Autism

[42][43] Guidelines from the US Centers for Disease Control and Prevention (CDC) and European Society for Child & Adolescent Psychiatry endorse the use of ABA on the grounds that it reduces symptoms impairing daily functioning and quality of life,[42][44] but the National Institute for Health and Care Excellence cites a lack of high-quality evidence to support its use.

Autism is currently defined as a highly variable neurodevelopmental disorder[56] that is generally thought to cover a broad and deep spectrum, manifesting very differently from one person to another.

The ICD and the DSM change over time, and there has been collaborative work toward a convergence of the two since 1980 (when DSM-III was published and ICD-9 was current), including more rigorous biological assessment—in place of historical experience—and a simplification of the classification system.

The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities.

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), released in 2022, is the current version of the DSM.

Common signs and symptoms include:[81][82] The broader autism phenotype describes people who may not have ASD but do have autistic traits, such as abnormalities in eye contact and stimming.

[109][104] Temple Grandin, an autistic woman involved in autism activism, described her inability to understand neurotypicals' social communication as leaving her feeling "like an anthropologist on Mars".

[110] Autistic people struggle to understand the social context and subtext of neurotypical conversational or printed situations, and form different conclusions about the content.

[117] As they progress through life, autistic people observe and form a model of social patterns, and develop coping mechanisms, referred to as "masking",[118][119] which have recently been found to come with psychological costs and a higher increased risk of suicidality.

[120][121] Other behavioral characteristics include abnormal responses to sensations (such as sights, sounds, touch, taste and smell) and problems keeping a consistent speech rhythm.

[162] In May 2019, the Journal of Developmental and Behavioral Pediatrics published a systematic review of 16 studies that found that children and adolescents with ASD are exposed to more screen time than typically developing peers and that the exposure starts at a younger age.

[170][171][172][173] It was long mostly presumed that there is a common cause at the genetic, cognitive, and neural levels for the social and non-social components of ASD's symptoms, described as a triad in the classic autism criteria.

[clarification needed][176] Research into causes has been hampered by the inability to identify biologically meaningful subgroups within the autistic population[177] and by the traditional boundaries between the disciplines of psychiatry, psychology, neurology and pediatrics.

[188] The large number of autistic people with unaffected family members may result from spontaneous structural variation, such as deletions, duplications or inversions in genetic material during meiosis.

[219][220] Environmental factors that have been claimed without evidence to contribute to or exacerbate autism include certain foods, infectious diseases, solvents, PCBs, phthalates and phenols used in plastic products, pesticides, brominated flame retardants, alcohol, smoking, illicit drugs, vaccines,[221] and prenatal stress.

Research exploring the evolutionary benefits of autism and associated genes has suggested that autistic people may have played a "unique role in technological spheres and understanding of natural systems" in the course of human development.

[246] In 2011, a paper in Evolutionary Psychology proposed that autistic traits, including increased spatial intelligence, concentration and memory, could have been naturally selected to enable self-sufficient foraging in a more (although not completely) solitary environment.

Because natural selection favors reproduction over health and longevity, the lack of this impetus to adapt to certain harmful circumstances creates a tendency for genes in descendant populations to over-express themselves, which may cause a wide array of maladies, ranging from mental disorders to autoimmune diseases.

[310] Intensive, sustained special education programs and behavior therapy early in life may help children acquire self-care, language, and job skills.

[305] Although evidence-based interventions for autistic children vary in their methods, many adopt a psychoeducational approach to enhancing cognitive, communication, and social skills while minimizing problem behaviors.

[316][317][318] Sandoval-Norton et al. also discuss the "unintended but damaging consequences, such as prompt dependency, psychological abuse and compliance" that result in autistic people facing challenges as they transition into adulthood.

[307] Early, intensive ABA therapy has demonstrated effectiveness in enhancing communication and adaptive functioning in preschool children;[305][327] it is also well-established for improving the intellectual performance of that age group.

[43] Similarly, a teacher-implemented intervention that utilizes a more naturalistic form of ABA combined with a developmental social pragmatic approach has been found to be beneficial in improving social-communication skills in young children, although there is less evidence in its treatment of global symptoms.

[336] SSRI antidepressants, such as fluoxetine and fluvoxamine, have been shown to be effective in reducing repetitive and ritualistic behaviors, while the stimulant medication methylphenidate is beneficial for some children with comorbid inattentiveness or hyperactivity.

[337] No known medication is approved for treating autism's core symptoms of social and communication impairments,[311] although animal models indicate that postnatal administration of MDMA may be effective.

[313] A 2020 systematic review on adults with autism provided evidence that mindfulness-based interventions may decrease stress, anxiety, ruminating thoughts, anger, and aggression and improve mental health.

[372] While it remains unclear whether this trend represents a true rise in incidence, it likely reflects changes in ASD diagnostic criteria, improved detection, and increased public awareness of autism.

[38] This increase is largely attributable to changes in diagnostic practices, referral patterns, availability of services, age at diagnosis, and public awareness,[380][381][382] particularly among women,[38] though unidentified environmental risk factors cannot be ruled out.

[401][402][388] Some autistic people, as well as a growing number of researchers,[403] have advocated a shift in attitudes toward the view that autism spectrum disorder is a difference, rather than a disease that must be treated or cured.

[422][423][393][424]In 2004, neurodiversity advocates Amy and Gwen Nelson designed the "rainbow infinity symbol", originally as the logo for their advocacy group Aspies For Freedom.