Autism spectrum
Autism, formally called autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental disorder marked by deficits in reciprocal social communication and the presence of restricted and repetitive patterns of behavior. Other common signs include difficulty with social interaction, verbal and nonverbal communication, along with perseverative interests, stereotypic body movements, rigid routines, and hyper- or hyporeactivity 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.
| Autism spectrum disorder | |
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| Repetitively stacking or lining up objects is a common trait associated with autism. | |
| 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, anxiety, stress, bullying, depression, self-harm |
| 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, learning disorders (mainly speech disorders) |
| Management | Applied behavior analysis, cognitive behavioral therapy, occupational therapy, psychotropic medication, speech–language pathology |
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There are many theories about what causes autism; it is highly heritable and mainly genetic, but many genes are involved, and environmental factors may also be relevant. The syndrome frequently co-occurs with other conditions, including attention deficit hyperactivity disorder, epilepsy, and intellectual disability. Disagreements persist about what should be included as part of the diagnosis, whether there are meaningful subtypes of autism, and the significance of autism-associated traits in the wider population. The combination of broader criteria, increased awareness, and potentially increasing actual prevalence, has led to a trend of steadily increasing estimates of autism prevalence, perpetuating the disproven myth that it is caused by vaccines.
Psychiatry has traditionally classified autism as a mental disorder, but the autism rights movement and an increasing number of researchers see autism as part of neurodiversity, the natural diversity in human thinking and experience, with strengths, differences, and weaknesses. From this point of view, autistic people often still have a disability, but need to be accommodated rather than cured. This perspective has led to significant controversy among those who are autistic and advocates, practitioners, and charities. As of 2023, consensus is growing among researchers of various empirical and theoretical positions that the established ASD criteria are ineffective to describe autism as a unitary biological entity, and that alternative research approaches should be encouraged.
It is not possible to cure autism. Although early intervention services based on applied behavior analysis (ABA) can help children gain self-care, social, and language skills, independent living is unlikely in more severe forms of the condition. Speech and occupational therapy, as well as implementing alternative modes of communication, are effective adjunctive therapies, but some in the autism rights movement consider ABA therapy unethical and unhelpful. Pharmacological treatments also may be useful; the atypical antipsychotics risperidone and aripiprazole are empirically validated for alleviating co-morbid irritability, though these drugs tend to be associated with weight gain and sedation.