A common phrase in the autism community is “If you’ve seen one person with autism, you’ve seen one person with autism.” While the diagnostic medical codes for autism list a variety of symptoms, no two people will present with the same combination of symptoms. Further, the severity of those symptoms may vary widely.

Most people with autism have communication issues. Some people with autism have almost no spoken language capabilities. They may be able to understand spoken language but have limited ability to use spoken language themselves. Some can communicate by using American Sign Language (ASL), while others learn to express basic thoughts with the use of a tablet using apps designed for communicative purposes.

Others with autism have significant spoken language but may depend mostly on repetition of phrases they have heard before. Even for those who appear to have no spoken language challenges, certain idioms or words/phrases with multiple meanings may be confusing.

The wide variance among people with autism has been challenging for researchers for decades. Today there is a growing recognition of “the autisms” – plural. That is, there may be several underlying situations which present with similar symptoms. Those with a family history of autism may have a different underlying cause than those who had typical developmental history up to age 3 and then suddenly started displaying symptoms of autism.

The problem likely lies in the diagnostics for autism, and our limited understanding of what contributes to the symptoms identified with autism. As an analogy, consider scarlet fever. That illness was named because people only knew the symptoms – a red rash and an elevated temperature. Today, we know the underlying cause is streptococcus bacteria, so clinicians can distinguish “scarlet fever” from other viruses or bacteria that may cause a rash and fever. Someday clinicians may be able to distinguish among “the autisms”.

Some use the term “autism spectrum disorder” (ASD) to denote the many levels of symptom presentation. Until researchers better understand the underlying mechanisms of autism, this wide variety within presentation of autism will remain one of its core features.

nonPareil Institute is a 501(c)(3) nonprofit with a mission of building better futures for adults with autism. For more information, visit www.npusa.org.