Autism is a complex developmental condition that varies widely in how it presents across individuals. One important question is whether many autism cases are hidden or “buried” within broader developmental categories, such as general developmental delays or intellectual disabilities, rather than being distinctly identified as autism. This issue arises because autism shares overlapping features with other developmental disorders, and diagnostic practices or criteria may sometimes group autistic traits under broader labels.
Autism spectrum disorder (ASD) is characterized by differences in social communication, repetitive behaviors, and restricted interests. However, these core features can also appear in other developmental conditions, making clear differentiation challenging. For example, children with global developmental delays or intellectual disabilities may show social and communication difficulties that resemble autism, but their diagnosis might focus on the broader developmental delay rather than specifically identifying autism. This can lead to under-recognition of autism in some populations.
One reason autism cases might be subsumed under broader categories is the variability in symptom severity and presentation. Autism exists on a spectrum, ranging from individuals with profound challenges, including nonverbal communication and intellectual disability, to those with subtle social differences and average or above-average intelligence. When symptoms are less pronounced or overshadowed by other developmental issues, clinicians might diagnose a general developmental disorder without specifying autism. This is especially true in younger children or in settings where detailed autism-specific assessments are not routinely performed.
Another factor is the evolving understanding and diagnostic criteria of autism. Historically, autism was often diagnosed only in cases with clear, classic symptoms, while many individuals with atypical or milder presentations were labeled with other developmental disorders. Over time, diagnostic manuals have broadened the definition of autism, but some older diagnostic practices and lack of awareness still contribute to autism being “hidden” within broader categories.
Additionally, co-occurring conditions complicate diagnosis. Many autistic individuals also experience intellectual disabilities, language delays, or other neurodevelopmental disorders. When these co-occurring conditions are prominent, they may dominate the clinical picture, leading to a diagnosis that emphasizes the broader developmental issue rather than autism specifically.
The implications of autism being buried in broader developmental categories are significant. Without a clear autism diagnosis, individuals may miss out on tailored interventions and supports designed specifically for autistic people. Autism-specific therapies often focus on social communication skills, sensory processing differences, and managing repetitive behaviors, which might not be addressed adequately if the diagnosis is more general.
Moreover, research and healthcare systems rely on accurate diagnostic categories to understand prevalence, causes, and outcomes. If man
