latter described individuals who exhibited fewer of them2<\/sup>.<\/p>\n

Soon after Lorna Wing introduced the autism community to a little-known article published in 1944 by Hans Asperger3<\/sup>, she helped to popularize the term autism spectrum disorder<\/em>, or ASD. Much later, in 1994, the term Asperger syndrome<\/em> was officially recognized in the Diagnostic and Statistical Manual (DSM), version 44<\/sup>; however, this diagnosis was removed 10 years later in the DSM, version 55<\/sup>. It has been nearly a decade since this change was made, and the term Asperger syndrome<\/em> is still used today among researchers, clinicians, and the general population6-8<\/sup>.<\/p>\n

Recently, a consensus report, sponsored by the Lancet<\/em> journal, introduced the category profound autism<\/em>9<\/sup>.\u00a0 Soon after the introduction of this term, many in the autism community raised serious concerns about the assumptions and applicability of this new \u201cadministrative term\u201d to describe a subpopulation of individuals on the spectrum. The term refers to those with autism who suffer from \u201cintellectual and language impairment,\u201d require 24-hour support, and are unable to take care of many, if not most, of their basic needs. These individuals may also have additional challenges such as \u201cself-injury, aggression, and epilepsy.\u201d<\/p>\n

Although at first glance the term profound autism<\/em> may seem logical, there are many individuals with ASD whose condition is quite pronounced even though they have little or no impairment in intelligence and language. For example, these individuals may suffer from extreme anxiety, depression, and\/or hyper-reactivity to sensory stimuli, making it difficult or impossible for them to live independently. Thus, a more accurate terminology is needed to describe individuals with ASD and identify the services they need.<\/p>\n

Why not focus on level of independence?<\/strong><\/p>\n

One simple and straightforward way to classify individuals with ASD is with respect to their level of independence. In other words, how capable are they of taking care of their basic needs\u2014for instance, preparing food, obtaining water, dressing in proper clothing, having a structured sleep schedule, and finding and maintaining adequate shelter?<\/p>\n

Here are some examples of classifying individuals based on their level of independence:<\/p>\n