Autism, which today is clinically known as Autism Spectrum Disorder (ASD), is one of the more complex and largely still unknown conditions in medical science today. It is a disorder with so many symptoms, in a broad range of intensities, that for centuries, it was not even properly recognized as a distinct condition. In past years, some forms of ASD were misdiagnosed as schizophrenia, because of some behavioral similarities and the fact that some ASD patients did respond positively to some schizophrenic treatments like prescribing antipsychotic medication.
Today, ASD understanding has improved, but the knowledge we have of the disorder is far from complete. Over the decades, many iterations of our understanding of ASD have come and gone. This has left some people confused as to the exact state of an ASD diagnosis since many are now outdated and no longer medically classified in such a way. All ASD patients today, for example, are diagnosed on “the spectrum.” There is no longer any distinct classification such as one ASD patient having Asperger’s Syndrome, while another has Childhood Disintegration Disorder.
One of these classifications that are no longer used is Atypical Autism, and there are many good reasons for that.
The Early Classifications
There is one medical document that is often considered a central source for global medical references, and that is the Diagnostic & Statistical Manual of Mental Disorders. The DSM, as it is more conveniently referred to, has been a touchstone of American mental health knowledge and reference since 1952. It is a “living document” in the sense that it is periodically updated to reflect discoveries, treatments and developments in the mental health medical space. So, the first edition of the text used is now referred to as “DSM-I.”
It was only in the 1980s, with the introduction of DSM-III, that ASD was given a distinct classification. However, unlike the current system, which defines ASD as one condition with a spectrum of different symptoms at different intensities, the DSM-III text created four different classifications for ASD and then tried to fit ASD patients into each of these categories. Atypical Autism was one of these four categories.
What Was Atypical Autism?
Atypical Autism, under DSM-III was not clinically referred to with this term. The technical term for it was Pervasive Developmental Disorder-Not Otherwise Specified, or PDD-NOS. As the name indicates, PDD-NOS was a “miscellaneous” category where those diagnosed with autism who didn’t fall into the other three categories would go. Asperger’s Syndrome was the first category and considered the “mildest and high functioning.”
The other categories, “Classic Autism” and “Childhood Disintegration Disorder,” were considered more severe. This meant people with ASD symptoms more severe than Asperger’s, but milder than Classic or CDD went into the PDD-NOS category, which quickly showed how inadequate a four-class category system was as more and more people failed to fit into the other three categories neatly.
The symptoms of people formerly classed as having PDD-NOS included:
Anomalous/Unusual Social Interactions
This was difficult to categorize since so many potential symptoms could be included, but in general, if a child experienced difficulty smoothly socializing with other children, and it was due to specific behaviors, such as unprovoked hostility, or unwillingness to speak, these fell into the category.
Linguistic/Communication Issues
Those with PDD-NOS in the past were also characterized by having communication deficits that made it difficult for them to be understood by others. This may have manifested as delayed communication development, or other anomalies, such as speaking without inflection and sounding like a robot.
Repeating Actions
Like other former categories of autism, PDD-NOS also included symptoms of repetitive motions or behaviors. Repeating certain gestures, actions, or words would often be a soothing activity in times of stress. However, there was little discretion about when these repeating behaviors would occur, which could be interpreted as inappropriate given the timing and circumstance.
Atypical Sensory Experience
This can be difficult to diagnose properly since an objective measurement is difficult. Atypical sensory experience means people formerly diagnosed with PDD-NOS may have apprehended their senses in ways that differ from those without the condition. Colors, for example, may look different, smells may be stronger or weaker, the sensation of touch may feel different.
The New Classification
By the 21st century, it was apparent that trying to fit the huge variance of autism symptoms into four categories wasn’t working as accurately as envisioned. In 2013, with DSM-IV, the four categories of autism were discarded. We now operate on a single system of Autism Spectrum Disorder, where individuals are diagnosed as being “on the spectrum.” From there, a more in-depth diagnosis is made to catalog and diagnose the specific symptoms and then treat each person in a customized, personalized manner that suits their needs, rather than classing them as Category 1 or Category 4 and using only treatments specific to that category. ASD is far more complex than that and requires a nuanced treatment strategy.
