Autism | |
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Other names |
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Specialty | Psychiatry, clinical psychology, pediatrics, occupational medicine |
Symptoms | Difficulties in social interaction, verbal and nonverbal communication, and the presence of repetitive behavior or restricted interests |
Complications | Social isolation, educational and employment problems,[1] anxiety,[1] stress,[1] bullying, depression,[1][2] self-harm, suicidality[3][4] |
Usual onset | Early childhood |
Duration | Lifelong |
Causes | Multifactorial, with many uncertain factors |
Risk factors | Family history, certain genetic conditions, having older parents, certain prescribed drugs, perinatal and neonatal health issues |
Diagnostic method | Based on combination of clinical observation of behavior and development and comprehensive diagnostic testing completed by a team of qualified professionals (including psychiatrists, clinical psychologists, neuropsychologists, pediatricians, and speech-language pathologists). For adults, the use of a patient's written and oral history of autistic traits becomes more important |
Differential diagnosis | Intellectual disability, anxiety, bipolar disorder, depression, Rett syndrome, attention deficit hyperactivity disorder, schizoid personality disorder, selective mutism, schizophrenia, obsessive–compulsive disorder, social anxiety disorder, Einstein syndrome, PTSD,[5] learning disorders (mainly speech disorders) |
Management | Positive behavior support,[6][7] applied behavior analysis, cognitive behavioral therapy, occupational therapy, psychotropic medication,[8] speech–language pathology |
Frequency |
Autism, also called autism spectrum disorder[a] (ASD) or autism spectrum condition (ASC),[11] is a neurodevelopmental disorder characterized by symptoms of deficient reciprocal social communication and the presence of restricted, repetitive, and inflexible patterns of behavior that are impairing in multiple contexts and excessive or atypical to be developmentally and socioculturally inappropriate.[12][13] Other common signs include difficulty with social interaction, verbal and nonverbal communication, along with perseverative interests, stereotypic body movements, rigid routines, and hyper- or hypo-reactivity to sensory input. Autism is clinically regarded as a spectrum disorder, meaning that it can manifest very differently in each person. For example, some are nonspeaking, while others have proficient spoken language. Because of this, there is wide variation in the support needs of people across the autism spectrum.
Psychiatry has traditionally classified autism as a mental disorder, but the autism rights movement (and an increasing number of researchers) see autistic people as part of humanity's natural neurodiversity.[14][15] From this point of view, autistic people may also be diagnosed with a disability of some sort, but that disability may be rooted in the systemic structures of a society rather than in the person;[16] thus, proponents argue that autistic people should be accommodated rather than cured.[17] The neurodiversity perspective has led to significant controversy among those who are autistic and advocates, practitioners, and charities.[18][19]
There are many theories about the causes of autism; it is highly heritable and mainly genetic, but many genes are involved, and environmental factors may also be relevant.[20] The syndrome frequently co-occurs with attention deficit hyperactivity disorder, epilepsy, and intellectual disability and research indicates that autistic people have significantly higher rates of LGBTQ+ identities and feelings than the general population.[21][22][23] Disagreements persist about what should be included as part of the diagnosis, whether there are meaningful subtypes or stages of autism,[24] and the significance of autism-associated traits in the wider population.[25][26] The combination of broader criteria, increased awareness, and the potential increase of actual prevalence, has led to a trend of steadily considerably increasing estimates of autism prevalence since the 1990s.[27][28] The World Health Organization estimates about 1 in 100 children had autism during the period from 2012 to 2021 as that was the average estimate in studies published during that period with a trend of increasing prevalence over time.[b][9][10] Boys are also significantly far more frequently diagnosed than girls.[29] The increasing prevalence has unintentionally aided the disproven myth perpetuated by anti-vaccine activists that it is caused by vaccines.[30]
There is no cure for autism. Although early intervention services based on applied behavior analysis (ABA) can help children gain self-care, social, and language skills,[31][32][33][34] independent living is unlikely in more severe forms of the condition. Speech and occupational therapy, as well as augmentative and alternative modes of communication, are effective adjunctive therapies, but some in the autism rights movement consider ABA therapy unethical and unhelpful.[35] Pharmacological treatments may also be useful; the atypical antipsychotics risperidone and aripiprazole are empirically validated for alleviating comorbid irritability, though these drugs tend to be associated with sedation and weight gain.[36]
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