Classic autism

Former neurodevelopmental disorder now classified under autism spectrum disorder

This article is about the condition and diagnosis. For autism spectrum conditions not associated with a broader medical condition, see non-syndromic autism.

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Medical condition

Autism

Major brain structures implicated in autism
Specialty| Psychiatry, pediatrics, occupational medicine
Symptoms| Trouble with social interaction, verbal and nonverbal communication, and presence of restricted interests and repetitive behavior[1]
Complications| Social isolation, employment problems, stress, self-harm, suicide
Usual onset| By age two or three
Duration| Long-term
Causes| Genetic and environmental factors[2]
Diagnostic method| Based on behavior and developmental history
Differential diagnosis| Reactive attachment disorder, intellectual disability, schizophrenia[3]
Treatment| Occupational therapy, speech therapy, psychotropic medication[4][5]
Medication| Antipsychotics, antidepressants, stimulants (associated symptoms)[6]
Frequency| 24.8 million (2015)[7]

Classic autism, also known as childhood autism, autistic disorder, (early) infantile autism, infantile psychosis, Kanner's autism, Kanner's syndrome, or (formerly) just autism, is a neurodevelopmental condition first described by Leo Kanner in 1943. It is characterized by atypical and impaired development in social interaction and communication as well as restricted, repetitive behaviors, activities, and interests. These symptoms first appear in early childhood and persist throughout life.

It was last recognized as a diagnosis in the DSM-IV and ICD-10, and has been superseded by autism spectrum disorder in the DSM-5 (2013) and ICD-11 (2022). Globally, classic autism was estimated to affect 24.8 million people as of 2015[update].[7]

Autism is caused by a combination of genetic and environmental factors,[2] with genetic factors thought to heavily predominate.[8] Controversies surrounded other proposed environmental causes; for example, the vaccine hypothesis, which although disproved, continues to hold sway in certain communities.[9][10]

After DSM-5/ICD-11 the term "autism" has become more commonly used in reference to the autism spectrum more broadly.[11][12][13]

## Characteristics

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Autism is a highly variable neurodevelopmental disorder[14][15] whose symptoms first appear during infancy or childhood, and generally follows a steady course without remission.[16] Autistic people may be severely impaired in some respects but average, or even superior, in others.[17] Overt symptoms gradually begin after the age of six months and become established by age two or three years.[18] Some autistic children experience regression in their communication and social skills after reaching developmental milestones at a normal pace.[19][20] It was said to be distinguished by a characteristic triad of symptoms: impairments in social interaction, impairments in communication, and repetitive behavior.[15] Other aspects, such as atypical eating, are also common but are not essential for diagnosis.[21] Individual symptoms of autism occur in the general population and appear not to associate highly, without a sharp line separating pathologically severe from common traits.[22]

### Social development

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Autistic people have social impairments and often lack the intuition about others that many people take for granted. Unusual social development becomes apparent early in childhood. Autistic infants show less attention to social stimuli, smile and look at others less often, and respond less to their own name. Autistic toddlers differ more strikingly from social norms; for example, they have less eye contact and turn-taking, and do not have the ability to use simple movements to express themselves, such as pointing at things.[23] Three- to five-year-old autistic children are less likely to exhibit social understanding, approach others spontaneously, imitate and respond to emotions, communicate nonverbally, and take turns with others. However, they do form attachments to their primary caregivers.[24] Most autistic children displayed moderately less attachment security than neurotypical children, although this difference disappears in children with higher mental development or less pronounced autistic traits.[25] Children with high-functioning autism have more intense and frequent loneliness compared to non-autistic peers, despite the common belief that autistic children prefer to be alone. Making and maintaining friendships often proves to be difficult for autistic people. For them, the quality of friendships, not the number of friends, predicts how lonely they feel. Functional friendships, such as those resulting in invitations to parties, may affect the quality of life more deeply.[26]

### Communication

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Differences in communication may be present from the first year of life, and may include delayed onset of babbling, unusual gestures, diminished responsiveness, and vocal patterns that are not synchronized with the caregiver. In the second and third years, autistic children have less frequent and less diverse babbling, consonants, words, and word combinations; their gestures are less often integrated with words. Autistic children are less likely to make requests or share experiences, and are more likely to simply repeat others' words (echolalia)[27] or reverse pronouns.[28] Deficits in joint attention may be present -- for example, they may look at a pointing hand instead of the object to which the hand is pointing.[23] Autistic children may have difficulty with imaginative play and with developing symbols into language.[27] It is also thought that autistic and non-autistic adults produce different facial expressions, and that these differences could contribute to bidirectional communication difficulties.[29]

### Repetitive behavior

[edit]

A young autistic boy who has arranged his toys in a row

Autistic individuals can display many forms of repetitive or restricted behavior, which the Repetitive Behavior Scale-Revised (RBS-R) categorizes as follows.[30][31]

* Stereotyped behaviors: Repetitive movements, such as hand flapping, head rolling, or body rocking.
* Compulsive behaviors: Time-consuming behaviors intended to reduce the anxiety that an individual feels compelled to perform repeatedly or according to rigid rules, such as placing objects in a specific order, checking things, or handwashing.
* Sameness: Resistance to change; for example, insisting that the furniture not be moved or refusing to be interrupted.
* Ritualistic behavior: Unvarying pattern of daily activities, such as an unchanging menu or a dressing ritual.
* Restricted interests: Interests or fixations that are abnormal in theme or intensity of focus, such as preoccupation with a single television program, toy, or game.

No single repetitive or self-injurious behavior seems to be specific to autism, but autism appears to have an elevated pattern of occurrence and severity of these behaviors.[32]

### Other symptoms

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Autistic individuals may have symptoms that are independent of the diagnosis.[21] An estimated 0.5% to 10% of individuals with classic autism show unusual abilities, ranging from splinter skills such as the memorization of trivia to the extraordinarily rare talents of prodigious autistic savants.[33] Sensory abnormalities are found in over 90% of autistic people, and are considered core features by some,[21] although there is no good evidence that sensory symptoms differentiate autism from other developmental disorders.[34] An estimated 60–80% of autistic people have motor signs that include poor muscle tone, poor motor planning, and toe walking.[21]

## Causes

[edit]

Main article: Causes of autism

It was presumed initially that there was a common cause at the genetic, cognitive, and neural levels for classic autism's characteristic triad of symptoms.[35] However, over time, there was increasing evidence that autism was instead a complex and highly heritable disorder whose core aspects have distinct causes which often co-occur.[35][36][37]

Deletion (1), duplication (2), and inversion (3) are all chromosome abnormalities that have been implicated in autism.[37]

The exact causes of autism are unknown, but it is believed that both genetic and environmental factors play a role in its development.[38] Multiple studies have shown structural and functional atypicalities in the brains of autistic people.[39] Experiments have been conducted to determine if the degree of brain atypicality yields any correlation to the severity of autism. One study done by Elia et al. (2000) used magnetic resonance imaging (MRI) on the midsagittal area of the cerebrum, midbrain, cerebellar vermis, corpus callosum, and vermal lobules VI and VII to measure brain atypicalities in children with low-functioning autism. The results suggested that the midbrain structures correlate with certain developmental behavioral aspects such as motivation, mnemonic, and learning processes, though there is more research needed to confirm this.[40] Furthermore, many developmental processes may contribute to several types of brain atypicalities in autism; therefore, determining the link between such atypicalities and severity of autism proves difficult.[39]

Although theories regarding vaccines lack convincing scientific evidence, are biologically implausible,[41] and originated from a fraudulent study,[42] parental concern about a potential vaccine link with autism (and subsequent concern about ASD) has led to lower rates of childhood immunizations, outbreaks of previously controlled childhood diseases in some countries, and the preventable deaths of several children.[43][44]

## Diagnosis

[edit]

Diagnosis of classic autism was based on behavioral symptoms, not cause or mechanism.[22][45]

The ICD-10 criteria for childhood autism postulate that abnormal or impaired development is evident before the age of 3 in receptive or expressive language used in social communication, development of selective social attachments or reciprocal social interactions, or functional and symbolic play. The children would also be required to exhibit six other symptoms from three macro-categories pertaining to qualitative impairment in social interactions, quantitative abnormalities in communication, and restricted/repetitive/stereotyped patterns of behavior, interests, and activities. ICD-10 differentiates high functioning and low-functioning autistic people by diagnosing the additional code of intellectual disability.[46]

### Classification

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Classic autism was listed as autistic disorder in the fourth edition of the American Psychiatric Association's diagnostic manual, as one of the five pervasive developmental disorders (PDDs).[47] However, the PDDs were collapsed into the single diagnosis of Autism Spectrum Disorder in 2013,[47] and the WHO's diagnostic manual ICD-11 (which had listed it as childhood autism in its previous edition[48]) followed suit a few years later.[49] Classic autism was said to be characterized by widespread abnormalities of social interactions and communication, severely restricted interests, and highly repetitive behavior.[16]

Of the PDDs, Asperger syndrome was closest to classic autism in signs and likely causes; Rett syndrome and childhood disintegrative disorder share several signs with it, but were understood to potentially have unrelated causes; PDD not otherwise specified (PDD-NOS; also called atypical autism) was diagnosed when the criteria were not met for one of the other four PDDs.[50] People would usually attract a diagnosis of Asperger syndrome rather than classic autism if they showed no substantial delay in language development,[51] but early language ability was found to be a poor predictor of outcomes in adulthood.[52]

## Low-functioning autism

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Low-functioning autism (LFA) is a degree of autism marked by difficulties with social communication and interaction, challenging behavior, and differences in social or emotional reciprocity. Sleep problems, aggression, stereotypical, and self-injurious behavior are also common symptoms.[39] LFA is not a recognized diagnosis in either the DSM or the ICD.

The term overlaps with severe autism and profound autism, as opposed to mild or moderate, which do not necessarily correlate with severe and profound levels of intellectual disability, where profound is the most severe level.[53][54]

### Characterization

[edit]

Those who display symptoms for LFA usually have "impairments in all the three areas of psychopathology: reciprocal social interaction, communication, and restricted, stereotyped, repetitive behaviour".[55]

Severe impairment of social skills can be seen in people with LFA.[56] This could include a lack of eye contact,[57] inadequate body language and a lack of emotional or physical response to others' behaviors and emotions. These social impairments can cause difficulty in relationships.[39]

Communication impairments shown in people with LFA include lack of communication (both oral communication — i.e., nonverbal autism — and body language), repetitive use of words or phrases, and lack of imaginative play skills.[39] They also may respond only to very direct external social interaction from others. Specific behavioral impairments that may be exhibited by a person with LFA include adherence to nonfunctional rituals or routines, repetitive motor functions such as hand flapping or complex whole body movements, and restrictive or obsessive patterns of interest that are abnormal. Other symptoms may include preoccupation with sensory elements of play materials such as their odor, feel, or noise they generate.[citation needed]

## Prognosis and management

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This section is missing information about sources from autistic scholars, social activists, researchers, among others, would strengthen the bottom of this section. Please expand the section to include this information. Further details may exist on the talk page. (June 2023)

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Main article: Autism therapies

An autistic three-year-old points to fish in an aquarium, as part of an experiment on the effect of intensive shared-attention training on language development.[58]

There is no known cure for autism,[4] and very little research addressed long-term prognosis for classic autism.[59] Many autistic children lack social support, future employment opportunities or self-determination.[26]

The main goals when treating autistic children are to lessen associated deficits and family distress, and to increase quality of life and functional independence. In general, higher IQs are correlated with greater responsiveness to treatment and improved treatment outcomes.[60] Services should be carried out by behavior analysts, special education teachers, speech pathologists, and licensed psychologists.

Intensive, sustained special education programs and behavior therapy early in life often improves functioning and decreases symptom severity and maladaptive behaviors;[61] claims that intervention by around age three years is crucial are not substantiated.[62]

No known medication relieves autism's core symptoms of social and communication impairments.[63]

## Therapy

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### Augmentative and alternative communication

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Augmentative and alternative communication (AAC) is used for autistic people who cannot communicate orally. People who have problems speaking may be taught to use other forms of communication, such as body language, computers, interactive devices, and pictures.[64] The Picture Exchange Communication System (PECS) is a commonly used form of augmentative and alternative communication with children and adults who cannot communicate well orally. People are taught how to link pictures and symbols to their feelings, desires and observation, and may be able to link sentences together with the vocabulary that they form.[65]

### Speech-language therapy

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Speech-language therapy can help those with autism who need to develop or improve communication skills.[55] According to the organization Autism Speaks, "speech-language therapy is designed to coordinate the mechanics of speech with the meaning and social use of speech".[65] People with low-functioning autism may not be able to communicate with spoken words. Speech-language pathologists (SLP) may teach someone how to communicate more effectively with others or work on starting to develop speech patterns.[66] The SLP will create a plan that focuses on what the child needs.

### Occupational therapy

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Occupational therapy helps autistic children and adults learn everyday skills that help them with daily tasks, such as personal hygiene and movement. These skills are then integrated into their home, school, and work environments. Therapists will oftentimes help people learn to adapt their environment to their skill level.[67] An occupational therapist will create a plan based on a person's needs and desires and work with them to achieve their set goals.

### Sensory integration therapy

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Sensory integration therapy helps people with autism adapt to different kinds of sensory stimuli. Many with autism can be oversensitive to certain stimuli, such as lights or sounds, causing them to overreact. Others may not react to certain stimuli, such as someone speaking to them.[68] Therapists will create a plan that focuses on the type of stimulation the person needs integration with.

### Applied behavioral analysis (ABA)

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Applied behavioral analysis (ABA) is considered the most effective therapy for autism spectrum disorders by the American Academy of Pediatrics.[69] ABA focuses on teaching adaptive behaviors like social skills, play skills, or communication skills[70][71] and diminishing problematic behaviors like eloping or self-injury[72] by creating a specialized plan that uses behavioral therapy techniques such as positive or negative reinforcement to encourage or discourage certain behaviors over-time.[73]

### Medication

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There are no medications specifically designed to treat autism. Medication is usually used for problems as a cause of autism, such as depression, anxiety, or behavioral problems.[74] Medicines are usually used after other alternative forms of treatment have failed.[75]

### Education

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Welsh Government's code of practice on provision of autism services

Early, intensive ABA therapy has demonstrated effectiveness in enhancing communication and adaptive functioning in preschool children;[76] it is also well-established for improving the intellectual performance of that age group.[61][76] It is not known whether treatment programs for children lead to significant improvements after the children grow up,[61] and the limited research on the effectiveness of adult residential programs shows mixed results.[77]

### Alternative medicine

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Although many alternative therapies and interventions were used, few are supported by scientific studies.[78] Treatment approaches have little empirical support in quality-of-life contexts, and many programs focus on success measures that lack predictive validity and real-world relevance.[26] Some alternative treatments placed autistic individuals at risk.[79] For example, in 2005, a five-year-old child with autism was killed by botched chelation therapy (which is not recommended for autism as risks outweigh any potential benefits).[80][81][82]

## Epidemiology

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Main article: Epidemiology of autism

Reports of autism cases per 1,000 children rose considerably in the US from 1996 to 2007.

Globally, classic autism was understood to affect an estimated 24.8 million people as of 2015[update].[7] After it was recognised as a distinct disorder, reports of autism cases substantially increased, which was largely attributable to changes in diagnostic practices, referral patterns, availability of services, age at diagnosis, and public awareness[83][84] (particularly among women).[85]

Several other conditions were commonly seen in children with autism. They include:

* Intellectual disability. The percentage of autistic individuals who also met criteria for intellectual disability has been reported as anywhere from 25% to 70%, a wide variation illustrating the difficulty of assessing intelligence of individuals on the autism spectrum.[86] In comparison, for PDD-NOS the association with intellectual disability was much weaker,[87] and by definition, the diagnosis of Asperger's excluded intellectual disability.[88]
* Minor physical anomalies are significantly increased in the autistic population.[89]
* Preempted diagnoses. Although the DSM-IV ruled out the concurrent diagnosis of many other conditions along with autism, the full criteria for Attention deficit hyperactivity disorder (ADHD), Dyspraxia, Tourette syndrome, and other of these conditions were often present. As a result, modern ASD allows for these diagnoses.[90]

## History

[edit]

Further information: History of Asperger syndrome

Portrait of Victor of Aveyron, a feral child caught in 1798 who displayed possible symptoms of autism[91]

The Neo-Latin word autismus (English translation autism) was coined by the Swiss psychiatrist Eugen Bleuler in 1910 as he was defining symptoms of schizophrenia. He derived it from the Greek word autós (αὐτός, meaning "self"), and used it to mean morbid self-admiration, referring to "autistic withdrawal of the patient to his fantasies, against which any influence from outside becomes an intolerable disturbance".[92] The word autism first took its modern sense in 1938 when Hans Asperger of the Vienna University Hospital adopted Bleuler's terminology autistic psychopaths in a lecture in German about child psychology.[93] Asperger was investigating Asperger syndrome which, for various reasons, was not widely considered a separate diagnosis until 1981,[91] although both are now considered part of ASD. Leo Kanner of the Johns Hopkins Hospital first used autism in English to refer to classic autism when he introduced the label early infantile autism in a 1943 report.[28] Almost all the characteristics described in Kanner's first paper on the subject, notably "autistic aloneness" and "insistence on sameness", are still regarded as typical of the autistic spectrum of disorders.[36] Starting in the late 1960s, classic autism was established as a separate syndrome.[94]

It took until 1980 for the DSM-III to differentiate autism from childhood schizophrenia. In 1987, the DSM-III-R provided a checklist for diagnosing autism. In May 2013, the DSM-5 was released, updating the classification for pervasive developmental disorders. The grouping of disorders, including PDD-NOS, autism, Asperger syndrome, Rett syndrome, and CDD, has been removed and replaced with the general term of Autism Spectrum Disorder.[95]

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* Doja A, Roberts W (November 2006). "Immunizations and autism: a review of the literature". The Canadian Journal of Neurological Sciences. Le Journal Canadien des Sciences Neurologiques. 33 (4): 341–346. doi:10.1017/s031716710000528x. PMID 17168158.
* Gerber JS, Offit PA (February 2009). "Vaccines and autism: a tale of shifting hypotheses". Clinical Infectious Diseases. 48 (4): 456–461. doi:10.1086/596476. PMC 2908388. PMID 19128068.
* Gross L (May 2009). "A broken trust: lessons from the vaccine--autism wars". PLOS Biology. 7 (5): e1000114. doi:10.1371/journal.pbio.1000114. PMC 2682483. PMID 19478850.
* Paul R (June 2009). "Parents ask: Am I risking autism if I vaccinate my children?". Journal of Autism and Developmental Disorders. 39 (6): 962–963. doi:10.1007/s10803-009-0739-y. PMID 19363650. S2CID 34467853.
* Poland GA, Jacobson RM (January 2011). "The age-old struggle against the antivaccinationists". The New England Journal of Medicine. 364 (2): 97–99. doi:10.1056/NEJMp1010594. PMID 21226573.
44. ^ McBrien J, Murphy J, Gill D, Cronin M, O'Donovan C, Cafferkey MT (July 2003). "Measles outbreak in Dublin, 2000". The Pediatric Infectious Disease Journal. 22 (7): 580–584. doi:10.1097/00006454-200307000-00002. PMID 12867830.
45. ^ Baird G, Cass H, Slonims V (August 2003). "Diagnosis of autism". BMJ. 327 (7413): 488–493. doi:10.1136/bmj.327.7413.488. PMC 188387. PMID 12946972.
46. ^ Strunecká, A (2011). Cellular and molecular biology of autism spectrum disorders. Bentham e Books. pp. 4–5.
47. ^ a b Rosen NE, Lord C, Volkmar FR (December 2021). "The Diagnosis of Autism: From Kanner to DSM-III to DSM-5 and Beyond". Journal of Autism and Developmental Disorders. 51 (12): 4253–4270. doi:10.1007/s10803-021-04904-1. PMC 8531066. PMID 33624215.
48. ^ "ICD-10 Version:2016". icd.who.int. Retrieved 2022-04-28.
49. ^ "World Health Organisation updates classification of autism in the ICD-11 – Autism Europe". Retrieved 2022-04-28.
50. ^ Volkmar FR, State M, Klin A (January 2009). "Autism and autism spectrum disorders: diagnostic issues for the coming decade". Journal of Child Psychology and Psychiatry, and Allied Disciplines. 50 (1–2): 108–115. doi:10.1111/j.1469-7610.2008.02010.x. PMID 19220594.
51. ^ "Diagnostic criteria for 299.00 Autistic Disorder". Diagnostic and statistical manual of mental disorders: DSM-IV (4th ed.). Washington, D.C.: American Psychiatric Association. 2000. ISBN 978-0-89042-025-6. LCCN 00024852. OCLC 768475353. Archived from the original on 29 October 2013 - via Centers for Disease Control.
52. ^ Howlin P (2003-02-01). "Outcome in High-Functioning Adults with Autism with and Without Early Language Delays: Implications for the Differentiation Between Autism and Asperger Syndrome". Journal of Autism and Developmental Disorders. 33 (1): 3–13. doi:10.1023/A:1022270118899. ISSN 1573-3432. PMID 12708575. S2CID 35817450.
53. ^ Coleman, Mary; Gillberg, Christopher (2011). The Autisms. Oxford University Press. p. 192\. ISBN 978-0-19-999629-2. "For extremely low-functioning children with clinically estimated IQs of about 30 or under, [a test is suitable for those with] autism with severe and profound levels of mental retardation/intellectual disability."
54. ^ Thurm, Audrey; et al. (30 July 2019). "State of the Field: Differentiating Intellectual Disability From Autism Spectrum Disorder". Frontiers in Psychiatry. 10: 526. doi:10.3389/fpsyt.2019.00526. ISSN 1664-0640. PMC 6683759. PMID 31417436.
55. ^ a b "What is Autism, Asperger Syndrome, and Pervasive Developmental Disorders?". US Autism and Asperger Association. Retrieved 2 September 2019.
56. ^ "Autism (Autism Spectrum Disorder - ASD): Symptoms of Autism Spectrum Disorder". Otsimo. 29 April 2020. Retrieved 20 February 2021.
57. ^ "Why do those with autism avoid eye contact? Imaging studies reveal overactivation of subcortical brain structures in response to direct gaze". ScienceDaily. Retrieved 20 February 2021.
58. ^ Powell K (August 2004). "Opening a window to the autistic brain". PLOS Biology. 2 (8): E267. doi:10.1371/journal.pbio.0020267. PMC 509312. PMID 15314667.
59. ^ Seltzer MM, Shattuck P, Abbeduto L, Greenberg JS (2004). "Trajectory of development in adolescents and adults with autism". Mental Retardation and Developmental Disabilities Research Reviews. 10 (4): 234–247. doi:10.1002/mrdd.20038. PMID 15666341. S2CID 682311.
60. ^ Eldevik S, Hastings RP, Hughes JC, Jahr E, Eikeseth S, Cross S (May 2009). "Meta-analysis of Early Intensive Behavioral Intervention for children with autism". Journal of Clinical Child and Adolescent Psychology. 38 (3): 439–450. CiteSeerX 10.1.1.607.9620. doi:10.1080/15374410902851739. PMID 19437303. S2CID 205873629.
61. ^ a b c Rogers SJ, Vismara LA (January 2008). "Evidence-based comprehensive treatments for early autism". Journal of Clinical Child and Adolescent Psychology. 37 (1): 8–38. doi:10.1080/15374410701817808. PMC 2943764. PMID 18444052.
62. ^ Howlin P, Magiati I, Charman T (January 2009). "Systematic review of early intensive behavioral interventions for children with autism". American Journal on Intellectual and Developmental Disabilities. 114 (1): 23–41. doi:10.1352/2009.114:23-41. PMID 19143460.
63. ^ CDC (2022-03-09). "Treatment and Intervention Services for Autism Spectrum Disorder". Centers for Disease Control and Prevention. Retrieved 2023-12-28.
64. ^ "Augmentative and Alternative Communication (AAC)". American Speech-Language-Hearing Association.
65. ^ a b "What Treatments are Available for Speech, Language and Motor Issues?". Autism Speaks. Archived from the original on 2015-12-22. Retrieved 2015-12-16.
66. ^ "Speech and Language Therapy". Autism Education Trust.[permanent dead link]
67. ^ "Occupational Therapy's Role with Autism". American Occupational Therapy Association.
68. ^ Smith, M; Segal, J; Hutman, T. "Autism Spectrum Disorders". `{{cite journal}}`: Cite journal requires `|journal=` (help)
69. ^ Myers, Scott M.; Johnson, Chris Plauché (1 November 2007). "Management of Children With Autism Spectrum Disorders". Pediatrics. 120 (5): 1162–1182. doi:10.1542/peds.2007-2362. ISSN 0031-4005. PMID 17967921.
70. ^ "Applied Behavioral Analysis (ABA): What is ABA?". Autism partnership. 16 June 2011.
71. ^ Matson, Johnny; Hattier, Megan; Belva, Brian (January–March 2012). "Treating adaptive living skills of persons with autism using applied behavior analysis: A review". Research in Autism Spectrum Disorders. 6 (1): 271–276. doi:10.1016/j.rasd.2011.05.008.
72. ^ Summers, Jane; Sharami, Ali; Cali, Stefanie; D'Mello, Chantelle; Kako, Milena; Palikucin-Reljin, Andjelka; Savage, Melissa; Shaw, Olivia; Lunsky, Yona (November 2017). "Self-Injury in Autism Spectrum Disorder and Intellectual Disability: Exploring the Role of Reactivity to Pain and Sensory Input". Brain Sci. 7 (11): 140. doi:10.3390/brainsci7110140. PMC 5704147. PMID 29072583.
73. ^ "Applied Behavioral Strategies - Getting to Know ABA". Archived from the original on 2015-10-07. Retrieved 2015-12-16.
74. ^ National Institute of Mental Health. "Medications for Autism". Psych Central. Archived from the original on 2015-12-13. Retrieved 2015-12-16.
75. ^ Pope, J; Volkmar, Fred R. (November 14, 2014). "Medicines for Autism". `{{cite journal}}`: Cite journal requires `|journal=` (help)
76. ^ a b Eikeseth S (2009). "Outcome of comprehensive psycho-educational interventions for young children with autism". Research in Developmental Disabilities. 30 (1): 158–178. CiteSeerX 10.1.1.615.3336. doi:10.1016/j.ridd.2008.02.003. PMID 18385012.
77. ^ Van Bourgondien ME, Reichle NC, Schopler E (April 2003). "Effects of a model treatment approach on adults with autism". Journal of Autism and Developmental Disorders. 33 (2): 131–140. doi:10.1023/A:1022931224934. PMID 12757352. S2CID 30125359.
78. ^ Sigman M, Spence SJ, Wang AT (2006). "Autism from developmental and neuropsychological perspectives". Annual Review of Clinical Psychology. 2: 327–355. doi:10.1146/annurev.clinpsy.2.022305.095210. PMID 17716073.
79. ^ Tye C, Runicles AK, Whitehouse AJ, Alvares GA (2019). "Characterizing the Interplay Between Autism Spectrum Disorder and Comorbid Medical Conditions: An Integrative Review". Frontiers in Psychiatry (Review). 9: 751. doi:10.3389/fpsyt.2018.00751. PMC 6354568. PMID 30733689.
80. ^ Levy SE, Hyman SL (October 2008). "Complementary and alternative medicine treatments for children with autism spectrum disorders". Child and Adolescent Psychiatric Clinics of North America (Review). 17 (4): 803–20, ix. doi:10.1016/j.chc.2008.06.004. PMC 2597185. PMID 18775371.
81. ^ Brown MJ, Willis T, Omalu B, Leiker R (August 2006). "Deaths resulting from hypocalcemia after administration of edetate disodium: 2003-2005". Pediatrics. 118 (2): e534–e536. doi:10.1542/peds.2006-0858. PMID 16882789. S2CID 28656831. Archived from the original on 27 July 2009.
82. ^ James S, Stevenson SW, Silove N, Williams K (May 2015). James S (ed.). "Chelation for autism spectrum disorder (ASD)". The Cochrane Database of Systematic Reviews (Review) (5): CD010766. doi:10.1002/14651858.CD010766. PMID 26106752.
83. ^ Fombonne E (June 2009). "Epidemiology of pervasive developmental disorders". Pediatric Research. 65 (6): 591–598. doi:10.1203/PDR.0b013e31819e7203. PMID 19218885.
84. ^ Gernsbacher MA, Dawson M, Goldsmith HH (April 2005). "Three Reasons Not to Believe in an Autism Epidemic". Current Directions in Psychological Science. 14 (2): 55–58. doi:10.1111/j.0963-7214.2005.00334.x. PMC 4232964. PMID 25404790.
85. ^ Russell G, Stapley S, Newlove-Delgado T, Salmon A, White R, Warren F, et al. (August 2021). "Time trends in autism diagnosis over 20 years: a UK population-based cohort study". Journal of Child Psychology and Psychiatry, and Allied Disciplines. 63 (6): 674–682. doi:10.1111/jcpp.13505. hdl:10871/126929. PMID 34414570. S2CID 237242123. "The figure starkly illustrates an overall 787% increase in recorded incidence of autism diagnosis over 20 years."
86. ^ Dawson M, Mottron L, Gernsbacher MA (2008). "Learning in autism" (PDF). In Byrne JH, Roediger HL (eds.). Learning and Memory: A Comprehensive Reference. Vol. 2\. Elsevier. pp. 759–772. doi:10.1016/B978-012370509-9.00152-2. ISBN 978-0-12-370504-4. OCLC 775005136. Archived from the original (PDF) on 3 March 2012. Retrieved 26 July 2008.
87. ^ Chakrabarti S, Fombonne E (June 2001). "Pervasive developmental disorders in preschool children". JAMA. 285 (24): 3093–3099. doi:10.1001/jama.285.24.3093. PMID 11427137.
88. ^ Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Washington, D.C.: American Psychiatric Association. 2000. p. 80.
89. ^ Ozgen HM, Hop JW, Hox JJ, Beemer FA, van Engeland H (March 2010). "Minor physical anomalies in autism: a meta-analysis". Molecular Psychiatry. 15 (3): 300–307. doi:10.1038/mp.2008.75. PMID 18626481.
90. ^ American Psychiatric Association (2013). "Autism Spectrum Disorder, 299.00 (F84.0)". Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). American Psychiatric Publishing. pp. 50–59.
91. ^ a b Wolff S (August 2004). "The history of autism". European Child & Adolescent Psychiatry. 13 (4): 201–208. doi:10.1007/s00787-004-0363-5. PMID 15365889. S2CID 6106042.
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## External links

[edit]

Media related to Autism at Wikimedia Commons

Library resources about
Classic autism

* * *

* Resources in your library
* Resources in other libraries

Classification|

* ICD-10: F84.0
* ICD-9-CM: 299.00
* OMIM: 209850
* MeSH: D001321
* DiseasesDB: 1142

|

External resources|

* MedlinePlus: 001526
* eMedicine: med/3202 ped/180
* GeneReviews: Autism overview

Classic autism at Wikipedia's sister projects:

* Definitions from Wiktionary
* Media from Commons
* News from Wikinews
* Quotations from Wikiquote
* Textbooks from Wikibooks
* Data from Wikidata

* v
* t
* e

Autism

Main|

* Causes
* Diagnosis
* Epidemiology
* Epigenetics
* Heritability
* History
* Memory
* Pathophysiology
* Sex and gender
* Societal and cultural aspects
* Therapies

Diagnoses|

* Pervasive developmental disorder
* Classic autism
* Asperger syndrome
* Pervasive developmental disorder not otherwise specified
* Childhood disintegrative disorder
* High-functioning autism

Associated conditions
and phenomena|

* Alexithymia
* Autism and LGBTQ identities
* Autistic burnout
* Autistic catatonia
* Autistic masking
* Autistic meltdown
* Hyperlexia
* Late talker
* Monotropism
* Nonverbal autism
* Pathological demand avoidance
* Savant syndrome
* Special interests
* Infodumping
* Dopamine Dressing
* Stimming
* Echolalia
* Echopraxia
* Emotional dysregulation

Comorbid conditions|

* Avoidant/restrictive food intake disorder
* Attention deficit hyperactivity disorder
* Anxiety disorder
* obsessive–compulsive disorder
* Developmental coordination disorder
* Epilepsy
* Intellectual disability
* Sensory processing disorder
* Global developmental delay
* Verbal Dyspraxia

Associated syndromes|

* 22q11.2 deletion syndrome
* 22q13 deletion syndrome
* Angelman syndrome
* CHARGE syndrome
* Cohen syndrome
* Cornelia de Lange syndrome
* Down syndrome
* Fetal valproate spectrum disorder
* Fragile X syndrome
* MECP2 duplication syndrome
* Neurofibromatosis type I
* Noonan syndrome
* PTEN hamartoma tumor syndrome
* Rett syndrome
* Smith–Lemli–Opitz syndrome
* Timothy syndrome
* Tuberous sclerosis complex
* Williams syndrome

Related issues|

* Autism rights movement
* Critical autism studies
* Double empathy problem
* Multiple complex developmental disorder
* Neurodiversity
* TEACCH program
* Violence and autism

Controversies|

* Facilitated communication
* Lancet MMR autism fraud
* MMR vaccine
* Rapid prompting method
* Thiomersal
* Chelation

Diagnostic scales|

* Autism Diagnostic Interview
* Autism Diagnostic Observation Schedule
* Childhood Autism Rating Scale
* Gilliam Asperger's disorder scale

Screening scales|

* Autism-spectrum quotient
* Childhood Autism Spectrum Test
* Ritvo Autism and Asperger Diagnostic Scale

Lists|

* Autism-related topics
* Fictional characters
* Schools

Accommodations|

* Autism-friendly
* Sensory friendly

* v
* t
* e

Mental disorders (Classification)

Adult personality and behavior

| Sexual|

* Ego-dystonic sexual orientation
* Paraphilia
* Fetishism
* Voyeurism
* Sexual anhedonia
* Sexual anorexia
* Sexual maturation disorder
* Sexual relationship disorder

|

Other|

* Factitious disorder
* Munchausen syndrome
* Fear of intimacy
* Gender dysphoria
* Intermittent explosive disorder
* Dermatillomania
* Kleptomania
* Pyromania
* Trichotillomania
* Personality disorder

Childhood and learning

| Emotional and behavioral|

* ADHD
* Conduct disorder
* ODD
* Emotional and behavioral disorders
* Separation anxiety disorder
* Movement disorders
* Stereotypic
* Social functioning
* DAD
* RAD
* Selective mutism
* Speech
* Cluttering
* Stuttering
* Tic disorder
* Tourette syndrome

|

Intellectual disability|

* X-linked intellectual disability
* Lujan–Fryns syndrome

Psychological development
(developmental disabilities)|

* Pervasive
* Specific

Mood (affective)

* Bipolar
* Bipolar I
* Bipolar II
* Bipolar NOS
* Cyclothymia
* Depression
* Atypical depression
* Dysthymia
* Major depressive disorder
* Melancholic depression
* Seasonal affective disorder
* Mania

Neurological and symptomatic

| Autism spectrum|

* Autism
* Asperger syndrome
* High-functioning autism
* PDD-NOS
* Savant syndrome

|

Dementia|

* AIDS dementia complex
* Alzheimer's disease
* Creutzfeldt–Jakob disease
* Frontotemporal dementia
* Huntington's disease
* Mild cognitive impairment
* Parkinson's disease
* Pick's disease
* Sundowning
* Vascular dementia
* Wandering

Other|

* Delirium
* Organic brain syndrome
* Post-concussion syndrome

Neurotic, stress-related and somatoform

| Adjustment|

* Adjustment disorder with depressed mood

|

Anxiety|

| Phobia|

* Agoraphobia
* Childhood phobia
* Social anxiety
* Social phobia
* Anthropophobia
* Specific social phobia
* Specific phobia
* Claustrophobia

|

Other|

* Generalized anxiety disorder
* OCD
* Panic attack
* Panic disorder
* Stress
* Acute stress reaction
* PTSD

Dissociative|

* Depersonalization-derealization disorder
* Dissociative identity disorder
* Dissociative fugue
* Psychogenic amnesia

Somatic symptom|

* Body dysmorphic disorder
* Conversion disorder
* Ganser syndrome
* Globus pharyngis
* Psychogenic non-epileptic seizures
* False pregnancy
* Hypochondriasis
* Mass psychogenic illness
* Nosophobia
* Psychogenic pain
* Somatization disorder

Physiological and physical behavior

| Eating|

* Anorexia nervosa
* Bulimia nervosa
* Rumination syndrome
* Other specified feeding or eating disorder

|

Nonorganic sleep|

* Hypersomnia
* Insomnia
* Parasomnia
* Night terror
* Nightmare
* REM sleep behavior disorder

Postnatal|

* Postpartum depression
* Postpartum psychosis

Sexual desire|

* Hypersexuality
* Hypoactive sexual desire disorder

Psychoactive substances, substance abuse and substance-related

* Drug overdose
* Intoxication
* Physical dependence
* Rebound effect
* Stimulant psychosis
* Substance dependence
* Withdrawal

Schizophrenia, schizotypal and delusional

| Delusional|

* Delusional disorder
* Folie à deux

|

Psychosis and
schizophrenia-like|

* Brief reactive psychosis
* Schizoaffective disorder
* Schizophreniform disorder

Schizophrenia|

* Childhood schizophrenia
* Disorganized (hebephrenic) schizophrenia
* Pseudoneurotic schizophrenia
* Simple-type schizophrenia

Other|

* Catatonia

Symptoms and uncategorized

* Impulse-control disorder
* Klüver–Bucy syndrome
* Psychomotor agitation
* Stereotypy

* v
* t
* e

Autism resources

* Autism
* outline
* history

Awareness|

* Autism-friendly
* Autism Sunday
* Communication Shutdown
* World Autism Awareness Day

Culture|

* Autistic art
* Autism in popular culture
* Fictional characters
* Films about autism
* Circle of Friends
* Neurodiversity

Accommodations|

* Sensory friendly
* KultureCity

Therapies

| Psychotropic medication (antipsychotics)|

* Aripiprazole
* Risperidone

|

Behavioral|

* Applied behavior analysis (ABA)
* Discrete trial training (Lovaas)
* Picture exchange communication system (PECS)
* Pivotal response treatment
* Positive behavior support
* Early Start Denver Model (ESDM)
* Cognitive behavioral therapy (CBT)
* Social skills training

Developmental|

* Floortime (PLAY Project)

Controversial|

* Auditory integration training
* Aversion therapy (Judge Rotenberg Center)
* Chelation of mercury
* Facilitated communication
* Gluten-free, casein-free diet
* Hug machine
* Hyperbaric oxygen therapy
* Holding therapy
* Relationship development intervention
* Secretin
* Sensory integration therapy
* Son-Rise
* Vitamin B12

Related|

* ADHD medication
* Melatonin
* Occupational therapy
* Social Stories
* Speech therapy
* Selective serotonin reuptake inhibitors
* Structured teaching (TEACCH)

Centers

| Research|

| United States|

* Association for Science in Autism Treatment
* Autism Research Institute
* Autism Science Foundation
* Kennedy Krieger Institute
* National Alliance for Autism Research
* Simons Foundation Autism Research Initiative
* Yale Child Study Center

|

United Kingdom|

* Autism Research Centre (UK)

* Conditions and research areas
* Researchers

Therapy|

| United States|

* Center for Autism and Related Disorders (CARD)
* MIND Institute

|

Schools|

* Alpine Learning Group
* Eden II School for Autistic Children
* ESPA College (UK)
* Exceptional Minds (USA)
* New England Center for Children
* Pathlight School (Singapore)
* Rebecca School
* Sunfield Children's Home (UK)
* TreeHouse School (UK)
* Western Autistic School (Australia)

Organizations

| International|

* Autism rights movement
* Wrong Planet

|

Americas|

| United States|

* Autism Network International
* Autism Science Foundation
* Autistic Self Advocacy Network
* Autism Society of America
* Autism Speaks
* Centro Ponceño de Autismo
* Daniel Jordan Fiddle Foundation
* Generation Rescue
* Interactive Autism Network
* Interagency Autism Coordinating Committee
* LENA Foundation
* National Alliance for Autism Research
* National Council on Severe Autism
* National Database for Autism Research
* The Autism Community in Action

|

* Centro Ann Sullivan (Peru)
* Domus Instituto de Autismo (Mexico)

Asia|

* Action for Autism (India)
* Autism Resource Centre (Singapore)

Caribbean|

* Autistic Society (Trinidad and Tobago)
* Maia Chung Autism and Disabilities Foundation (Jamaica)

Europe|

| UK|

* Autism Anglia
* The Autism Directory
* Autism Awareness Campaign UK
* Autism Cymru
* Autism Plus
* Autistica
* National Autistic Society
* Sacar

|

* Specialisterne (Denmark)
* Aspies For Freedom

Oceania|

* Luke Priddis Foundation (Australia)

Literature

| Non-fiction|

* The Accidental Teacher: Life Lessons from My Silent Son
* Animals in Translation
* Aspergirls: Empowering Females with Asperger's Syndrome
* Autism's False Prophets
* Extreme Love: Autism
* Freaks, Geeks, and Asperger Syndrome: A User Guide to Adolescence
* In a Different Key
* Life, Animated
* Like Colour to the Blind
* Look Me in the Eye
* Mother Warriors
* My Autobiography
* NeuroTribes
* Nobody Nowhere
* The Reason I Jump
* Somebody Somewhere
* Son-Rise: The Miracle Continues
* Strange Son
* Switched On
* Unstrange Minds

|

Fiction|

* The Curious Incident of the Dog in the Night-Time
* Dear John
* House Rules
* Mockingbird
* Saving Max
* Speed of Dark
* The Winter Journey
* With the Light

For younger people|

* Everybody Is Different: A Book for Young People Who Have Brothers or Sisters With Autism
* Ian's Walk: A Story about Autism
* Marcelo in the Real World
* Rage: A Love Story
* Rules

Journals|

* Autism
* Autism in Adulthood
* Autism Research
* Journal of Autism and Developmental Disorders
* Molecular Autism
* Research in Autism Spectrum Disorders

* v
* t
* e

Nonverbal communication

Modalities

| Physical|

* Blushing
* Body language / Kinesics
* Body-to-body communication
* Facial expression
* Facial Action Coding System
* Microexpression
* Subtle expression
* Gesture
* List
* Speech-independent gestures
* Haptic communication
* Imitation
* Interpersonal synchrony
* Laughter
* Oculesics
* Eye contact
* Pupil dilation
* Olfaction
* Posture
* Proxemics

|

Speech|

* Affect
* Emotional prosody
* Paralanguage
* Intonation
* Loudness
* Prosody
* Rhythm
* Stress
* Tone
* Voice quality

Social context|

* Chronemics
* Conventions
* Display rules
* Habitus
* High-context and low-context cultures
* Interpersonal relationship
* Social norm

Other|

* Emoticon / Smiley
* One-bit message
* Missed call
* Silent service code

Unconscious|

* Microexpression
* Non-verbal leakage

Multi-faceted|

* Affect display
* Deception
* Emotion recognition
* First impression
* Intimacy

Broader concepts

* Basic interpersonal communicative skills
* Communication
* Emotional intelligence
* Nunchi
* People skills
* Semiotics
* Social behavior
* Social cue
* Social competence
* Social skills
* Unsaid

Further information

| Disorders|

* Aprosodia
* Asperger syndrome
* Autism
* Fragile X
* Pervasive developmental disorder not otherwise specified
* Childhood disintegrative disorder
* Rett syndrome
* Dyssemia
* Nonverbal learning disorder
* Social (pragmatic) communication disorder

|

Neuroanatomy|

* Limbic system / Limbic lobe
* Mirror neuron

Applications|

* Cold reading
* Lie detection
* Freudian slip
* Poker tell
* Targeted advertising

Technology|

* Computer processing of body language
* Emotion recognition in conversation
* Gesture recognition
* List of facial expression databases
* Sentiment analysis

Key people|

* Ray Birdwhistell
* Charles Darwin
* Paul Ekman

Related|

* Animal communication
* Behavioral communication
* Aggressive
* Assertive
* Passive
* Passive-aggressive
* Impression management
* Meta-communication
* Monastic sign lexicons
* Verbal communication

Non-verbal language|

* Sign language
* Tactile signing
* Tadoma

Art and literature|

* Mime
* Mimoplastic art
* Subtext

Authority control databases |

* IdRef

|

*[v]: View this template
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*[e]: Edit this template