Autism

by

James D. Herbert

• LAST REVIEWED: 19 March 2013
• LAST MODIFIED: 19 March 2013
• DOI: 10.1093/obo/9780199828340-0110

Introduction

The term “autism” refers to a heterogeneous class of related neurodevelopmental disorders that emerge early in childhood and are associated with pervasive effects across multiple areas of functioning. Autism is increasingly conceptualized as a collection of deficits and functional impairments that fall on a continuum—hence the term “autism spectrum disorders” or ASDs—rather than a single disorder. Once thought to be rare, ASDs have dramatically increased in prevalence in recent years and are now thought to affect up to one in eighty-eight children in the United States. There remains debate, however, on the extent to which there has been an actual increase in prevalence and on whether the apparent increase is attributable to better case recognition and expanded diagnostic criteria. Autism was first recognized by the medical establishment in the early 1940s, although there are various descriptions in earlier literature of individuals who would undoubtedly be understood as falling within the autistic spectrum today. Early causal theories were dominated by the psychoanalytic perspective, which blamed the condition on cold, rejecting parents (especially mothers). Although psychoanalytic accounts have been thoroughly discredited, they remain popular in some parts of the world. More recent etiological work focuses on the interactive effects of genetic and environmental factors (especially prenatal exposure to certain substances). Although there is no cure for autism, several helpful treatments have been developed, including those based on behavioral psychology, those focused on developmental interventions, and those employing structured classroom environments. In addition, pharmacotherapy can be helpful for some ASD individuals as a treatment for co-occurring problems. The scientific evidence is strongest for applied behavior analytic approaches, although some positive data also exist for certain developmental and structured learning approaches. Nevertheless, the research literature is marked by several deficiencies, including the lack of studies directly comparing these approaches, a lack of studies focused on determining the specific “active ingredients” within each approach that are responsible for their effects, and a paucity of longitudinal research, including research on adolescents and adults. Finally, for a number of reasons, autism has become a magnet for a variety of dubious, unsupported pseudoscientific theories and intervention programs. Parents, policymakers, and professionals alike would do well to adopt a skeptical attitude to simplistic claims about the causes of ASDs and about treatment programs that sound too good to be true.

General Overviews

There are a number of resources that provide useful introductory overviews of autism spectrum disorders (ASDs). The websites of the Centers for Disease Control and Prevention (Autism Spectrum Disorders) and of the National Institute of Mental Health (Autism Spectrum Disorders) are the principal official US government sites regarding autism. They both target general audiences and provide a snapshot of current knowledge about the spectrum. Carr and LeBlanc 2007 goes into somewhat more depth and briefly assesses the degree of research support for the most common interventions for autism. Newschaffer, et al. 2007, although focused primarily on epidemiology, also provides a good overview of the condition and what is known about its causes in particular. Attwood 2008 likewise provides a useful overview of the condition from the point of view of educators. Finally, Goldstein and Ozonoff 2009, although focused primarily on the assessment of ASDs, includes a couple of case examples that nicely illustrate the diversity of ASDs.

• Attwood, Tony. 2008. An overview of autism spectrum disorders. In Learners on the autism spectrum: Preparing highly qualified educators. Edited by Kari D. Buron and Pamela Wolfberg, 19–44. Shawnee Mission, KS: Autism Asperger.

  Introductory textbook chapter aimed primarily at educators. Has a useful description of the autism spectrum, including social, communication, cognitive, and sensory deficits. Outlines “tips for the classroom” for educators to consider in identifying and working with ASD children.

• Autism Spectrum Disorders (ASDs). Centers for Disease Control and Prevention.

  This official governmental website targeting general audiences provides an overview of ASDs, focusing primarily on symptoms. It includes a useful video clip. Most likely in an effort to avoid controversy, however, the site does not sufficiently distinguish scientifically well-established interventions from those with little research support.

• Carr, James E., and Linda A. LeBlanc. 2007. Autism spectrum disorders in early childhood: An overview for practicing physicians. Primary Care: Clinics in Office Practice 34.2: 343–359.

  DOI: 10.1016/j.pop.2007.04.009

  This paper is an excellent overview of the symptoms of and treatments for autism. The authors briefly note the evidence base of the most common treatments for ASDs, including scientifically supported and unsupported interventions. Although designed for physicians, the review is very accessible to wider audiences.

• Autism Spectrum Disorders (Pervasive Developmental Disorders). National Institute of Mental Health.

  Another governmental website targeting general audiences. This site is similar to the Centers for Disease Control and Prevention site and provides a useful introductory overview of basic information about ASDs. The video clip focuses on a project for pooled data collection to facilitate research.

• Goldstein, Sam, and Sally Ozonoff. 2009. Historical perspective and overview. In Assessment of autism spectrum disorders. Edited by Sam Goldstein, Sally Ozonoff, and Jack Naglieri, 1–17. New York: Guilford.

  Introductory chapter to a book on the assessment of ASDs. The chapter provides a nice overview of the history of autism and related conditions as well as a descriptive overview of ASDs. Case illustrations are used to illustrate complexities in the assessment.

• Newschaffer, Craig J., Lisa A. Croen, Julie Daniels, et al. 2007. The epidemiology of autism spectrum disorders. Annual Review of Public Health 28:235–258.

  DOI: 10.1146/annurev.publhealth.28.021406.144007

  An overview of ASDs, with particular focus on epidemiology.