Autism or ASD is it is more accurately referred to today, is a condition with no known cure. It is not normally a lethal, degenerative disease, and while it does have some physical symptoms, such as inflammation in the brain, the majority of the symptoms displayed by those with ASD is behavioral. They often do not interact with others in a normal, expected way, and socializing with people may sometimes present great challenges.
It’s because ASD covers such a wide spectrum of different behavioral symptoms that ASD wasn’t even recognized until the 1980s as its own unique condition. Before that, people with ASD were diagnosed as schizophrenic and treated in the same way as the mentally ill, with anti-psychotics and other treatments, since some ASD patients may, in fact, respond well to anti-psychotics, while for others it is not appropriate.
As ASD was first recognized, medical experts of the time used a simpler, more rigid and less accurate form of diagnosing ASD.
Classifying The Groups
Modern diagnosis now considers everyone to have ASD, with different, specific behaviors, symptoms, or syndromes measured for individual intensity on the spectrum. This is now the preferred way, since the individual symptoms matter far more than what “class” of ASD a person falls in, and a wrong categorization could lead to incorrect treatment, as medical staff tried to fit a “square peg into a round hole.” However, this newer form of diagnosis only came into effect in 2013. Before that, from the 1980s onwards, groupings were used.
In this older system of categorization, four basic groups of ASD patients existed, with symptoms being roughly divided from one group to the next, and severity being another qualifier for ranking which people fell into which groups. Adults diagnosed with ASD recognize many of these terms, as they were widely used in the media, and even portrayed in film, television and other forms of fiction.
This is the most famous and, in some ways, the “desirable” form of ASD. The name comes from the Austrian physician Hans Asperger, who first documented patients in 1944 with similar characteristics. Asperger’s was considered the “mildest” form of ASD and was often considered the “high-functioning” version of the disorder. In many cases, people who were classified as having Asperger’s didn’t even require any kind of medical treatment.
People with Asperger’s would be considered “eccentric” or “quirky” in terms of personality. The stereotype of someone with Asperger’s is the introverted genius, as ASD can often channel awareness into a focus on detail, and an ability to process specific, high volumes of information. Former Asperger’s syndrome diagnosed patients would often be able to interact with people, though it would be with some difficulty and introversion. The “social awkward professor” would be another example of an Asperger’s stereotype that was frequently portrayed in the media.
Pervasive Developmental Disorder—Not Otherwise Specified
This next “stage” was often referred to as PDD-NOS, was considered to be more severe, than Asperger’s. In other words, this was a “step down,” and people classified in this group were generally considered to have similar symptoms to Asperger’s but often more severe, to the point where it could actively hamper or cripple social interaction. Of course, with a name like “PDD-Not Otherwise Specified,” there was a bit more to PDD-NOS than just a more severe form of Asperger’s.
PDD-NOS was one of the reasons why the classification system of the four groups was ultimately abandoned. So many of the symptoms displayed in ASD didn’t neatly fit any of the three remaining categories that PDD-NOS grew too large, unwieldy, and unrealistic as a place to categorize “everyone else.” When the miscellaneous group becomes larger than the other categories, this presents a serious challenge to the validity of the categorization system. Poor adaptive behavior, poor response to changes in routine, and difficulty learning language were just a few of the symptoms grouped to PDD-NOS
As with Asperger’s, this category, also sometimes referred to as “classic autism” was one of the most widely known, and also portrayed frequently in the media. This is the type of ASD that most people imagine, thanks to films like Rain Man, with severe interactive issues, and an emphasis on routine and repetitive activities.
The Autistic Disorder category was considered severe enough that comprehensive intervention was often required here. Intensive treatment, therapy, and sometimes even medication is required at this level.
Childhood Disintegrative Disorder
This was considered the most severe form of the categories and was often characterized by regression. In this case, children seemed to be developing normally, learning to crawl, walk, and speak, and then, sometime between the ages of 2-4, the children would regress, and lose the skills they’d learned.
CCD, as it was known, was thought of as the “lowest functioning” form of autism. It could be so severe that even basic motor skills and coordination like hand-eye reflexes could be compromised, so children couldn’t eat properly or even tie their shoes. Depending on the severity of the symptoms, anti-psychotics, or anti-convulsants might be prescribed to help manage symptoms.