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Autism, referred to in clinical contexts as autism spectrum disorder (ASD), is a neurodevelopmental condition characterized by difficulties in social interaction, verbal and nonverbal communication; the presence of repetitive behavior and restricted interests; and uncommon responses to sensory stimuli. Being a spectrum, autism manifests in various ways, and support needs vary widely between different autistic people. For example, some are nonspeaking, while others have proficient spoken language.

Health authorities classify autism as a neurodevelopmental disorder, characterised by deficits.[1][2][3][4][5] An alternative perspective, arising out of autistic communities,[6] is neurodiversity, which positions autism as a healthy part of the diversity of humankind, rather than a disorder — with advantages, as well as disadvantages. This is usually associated with some version of the social model of disability,[7] suggesting that disability generally arises when a person's environment does not accommodate their needs.[8] It can also be argued that autism can be inherently disabling.[9][10] There is a significant controversy between the neurodiversity perspective and the medical model of disability among autistic people, practitioners, researchers and charities.[11][12] Support for the neurodiversity approach has increased substantially in recent years among all of these groups.[13][14]

The causes of autism are unknown in most individual cases. Research shows that autism is highly heritable and polygenic. Environmental factors are also relevant.[15][16][17] Autism frequently co-occurs with attention deficit hyperactivity disorder (ADHD), epilepsy, intellectual disability, hypermobility[18] and gastrointestinal problems.[19] Research indicates that autistic people have significantly higher rates of LGBTQ+ identities and feelings than the general population.[20][21][22] Autistic people are also significantly more likely to experience anxiety and depression, especially if they feel the need to mask their autism.[23]

There is ongoing debate within the autism community and among researchers regarding diagnostic criteria, whether there are meaningful subtypes or stages of autism,[24] and the significance of autism-associated traits in the wider population.[25][26] Estimates of autism prevalence have increased considerably since the 1990s, mainly due to the combination of broader criteria and increased awareness; there is disagreement on whether the actual prevalence has increased.[27][28][29] The increase in reported prevalence has reinforced the completely debunked pseudo-scientific conspiracy theory perpetuated by anti-vaccine activists that autism is caused by vaccines.[30] Boys are more frequently diagnosed than girls,[31] although this gap has been narrowing.[32]

  1. ^ (World Health Organization: International Classification of Diseases version 11 (ICD-11)): https://icd.who.int/browse/2024-01/mms/en#437815624
  2. ^ "Overview | Autism spectrum disorder in under 19s: support and management | Guidance". www.nice.org.uk. 2013-08-28. Retrieved 2024-11-02.
  3. ^ "IACC Subcommittee Diagnostic Criteria - DSM-5 Planning Group". iacc.hhs.gov. Retrieved 1 August 2024.
  4. ^ National Consultation Meeting for Developing IAP Guidelines on Neuro Developmental Disorders under the aegis of IAP Childhood Disability Group and the Committee on Child Development and Neurodevelopmental Disorders; Dalwai, Samir; Ahmed, Shabina; Udani, Vrajesh; Mundkur, Nandini; Kamath, S. S.; C Nair, M. K. (2017-05-15). "Consensus Statement of the Indian Academy of Pediatrics on Evaluation and Management of Autism Spectrum Disorder". Indian Pediatrics. 54 (5): 385–393. doi:10.1007/s13312-017-1112-4. ISSN 0974-7559. PMID 28368272.
  5. ^ Howes, Oliver D; Rogdaki, Maria; Findon, James L; Wichers, Robert H; Charman, Tony; King, Bryan H; Loth, Eva; McAlonan, Gráinne M; McCracken, James T; Parr, Jeremy R; Povey, Carol; Santosh, Paramala; Wallace, Simon; Simonoff, Emily; Murphy, Declan G (2018-01-01). "Autism spectrum disorder: Consensus guidelines on assessment, treatment and research from the British Association for Psychopharmacology". Journal of Psychopharmacology. 32 (1): 3–29. doi:10.1177/0269881117741766. ISSN 0269-8811. PMC 5805024. PMID 29237331.
  6. ^ Kapp, Steven K., ed. (2020). "Autistic Community and the Neurodiversity Movement". SpringerLink. doi:10.1007/978-981-13-8437-0.
  7. ^ Dwyer, Patrick; Gurba, Ava N; Kapp, Steven K; Kilgallon, Elizabeth; Hersh, Lynnette H; Chang, David S; Rivera, Susan M; Gillespie-Lynch, Kristen (2024-09-18). "Community views of neurodiversity, models of disability and autism intervention: Mixed methods reveal shared goals and key tensions". Autism: 13623613241273029. doi:10.1177/13623613241273029. ISSN 1362-3613.
  8. ^ Shakespeare, Tom (1997). "The Social Model of Disability". In Davis, Lennard J. (ed.). The disability studies reader (PDF). New York: Routledge. ISBN 978-0-415-91470-3.{{cite book}}: CS1 maint: date and year (link)
  9. ^ Nelson RH (2021). "A Critique of the Neurodiversity View". Journal of Applied Philosophy. 38 (2): 335–347. doi:10.1111/japp.12470.
  10. ^ Shields, Kenneth; Beversdorf, David (1 July 2021). "A Dilemma For Neurodiversity". Neuroethics. 14 (2): 125–141. doi:10.1007/s12152-020-09431-x. ISSN 1874-5504.
  11. ^ Robison JE (2020). "My Time with Autism Speaks". In Kapp SK (ed.). Autistic Community and the Neurodiversity Movement: Stories from the Frontline. Singapore: Springer. pp. 221–232. doi:10.1007/978-981-13-8437-0_16. ISBN 978-981-13-8437-0. S2CID 210496353.
  12. ^ Opar, Alisa (24 April 2019). "In search of truce in the autism wars". Spectrum. Simons Foundation. doi:10.53053/VRKL4748. S2CID 249140855. Archived from the original on 8 July 2022. Retrieved 9 July 2022.
  13. ^ "Moving from Disorder to Difference: A Systematic Review of Recent Language Use in Autism Research". Autism in Adulthood.
  14. ^ "Annual Research Review: Shifting from 'normal science' to neurodiversity in autism science". Journal of Child Psychology and Psychiatry.
  15. ^ Hodges, Holly; Fealko, Casey; Soares, Neelkamal (February 2020). "Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation". Translational Pediatrics. 9 (Suppl 1): S55–S5S65. doi:10.21037/tp.2019.09.09. ISSN 2224-4344. PMC 7082249. PMID 32206584.
  16. ^ Ratajczak, Helen V. (2011-03-01). "Theoretical aspects of autism: Causes—A review". Journal of Immunotoxicology. 8 (1): 68–79. doi:10.3109/1547691X.2010.545086. ISSN 1547-691X. PMID 21299355.
  17. ^ Mandy W, Lai MC (March 2016). "Annual Research Review: The role of the environment in the developmental psychopathology of autism spectrum condition". Journal of Child Psychology and Psychiatry, and Allied Disciplines. 57 (3): 271–292. doi:10.1111/jcpp.12501. eISSN 1469-7610. ISSN 0021-9630. OCLC 01307942. PMID 26782158.
  18. ^ Donaghy, Bethany; Moore, David; Green, Jane (2023-01-02). "Co-Occurring Physical Health Challenges in Neurodivergent Children and Young People: A Topical Review and Recommendation". Child Care in Practice. 29 (1): 3–21. doi:10.1080/13575279.2022.2149471. ISSN 1357-5279.
  19. ^ Leader, Geraldine; Abberton, Cathal; Cunningham, Stephen; Gilmartin, Katie; Grudzien, Margo; Higgins, Emily; Joshi, Lokesh; Whelan, Sally; Mannion, Arlene (January 2022). "Gastrointestinal Symptoms in Autism Spectrum Disorder: A Systematic Review". Nutrients. 14 (7): 1471. doi:10.3390/nu14071471. ISSN 2072-6643.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  20. ^ Bertelli, Marco O.; Azeem, Muhammad Waqar; Underwood, Lisa; Scattoni, Maria Luisa; Persico, Antonio M.; Ricciardello, Arianna; Sappok, Tanja; Bergmann, Thomas; Keller, Roberto (2022), Bertelli, Marco O.; Deb, Shoumitro (Shoumi); Munir, Kerim; Hassiotis, Angela (eds.), "Autism Spectrum Disorder", Textbook of Psychiatry for Intellectual Disability and Autism Spectrum Disorder, Cham: Springer International Publishing, p. 391, doi:10.1007/978-3-319-95720-3_16, ISBN 978-3-319-95720-3, retrieved 8 June 2022, Persons with autism spectrum disorder and/or other neurodevelopmental problems are more likely than the general population to have transgender identity, non-heterosexual sexual orientation, and other gender non-conformities.
  21. ^ Lord, Catherine; Charman, Tony; Havdahl, Alexandra; Carbone, Paul; Anagnostou, Evdokia; Boyd, Brian; Carr, Themba; de Vries, Petrus J; Dissanayake, Cheryl; Divan, Gauri; et al. (2022). "The Lancet Commission on the future of care and clinical research in autism" (PDF). The Lancet. 399 (10321): 299–300. doi:10.1016/s0140-6736(21)01541-5. hdl:11250/2975811. PMID 34883054. S2CID 244917920 – via Norwegian Institute of Public Health.
  22. ^ Graham Holmes, Laura; Ames, Jennifer L.; Massolo, Maria L.; Nunez, Denise M.; Croen, Lisa A. (1 April 2022). "Improving the Sexual and Reproductive Health and Health Care of Autistic People". Pediatrics. 149 (Supplement 4). American Academy of Pediatrics: e2020049437J. doi:10.1542/peds.2020-049437J. ISSN 0031-4005. PMID 35363286. A substantial proportion of autistic adolescents and adults are LGBTQIA+. Autistic people are more likely to be transgender or gender nonconforming compared with non-autistic people, and findings from a recent autism registry study suggest that among autistic people able to self-report on a survey, up to 18% of men and 43% of women may be sexual minorities.
  23. ^ "Camouflaging in autism: A systematic review". Clinical Psychology Review.
  24. ^ 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.fix this citation
  25. ^ Losh M, Adolphs R, Piven J (2011). "The Broad Autism Phenotype". Autism Spectrum Disorders. Oxford University Press. pp. 457–476. doi:10.1093/med/9780195371826.003.0031. ISBN 978-0-19-996521-2.
  26. ^ Chapman R, Veit W (November 2021). "Correction to: The essence of autism: fact or artefact?". Molecular Psychiatry. 26 (11): 7069. doi:10.1038/s41380-021-01057-6. PMID 34697454. S2CID 239771302.
  27. ^ Wazana A, Bresnahan M, Kline J (June 2007). "The autism epidemic: fact or artifact?". Journal of the American Academy of Child and Adolescent Psychiatry. 46 (6): 721–730. doi:10.1097/chi.0b013e31804a7f3b. PMID 17513984.
  28. ^ 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. eISSN 1469-7610. hdl:10871/126929. ISSN 0021-9630. OCLC 01307942. PMID 34414570. S2CID 237242123. The figure starkly illustrates an overall 787% increase in recorded incidence of autism diagnosis over 20 years.
  29. ^ "Autism phenotype versus registered diagnosis in Swedish children: prevalence trends over 10 years in general population samples". The BMJ.
  30. ^ DeStefano F, Shimabukuro TT (September 2019). "The MMR Vaccine and Autism". Annual Review of Virology. 6 (1): 585–600. doi:10.1146/annurev-virology-092818-015515. PMC 6768751. PMID 30986133.
  31. ^ Maenner MJ, Shaw KA, Baio J, Washington A, Patrick M, DiRienzo M, et al. (March 2020). "Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years - Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016". MMWR. Surveillance Summaries. 69 (4): 1–12. doi:10.15585/mmwr.ss6904a1. PMC 7119644. PMID 32214087.
  32. ^ "What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis". Journal of the American Academy of Child and Adolescent Psychiatry.
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