Autism

Autism (also sometimes called Infantile Autism, Early Infantile Autism, Autistic Disorder, or Kanner's syndrome) was first described by Dr. Leo Kanner in 1943, who reported on eleven children who exhibited an apparently congenital lack of interest in other people. In contrast, these children were highly interested in unusual aspects of the inanimate environment. For several decades after the initial description of autism, research on this and related conditions was impeded by a lack of consensus on aspects of syndrome definition, as well as by assumptions of continuity between these conditions and severe forms of mental illness in adults, particularly schizophrenia. The idea that autism was the earliest form of schizophrenia reflected an awareness of the severity of both conditions, the then-current extremely broad views of schizophrenia, and Kanner's use of the word autism, which had previously been used to describe the self-centered quality of thinking in schizophrenia, not a relative absence of social relatedness. It took many years before researchers and clinicians could be sure that autism and schizophrenia were indeed different conditions. As part of this confusion, some early clinicians thought that perhaps autism could be caused by negative experience; we now know that this is not in fact the case. Autism is associated with various kinds of neurobiological symptoms, which range from the persistence of unusual reflexes, the high rates of seizure disorder in persons with autism (25 percent in most cases), and increased frequency of the condition in identical twins.

Autism has its origins in the first weeks or months of life. It is characterized by marked problems in social interaction (autism), as well as by delayed and deviant communication development (speech is absent in about 50 percent of cases) and various other behaviors which are usually subsumed in the term 'insistence on sameness.' Such behaviors include stereotyped motor behaviors (hand flapping, body rocking), insistence on sameness and resistance to change. Both categorical and dimensional approaches to diagnosis have been used, as for instance in the DSM-IV Worldwide Field Trial. Many individuals with autism exhibit mental retardation on the basis of their full-scale (or averaged) IQ score; however, unlike most people with primary mental retardation, those with autism often have marked scatter in their development, so that some aspects of the IQ, particularly nonverbal skills, may be within the normal range. Autism is sometimes observed along with other medical and psychiatric conditions such as Fragile X syndrome.

Current research on autism at the Child Study Center includes an ongoing study of longitudinal development and of molecular genetics in muliple-incidence families, and also a study of High-Functioning Autism and Asperger Syndrome.

Asperger's Syndrome

This condition was originally described by Hans Asperger in Vienna in 1944. Although Asperger was not aware of Leo Kanner's work on autism, he did use the word autism ("autistic psychopathy") to describe the social deficits he observed in a group of boys. His original description, in German, received little attention in the English-language literature until recent years. In people with Asperger's Syndrome, deficits in social interaction and unusual responses to the environment, similar to those in autism, are observed. Unlike in autism, however, cognitive and communicative development are within the normal or near-normal range in the first years of life, and verbal skills are usually an area of relative strength. Idiosyncratic interests are common and may take the form of an unusual and/or highly circumscribed interest (e.g., in train schedules, snakes, the weather, deep-fry cookers, or telegraph pole insulators). There is some suggestion of an increased incidence of this condition in family members. The validity of this condition, as opposed to high-functioning autism, remains a topic of debate (Szatmari, 1992). Inconsistencies in the way the term has been used and the lack, until quite recently, of recognized official definitions has made it difficult to interpret the research available on this condition. Even now, some clinicians will use the term to refer to persons with autism who have IQs in the normal range, or to adults with autism, or to PDD-NOS; recent official definitions emphasize differences from autism, e.g. in terms of better communication (particularly verbal) skills. It also seems likely that that the condition overlaps, at least in part, with some forms of learning disability, e.g., the syndrome of Nonverbal Learning Disability (Rourke, 1989).

The transcript from the April 6, 1999 New York Times online chat is still available at the New York Times site.

Asperger's Syndrome
Guidelines for Assessment and Diagnosis
by Ami Klin, Ph.D., and Fred R. Volkmar, M.D.
Yale Child Study Center, New Haven, Connecticut
Published by the Learning Disabilities Association of America, June 1995
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Asperger's Syndrome
Guidelines for Treatment and Intervention
by Ami Klin, Ph.D., and Fred R. Volkmar, M.D.
Yale Child Study Center, New Haven, Connecticut
Published by the Learning Disabilities Association of America, June 1995
Download PDF