‘D’ is for Difference

Clinically, the ‘D’ of ASD stands for ‘disorder’. However, a paradigm shift has been taking place which rightly insists the ‘D’ should stand for ‘difference’.

Disorder or difference

Unfortunately, the ‘D’ in ASD stands for ‘disorder’ rather than ‘difference’. This may seem odd, especially from the perspective of autistic people who readily acknowledge they have both advantages and disadvantages on account of their condition.

And yet, clinically autism is defined as a dysfunction and a pathology (i.e. mental illness)—as all conditions in the DSM are. Remember, this is the Diagnostic and Statistical Manual of Mental Disorders.

But let’s not blindly accept the way things are; I think it’s time we adopt more neutral terminology to describe autism, and quite a few autism researchers seem to agree—perhaps most notably Simon Baron-cohen.^[1]Rethinking the concept of autism | University of Cambridge

‘D’ is for Disorder—but it doesn’t have to stay that way

Neurodiversity

It wasn’t until the late 90s* that the neurodiversity movement emerged,^[2]Neurodiversity – On the neurological underpinnings of geekdom | The Atlantic and autism started to be seen not exclusively in terms of dysfunction, but as a function characterized by both impairments and advantages. It is through this acknowledgment that autism can be seen as a difference, rather than exclusively a disorder.

• The change in perspective that led to the explicit formulation of the neurodiversity movement probably already became apparent in the early 90s.

The neurodiversity movement celebrates neurological differences, and is more restrained when it comes to the use of terminology that is imbued with negative connotations, such as the term disorder, the meaning of which can be:

• Disrupt the systematic functioning or neat arrangement thereof.
• An abnormal physical or mental condition.

Even in its most favorable definition, the term ‘disorder’ is unnecessarily negative. Autism is a neurological deviation and can be described as such, without using terms such as “abnormal”; these terms are value judgments, which have nothing to do with science, and so I would argue these terms have no place in scientific terminology, and ought to be avoided in clinical settings.

It should be emphasized however that the pressure to adopt more neutral terminology is not to suit socio-political sensitivities, or to make ourselves feel better.

No! Science ought to be neutral in its communication. To describe neurological conditions in terms of value judgments is to politically weaponize science communication. The need to adapt neutral terminology to describe science is absolutely not as trivial as wanting terminology to make ourselves feel better.

Read more about why autism is defined as a disorder here:

Why is autism seen as a disorder?

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Asperger syndrome

Interestingly, the neurodiversity movement seems to coincide with the inclusion of Asperger syndrome in the ICD-10 in 1993 and the DSM-IV in 1994.

At the end of the 90s, Asperger syndrome has become more readily recognized and diagnosed, and high-functioning autism is starting to become public knowledge.

The English psychiatrist Lorna Wing had a big part to play in laying down the foundation for neurodiversity by introduced the English-speaking medical world to the work of Hans Asperger in her 1981 paper, Asperger’s syndrome: a clinical account.



I suspect the acknowledgment of advantages as seen in Asperger syndrome and high-functioning autism probably played a part in the emergence and perpetuation of the neurodiversity movement.

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Alternative terminology

Some researchers use ASC instead of ASD, which stands for autism spectrum condition(s).

I think ASC is a much more appropriate term. However, due to a lack of popularity, this terminology—while neutral—is not as effective in communication. It’s also for this reason that Natalie and I chose to name our autism enterprise Embrace ASD rather than Embrace ASC. Some people, like lecturer and autism consultant Damian Milton avoid the use of ASC as well, due to its ‘medical model’ connotations.^[3]So what exactly is autism? | Autism Education Trust

Read more about the history of autism terminology and the introduction of Asperger syndrome here:

A timeline of autism classifications

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You may see Embrace ASD as a rather ironic name, but since 2013 the condition I am diagnosed with has been generalized to ASD, so despite personal objections to the name, our enterprise really is about embracing our ASD—to celebrate our advantages, and acknowledge—and potentially overcome—our dysfunctions. So I embrace ASD in the sense that I embrace my neurology, and I embrace it ironically in terms of “accepting” the terminology.

However, on a personal level, I sometimes insist we are called Embrace Autism Spectrum Differences. Insisting the ‘D’ stands for ‘difference’ rather than ‘disorder’ may be another way to fuel the neurodiversity movement by reappropriating ideologically outdated terminology. For more information on our name, read the post below.

Embracing ASD

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For more on the topic of disorder, have a look at:

Why is autism seen as a disorder?