1.3 Describe the range of diagnoses and profiles that are recognised on the autism spectrum

This guide will help you answer 1.3 Describe the range of diagnoses and profiles that are recognised on the autism spectrum.

The autism spectrum describes a group of related neurodevelopmental conditions. These impact how a person communicates, interacts, and experiences the world. Autism is lifelong. The presentation varies greatly from one person to another. Each individual is unique.

People once used separate terms for different subtypes of autism. Today, many professionals and official guidelines use the broad term “autism spectrum disorder” (ASD). In the UK, the guidelines from NICE and the NHS recommend using “autism” or “autistic spectrum condition” (ASC). Understanding the range of diagnoses and profiles supports you to provide the right care and support in a health and social care setting.

What Does ‘Autism Spectrum’ Mean?

Autism is described as a “spectrum” because each person with autism can present very differently. Some may need much support; others may live independently. Communication, self-care, learning, and sensory response needs can all vary. No two autistic people are exactly alike.

Key features can include:

• Difficulties with social interaction
• Challenges with communication (spoken or non-verbal)
• Repetitive behaviours or strict routines
• Strong interests in specific things
• Unusual responses to sensory input (such as sound, touch, or light)

These features exist on a spectrum, from mild to severe. Some people have very obvious traits, others not.

Historical Diagnoses on the Autism Spectrum

Professionals once diagnosed several different “types” of autism. You might still hear these terms from older medical records, families, or individuals themselves.

• Classic autism (Kanner’s autism)
  Identified first in the 1940s. People with classic autism display significant difficulties in social communication, language, restricted interests, and often show repetitive actions. They usually have noticeable delays in speech and interaction.
• Asperger’s syndrome
  This term describes people with average or above-average intelligence without significant speech delay. Social understanding and flexibility are affected, but speech development is not noticeably behind. Many adults still identify with this label.
• Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS)
  Used when someone shows some features of autism but does not meet the full criteria for classic autism or Asperger’s syndrome.
• Childhood Disintegrative Disorder (CDD)
  This rare diagnosis described a child who develops normally for the first few years, then loses acquired skills, especially in language and social function.
• Rett Syndrome
  Mostly affects girls. It involves normal early development up to about 6–18 months, followed by a loss of skills and movement problems like repetitive hand movements. It results from a specific gene mutation and is not always considered part of the autism spectrum today.

In the UK, and elsewhere, these individual diagnoses are less commonly used now, but they form an important part of understanding the different profiles that make up the autism spectrum.

Modern Understanding and Diagnosis

Today, diagnosis does not focus so much on type or “severity” but on the impact for the individual. The autism spectrum includes anyone who meets the recognised pattern of behaviours and ways of processing information.

Official diagnostic manuals (like the DSM-5 and the ICD-11) now use “autism spectrum disorder.” Professionals look at where someone sits on the spectrum in terms of support needs. The autism spectrum covers a huge range of strengths, challenges, and abilities.

Current Diagnostic Criteria

Key areas assessed are:

• Social communication difficulties (spoken or non-spoken)
• Patterns of restricted, repetitive interests or actions
• Symptoms seen during early development (but may only become clear as social demands grow)
• Symptoms that cause significant impact in social, school, or work settings

These criteria recognise that people may show these features in very different ways, and support needs are not always linked to intelligence or academic ability.

Levels of Support Need

Assessment now considers how much support a person needs for day-to-day life. This helps plan care, education, and other services.

Support is often described in three broad levels:

• Low support needs
  People may manage many things on their own but benefit from guidance or adjustments in work, study, or social settings. Challenges may be less visible to others.
• Moderate support needs
  Requires some help for daily routines and social situations. There may be clear difficulties with communication or self-care.
• High support needs
  Needs regular or intensive assistance with communication, personal care, and everyday activities. May have significant learning difficulties or other complex needs.

Common Profiles Recognised on the Autism Spectrum

Although autism is now considered a single condition, people present with different profiles. Understanding these makes it easier for workers to recognise strengths and challenges.

1. Profile Focusing on Social Communication

Many autistic people find social interaction hard. They may:

• Not use eye contact in usual ways
• Have difficulty picking up social cues
• Seem unaware of how close to stand to others
• Struggle to start or keep up conversations
• Find it hard to understand jokes, sarcasm, or idioms

This profile includes people who might take things literally or who might prefer to be alone. Some may be very talkative but not know when to stop, or struggle to read the mood in a room.

2. Nonverbal or Minimally Verbal Profile

Some autistic people use few words, or none at all. They may communicate using:

• Gestures
• Pictures or communication boards
• Electronic devices

It is important to remember that being nonverbal does not mean someone has nothing to say or does not understand their surroundings.

3. Profile with Repetitive Behaviours or Routines

This can look like:

• Repeating certain actions, phrases, or sounds (sometimes called “stimming”)
• Insisting on the same order of actions each day
• Becoming distressed if routines are changed
• Having very strong interests in a topic or activity

These behaviours can provide comfort. They may become more obvious in stressful or unfamiliar situations.

4. Sensory Processing Profile

People may have unusual responses to sensations. Some may be oversensitive, others undersensitive, in areas such as:

• Noise
• Light
• Touch
• Smell
• Taste

This can lead to withdrawal, distress, or using objects in unexpected ways (such as smelling or licking items). Adjusting lights, noise, or the environment can help.

5. Co-occurring Learning Disability

Many, but not all, autistic people have a learning disability. This affects their ability to understand information or learn new skills at the same rate as their peers. The profile and needs are shaped by both conditions together.

6. Autism with Other Conditions

It is common for people on the autism spectrum to have other diagnoses such as:

• Attention Deficit Hyperactivity Disorder (ADHD)
• Anxiety and depression
• Epilepsy
• Dyspraxia (affecting movement and coordination)

Support should take all these aspects into account.

7. Female/External Masking Profile

Some people, often women and girls, do not show classic signs but instead “mask” or hide their autistic traits. They might copy others, learn social rules by observation, and try hard to fit in. This can cause exhaustion and anxiety and may delay diagnosis.

This group might be missed by traditional checklists that focus on signs more common in boys.

Examples of Different Autism Profiles

To give these ideas context, here are some brief examples:

• Tom is six and does not talk. He flaps his hands when excited, lines up his toys, and finds loud sounds distressing.
• Samira has a deep interest in train timetables. She speaks fluently but does not seem to notice when her friends are bored or upset.
• Aled is in his twenties, very sensitive to bright lights, and avoids busy situations. He needs support with shopping and planning meals.
• Harriet excelled at school but always felt different. At 25, she was diagnosed with autism after years of anxiety and masking social difficulties.

These examples are simplified, but they show the wide range of experiences.

The Role of Diagnosis

Having a diagnosis can help people access support, make sense of their experiences, and plan for the future. Diagnosis involves collecting information about development, behaviour, and daily life. It should involve the person and, where possible, their family or carers.

A health or social care worker may not diagnose, but recognising varied profiles and pathways to diagnosis will allow them to offer better support.

Cultural and Individual Differences

Not all cultures or families understand or describe autism in the same way. Some communities may not recognise autism or may assign different meanings to behaviour. Some people prefer “autistic person,” others use “person with autism.” The person’s own views should always be prioritised.

Impact of Recognising Profiles in Care

Recognising the full autism spectrum helps shape care and support in practical ways.

• Adapting communication methods
• Adjusting environments to reduce distress
• Supporting routines and special interests safely
• Allowing choice and control
• Encouraging independence, while meeting emotional and practical needs

By acknowledging the whole range of profiles, health and social care workers can respond flexibly. This makes life better for autistic people and their families.

Final Thoughts

Each autistic person brings a different mix of strengths, interests, and challenges. Labels change over time but the need for understanding and thoughtful, person-centred care does not. As a health and social care worker, you will meet individuals right across the autism spectrum.

Pay attention to how autism presents in each person’s daily life. Remember that support needs can change, and what works for one person may not suit another. Respect communication preferences and seek out the person’s own views and those of those who know them best.

Knowledge of the range of diagnoses and profiles allows you to see each person as an individual, not a stereotype. This understanding underpins good care, builds trust, and makes a genuine difference in people’s lives.