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Autistic Disorder (Autism)

Adult on the autism spectrum

Autistic disorder is a form of autism. It is also known as autism, childhood autism, early infantile autism, Kanner's syndrome or infantile psychosis.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, published in 2013, eliminates autistic disorder as a formal diagnosis by dissolving it and other subtypes of autism into one diagnosis called autism spectrum disorder.

The 11th edition of the International Classification of Diseases and Related Health Problems, which is due for publication in 2019, is also likely to eliminate childhood autism as a formal diagnosis by dissolving it and other subtypes of autism into one diagnosis called autism spectrum disorder.

The 10th edition of the International Classification of Diseases and Related Health Problems, published in 2010, stated that 'childhood autism' is

'A type of pervasive developmental disorder that is defined by: (a) the presence of abnormal or impaired development that is manifest before the age of three years, and (b) the characteristic type of abnormal functioning in all the three areas of psychopathology: reciprocal social interaction, communication, and restricted, stereotyped, repetitive behaviour. In addition to these specific diagnostic features, a range of other nonspecific problems are common, such as phobias, sleeping and eating disturbances, temper tantrums, and (self-directed) aggression'

Causes

There are many possible causes of autistic disorder. For example, according to the Medical Research Council

'Most researchers believe that ASDs have a variety of causes, perhaps all affecting the same brain systems, or impeding development through disruption of different abilities necessary for social and communicative development.Whether environmental factors interact with genetic susceptibility is as yet unclear.'

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Statistics

Recent studies state that the number of people with all forms of autism cannot be precisely fixed, but it appears to be around 1 in 100 people. We do not know how many of these have autistic disorder.

Autism is present from birth, although the symptoms may not be immediately obvious. It is four times more common in boys than in girls.

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Diagnostic Criteria

ICD

ICD-11

The 11th edition of the International Classification of Diseases and Related Health Problems, which is due for publication in 2019, is likely to eliminate childhood autism as a formal diagnosis by dissolving it and other subtypes of autism into one diagnosis called autism spectrum disorder.

ICD-10

According to the International Classification of Diseases and Related Health Problems - 10th Edition, 'childhood autism' is

'A type of pervasive developmental disorder that is defined by: (a) the presence of abnormal or impaired development that is manifest before the age of three years, and (b) the characteristic type of abnormal functioning in all the three areas of psychopathology: reciprocal social interaction, communication, and restricted, stereotyped, repetitive behaviour. In addition to these specific diagnostic features, a range of other nonspecific problems are common, such as phobias, sleeping and eating disturbances, temper tantrums, and (self-directed) aggression.'

DSM

DSM 5

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders published in 2013 eliminates autistic disorder as a formal diagnosis by dissolving it and other subtypes of autism into one diagnosis called autism spectrum disorder . According to the American Psychiatric Association, this represents an effort to more accurately diagnose all individuals showing the signs of autism.

DSM 4

According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders people with autistic disorder show the following symptoms

A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3):
(1) qualitative impairment in social interaction, as manifested by at least two of the following:
a. marked impairment in the use of multiple nonverbal behaviors such as eye-to-eye gaze, facial expression, body postures,
and gestures to regulate social interaction
b. failure to develop peer relationships appropriate to developmental level
c. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by a lack of showing, bringing, or pointing out objects of interest)
d. lack of social or emotional reciprocity

(2) qualitative impairments in communication as manifested by at least one of the following:
a. delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime)
b. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others
c. stereotyped and repetitive use of language or idiosyncratic language
d. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level

(3) restricted repetitive and stereotyped patterns of behavior, interests, and activities, as manifested by at least one of the following:
a. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus
b. apparently inflexible adherence to specific, nonfunctional routines or rituals
c. stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)
d. persistent preoccupation with parts of objects

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years: (1) social interaction, (2) language as used in social communication, or (3) symbolic or imaginative play.

C. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder

Variations

Each individual will experience these symptoms to a different extent. For example, a child may have little trouble learning to speak but exhibit extremely poor social interaction. Each child will display communication, social, and behavioral patterns that are individual but fit into the overall diagnosis of autism.

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Other Conditions

Individuals with autistic disorder, like other individuals on the autism spectrum, are more likely to have a range of related conditions (comorbidities).

For example, they are more likely to have genetic syndromes (such as Fragile X Syndrome), medical conditions (such as epilepsy) or other developmental disabilities (such as ADHD).

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Issues

People with autistic disorder face many issues, including some problems and some challenges, on a day to day basis.

For example, they may find it difficult to communicate with other people or to socialise with them. And they may have additional conditions, such as epilepsy or gastro-intestinal problems, which bring their own issues.

More Information

Please see Issues, Problems and Challenges

Outcomes

Individuals with autistic disorder vary enormously but most will find it hard to cope with other people, to work or to function independently.

Realistically, the majority of children with autistic disorder can be expected to continue to need some degree of assistance as adults.

In severe form the condition may require intensive, specialised, life long care and support.

Without timely and informed help and support there can be potentially devastating outcomes for people with autistic disorder and those around them.

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Interventions

An intervention is any kind of activity (such as a treatment, a therapy or the provision of a service) that is designed to improve the quality of life for people on the autism spectrum

There are many different types of intervention and the names and numbers of interventions are increasing all the time.

Some interventions are designed to address the core features of autistic disorder (persistent difficulties with social communication and social interaction, along with restricted, repetitive patterns of behaviour, interests, or activities).

Other interventions are designed to address other issues (such as anxiety, aggression or self injurious behaviour).

Some interventions can be quite simple and straightforward. For example, if someone finds a specific situation difficult (such as being in a noisy, crowded room) you can change the situation (by reducing the noise in the room or by not asking the person to be in that room).

Other interventions may be more complex, requiring a team of professional experts and/or expensive materials and implemented over the course of many years.

Unfortunately some interventions are scientifically unfeasible and potentially hazardous. And there is currently very little scientific research to support the use of some interventions despite sometimes extravagant and misleading claims about their effectiveness.

What the research does show is that, while there is no cure for autistic disorder, some interventions do appear to help at least some individuals.

However there is no 'one-size fits all' solution. Each person with autistic disorder is a unique individual, with unique needs and abilities. The most effective interventions follow some key principles, such as being tailored to meet the unique characteristics of each individual.

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Interventions

Studies and Reviews

This page provides details of some of the most significant scientific studies and reviews on autistic disorder. 

You can find more studies and reviews on autistic disorder in our publications database.

If you know of any other studies we should include please email info@researchautism.net with the details. Thank you.

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Studies and Reviews


Other Reading

This section provides details of other publications on autistic disorder.

You can find more publications on autistic disorder in our publications database.

If you know of any other publications we should include please email info@researchautism.net with the details. 

Please note that we are unable to supply publications unless we are listed as the publisher. However, if you are a UK resident you may be able to obtain them from your local public library, your college library or direct from the publisher.

Related Other Reading


Updated
27 Jun 2018