![]() ![]() Physiological disorders (e.g., gastrointestinal disorders) and genetic disorders (e.g., fragile X syndrome) may also be prevalent ( 2, 14). These include psychiatric disorders such as attention deficit hyperactivity disorder (ADHD), which is considered the most common comorbidity in people with ASD (~ 28%) ( 13), along with other conditions and diseases including anxiety and phobias, dissociative disorders, depression, bipolar disorder, and episodic mood disorders ( 13, 14). Other disorders that may co-occur with ASD. Consequently, today’s clinical diagnosis of ASD is based on assessing behaviors as outlined in APA’s DSM-5 criteria ( 2, 12). Despite recent advancements, there are currently no reliable biomarkers for ASD ( 11). ![]() However, ASD individuals tend to differ from one another, so one feature may be more prevalent than another ( 2, 10) (see Chapter 1). These core features are observed irrespective of race, ethnicity, culture, or socioeconomic status. The diagnostic features historically associated with ASD are a triad of impaired social interactions, verbal and nonverbal communication deficits, and restricted, repetitive behavior patterns. Nowadays, ASD is widely recognized as a somewhat common condition that, for many, but not all, requires lifelong support ( 2). Our knowledge of pathology, etiology, and behavior of ASD continues to evolve. Moving to the present day, due to the difficulty in defining and distinguishing between the various PDD, DSM-5 and the International Classification of Diseases 11 th revision use ‘ASD’ as a blanket term and distinguish individuals using clinical specifiers and modifiers ( 1). In 1990, autism was first classified as a disability ( 9). In the mid to late 1980s, works by Simon Baron-Cohen, Uta Frith, and Alan Leslie led to the hypothesis that autistic children lacked “theory of mind”, which is the ability to attribute mental states to others and ourselves, an essential component of social interaction ( 8). Asperger’s syndrome was eventually included in the DSM-IV in 1994 ( 7). In 1981, Wing proposed that autism is part of a wider group of conditions that share commonalities, including impairments of communication, imagination, and social interactions. In the 1980s, Wing and Gould placed autistic children on a continuum with other abnormal children and discussed autism in behavioral terms rather than psychosis ( 4, 6).Īsperger’s syndrome, an ASD named after Hans Asperger, who first described its symptomatology in 1944, gained prominence in the ASD literature due to the works of psychiatrist Lorna Wing, who coined the term in 1976 ( 4). Consequently, childhood schizophrenia was excluded from DSM-III ( 1, 4). ![]() ![]() At this point, it was recognized that the previously described symptomatology resembling schizophrenia was not a component of ASD because of the research conducted by Kolvin Rutter and others in the early 1970s. The PPD contained four categories: infantile autism, childhood-onset PDD, residual autism, and an atypical form ( 5). In 1980, the 3 rd edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM)-III), listed autism as a subgroup within the diagnostic category of pervasive developmental disorders (PDD) to convey the view that there is a broader spectrum of social communication deficits. In the 1970s, sensory deficits in infancy were recognized in autistic children and became a defining feature of ASD ( 4). Between the 1940s and 1980s, ASD was described as abnormalities in language development, display of ritualistic and compulsive behaviors, and disturbance in interpersonal relationships. Since then, the classification, diagnosis, and meaning of autism have radically changed ( 4). Swiss psychiatrist Eugen Bleuler first coined the term autism in 1908 to describe symptoms associated with severe schizophrenia, hallucinations, and unconscious fantasy in infants. These include impaired or diminished social communication skills, repetitive behaviors, and restricted sensory processing or interests ( 1– 3). Autism spectrum disorders (ASD) are complex, highly heritable neurodevelopmental diseases characterized by individuals with a combination of behavioral and cognitive impairments. ![]()
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