The question of whether autism cases are hidden behind euphemisms in clinical data touches on how language, diagnostic practices, and social attitudes influence the recognition and reporting of autism spectrum disorder (ASD). Autism is a complex neurodevelopmental condition characterized by differences in social communication, interaction, and behavior, with a wide spectrum of presentations. Over time, the terminology and diagnostic categories have evolved, and this evolution affects how autism is recorded and understood in clinical and research contexts.
One key factor is the shift in diagnostic manuals. Before 2013, autism was often diagnosed under various labels such as Asperger syndrome, classic autism, or childhood autism. These were later unified under the broader category of autism spectrum disorder in the DSM-5 and ICD-11. This change aimed to reduce overlap and confusion but also meant that some individuals previously diagnosed with distinct labels might now be grouped differently. This can create challenges in tracking prevalence and understanding the full scope of autism, as some cases might be recorded under different or broader terms rather than explicitly as autism.
Language plays a crucial role in how autism is described and perceived. In recent years, there has been a move toward neurodiversity-affirming language, which prefers terms like “characteristics” instead of “symptoms” and avoids words implying pathology or the need for a “cure.” This shift reflects a broader cultural change toward recognizing autism as a natural variation in human neurology rather than a disorder to be fixed. While this is positive for reducing stigma, it can also lead to more cautious or indirect language in clinical documentation, potentially obscuring the presence of autism behind softer or more neutral terms.
Euphemisms and inclusive language guidelines often encourage avoiding stigmatizing or overly clinical terms. For example, instead of saying someone “suffers from autism,” clinicians and advocates might say a person “has autism” or “is autistic,” emphasizing identity rather than illness. However, in some cases, this can lead to underreporting or vague descriptions in clinical data if professionals prioritize non-pathologizing language over clear diagnostic labels. This is especially true when autism traits overlap with other conditions or when individuals present with subtle or atypical features that do not fit neatly into diagnostic criteria.
Another layer is the use of people-first language versus identity-first language. Some prefer “person with autism” to emphasize the individual before the diagnosis, while others prefer “autistic person” to affirm autism as an integral part of identity. These preferences influence how autism i
