Autism
In 2013, the American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual. This document unified previous labels like Asperger syndrome and childhood autism into a single diagnosis called autism spectrum disorder. Before this change, clinicians used separate terms for what they now consider variations of the same condition. The new framework recognizes that presentations vary widely from minimal support needs to requiring 24-hour care. A formal diagnosis requires professional assessment showing these characteristics cause significant challenges in daily life beyond expectations given age and social environment. Autistic people may be significantly disabled in some respects but average or superior in others. Features are present from early childhood and typically persist throughout life. Social communication differences often include little or no babbling in infancy. Many autistic children develop language skills at an uneven pace with speech emerging later than typical or not at all.
Hundreds of different genes influence the likelihood of being autistic according to current research. Most loci individually explain less than one percent of autism cases while having only small effects. Twin studies indicate that genetic factors explain most of the risk with shared environmental effects playing a minor role. If parents have one autistic child the chance of having a second ranges from seven to twenty percent. Autism is associated with genes influencing neural development and connectivity involved in key neuronal processes such as protein synthesis and synaptic activity. Research has identified lower expression of genes linked to the inhibitory neurotransmitter gamma-aminobutyric acid alongside higher expression of genes associated with glial cells. Some hypotheses suggest autism-associated genes may persist because of proposed links to traits like intelligence or systematizing abilities. Advanced parental age increases the likelihood of autism though no single factor is conclusive. Certain medications during pregnancy like valproate and exposure to significant air pollution may increase risk. No convincing scientific evidence supports claims linking vaccines to autism despite widespread belief.
In 1998 British physician Andrew Wakefield led a fraudulent study suggesting the MMR vaccine causes autism. His co-authors later recanted the claims made in the study. Wakefield was struck off the British medical register for serious professional misconduct after determination that his involvement amounted to fraud leading to loss of his right to practice medicine. A 2014 meta-analysis examined ten major studies on autism and vaccines involving 1.25 million children worldwide concluding neither thimerosal nor the MMR vaccine lead to autism. The rate of autism continues to climb despite elimination of thimerosal from most routine vaccines given to children from birth to six years of age. Misplaced parental concern has led to lower rates of childhood immunizations causing outbreaks of previously controlled diseases. In the mid-20th century work on autism proposed the frigid mother hypothesis claiming poor parenting leads to autism. This hypothesis contributed to considerable media attention but has since fallen out of favor and garnered no support when studied. Blame placed on parents especially mothers has contributed to substantial stigma against families raising autistic children.
Research suggests autistic people may have contributed uniquely to human development particularly in technological innovation such as tool-making. Systematic reviews emphasize these ideas remain speculative with no single evolutionary explanation established yet. Some hypotheses propose autism-associated genes persist because of links to traits like intelligence or systematizing abilities. Autistic people are significantly more likely to be LGBTQ than the general population according to recent research. They are also significantly more likely to be non-theistic or non-religious. Environmental activist Greta Thunberg has spoken favorably about her autism diagnosis saying it can be a source of life purpose. Entrepreneur Bill Gates wrote If I were growing up today I probably would be diagnosed on the autism spectrum. The Intense World Theory proposes higher neural responsiveness leads to more intense sensory perception shaping experience. The Enhanced Perceptual Functioning model posits superior auditory and visual functioning is root cause of specific cognitive patterns observed in autistic people.
The DSM-5 released in 2013 was first to define ASD as single diagnosis combining previously distinct labels. Before this manual social deficits and communication deficits separated into two domains. The DSM-5 revised onset criteria specifying symptoms appear in early developmental period noting they may manifest later when social demands exceed capabilities. Previous editions required onset before age three. The World Health Organization's International Classification of Diseases version 11 came into full effect in 2022 describing autism spectrum disorder as neurodevelopmental disorder. Since 1980 committees behind both manuals aimed for greater convergence incorporating biological research while keeping behavior-based criteria. DSM-5 specifies three levels of support needs while ICD-11 records whether person has co-occurring intellectual disability or language impairment. Some researchers question existing criteria capturing full phenomenon prompting proposals for prototype descriptions or transdiagnostic biological markers. Others propose alternatives deconstructing autism into separate phenomena including non-pathological spectrum of behavioral traits in general population.
No medication addresses core features of autism though some help manage commonly co-occurring conditions like anxiety depression irritability ADHD and epilepsy. More than half of autistic children in United States are prescribed psychoactive drugs or anticonvulsants. Among antipsychotics risperidone and aripiprazole only medications approved by U.S. Food and Drug Administration specifically for reducing irritability aggression and self-injurious behaviors. These drugs can have significant side effects with responses varying widely. Applied behavior analysis aims to teach social behaviors using rewards and reinforcement learning. Early intensive ABA therapy demonstrated effectiveness enhancing preschool children's language skills adaptive functioning and intellectual performance. However Sandoval-Norton et al describe it as unethical arguing unintended consequences include prompt dependency susceptibility to psychological abuse and overemphasis on compliance. Inclusive education models strive supporting autistic students in mainstream settings moving away from segregated special education environments toward participation alongside peers despite barriers leading to trauma or emotionally-based school non-attendance.
Some autistic people advocate shift in attitudes viewing autism as difference rather than disease requiring treatment or cure. The neurodiversity movement describes autism spectrum as result of healthy valuable variations in human brain rather than disorder to be cured. Autism rights advocates believe spectrum is genetic should accepted as healthy variation in human genome. Clinical policy guidance in Australia United States and United Kingdom now promote neurodiversity-affirming language using characteristics instead of symptoms avoiding words like cure. Events related to autism include World Autism Awareness Day Autistic Pride Day and Autreat. Critics bemoan entrenchment of some groups opinions speaking to select group with limited difficulties. Common argument against activists most have relatively low support needs or are self-diagnosed not representing views of those with higher support needs. About 85% of autistic people need support with independent living in adulthood according to recent data. Factors such as developing spoken language before age six having IQ above 50 possessing marketable skills associated with higher likelihood of independent living.
Common questions
When did the American Psychiatric Association release the fifth edition of its Diagnostic and Statistical Manual?
The American Psychiatric Association released the fifth edition of its Diagnostic and Statistical Manual in 2013. This document unified previous labels like Asperger syndrome and childhood autism into a single diagnosis called autism spectrum disorder.
What genes influence the likelihood of being autistic according to current research?
Hundreds of different genes influence the likelihood of being autistic according to current research. Autism is associated with genes influencing neural development and connectivity involved in key neuronal processes such as protein synthesis and synaptic activity.
Who led the fraudulent study suggesting the MMR vaccine causes autism in 1998?
British physician Andrew Wakefield led a fraudulent study suggesting the MMR vaccine causes autism in 1998. His co-authors later recanted the claims made in the study and he was struck off the British medical register for serious professional misconduct after determination that his involvement amounted to fraud leading to loss of his right to practice medicine.
Which medications are approved by U.S. Food and Drug Administration specifically for reducing irritability aggression and self-injurious behaviors in autism?
Among antipsychotics risperidone and aripiprazole only medications approved by U.S. Food and Drug Administration specifically for reducing irritability aggression and self-injurious behaviors. These drugs can have significant side effects with responses varying widely.
When did the World Health Organization's International Classification of Diseases version 11 come into full effect describing autism spectrum disorder?
The World Health Organization's International Classification of Diseases version 11 came into full effect in 2022 describing autism spectrum disorder as neurodevelopmental disorder. Since 1980 committees behind both manuals aimed for greater convergence incorporating biological research while keeping behavior-based criteria.