Autism

According to the American Psychiatric Association's Diagnostic Statistical Manual of Mental Disorders–Text Revision (DSM-IV-TR), autism, or autistic disorder, belongs to a group of pervasive developmental disorders that include Asperger's syndrome, Rett's syndrome, childhood [Page 81]disintegrative disorder, and pervasive developmental disorder not otherwise specified (PDD-NOS), also referred to as atypical autism. Three disorders from this group are combined under the “autism spectrum” umbrella: autistic disorder, Asperger's syndrome, and PDD-NOS. Asperger's syndrome is differentiated from autistic disorder in that language development is normal. A diagnosis of PDD-NOS is given when a child's symptoms meet some but not all criteria for the diagnosis of autistic disorder or Asperger's syndrome.

Autistic disorder is a neurological condition that emerges in the first 3 years of life. It disrupts sociocommunicative development and thus impairs children's ability to use spoken language in culturally normative ways. Autistic disorder is diagnostically defined in the DSM-IV-TR by a combination of impairments in social interaction and communication; atypical patterns of behavior, interests, and activities; and delays or atypical functioning before age 3 in social interaction, language, and symbolic or imaginative play. Specific symptoms include impairments in the use of eye gaze, facial expression, and gesture; failure to develop age-appropriate peer relationships; delay in spoken language development, with no attempts to compensate through alternative modes of communication, such as gesture; repetitive or idiosyncratic use of spoken language; narrow repertoire of interests and activities, and adherence to routines and rituals; and stereotyped and repetitive motor movements, such as hand or finger flapping. The severity of autistic symptoms varies across children and may change with age, often in the direction of improvement, especially if intervention and educational programs are tailored to a child's unique talents, interests, and sociocommunicative needs.

There is growing national and international concern over the rising rates of autism spectrum diagnoses and an ongoing debate about whether the rising rates truly reflect increasing prevalence or changing diagnostic criteria, improved differentiation from other diagnoses, and diagnostic migration from other clinical groupings, especially mental retardation.