Autism spectrum disorder: characteristics, causes, and practical issues

Part I. What is autism? : 1. Historical background : Early case reports

The first attempts to identify autism as a distinct condition : Kanner's and Asperger's seminal accounts; Two blind alleys; Back to Kanner

The first official definitions : Diagnostic and Statistical Manual (DSM) definitions; International Classification of Diseases (ICD) definitions

2. Current concept and definition : DSM-5 concept and definition : Diagnostic criteria for autism spectrum disorder ; Changes from DSM-IV to DSM-5

Why the changes? : Why abandon subtypes in favour of a 'spectrum'? ; Why only two core impairments? ; Why are sensory anomalies included? ; Why add 'descriptors'? ; Why the changed status of impaired language? ; Why allow for late diagnosis? ; 'Social communication disorder': what is it, and why is it mentioned?

Objections to the changes : People with an existing subtypes diagnosis, and their families ; Professionals, especially clinicians and researchers

Applying the criteria in practice : Generalised versus manifest behaviour

3. The fuller picture: shared characteristics : Expanding the diagnostic descriptions : Social, emotional and communicative impairments ; Restricted, repetitive behaviours and sensory-perceptual anomalies

Some additional shared characteristics : Imagination and creativity: strengths and weaknesses ; Islets of ability ; Motor skills: strengths and weaknesses ; Impaired sense of self

4. The fuller picture: sources of diversity : Major specifiers : Learning disability ; Language impairment

Minor specifiers : Comorbid physical and medical conditions ; Mental health problems ; Neurodevelopmental problems ; Behavioural problems

Individual differences

5. Facts and figures: epidemiology and lifespan development : Epidemiology : Frequency of occurrence of ASD ; Distribution of cases of ASD : Age of onset ; The developmental trajectory: continuities and change ; Adult outcomes ; Judging long-term outcomes

Part II. What causes autism? : 6. A framework for explaining autism : Why explaining autism is important

Complications and simplifications : Identifying a realistic agenda ; Keeping the explanatory levels apart and putting them together ; Simplifying the search for causes

Assessing the merits of causal theories : Some points to bear in mind ; Criteria for judging the strength of theories

7. Root causes : Introduction : Idiopathic and syndromic forms of ASD ; The concept of risk factors

Genetic risk factors : What are 'genetic risk factors'? ; Evidence for the involvement of genetic factors ; Current knowledge of genetic risk factors for ASD ; Genetic risk factors and abnormal brain development

Environmental risk factors : What are 'Environmental risk factors'? ; Evidence for the involvement of environmental risk factors in ASD ; Current knowledge of environmental risk factors in ASD ; Environmental risk factors and abnormal brain development

Brain bases : The neurotypical brain : Neurotypical brain structure ; Neurotypical brain chemistry ; Neurotypical brain function ; Neurotypical brain development

8. The autistic brain : Brain structure in ASD ; Brain chemistry in ASD ; Brain function in ASD ; Brain development in ASD

Comment

9. Proximal causes 1: Diagnostic behaviours : Socio-emotional-communicative impairments : What has to be explained ; Explanatory theories

Restricted and repetitive behaviours : What has to be explained ; explanatory theories

10. Proximal causes 2: Additional shared characteristics and major specifiers : Additional shared characteristics : Imagination and creativity: strengths and weaknesses ; Islets of ability ; Uneven motor skills ; Impaired sense of self

Major specifiers : Learning disability ; Language impairment

Part III. Practical issues : Assessment, diagnosis and screening : Assessment

Diagnosis : Why diagnose? ; The diagnostic pathway ; Methods for diagnosing ASD

Screening : Why screen? ; Methods of screening for ASD

Intervention : The aims of intervention

Pros and cons of intervention : Prevention and cure ; Treatment

Possibilities for prevention and cure : Prevention ; Care

Treatment methods : Discriminating between the options ; Evidence-based versus non-evidence-based treatments ; Evidence-based non-physical treatments ; Borderline evidence-based non-physical treatments ; Evidence-based physical treatments ; Borderline evidence-based physical treatments ; Non-evidence-based physical treatments ; Unproven does not necessarily mean useless

Future directions

Care : Inclusion : The principle of inclusion

Families and care : Roles ; Sources of stress ; Support needs

Other care providers : Substitute care for children ; Residential arrangements for adults

Accessing services and rights : Services and organizations ; Human rights.