Autism Spectrum Disorder is a mental condition that affects the brain’s development and maturation, thereby affecting the way the patient sees and understands the world. Brain imaging is yet to find a strong difference between autistic and neurotypical brains, meaning the salient difference we see is in terms of behavior.
This encompasses a large range, including the 38% of sufferers that have Intellectual Disability to possibly Einstein and Bill Gates. In less severe forms, someone with autism might not catch when information is nonliteral and display context blindness, where they have difficulty picking up the nuanced rules of social behavior.
Other sufferers might have trouble finding the right words to convey information, or trying to speak at all. Often appearing detached and unemotional, 50% of autistic patients have co-occurring alexithymia, meaning difficulty understanding the feelings of others and themselves.
However, on the inside, those on the spectrum often feel more intensely, due to not being able to filter out and ignore sensory input the way a neurotypical can.
Sufferers find refuge in familiarity, and often display intense interests and routines, along with repetitive body movements. Autism Spectrum Disorder causes difficulty with relationships, understanding others, and sometimes integrating into society or with everyday tasks.
The American Diagnostic and Statistical Manual of Mental Disorders (DSM) and The International Classification of Diseases (ICD) can be thought of the governing bodies for the diagnoses of all mental illnesses.
When the fifth edition of the DSM was published in 2013, it collapsed three former mental conditions into the name Autism Spectrum Disorder: autism, Asperger Syndrome, and Pervasive Developmental Disorder. (The ICD plans to follow suit with its eleventh revision in 2019).
The first term coined of the three was autism, by the Swiss psychiatrist Eugen Bleuler in 1911. It was originally thought to be a form of schizophrenia, because the two can appear similar if a schizophrenic starts to socially withdraw.
Then, in 1944, the American psychiatrist Dr. Leo Kanner classified autism as a social and emotional disorder, after studying minors experiencing isolation and speech delays. Meanwhile, the German doctor Hans Asperger was meeting with bright children who had an abnormal social approach and intense interests.
Utilizing his namesake, Asperger Syndrome would come to be known as “a touch of autism” among psychiatrists. Pervasive Developmental Disorder was a term for “subthreshold autism,” meaning someone who met much of the diagnostic criteria for autism, but did not fit the symptoms neatly.
Twenty-first century cognitive professionals found terms such as “a touch of autism” and “subthreshold autism” unpalatable, and Autism Spectrum Disorder was coined. However, to accommodate the diversity of the condition, the 2013 DSM ranks the disorder on a level of severity from one to three.
ASD is estimated at 1-2% of the world population (males make up about 80% of that figure), with developed countries having seemingly higher prevalences. In fact, distributions appear to increase in states with better neuropsychiatric services/hospitals, and minorities remain underidentified due to a lack of access.
Only 10% of autistic children have a psychiatric diagnosis, the majority of which were identified before the age of four. Early detection is key to prognosis because it more readily allows behavioral, educational, and family therapies to mitigate symptoms.
However, the earliest age diagnosis reliably can occur is two, and one can reach adulthood before finding out the root of their symptoms in ASD’s more nuanced forms. What if scientists could find a biological mechanism for earlier diagnosis and intervention?
A day where we can spot ASD through an MRI scan still appears to be far off into the future. Underlying neurology is still hotly debated, with competing theories. Some experts even believe, as a spectrum disorder, different sufferers have different neurological foundations.
However, scientists do know autism is 90% inheritable due to twin studies. Although probably with hundreds of genes involved with its development, genetic screening is a promising way to improve the diagnosis of Autism Spectrum Disorder. But
this would come with an ethical dilemma that the psychiatric community knows all too well.
Professionals have discussed evolutionary benefits of autism, particularly within the Neurodiversity movement. Tony Attwood was the first person to cast ASD in a positive light in 1998 with his book Asperger’s Syndrome.
According to the professor of human origin archaeology Penny Spikins, it is known that “Many people with autism have exceptional memory skills, heightened perception in realms of [sensory] and… an enhanced understanding of natural systems…”
However, the condition still mainly carries a negative stigma, with cultures perpetrating pseudoscience that it can be cured via dangerous bleach solutions, or it is caused by vaccination. Around the world, some parents are coaxed to give up their autistic children, or it may be seen as a curse on the family lineage.
Therefore, whether autism research should aim towards finding a “cure” is an important question in bioethics, with genetic studies under scrutiny. For example, would prenatal genetic screening, and elimination, of autism be ethical? Therefore, would we as a society use such genetic information ethically?
