The autism diagnosis should be split, with a ‘profound’ category introduced for those more severely affected.
That’s the view of scientist Paul Whiteley, who argues the condition has a wide range of causes, presentations and trajectories.
Researcher Paul Whiteley says it is time to split the autism diagnosis
Whiteley runs Education and Services for People with Autism (ESPA) in Sunderland. Writing in a science journal, he insists that having several different autism diagnoses is increasingly popular.
Two major diagnosis manuals
He acknowledges, however, that the world’s two major manuals for diagnosing autism already recognise the condition’s varied symptoms.
Psychiatrists in the US use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). It splits autism into three different levels based on support needs.
In Europe, medics use the International Classification of Diseases (ICD-11).
This distinguishes between those with and without a learning disability.
It also assesses whether symptoms undermine daily functioning.
Manuals ‘incomplete’
Whiteley says it is because the DSM-5-TR and ICD-11 already plot autism severity that it is better to split the diagnosis and include a ‘profound’ category.
The scientist argues the manuals are “incomplete”.
The DSM-5-TR does not offer a full picture of autism’s trajectory by acknowledging that some can lose their diagnosis, says Whiteley.
He cites “verifiable reports” documenting how between 10 and 30 per cent lose their diagnosis.
Whiteley maintains that autism’s causes are tackled only partially in the manuals, with the ICD referring to how “autistic features may become manifest” in acquired conditions such as encephalitis.
‘Full picture’ of causes
He says his analysis offers a full picture of differing genetic and environmental causes.
Whiteley says splitting the diagnosis offers the hope of developing “specific interventions” for “specific autisms”.
The National Autistic Society (NAS) said it had no one available to comment.
But the charity added that it does not use ‘functioning and severity labels’ because they are ‘considered offensive’ as they ‘fail to capture how a person’s needs may vary’.
Whiteley’s article, penned with support from several colleagues, appeared in the British Journal of Psychiatry on 21 March.
Related:
- Researchers want better dual diagnosis
- Blog: What has changed in the field of early diagnosis and intervention for ASC
- Young autistic people create diagnosis resources
- Children who regress can miss diagnosis
- Some people overcome autism, says doctor
Published: 14 April 2025
