ASD vs. ASC: Is One Small Letter Important?

Thursday, May 14, 2015: 12:00 PM
Grand Ballroom B (Grand America Hotel)
S. Baron-Cohen, Autism Research Centre, University of Cambridge, Cambridge, United Kingdom
Background:   The term "disorder" is defined as a "lack of order or intelligible pattern" or "randomness" whereas the term "condition" is simply "a state of being. Those who prefer the term ASD (autism spectrum disorder) argue that "disorder" implies severity and suffering, and thus is necessary to trigger medical services.

Objectives: The term "disorder" may be appropriate for comorbid symptoms such as epilepsy, self-injury, mutism, gastro-intestinal pain, and perhaps general learning difficulties. However, it can be also be argued that most individuals on the autism spectrum do not have these comorbid features, and that a term denoting something broken is harsh, stigmatizing, and inaccurate.

Methods: Scientific evidence from both neurobiology and psychology shows difference, not dysfunction.

Results: Those who argue in favour of the term ASC (autism spectrum conditions) propose that the term "condition" still succeeds in signaling that autism is biomedical, entails disability and vulnerability, and thus can serve as a trigger for services.  But "condition" is a less hard-hitting and more respectful concept that can comprise a range of levels of severity, whilst acknowledging both cognitive deficits and assets – in short, a different ‘cognitive style.’ The more neutral term ASC carries fewer value judgments.

Conclusions: The DSM (editions I through to 5)  uses the term "disorder" (not just for autism but for any atypical behaviour), but that word may be a legacy from an earlier period in the history of psychiatry. It may be time to consider the emotional and social impact of the conventional language used to describe autism, and rethink our categories. Certainly, whether we opt for ASD vs. ASC, it should not affect insurance cover.