Atypical autism, also known aspervasive developmental disorder not otherwise specified (PDD-NOS), was a diagnosis previously used to classify children who had some, but not all, of the symptoms of autism. The terms have since been phased out as the definition of autism has changed in recent years.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) updated the definition of autism in 2013 to include a broader range of symptoms that fall under the larger umbrella of autism spectrum disorder (ASD).
Under this new definition, autism is regarded as a broader spectrum of behaviors and characteristics whose severity is classified by three levels of support. As such, people previously diagnosed with PDD-NOS would now be diagnosed with ASD.
This article explains how and why PDD-NOS evolved into ASD and what this means to children and adults living with autism.
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How the Definition of Autism and PDD-NOS Evolved
The DSM, published by the American Psychiatric Association (APA), outlines the criteria by which psychiatric and mental disorders are diagnosed. There are five versions of the DSM, dating back to 1952.
Autism was first classified as its own diagnosis in the DSM-3, published in 1980. Prior to that, children with autism-like behaviors were given a diagnosis of childhood schizophrenia.
The DSM-4, published in 1994, divided autism into five separate diagnostic categories. Among these were autistic disorder, Asperger syndrome, and PDD-NOS.
For autism to be diagnosed under the DSM-4, a child had to meet three diagnostic criteria:
- Impairments in social interaction
- Impairments in communication
- Repetitive behaviors
For PDD-NOS to be diagnosed, a child only needed to meet two criteria, one of which must be impairments in social interactions. On top of this, schizophrenia, schizotypal personality disorder (STPD), and avoidant personality disorder (APD) had to be ruled out before the diagnosis could be considered definitive.
PDD-NOS, also known as subthreshold autism or atypical autism, was used when some but not all symptoms of autism were present. It suggested a milder form of autism, which some today might refer to as high-functioning autism.
What Are Pervasive Developmental Disorders (PDD)?
Pervasive developmental disorders are those characterized by impaired communication and socialization skills. These not only included PDD-NOS and Asperger syndrome but also Rett syndrome and childhood disintegrative disorder (CDD).
What Causes Autism?
Changing Definitions: DSM-5 and Autism Spectrum Disorder
When the DSM-5 was released in 2013, the APA made the decision to fold all five autism categories into a single diagnostic category known as autism spectrum disorder (ASD).
Rather than describing autism as a condition bound by a relatively narrow list of characteristics and behaviors, the DSM-5 acknowledges that ASD comes in many different forms.
Today, there isa single diagnosis of ASDthat replaces the different subcategories used in the DSM-4. The DSM-5 criteria are based on difficulties in two specific areas:
Social-Communication Skills
Signs of impairment of social-communications skills in children with ASD include:
- Rarely or never using language to communicate with others
- Rarely or never responding when spoken to
- Rarely or never using gesturing like waving or pointing
- Limited facial expressions
- Rarely or never engaging in imaginative play
- Not sharing interests or recalling events or achievements
- Not showing interest in making friends or interacting with others
Restricted, Repetitive, and Sensory Behaviors or Interests
These are behaviors in which a child with ASD has a limited range of focus or interest and an often obsessive attachment to objects or sensations.
Examples include:
- Lining up toys in a specific way over and over again
- Repeatedly flicking switches or spinning objects
- Speaking in a repetitive way
- Having very narrow and/or intense interests
- Needing things to happen in the same way every time
- Difficulty switching out of patterned behaviors or changing schedules
- Intense reactions to certain sounds, textures, tastes, smells, or sights
To be diagnosed with ASD, children must have difficulties with both social-communications skills and restricted, repetitive, or sensory behaviors. Moreover, they must have had these issues from early childhood.
How Autism Spectrum Disorder Is Diagnosed
Treatment of PDD-NOS vs. ASD
Another way that PDD-NOS stands outside of the current definition of ASD is how mental health professionals address the severity of the condtion. In the past, the treatment of PDD-NOS was largely the same as for Asperger's syndrome given that both were regarded as "milder" forms of impairment.
And, while it is true that people with PDD-NOS often have milder symptoms, that doesn't necessarily mean that it is any less disabling. In fact, some people with PDD-NOS are severely disabled.
As such, the DSM-5 has established three levels of support that a person with ASD needs irrespective of the exact features of their condition:
- Level 1 ASD indicates a high level of functioning in which assistance may be needed to overcome challenges with social connections, schedules and organization, and nuanced communication.
- Level 2 ASD indicates the need for structured support to overcome problems with spatial awareness, sensory hypersensitivity, thought fixation, and gaps in social skills, among others.
- Levels 3 ASD indicates the need for substantial support when autism symptoms are severe and limit a person's ability to communicate, avoid repetitive behaviors, or deal with sensory overload.
As of 2022, PDD-NOS was removed from theInternational Statistical Classification of Diseases and Related Health Problems, Version 11(ICD-11) used to classify diseases for surveillance reasons as well as to facilitate medical billing and reimbursements.
Summary
Pervasive developmental disorder not otherwise specified (PDD-NOS)—also known as atypical autism—is an outdated term used when a child has some symptoms of autism but does not meet the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-4).
With the release of the DSM-5 in 2013, PDD-NOS has been folded into a larger category known as autism spectrum disorder (ASD). ASD is diagnosed based on a broader range of symptoms and classified based on its severity and the level of support a person needs in everyday life.
How Autism Spectrum Disorder Is Treated
A Word From Verywell
Technically, most mental health professionals in the United States no longer diagnose children with atypical autism or PDD-NOS. That doesn't mean that the treatment approach or the need for treatment has changed.
Regardless of the category of diagnosis—whether PDD-NOS or ASD—the approach will likely involve behavioral and/or developmental therapy along with speech, occupational, and physical therapies, and social skills classes for older children.
The diagnosis of ASD simply acknowledges that autism is not one thing. Broadening the definition better ensures that people with mild autism don't "fall between the cracks" and can still get the individualized care and support they need.
What Is the Best Treatment for Autism?
Frequently Asked Questions
Is Asperger syndrome still a condition?
As of 2013, the American Psychiatric Association no longer regards Asperger syndrome as an official diagnosis. Symptoms of Asperger syndrome now fall under the larger umbrella of autism spectrum disorder.
Learn More:Why Asperger's Syndrome Is No Longer an Official Diagnosis
Is Rett syndrome a form of autism?
Rett syndrome was listed in the DSM-4 as a form of autism but was removed from the DSM-5 in 2013. Even so, there has been long been debate about its inclusion in the DSM-4 as it is, in fact, a genetic disorder that causes autism-like symptoms mainly in females.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Kim YS, Fombonne E, Koh YJ, Kim SJ, Cheon KA, Leventhal BL. A comparison of DSM-IV pervasive developmental disorder and DSM-5 autism spectrum disorder prevalence in an epidemiologic sample. J Am Acad Child Adolesc Psychiatry. 2014 May;53(5):500-8. doi:10.1016/j.jaac.2013.12.021
Surís A, Holliday R, North CS. The evolution of the classification of psychiatric disorders.Behav Sci (Basel). 2016;6(1):5. doi:10.3390/bs6010005
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Guthrie W, Swineford LB, Wetherby AM, Lord C. Comparison ofDSM-IVandDSM-5factor structure models for toddlers with autism spectrum disorder. J Am Acad Child Adolesc Psychiatry. 2013 Aug;52(8):797–805.e2. doi:10.1016/j.jaac.2013.05.004
Huerta M, Bishop SL, Duncan A, Hus V, Lord C. Application of DSM-5 criteria for autism spectrum disorder to three samples of children with DSM-IV diagnoses of pervasive developmental disorders. Am J Psychiatry. 2012 Oct;169(10):1056-64.doi: 10.1176/appi.ajp.2012.12020276
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By Lisa Jo Rudy
Lisa Jo Rudy, MDiv, is a writer, advocate, author, and consultant specializing in the field of autism.
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FAQs
What is atypical autism? ›
What does atypical autism mean? A person has atypical autism when they display some symptoms of autism spectrum disorder (ASD), but not enough to fit a diagnosis. Atypical autism is another term for pervasive developmental disorder-not otherwise specified (PDD-NOS).
How accurate is autism in atypical? ›Does Atypical Accurately Portray Autism? Because autism encompasses a range of symptoms and severities, there is no one “right way” to portray autism. As a whole, the show does a good job of representing the challenges a teen or young adult with autism may endure.
What is the difference between atypical autism and Aspergers? ›The principal difference between autism and what was once diagnosed as Asperger's is that the latter features milder symptoms and an absence of language delays. Most children who were previously diagnosed with Asperger's have good language skills but may have difficulty “fitting in” with their peers.
Is autism an atypical development? ›Abstract. Autism spectrum disorder (ASD) is marked by atypical trajectory of brain maturation, yet the developmental abnormalities in brain function remain unclear.
What level of autism is atypical? ›People with atypical autism have some of the classic autism symptoms, but not enough to meet the required criteria for childhood autism or autism spectrum disorder. Atypical autism is sometimes diagnosed when there is a late onset of symptoms. It is not to be confused with high-functioning autism.
What are the characteristics of atypical autism? ›In our experience, children with atypical autism do still demonstrate difficulties very similar to that of children with autism. This can include communication difficulties, understanding non-verbal communication, social boundaries, preferring routine and difficulties with processing sensory information.
Does Atypical have good autistic representation? ›Atypical Fell Short as Both Autistic Representation and Entertainment. At Least It Was Eclipsed During Its Own Time. The year 2017 was a great one if you were in the business of TV autism.
Is everyone in Atypical autistic? ›Despite playing an autistic character, Gilchrist is not autistic. The actor did a great deal of research to get to the point where he could play an autistic person, including reading works by writer and speaker David Finch.
Is anyone on Atypical autistic? ›And yet each season the show has increased its autism representation. The new one gives big punchlines to two autistic actors, Domonique Brown and Tal Anderson, who portray Sam's friends Jasper and Sid, respectively. Anderson, in particular, effectively delivers one-liners.
What are examples of atypical behaviors? ›Unusual eating habits, abnormal sleep patterns, temper tantrums, and aggression to self and to others are among the most common of these abnormal behaviors.
Can you have autistic traits and not be autistic? ›
No, there is no such thing as being a little autistic. Many people may show some characteristics of autism from time to time. This may include avoiding bright lights and noises, preferring to be alone and being rigid about rules.
What is atypical speech and language in autism? ›For many people, especially those with autism spectrum disorder (ASD), atypical speech patterns interfere with social communication and interaction. Neurotypical society places enormous value on tone, inflection, speed and pattern of speech to convey meaning and emotion.
What does atypical behavior mean? ›1. ATYPICAL BEHAVIOUR. Definition 2: Deviation from social norms Atypical behaviour is defined here by behaviour which is not statistically deviant but socially deviant. These behaviours go against our social norms – they are considered to be anti-social or undesirable.
What is atypical development examples? ›It is atypical for a child to routinely fixate on one interest or part of an object. For example, consistently spinning the wheels on a car instead of rolling the car. It is also of concern if a child has a persistent need for a specific nonfunctional routine or ritual when playing with toys.
What is an atypical child? ›A child is described as developing atypically when one of two situations arises: A child reaches developmental milestones earlier than other children his/her age. A child reaches developmental milestones later than other children his/her age.
Where does atypical occur? ›Keir Gilchrist as Sam Gardner, an 18-year-old young man on the autism spectrum who has an interest in Antarctica and loves penguins.
What is borderline autistic? ›To be diagnosed with borderline autism, a child must display many of them but not in the frequency or severity that merits a full diagnosis. Borderline autism symptoms include problems with: social skills, body use, the ability to adapt or make transitions, language and other sensory and developmental issues.
Can autism be reduced? ›There is no cure for autism, but experts agree that the best way to manage symptoms and develop independence skills is through ABA therapy. It's important to remember that autism spectrum disorder (ASD) is a complicated condition that presents differently in every individual.
What is atypical sensory function? ›The atypical sensory processing can also consist of an unusual indifference to sensory stimuli like pain, heat, and cold (American Psychiatric Association, 2013). Note: Sensory under-responsivity is often found along with sensory over-responsivity in the same person (Miller et al., 2017)
What are uncommon signs of autism? ›- Have unusual interests and behaviors.
- Have extreme anxiety and phobias, as well as unusual phobias.
- Line up toys or other objects.
- Play with toys the same way every time.
- Like parts of objects (e.g., wheels)
- Become upset by minor changes.
- Have obsessive interests.
How many levels of autism are there? ›
The levels of ASD allow for more clarity to be placed on a person's diagnosis of ASD in terms of where they fit on the spectrum. Basically, the levels of ASD range from mild to severe symptoms. There are three levels of autism: Level 1, Level 2, and Level 3 (Kandola & Gill, 2019).
Why did Atypical get Cancelled? ›Netflix canceled 'Atypical' in February 2020.
In an interview with Bustle, per HITC, Robia said that the arrival of COVID-19 made it apparent that the show needed to end. The team decided the season would end on a note of hopefulness and positivity.
“High-functioning autism” isn't an official medical term or diagnosis. It's an informal one some people use when they talk about people with an autism spectrum disorder who can speak, read, write, and handle basic life skills like eating and getting dressed. They can live independently.
Are there any autistic actors? ›Anthony Hopkins - Actor
Anthony Hopkins is an award winning actor. He was diagnosed with Asperger's Syndrome as a child. Some of his traits of ASD include obsessive thinking, difficulty maintaining friendships, and looking at people with a unique perspective.
Jasper is probably the same age as Sam. Asides from Amber and Abby, he is the only black autistic character. He is portrayed by an autistic actor, unlike Sam (despite being autistic and the main protagonist of Atypical) who is portrayed by a neurotypical actor.
Is Sheldon autistic? ›This is ironic because according to the producers of The Big Bang Theory, Sheldon Cooper isn't actually autistic. And yet my autism is constantly compared – and seemingly failing to live up – to this fictional character.
Is Atypical based on a true story? ›More videos on YouTube
Atypical isn't based on one specific true story, but Rashid has taken great care to present a true-to-life portrayal of ASD. USA Today reported that the showrunner worked with a professor from UCLA's Center for Autism Research And Treatment to ensure accuracy.
Dive into the story of Tal Anderson—an autistic woman who did not let her ASD diagnosis stop her from making her dream of acting a reality. Tal Anderson made her debut as Sid on Netflix's hit show Atypical in 2019, a comedy-drama series about a teenager's life with asperger's.
What grade is Sam in Atypical? ›He won the 8th grade science fair while in 7th grade, and also won the the 7th grade reading challenge while in 6th grade.
Is Sam in Atypical autistic? ›Netflix family drama (and sometimes comedy) Atypical follows Sam Gardner, an 18-year-old boy who has autism.
What are examples of atypical behaviors? ›
Unusual eating habits, abnormal sleep patterns, temper tantrums, and aggression to self and to others are among the most common of these abnormal behaviors.
What are the 5 types of autism? ›There are five major types of autism which include Asperger's syndrome, Rett syndrome, childhood disintegrative disorder, Kanner's syndrome, and pervasive developmental disorder – not otherwise specified.
What are uncommon signs of autism? ›- Have unusual interests and behaviors.
- Have extreme anxiety and phobias, as well as unusual phobias.
- Line up toys or other objects.
- Play with toys the same way every time.
- Like parts of objects (e.g., wheels)
- Become upset by minor changes.
- Have obsessive interests.
(According to Atypical's official Twitter account, autistic actors did audition for the role, but it ultimately went to the non-autistic Keir Gilchrist because he was “best for the role.”)
How do you help an atypical child? ›- Family sing-a-longs. This is perhaps my favorite learning activity! ...
- Point out shapes and colors. Whenever you're spending time with your child, actively identify the shapes and colors you see. ...
- Count everything. ...
- Point out sounds. ...
- Ask questions.
It is atypical for a child to routinely fixate on one interest or part of an object. For example, consistently spinning the wheels on a car instead of rolling the car. It is also of concern if a child has a persistent need for a specific nonfunctional routine or ritual when playing with toys.
What does it mean when a child is atypical? ›Some children exhibit behaviors that fall outside of the normal, or expected, range of development. These behaviors emerge in a way or at a pace that is different from their peers.
What is the lowest level of autism? ›ASD Level 1 – Level 1 ASD is currently the lowest classification. Those on this level will require some support to help with issues like inhibited social interaction and lack of organization and planning skills.
What is the mildest form of autism? ›Asperger's syndrome.
This is on the milder end of the autism spectrum. A person with Asperger's may be very intelligent and able to handle their daily life.
Mild autism is also called high-functioning autism (HFA), Asperger's syndrome, or described as "being on the lower end of the spectrum." This article will explain why the term mild autism is used and how the definition has changed over time.
Are you born with autism? ›
Autism is not an illness
It's something you're born with. Signs of autism might be noticed when you're very young, or not until you're older. If you're autistic, you're autistic your whole life. Autism is not a medical condition with treatments or a "cure".
- Don't Approach Parents With Pity.
- Don't Bark Instructions.
- Don't Take Things Personally.
- Don't Assume Nonverbal Children Can't Communicate.
- Don't Insist on Eye Contact.
- Don't Use Creative Language.
- Don't Assume the Child Can't Hear.
- Don't Stare.
Studies suggest that ASD could be a result of disruptions in normal brain growth very early in development. These disruptions may be the result of defects in genes that control brain development and regulate how brain cells communicate with each other. Autism is more common in children born prematurely.
Why did Atypical get Cancelled? ›Netflix canceled 'Atypical' in February 2020.
In an interview with Bustle, per HITC, Robia said that the arrival of COVID-19 made it apparent that the show needed to end. The team decided the season would end on a note of hopefulness and positivity.
This is ironic because according to the producers of The Big Bang Theory, Sheldon Cooper isn't actually autistic. And yet my autism is constantly compared – and seemingly failing to live up – to this fictional character.
Are Sam's friends in Atypical actually autistic? ›And yet each season the show has increased its autism representation. The new one gives big punchlines to two autistic actors, Domonique Brown and Tal Anderson, who portray Sam's friends Jasper and Sid, respectively.