Autism Then and Now: Why Our Understanding is Growing — and That’s a Beautiful Thing

By Tim Aiello, MA, LPC, NCC, ADHD-CCSP, ASDCS

Over the past 30 years, our understanding of autism has undergone a transformation.

Not just in how we talk about it, but in how we see it, study it, support it, and—most importantly—how we honor the experiences of autistic individuals. Today, autism looks very different than it did in the 1990s. And that’s not because autistic people have changed. It’s because science has grown. And that growth is a beautiful thing.

A Brief Look Back: The Autism Lens of the 90s

If you were diagnosed with autism in the early 1990s, the criteria were narrower, more rigid, and often focused on what a person couldn’t do. Autism was largely viewed through a medical deficit model. The gold standard image of autism was often a young white boy who didn’t speak, didn’t make eye contact, and had obvious repetitive behaviors.

Those who didn’t fit that mold were often misdiagnosed—or missed entirely.

Enter Asperger’s syndrome, introduced in the DSM-IV in 1994. Asperger’s was used to describe individuals who had average to above-average intelligence, fewer language delays, and more subtle forms of social difficulty. It became the go-to label for people who didn’t "look autistic" by the standards of the time. It also created an artificial line between “low-functioning” and “high-functioning” autism—a divide we now understand to be harmful and inaccurate.

Why Asperger’s Is No Longer a Diagnosis

In 2013, the DSM-5 eliminated Asperger’s syndrome as a separate diagnosis and folded it into the broader umbrella of Autism Spectrum Disorder (ASD). This was not done to erase anyone’s identity, but rather to reflect what the research was showing: autism is a spectrum, not a set of distinct boxes.

Research consistently demonstrated that there was no clear, consistent clinical distinction between those diagnosed with Asperger’s and those with high-functioning autism (Lord et al., 2012). They shared similar traits in social communication, sensory sensitivities, and focused interests.

By removing Asperger’s as a separate category, the DSM-5 aimed to capture the breadth and diversity of autism more accurately—and to reduce diagnostic ambiguity.

It’s worth noting that many people who were diagnosed with Asperger’s still use the term to describe themselves, and that identity is absolutely valid. Clinical language may evolve, but personal identity remains deeply personal.

Why Autism “Looks Different” Now

It’s not that autism itself has changed—it’s that we’re finally learning to see it.

More adults are being diagnosed than ever before, especially women, nonbinary individuals, and people of color—groups historically underrepresented in autism research (Lai & Baron-Cohen, 2015). These individuals often mask or camouflage traits, consciously or unconsciously, to navigate a neurotypical world. This camouflaging can lead to exhaustion, burnout, anxiety, and misdiagnosis (Hull et al., 2017).

As awareness grows, so does access to diagnosis and support. Our cultural lens is expanding to recognize that autistic traits show up differently across gender, culture, age, and individual experience.

From Deficit to Difference

For decades, autism was described in terms of what someone lacked. But the neurodiversity paradigm—pioneered by autistic scholars and advocates—has helped shift the conversation from deficit to difference.

Autism isn’t a broken version of “normal.” It’s a valid, diverse way of being human. That doesn’t mean autistic people don’t face real challenges—they do, especially in a society built for neurotypicals. But it reframes the narrative to one of support and respect rather than “fixing” or curing.

We’re now seeing research explore autism through strengths-based models, sensory processing profiles, and emotional regulation frameworks like Polyvagal Theory (Porges, 2011), which helps explain why many autistic individuals live in a state of chronic fight-or-flight due to a world that constantly overwhelms their nervous systems.

Science Is Supposed to Grow

Some people feel uneasy when diagnostic labels change or when science shifts its stance. But this evolution is not a failure—it’s the essence of science. When we know better, we do better.

We should be constantly learning and updating our understanding. That’s what science is—a living process, not a static set of rules carved in stone.

And what we’re learning now is deeply hopeful.

We’re learning that autistic people can thrive with the right support, accommodations, and community. We’re learning that behavior is communication, that meltdowns are often sensory overload, and that a person’s internal experience matters just as much as external presentation.

Most importantly, we’re learning to listen to autistic voices—not just observe them from the outside.

The Beauty of Evolving Understanding

Yes, autism “looks” different today. And that’s something to celebrate. We’re not just seeing new traits—we’re seeing more people for who they truly are. We're recognizing that someone can be both empathetic and autistic, social and autistic, successful and autistic.

Autism is a spectrum because people are diverse. There’s no one way to be autistic. There’s no one right way to be you.

And if science is growing to reflect that complexity and beauty, then we are absolutely moving in the right direction.

References

• Hull, L., Mandy, W., & Petrides, K. V. (2017). Behavioral and cognitive sex/gender differences in autism spectrum condition and typically developing males and females. Autism, 21(6), 706–727.

• Lai, M. C., & Baron-Cohen, S. (2015). Identifying the lost generation of adults with autism spectrum conditions. The Lancet Psychiatry, 2(11), 1013–1027.

• Lord, C., Elsabbagh, M., Baird, G., & Veenstra-VanderWeele, J. (2018). Autism spectrum disorder. The Lancet, 392(10146), 508–520.

• Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. Norton & Company.