Autism spectrum disorder

Caroline DiBattisto MD MSCR (Dr. DiBattisto of the University of South Carolina School of Medicine has no relevant financial relationships to disclose.)
Bernard Maria MD, editor. (Dr. Maria of Icahn School of Medicine at Mount Sinai and Director of Pediatric Neurology and Developmental Medicine at Goryeb Children)
Originally released September 23, 1995; last updated January 4, 2016; expires January 4, 2019

This article includes discussion of autism spectrum disorder and autism. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Autism spectrum disorder is a neurodevelopmental condition characterized by significant impairment in social communication, repetitive behaviors, restricted interests, and hyper- or hyposensitivity to sensory stimuli. In this article, the author describes the clinical features of autism spectrum disorder and summarizes recent research regarding etiology, pathogenesis, genetics, diagnosis, and management.

Key points

 

• Autism spectrum disorder is a neurodevelopmental condition characterized by social communication impairment, restricted interests, and repetitive behaviors.

 

• It is estimated that 1 in 68 children (1 in 42 boys and 1 in 189 girls) have autism spectrum disorder.

 

• Autism spectrum disorder is complex with no single or precise etiology.

 

• Early identification and behavioral treatment lead to better outcomes.

 

• Pharmacological treatment targets problem behaviors such as hyperactivity, impulsivity, aggression, and perseverative or anxious behaviors.

Historical note and terminology

In 1908, psychiatrist Eugen Bleuler used the term “autistic” to describe a form of schizophrenia. The word has the Greek roots “autos,” meaning self. In 1943, Leo Kanner described “extreme autistic aloneness,” “inability to relate,” “communication difficulties,” and “desire for the maintenance of sameness” in children (Kanner 1943). In 1944, Hans Asperger described 4 children who had difficulty with social interaction. Table 1 shows the changes to the Diagnostic and Statistical Manual of Mental Disorders classification of autism or pervasive developmental disorders over time.

Table 1. Timeline of American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) Classification of Autism

DSM-I (1952) and DSM-II (1968)

No term for autism or pervasive developmental disorder

DSM-III (1980)

Pervasive developmental disorders: infantile autism, childhood onset pervasive developmental disorder, atypical autism

DSM-III-R (1987)

Pervasive developmental disorders: autistic disorder, pervasive developmental disorder not otherwise specified

DSM-IV (1994) and DSM-IV-TR (2000)

Pervasive developmental disorders: autistic disorder, Asperger disorder, pervasive developmental disorder not otherwise specified, childhood disintegrative disorder, Rett syndrome

DSM-5 (2013)

Autism spectrum disorder

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