Why Was The New Edition Needed
The American Psychiatric Association periodically updates the DSM to reflect new understanding of mental health conditions and the best ways to identify them.
The goals for updating the criteria for diagnosing autism included:
- More accurate diagnosis
- Identification of symptoms that may warrant treatment or support services
- Assessment of severity level
First Accounts Of Autism: Defining Characteristics
It is likely that autism has existed through the ages, but the first ever clinical account of the disorder was published by Dr. Leo Kanner in 1943.3 Dr. Kanner, who developed the first child psychiatric service at a U.S. hospital, described a group of 11 children eight boys and three girls who had “autistic disturbances of affective contact.”4
Dr. Kanner based his report on direct observation, and much of what he set down has stood the test of time. He vividly depicted the essential features of autism, all of which are echoed in current-day diagnostic manuals. It is interesting to note that, just as in Kanner’s study, the rate of autism in males continues to be much higher than the rate in females.
Hans Asperger, an Austrian pediatrician, was working at nearly the same time as Kanner with a similar group of children on the other side of the Atlantic. A milder form of autism, Asperger syndrome, was named after him.
How Does The Dsm
Six major changes included:
1. Four previously separate categories of autism consolidated into one umbrella diagnosis of autism spectrum disorder.
The previous categories were:
- Pervasive developmental disorder-not otherwise specified
2. Consolidation of three previous categories of autism symptoms
- Social impairment
into two categories of symptoms
- Persistent deficits in social communication/interaction and
- Restricted, repetitive patterns of behavior
3. The addition of sensory issues as a symptom under the restricted/repetitive behavior category. This includes hyper- or hypo-reactivity to stimuli or unusual interests in stimuli
4. A severity assessment scale based on level of support needed for daily function.
5. Additional assessment for:
- Any known genetic causes of autism
- Language level
- Intellectual disability and
- The presence of autism-associated medical conditions
6. Creation of a new diagnosis of social communication disorder, for disabilities in social communication without repetitive, restricted behaviors.
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Introduction To Asperger Syndrome
In 1944, Hans Asperger in Vienna had published an account of children with many similarities to Kanner autism but who had abilities, including grammatical language, in the average or superior range. ;There are continuing arguments concerning the exact relationship between Asperger and Kanner syndromes but it is beyond dispute that they have in common the triad of impairments of social interaction, communication and imagination and a narrow, repetitive pattern of activities .
- Stephan Ehlers and Christopher Gillberg published the results of a further study carried out in Gothenburg. This study examined children in mainstream schools. The aim was to find the prevalence of Asperger syndrome and other autism profiles in children with IQ of 70 or above.;
- From the numbers of children they identified, they calculated a rate of 36 per 10,000 for those who definitely had Asperger syndrome and another 35 per 10,000 for those with social difficulties. Some of these children;may have fitted Asperger description if more information had been available, but they were;certainly on the autism spectrum. Teachers of these children had previously recognised;social and/or educational differences, but had not been able to find a reason for these differences.
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The concept of autism was introduced over a century ago as a specific symptom of schizophrenia. Since then, autism has gradually become recognized as a neurodevelopmental disorder. Additionally, the perception of autism has changed from being a psychological problem caused by bad parenting to a disorder caused by biological and environmental factors.
Autism is recognized by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition as a developmental disorder. The criteria for diagnosis have been expanded to include milder symptoms, such as in the case of Aspergers syndrome. The DSM-5 does not distinguish subcategories of autism spectrum disorder it looks at deficits in social interactions and repetitive behaviors to help make a diagnosis.
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Use Of Principles Versus Examples
DSM-IV and ICD-10 criteria had included examples, derived from multiple levels of analyses, that described specific behaviors, such as shared enjoyment, general qualities, and important contexts , through which deficits in ASD could reliably be seen . Recognizing the myriad behavioral presentations among individuals with ASD of varying developmental levels, DSM-5 and ICD-11 introduced broad principles in place of specific examples to better define symptom subdomains. The new principles, each accompanied by a non-exhaustive list of similar examples, present deficits within each subdomain that are applicable across age ranges and developmental levels, thus providing greater systematic sensitivity and specificity. Notably, however, while conceptualized through clinical observation, the DSM-5 and ICD-11 criteria included within each domain are not empirically-defined dimensions .
What Are The Symptoms Of Autism
One symptom common to allÂ;types of autismÂ;is an inability to easily communicate and interact with others and the environment. In fact, some people with autism are unable to communicate at all. Others may have difficulty interpreting body language, also called non-verbal communication, or holding a conversation.
Other symptoms linked to autism may include unusual behaviors in any of these areas:
- Interest in objects or specialized information
- Reactions to sensations
- Physical coordination
These symptoms are usually seen early in development. Most children with severe autism are diagnosed by age 2.
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History Of Autism Science
Autism Spectrum Disorder might seem to be a fairly new condition, yet written evidences of its existence can be found as far back as the 1700s. The word Autism was coined after the Latin word Autismus in 1910 by Swiss psychiatrist Eugen Bleuler; however he applied the word to describing schizophrenia. The Latin word was in turn was derived from a Greek word, autos, meaning self. Once the condition we now know as autism was discovered in 1938, it was labeled with Bleulers word because people who are autistic have been observed to be morbidly self-absorbed to the exclusion of everyone else around them.
In 1938, a psychiatrist from Vienna University Hospital, Hans Asperger, adopted the term autistic psychopaths to what he was researching then, which is now known as Asperger Syndrome. It was not until 1981 that Asperger Syndrome became a specific classification within the autism spectrum.
In 1943, a psychiatrist from John Hopkins University, Leo Kanner, used the term autism in the modern sense. He then made a new classification which he called the Early Infantile Syndrome or Kanner Syndrome. It came about during his observation of 11 children who displayed similar symptoms. He described them as acting with autistic sameness and insistence on sameness.
Up to this day, there is still no scientifically proven single cause of autism.
Autism In Developing Countries
While a recent global burden study reported that 95% of all young children with developmental disabilities live in low and middle income countries , the majority remain undiagnosed . Furthermore, relatively little research originates from these countries, which results in their underrepresentation in the broader ASD literature . The low diagnostic rates in poor countries likely stem from the lack of dedicated infrastructure to assist people with ASD , difficulty obtaining referrals to meet with the limited number of specialists , and low levels of parental literacy that limit a parents ability to understand the disorder and to locate services . Families are often forced to manage the care of an individual with ASD on their own, which often involves enlisting the help of extended family and community members . Among the lucky families who find an available and appropriate assessment center, the target children may be brought to the clinic by non-parent adults, which limits the quality and quantity of relevant developmental information that can be shared with the specialist. Thus, given the numerous barriers to assessment, the children who ultimately receive ASD diagnoses are often the children with the most significant impairments and complex phenotypic profiles .
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Recent Studies From Other Countries
- The Autism and Developmental Disabilities Monitoring Network in the USA looked at eight-year-old children in 14 states in 2008, and found a prevalence rate of autism within those states overall of; 1 in 88, with around five times as many boys as girls;diagnosed .
- The National Center for Health Statistics in the USA published findings from telephone surveys of parents of children aged 6-17 undertaken in 2011-12. The report showed a prevalence rate for autism of 1 in 50, .
- A study of a 0-17 year olds resident in Stockholm between 2001-2007 found a prevalence rate of 11.5 in 1,000, very similar to the rate found other prevalence studies in Western Europe, .
- A much higher prevalence rate of 2.64% was found in a study done in South Korea, where the researchers found two thirds of the people on the autism spectrum were in the mainstream school population, and had never been diagnosed before. .
- Researchers comparing;studies from different parts of the world over the past few years have come up with a more conservative estimate of 62 in 10,000.;They conclude that the both the increase in estimates over time and the variability between countries and regions are likely thanks to;broadening diagnostic criteria, service availability and increasing awareness of autism among professionals and the public, .
When Did Autism Start To Rise
While there is no cure for autism spectrum disorder,Is autism on the rise? Was there something in Brick Townships water? In the mid-1990s, The specific pattern of abnormal behaviour first described by Leo Kanner is also known as early infantile autism, It found that children treated for two years, Centers for Disease Control and Prevention estimates that 1 in 110 children have autism spectrum disorders, The first use of the word autistic was in the early 20th century, using the early-start Denver model, as a descriptor of symptoms, which has been an almost four-fold increase, In 2006, all of which usually involve delayed verbal communication and difficulties in social interactions.
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Getting To The Causes Of Autism
Getting to the cause — or, more accurately, causes — of autism will be more difficult than unraveling the causes of cancer, says Gary Goldstein, MD, president and CEO of Kennedy Krieger Institute in Baltimore, a facility that helps children with autism and other developmental disorders.
“There won’t be one single explanation,” says Marvin Natowicz, MD, PhD, a medical geneticist and vice chairman of the Genomic Medicine Institute at the Cleveland Clinic.
“There’s been a lot of progress in the last few years in terms of understanding the causes of autism,” Natowicz says. “We know a lot more than we did.” Still, he says, research has a long way to go. “One number you see often is that about 10% of those with autism have a definitive diagnosis, a causative condition.” The other 90% of cases are still a puzzle to the experts.
Often, a child with autism will have a co-existing problem, such as a seizure disorder, depression, anxiety, or gastrointestinal or other health problems. At least 60 different disorders — genetic, metabolic, and neurologic — have been associated with autism, according to a report published in The New EnglandJournal of Medicine.
On one point most agree: A combination of genetics and environmental factors may play a role. Scientists are looking at both areas.
Autism: A True Increase Or Semantics
The jump in autism cases has spawned not only alarm but also debate about whether the number of children with autism could have increased that much in a relatively brief time.
“There’s a lot of controversy about that,” says Jeff Milunsky, MD, director of clinical genetics and associate director of the Center for Human Genetics at Boston University.
Two researchers who tracked the rate of autism in children born in the same area of England from 1992 to 1995 and then from 1996 to 1998 found that the rates were comparable, and concluded that the incidence of autism was stable. The study was published in the American Journal of Psychiatry in 2005.
But, Milunsky says, several studies have documented an increase in the U.S.
In a recent report in the journal Archives of Disease in Childhood, Milunsky and his colleagues point to several studies finding an increase in autism rates. In 2003, for instance, a large study conducted in Atlanta found that one in 166 to one in 250 children had autism, according to a report published in the Journal of the American Medical Association.
Another study conducted by the CDC in 14 states found an overall prevalence of one in 152, which Milunsky and others say is the generally accepted figure today.
“A kid labeled autistic today could have been labeled mentally retarded 10 years ago in the same school system,” Shattuck says. It wasn’t until 1992 that schools began to include autism as a special education classification.
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Autism: Cases On The Rise; Reason For Increase A Mystery
The number of children diagnosed with autism or related disorders has grown at what many call an alarming rate, It wasnt until 1943 that autism was used as a diagnostic term.The rise in cases was cited by campaigners as evidence for the damaging effects of MMR, some shots with multiple-vaccines, However there is a lack of evidence from low-and middle-income countries., residents of the coastal New Jersey community A small number of children appear to develop normally in the first year, and then go through a period of regression between 18 and 24 months of age when they develop autism symptoms, co-founder and executive director of
Origin And Diagnosis Of Autism
According to Martin Luther, A 12-year-old boy was affected by autism. Luther thought this boy was possessed by a devil. The earliest case of autism is of Hugh Blair of Borgue in 1747 which is registered as a court case in which his brother requests to annul Blairs marriage to get Blairs inheritance. In 1798, A feral child has some signs of autism who are treated by a medical student Jean Itard with a behavioral program.
In the 1940s, researchers within the United States began to use autism to explain kids with emotional or social issues. A doctor from Johns Hopkins University, Leo Kanner used it to elucidate the behavior of many kids he studied United Nations agency acted withdrawn. Simultaneously, Hans Asperger discovered Aspergers syndrome.
Donald Gray Triplett, born in 1933 in a rural town known as Forest, Mississippi. He is the one whom psychiatrist Dr. Leo Kanner in 1938 has first at Johns Hopkins Hospital. Dr. Kanner was puzzled after seeing his symptom and was initially unable to diagnose him. However, in Dr. Kanners 1943 paper, Autistic Disturbances of Affective Contact, Donald Triplett was registered as Case 1, Donald T.
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Zeroing In On Environmental Triggers
A variety of environmental triggers is under investigation as a cause or contributing factor to the development of ASD, especially in a genetically vulnerable child.
Exposure to pesticides during pregnancy may boost risk. In a study published in Environmental Health Perspectives, researchers compared 465 children diagnosed with ASD with nearly 7,000 children without the diagnosis, noting whether the mothers lived near agricultural areas using pesticides.
The risk of having ASD increased with the poundage of pesticides applied and with the proximity of the women’s homes to the fields.
Besides pesticide exposure, exposure to organic pollutants that have built up in the environment are another area of concern, says Pessah of UC Davis. For instance, polychlorinated biphenyls or PCBs, substances previously found in electrical equipment, fluorescent lighting and other products, are no longer produced in the U.S. but linger in the environment, he says. “Particular types of PCBs are developmental neurotoxins,” he says.
Another toxin to the brain is mercury in its organic form. But according to a report published in Pediatrics, there is no evidence that children with autism in the U.S. have increased mercury concentrations or environmental exposures. Though many parents of children with ASD believe their child’s condition was caused by vaccines that used to contain thimerosal , the Institute of Medicine concludes there is no causal association.
A History And Timeline Of Autism
The history of autism begins in 1911, when Swiss psychiatrist Paul Eugen Bleuler coined the term, using it to describe what he believed to be the childhood version of schizophrenia.Since then, our understanding of autism has evolved, culminating in the current diagnosis of autism spectrum disorder and informed by many notable events impacting autism clinical research, education, and support.
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History Of Asperger Syndrome
|This article needs to be . The reason given is: This diagnosis now part of autism spectrum for DSM and ICD classifications. Please help update this article to reflect recent events or newly available information.|
Asperger syndrome is an autism spectrum disorder . It is a relatively new diagnosis in the field of autism. It was named after Hans Asperger , who was an Austrian psychiatrist and pediatrician. An English psychiatrist, Lorna Wing, popularized the term “Asperger’s syndrome” in a 1981 publication; the first book in English on Asperger syndrome was written by Uta Frith in 1991 and the condition was subsequently recognized in formal diagnostic manuals later in the 1990s.