Autism: document information and overview

Autism is a very complex neurodevelopmental disorder previously classified in the diagnostic and statistical manual of mental disorders -- fourth edition -- text revision (DSM -- IV -- TR) as a pervasive developmental disorder (American Psychiatric Association [APA], 2000). In 2013 the diagnostic scheme for pervasive developmental disorders was changed and that term was deleted from the DSM-5 (APA, 2013). The new designation became Autistic Spectrum Disorders (ASD's) and now represents a heterogeneous set of disorders that clinically present as a spectrum of developmental issues ranging from severe cognitive impairment to functional cognitive impairment. The diagnosis of ASD replaces the previous diagnoses of autistic disorder (often called autism), Asperger's disorder, childhood disintegrative disorder, and the rather vague category of pervasive developmental disorder that is not otherwise specified (APA, 2013). ASD's are characterized by varying levels of deficits in social skills (these skills are identified as being deficits in skills of social interaction and social communication) and the presence of restrictive repetitive behaviors (RPR; these can include actual repetitive behavior such as hand flapping or such things as interests or other activities). In order to be diagnosed with an ASD the child must display both of these symptoms to some degree (APA, 2013). If the child demonstrates only symptomatic problems with communication and social interaction without the presence of any RPR's the diagnosis of a social communication disorder is now deemed appropriate by the APA (APA, 2013).

Deficits and Etiology

In nearly every case of autism the disorder is recognized at an early age, often before the age of three, and the core symptoms are recognized. The core symptoms of autism include the following:

A. Difficulties in the child's ability to understand and interpret the intentions or emotions other people display. For instance, an early common symptom of children with autism is the observation that children with ASD do not reciprocate smiles, whereas young babies without ASD instinctively reciprocate smiles and produce smiles as a means to garner attention from adults (APA, 2000, 2013; Sadock & Sadock, 2007). In addition, autistic children also do not respond to changes in voice inflection (APA, 2000, 2013; Sadock & Sadock, 2007).

B. ASD children display a reduced capacity for social interaction and communication. Often parents will notice quite early that these children lack the ability to respond to their attempts to get the child to reciprocate emotions such as happiness, cooing, and so forth. Children ASD appeared to be very detached and distant, often at a very early age. It is very common for children with ASD to demonstrate extreme delays in verbal abilities such as age of onset where children typically begin to talk (APA, 2000, 2013; Sadock & Sadock, 2007).

C. Children with ASD's often have an odd preoccupation with a subject or activity that is very different from the types of preoccupations that young children typically display (APA, 2000, 2013; Sadock & Sadock, 2007). For instance, a common symptom of ASD children his hand flapping were the child leaves their hand back and forth for hours at a time. Other children demonstrate preoccupations with activities that normal children their age typically do not immerse themselves in such as street addresses, numbers, trivial facts that only adults to be interested in, etc. (APA, 2000, 2013; Sadock & Sadock, 2007).

In the early 1900s the incidence of autistic births was estimated to be less than one in 1000. Prevalence rates for autism have been on the rise since the year 2000; however, this is most likely due to better recognition and diagnostic procedures as well as changes in the diagnostic criteria that are used to diagnose the former pervasive developmental disorders and current ASD's as opposed to theories such as autism being caused by vaccines such as the MMR vaccine (see Jain, Marshall, Buikema et al., 2015; King & Bearman, 2009).

There are several risk factors for a child developing an ASD. There many are genetic factors that have been empirically established with the presence of ASD's in children; however, at the current time there is no definite genetic etiology that can explain the development of an ASD (APA, 2000, 2013; Sadock & Sadock, 2007). Overall findings suggest that the development of an ASD is most likely triggered by an interaction of many factors such as genes interacting with environmental factors.