Do we need a category for profound autism?
What about those kids who need substantial help with self-care, communication, and behavior?
Some readers of Special Education Today will likely be up in arms about an essay by Emily May in the NY Times, but others may celebrate it. In “Autism Means Too Many Things to Mean Anything,” published 16 October 2025, Ms May explains why she supports a designation of “profound autism” and considers it appropriate for her daughter.
Proposals for adopting or creating a category of profound autism in diagnostic documents are controversial. Some advocates support the creation of a category, but others do not. Among the former are, of course, the Profound Autism Alliance, a Massachusetts-based non-profit formed in 2023 that promotes community connections, research, and advocacy.
Azeen Ghorayshi of the New York Times published an article 7 October 2025 in which she examined the differing perspectives on separating individuals with severe forms of autism (those who have intellectual deficits, little or no functional language skills, self-injurious behavior) from those who have normal intelligence, language skills, and such. Ms. Ghorayshi’s article, which was entitled “Should the Autism Spectrum Be Split Apart?,” included the views of both professionals and parents.
As Ms. May noted in her essay, widely used guidance from the American Psychiatric Association has changed over the years; the category of Asperger’s Syndrome is no longer considered a distinct diagnosis in the organization’s Diagnostic and Statistical Manual (or the World Health Organization’s ISD-11).1
These discussions are important for special educators. because they can help us to understand the unique needs of individuals with autism. Whether a separate diagnostic category would be helpful to special educations, though, I think it would not. I doubt that having a diagnosis of profound autism would make any difference in whether a child qualified for special education. Those who have the level of difficulties manifested by children with profound autism would surely be found eligible by any reasonable eligibility committee. And, if we’re doing special ed the right way, once a child is eligible, the diagnostic category should no longer matter, because that child should receive an individualized education program designed to meet her or his unique educational needs (Bateman & Linden, 2017; Yell, 2021).
References
Bateman, B., & Linden, M. A. (2012). Better IEPs: How to develop legally correct and educationally useful programs. Attainment.
Grinker, R. (2007). Unstrange minds: Remapping the world of autism (fifth edition). Basic Books.
Yell, M. (2021) Developing educationally meaningful and legally sound IEPs. Rowman & Littlefield.
Footnote
I encourage readers to review Roy Grinker’s Unstrange Minds, as it provided helpful recounting of the history of the category of “autism” as well as important perspective on the matter of severity.