The Evolving Language Around The Autism Spectrum: What You Need To Know

According to the World Health Organization’s international studies, an estimated 1 in 270 people has autism spectrum disorder. This prevalence has inspired the declaration of April as Autism Awareness Month or Autism Acceptance Month. The United Nations also observes April 2 as World Autism Awareness Day. With this recognition comes the expectation that people will be inspired to learn more and share information about autism spectrum disorder, which is commonly referred to as autism in everyday settings.

The month of April provides us with an opportunity to learn about autism through the language related to this spectrum of disorders. Many of the terms used to describe autism have evolved since they were first used and continue to change, making a conversation about terminology both valuable and necessary. It’s also important to note that terminology can vary across different communities, organizations, and bodies of literature.

If you’d like to understand the terms associated with autism so as to use them correctly, we are here for you. We’ve gathered together a Dictionary.com-approved glossary of need-to-know terms that will go a long way in helping you respectfully and knowledgeably discuss autism spectrum disorder.

Please do note this list isn’t exhaustive by any means, and be aware that these terms may evolve with time and vary in their actual use among different communities.

Why does recognizing April as Autism Acceptance Month matter? Find out the details on the meaning and origin of the term here.

Autistic person vs. person with autism?

Before we get to specific terms, though, we want to provide some context on an ongoing and important debate about labels: whether or not a person who has been diagnosed with autism spectrum disorder should be referred to as autistic or a person with autism. Commonly, these two approaches are referred to as identity-first language and person-first language, respectively.

Identity-first supporters, which often include many people on the autism spectrum, argue that autism is an inherent part of a person’s identity and you cannot nor should you separate a person from their disorder, which impacts every part of their life. Identity-first advocates argue that using people with autism suggests autism is a disease that affects the person negatively (like person with cancer) instead of a part of a person’s identity.

Person-first supporters, however, argue that person with autism emphasizes the person and doesn’t define them by their disorder. This language, they argue, draws attention to the fact that a person’s humanity should be the focus and they shouldn’t be solely identified or stereotyped based on their condition.

Currently, you may be more likely to see person with autism language used in scientific reports and studies, as many style guides prefer person-first language. Some groups, such as Autism Awareness Australia, consider both choices equally valid and use them interchangeably. Some have raised another alternative and suggested neutral language such as on the autism spectrum, which is often deemed acceptable by both sides of the argument.

🔑 Key message about language use

When it comes to choosing autistic or a person with autism, most experts agree that it is best to use the language that a person or group prefers. Politely ask which language someone prefers before making a choice on which of these terms to use.

Glossary of terms

The list of terms below are all important to the conversations about and around autism spectrum disorder, but do note that this isn’t a complete list by any means. It should still should help you navigate essential conversations on and bridge the gap of awareness about autism spectrum disorder.

Autism Spectrum Disorder (ASD)

Clinically, the American Psychiatric Association states that “Autism spectrum disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors.” The APA goes into much more detail about ASD in their fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Autism spectrum disorder includes a wide range of symptoms of varying severity that a person experiences. The term indicates that the condition is both a disorder (not a disease) that can include a wide range (a spectrum) of symptoms that vary in how much they impact a person’s life.

According to the APA, in order for a person to be diagnosed with ASD, they must be deficient in three of three specific criteria:

  • social-emotional reciprocity: This includes inability to hold back and forth conversations and difficulty in recognizing appropriate social boundaries.
  • non-verbal communicative behaviors: This includes impairments in the use of eye contact, gestures, and facial expressions.
  • developing and maintaining relationships

Additionally, a person must display two of four specific symptoms. Speaking generally, these symptoms are:

  1. Repetitive speech, bodily movements, or use of objects
  2. Excessive following of routines and patterns
  3. Having very narrow interests that are obsessively focused on
  4. Very high or very low reactivity to sensory stimuli (such as pain or changes in temperature)

Clinically, the term ASD has replaced three terms that used to refer to subtypes of autism: these were Autistic Disorder, Asperger Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). Outside of clinical medicine, all three of these terms are still sometimes used.

The DSM-5 does not recognize specific types of autism. Instead, ASD is categorized into three distinct levels. The DSM-5 goes into detail about each level but simplifies them as requiring support, requiring substantial support, and requiring very substantial support.

Important notes of Pervasive Development Disorder (PDD) and Pathological Demand Avoidance (PDA):

Pervasive Development Disorder used to be an official term for a wide variety of disorders that impacted socialization and communication skills. Autism, Asperger syndrome, and Rett’s Syndrome were considered to be PDDs. While this term may still be used by some health professionals or older research papers, it has been officially replaced by autism spectrum disorder.

The term Pathological Demand Avoidance is used by some groups to refer to a specific type of autism. According to psychologists, people with PDA display avoidance of people’s demands and expectations that is much more extreme than displayed by most autistic people, such as avoiding even putting on clothing. PDA is not officially recognized by American psychologists and the majority of research of PDA has been done by non-American psychologists.

Why the term Asperger’s is no longer used

The term Asperger syndrome, commonly shortened to Asperger’s, has not officially been used by clinical psychologists since 2013, when it was replaced in the DSM-5 by the term autism spectrum disorder. Asperger syndrome was previously used to refer to a form of autism that had less severe symptoms and much lower impairment of language. While not in official use anymore, this term may still be used outside of medical diagnoses.

neurodiversity

Neurodiversity is “the variation and differences in neurological structure and function that exist among human beings,” and as a term, refers to the idea that differences in brain development and behavior are normal and not the result of mental disorders. This idea suggests that conditions such as autism or ADHD are normal variations and not disorders that negatively impact the brain. People with these conditions are said to be neurodiverse.

Importantly, these terms are not used to describe individuals who have suffered traumatic head injuries or suffer from diseases that can damage the brain such as rabies or syphilis.

Another set of terms to be clear about is the difference between Alzheimer’s and dementia. Learn how to tell them apart here.

neurotypical and neuroatypical

Some people use the term neuroatypical to refer to any person who has autism or any similar condition. However, this term has largely fallen out of use and the terms neurodiverse and neurodivergent have largely replaced it.

The term neurotypical is commonly used by supporters of neurodiversity to describe a person who “shows typical neurological behavior and development.” It refers to a person that general society would consider to have an “average” or “normal” (typical) brain (neuro-).

Neither neurodiversity nor neurotypical are official medical terms.

neurodivergent

Neurodivergent is a non-medical term used similarly to the term neurodiverse to refer to people who have conditions such as autism, dyslexia, and OCD that impact cognitive abilities and social skills. Like neurodiverse, the term neurodivergent is used to mean someone “shows atypical neurological behavior and development.” A person with one of these conditions is simply different (or divergent).

developmental disability

According to the CDC, a developmental disability is a condition caused by an impairment in physical, learning, language, or behavior areas. The CDC considers autism, ADHD, blindness, and cerebral palsy to be examples of developmental disabilities.

executive functioning

The term executive functioning, or executive function, refers to the mental skills of working memory, cognitive flexibility, and inhibitory control. In short, these skills are responsible for things such as paying attention, planning, managing emotions, and understanding different points of view. Humans are not born with these skills and must develop them during childhood and into adolescence. Various conditions, such as ADHD, interfere with a person’s development of these skills. People who don’t develop these skills are said to have executive functioning issues. Examples of some executive functioning skills include:

  • working memory: the ability to store information and use it later.
  • self-control: the ability to avoid outbursts and control one’s own emotions.
  • planning: the ability to think about the future and prioritize important tasks.
  • self-monitoring: the ability to recognize how well one is doing at a task.
  • organization: the ability to arrange thoughts or objects in an orderly manner.
  • adaptable thinking: the ability to focus on a task and use different perspectives to solve problems.

Why high-functioning vs. low-functioning may not be helpful terms

Sometimes, people diagnosed with ASD are described as being high-functioning or low-functioning. These unofficial terms refer to the difficulties a person diagnosed with ASD has in life, with high-functioning referring to less difficulty and low-functioning referring to people who need more support.

Even though official organizations such as the American Counseling Association use both of these terms, some have criticized these terms as being unhelpful or even harmful. One argument is that use of these terms may ignore the nonverbal abilities of those considered low-functioning and may prevent high-functioning individuals from receiving the support they need.

Applied Behavioral Analysis (ABA)

Applied Behavioral Analysis (ABA) is a general term that refers to a therapy strategy used to modify the behavior of people diagnosed with ASD in order to improve their lives. Generally speaking, the strategy involves observing a person’s behavior and using positive reinforcement to encourage desirable behavior and discourage undesirable behavior. While ABA isn’t only used to modify behavior of people diagnosed with ASD and has come under increasing criticism by some in the ASD community in recent years, it is considered one of the longest-standing and most researched behavioral therapies for autism.

stimming

Stimming is an informal term short for the clinical term “self-stimulatory behaviors” and refers to repetitive behaviors or motions that a person does, such as a person biting their nails. Stimming is done when someone is feeling overwhelmed as a way of focusing on one activity. While stimming isn’t exclusively done by people diagnosed with ASD, the behavior can be more common and disruptive in this population.

perseverate

Perseverate means “to repeat something insistently or redundantly.” Just like stimming, perseveration is not exclusive to people diagnosed with ASD, but it is a commonly observed behavior among that particular group. An example of perseveration would be repeatedly salting a piece of food until no salt is left in the container.

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