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Interest in autism and related disorders has exploded. Established as an essential book on this complex syndrome, the new edition has been extensively revised to reflect significant advances in research. Featuring contributions from leading international authorities in the clinical and social sciences, the book covers recent progress in our understanding of the field and offers a perspective on the present state of the discipline. With new material on topics such as evidence-based treatment and practice, the book covers changes in diagnosis resulting from the publication of DSM-V, and developments in how autism is understood, including the removal of language delay as a necessary diagnostic criterion. Far-reaching, the book considers aspects from epidemiology, genetics, and neurobiology, to core symptoms, early interventions, and pharmacology. One section critically surveys the history of autism as a diagnostic concept, and issues such as an ageing population and the impact of research on national policy are considered.
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The purpose of this article is to explore the intersectionality of autism and sociocultural factors as well as discuss the complexities associated with appropriate assessment, diagnosis, and intervention. Based on a review of the literature, the authors present a brief history of the emergence of the term autism and highlight factors that have contributed to current concerns about failures to appropriately recognize autism within diverse populations. Referencing extant research as well as professional practice standards, this article examines aspects of autism and intersectionality, and explores some of the associated challenges related to assessment, diagnosis, and intervention. Further, the authors reflect on the critical importance of carefully considering all aspects of a child's identity when engaging in autism assessment and intervention within the school setting. School-based practitioners are provided with guidance for addressing the needs of diverse populations of students with autism.
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Leo Kanner’s classic description of autism appeared eight decades ago. Although the pace of research has increased dramatically, research specifically focused on adolescents and adults remains limited in many respects. Numerous outcome studies have been conducted and suggest potential for markedly improved outcome with intervention. Unfortunately, studies on adults after early adulthood are sparse and, for old age, almost nonexistent, reflecting a lack of support for research in this population. This is in stark contrast to other developmental disorders in which considerable information on adult life is often available. This book summarizes work across areas, focusing on what is known and not yet known, highlighting important areas for future research. While overall outcome has improved, a small group of individuals remain in need of high levels of adult care. For all individuals, the field requires new approaches to both research and clinical service.
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In this paper we review the impact of DSM-III and its successors on the field of autism—both in terms of clinical work and research. We summarize the events leading up to the inclusion of autism as a “new” official diagnostic category in DSM-III, the subsequent revisions of the DSM, and the impact of the official recognition of autism on research. We discuss the uses of categorical vs. dimensional approaches and the continuing tensions around broad vs. narrow views of autism. We also note some areas of current controversy and directions for the future.
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Autism spectrum disorder (ASD) is a neurodevelopmental disorder that manifests during the early developmental period of childhood. Behaviourally characterized by impairments in social interaction and communication, in combination with stereotyped and restricted patterns of behaviour and/or interest, it is currently believed that ASD occurs in approximately 1–2% of individuals. ASD is more prevalent among males than females (4–5:1), but the mechanisms resulting in this discrepancy are still unclear. This chapter will serve as an introduction to ASD, covering the topics of disorder history, prevalence rates, demographics, diagnostic criteria, differential diagnosis, and discussions on current and future diagnostic classification systems. The remaining chapters within Section 4 will then provide detailed discussions on more specific topics related to ASD, including current understandings of treatment planning, prevention and epidemiology, genetics, imaging, and disorder management.
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This paper, written in honor of Professor Ed Zigler, focuses on some of the themes in developmental disabilities research that were so central to his work. It has now been nearly 80 years since Leo Kanner first identified the prototypic form – early infantile autism – of what is now autism spectrum disorder. In this article we summarize the development of the concept and the important accumulation of knowledge over time that has now led us to the recognition of a broader autism phenotype just as, at the same time, the current official diagnostic system in the USA has narrowed the concept. We also address current controversies regarding autism as the diagnosis is impacted by age and developmental factors, gender, and cultural issues. In parallel to the work on intellectual deficiency and development pioneered by Zigler and his colleagues, we summarize some of the challenges for the years ahead.
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People with autism spectrum disorder (ASD) are represented among those who espouse extremist thought and have committed violent acts associated with their beliefs. Media often highlight a perpetrator's psychiatric diagnosis following acts of mass violence, which in some instances has included ASD. ASD may itself not provide useful information for understanding motivations. Instead, understanding specific traits and neuropsychological and other vulnerabilities may offer an opportunity to make sense of these very complex events.
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Youth with ASD are more likely to experience bullying than their typically developing peers. This risk has not been studied in youth with ASD transitioning to college. We examined the occurrence of bullying in 35 high functioning youth with ASD who were preparing to attend college. We also examined youth anxiety and ASD symptoms. Fifty-one percent of the sample reported being recent victims of bullying; 31% of parents reported their child was a victim of bullying. Parent report of bullying correlated significantly with ratings of youth social anxiety symptoms. These findings suggest that bullying is an issue of concern for higher functioning, older adolescents with ASD, and that their own reports may be particularly important in identifying its occurrence.
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Public education in the United States has a history of local control in the development of curriculum and instruction. Although notable court decisions have led to more universal applications of educational policy and practices (Brown v. Board of Education 1954, Oberti v. Clementon 1993), it has been federal law that has resulted in significant changes in instruction. The Individuals with Disabilities Education Improvement Act (IDEA; Public Law 108–142), first enacted in Public Law 94–142, guaranteed the right of a free, appropriate public education for all children, regardless of the severity of their disability. The word “appropriate” resulted in the beginning of what we refer to today as differentiated instruction: instructional strategies that allow a child to learn and progress in an educational setting. The federal law, No Child Left Behind (NCLB; Public Law 107-110), enacted in 2001, contributed to this initiative and added a caveat that these differentiated instructional strategies needed to be grounded in scientifically based research. Indeed, the term “scientifically based research” has been noted to appear in NCLB 111 times (Deshler 2002). The federal government, in IDEA 2004, identified 13 eligibility categories. In order to receive special education services, a student must, through a multidisciplinary evaluation, meet the eligibility criteria established for one of the 13 categories. Since 1975, when PL94–142 was enacted, educational interventions for students receiving special education have expanded, particularly in disability categories with a high level of incidence such as speech and language disorders and learning disabilities. Low-incidence disabilities, such as mental retardation, visual impairments, and autism, have received less attention.
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The present study objectives were to examine the performance of the new M-CHAT-R algorithm to the original M-CHAT algorithm. The main purpose was to examine if the algorithmic changes increase identification of children later diagnosed with ASD, and to examine if there is a trade-off when changing algorithms. We included 54,463 screened cases from the Norwegian Mother and Child Cohort Study. Children were screened using the 23 items of the M-CHAT at 18 months. Further, the performance of the M-CHAT-R algorithm was compared to the M-CHAT algorithm on the 23-items. In total, 337 individuals were later diagnosed with ASD. Using M-CHAT-R algorithm decreased the number of correctly identified ASD children by 12 compared to M-CHAT, with no children with ASD screening negative on the M-CHAT criteria subsequently screening positive utilizing the M-CHAT-R algorithm. A nonparametric McNemar's test determined a statistically significant difference in identifying ASD utilizing the M-CHAT-R algorithm. The present study examined the application of 20-item MCHAT-R scoring criterion to the 23-item MCHAT. We found that this resulted in decreased sensitivity and increased specificity for identifying children with ASD, which is a trade-off that needs further investigation in terms of cost-effectiveness. However, further research is needed to optimize screening for ASD in the early developmental period to increase identification of false negatives. © 2021 The Authors. Autism Research published by International Society for Autism Research and Wiley Periodicals LLC.
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