In 2013 the DSM-5 introduced a major revision to how autism was diagnosed.
Instead of listing Autistic Disorder, Asperger Syndrome, Pervasive Developmental Disorder–Not Otherwise Specified (PDD-NOS), and Childhood Disintegrative Disorder as separate conditions, the DSM-5 combined them into a single diagnosis: Autism Spectrum Disorder (ASD) (APA, 2013).
This new framework emphasized that autism existed on a spectrum of severity, rather than as a collection of distinct subtypes.
The change reflected decades of clinical observation and research showing that these categories often overlapped and varied across individuals and time.
The “severity” does not mean in a linear fashion, such as an “M” for mild on the left end of a long line, and an “S” for severe on the right end.
Instead, the spectrum is more like a pie chart of different-color slices with Autists having any number of those slices representing how their autism affects them.
Another way to see this is low support needs vs. high support needs.
New Diagnostic Criteria for ASD
The DSM-5 defines Autism Spectrum Disorder using two main domains:
- Persistent deficits in social communication and social interaction
- Restricted, repetitive patterns of behavior (e.g., stimming such as rocking or humming), interests (e.g., an “obsession” with shark attacks) or activities (such as extended jumping on a trampoline).
In addition, clinicians were required to assess:
- Severity levels based on support needs (support can range from simple accommodations at the workplace to constant supervision and help even with toileting.)
- Co-occurring conditions, such as intellectual disability, language delay or ADHD.
NOTE: The co-occurring conditions are simply that: co-occurring.
I can’t say this too much: Autism is NOT a form of intellectual impairment, nor does autism cause this, nor does an intellectual disability cause autism. Co-occurrence does not mean cause-and-effect.
By emphasizing functional impact and support needs rather than rigid labels, the DSM-5 aimed to create a more accurate and flexible diagnostic system.
Goodbye to Asperger Syndrome
The decision to eliminate Asperger syndrome as a separate diagnosis was controversial.
Critics worried that individuals previously diagnosed with Asperger’s might lose access to services or feel their identity was erased.
Others feared the broader ASD category would become too vague or inconsistent (Volkmar & McPartland, 2014).
However, the change also aligned with the growing neurodiversity movement, which emphasizes shared experiences across the spectrum rather than splitting people into rigid categories (for example, high functioning, middle functioning, mild, severe).
Broader Implications of the Spectrum Model
The spectrum model of autism helped increase public and professional awareness of how differently autism can present — from nonverbal individuals with very substantial support needs to highly articulate and educated adults (many in professional lines of work including the medical and mental health fields) who struggle with social nuance.
It also opened doors to more personalized approaches to education, therapy and support.
Since 2013, Autism Spectrum Disorder has become the standard diagnostic term in the U.S. and many other countries.
But I actually consider myself an ASPie even though I was diagnosed with Autism Spectrum Disorder after 2013. Autism Super Power = ASP = ASPie!
Next: Part 8 in this 10-part series: Modern Tools for Early Autism Screening and Diagnosis
Lorra Garrick has been covering medical and fitness topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer. In 2022 she received a diagnosis of Level 1 Autism Spectrum Disorder.
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