Autism: Difference between revisions

Research into causes has been hampered by the inability to identify biologically meaningful subgroups within the autistic population<ref>{{cite journal |vauthors=Altevogt BM, Hanson SL, Leshner AI |date=June 2008 |title=Autism and the environment: challenges and opportunities for research |url=http://pediatrics.aappublications.org/cgi/content/full/121/6/1225 |journal=Pediatrics |volume=121 |issue=6 |pages=1225–1229 |doi=10.1542/peds.2007-3000 |pmid=18519493 |archive-url=https://web.archive.org/web/20100115140620/http://pediatrics.aappublications.org/cgi/content/full/121/6/1225 |archive-date=15 January 2010 |s2cid=24595814}}</ref> and by the traditional boundaries between the disciplines of [[psychiatry]], [[psychology]], [[neurology]] and [[pediatrics]].<ref>{{cite journal |vauthors=Reiss AL |date=January 2009 |title=Childhood developmental disorders: an academic and clinical convergence point for psychiatry, neurology, psychology and pediatrics |journal=Journal of Child Psychology and Psychiatry, and Allied Disciplines| issn = 0021-9630 | eissn = 1469-7610 | oclc = 01307942 |volume=50 |issue=1–2 |pages=87–98 |doi=10.1111/j.1469-7610.2008.02046.x |pmc=5756732 |pmid=19220592}}</ref> Newer technologies such as [[Functional magnetic resonance imaging|fMRI]] and [[diffusion tensor imaging]] can help identify biologically relevant [[phenotype]]s (observable traits) that can be viewed on [[Neuroimaging|brain scans]], to help further [[Neurogenetics|neurogenetic]] studies of autism;<ref>{{cite journal |vauthors=Piggot J, Shirinyan D, Shemmassian S, Vazirian S, Alarcón M |date=November 2009 |title=Neural systems approaches to the neurogenetics of autism spectrum disorders |journal=Neuroscience |volume=164 |issue=1 |pages=247–256 |doi=10.1016/j.neuroscience.2009.05.054 |pmid=19482063 |s2cid=207246176}}</ref> one example is lowered activity in the [[fusiform face area]] of the brain, which is associated with impaired perception of people versus objects.<ref name="Levy 2009">{{cite journal |vauthors=Levy SE, Mandell DS, Schultz RT |date=November 2009 |title=Autism |journal=Lancet |volume=374 |issue=9701 |pages=1627–1638 |doi=10.1016/S0140-6736(09)61376-3 |pmc=2863325 |pmid=19819542}}{{Erratum|https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)61666-8/fulltext|doi=10.1016/S0140-6736(11)61666-8|checked=yes}}</ref> It has been proposed to classify autism using genetics as well as behavior.<ref>{{cite journal |vauthors=Stephan DA |date=January 2008 |title=Unraveling autism |journal=American Journal of Human Genetics |volume=82 |issue=1 |pages=7–9 |doi=10.1016/j.ajhg.2007.12.003 |pmc=2253980 |pmid=18179879}}</ref> (For more, see [[Brett Abrahams]])

Similarly, a teacher-implemented intervention that utilizes a more [[Pivotal response treatment|naturalistic form of ABA]] combined with a developmental social pragmatic approach has been found to be beneficial in improving social-communication skills in young children, although there is less evidence in its treatment of global symptoms.<ref name=":06" /> Neuropsychological reports are often poorly communicated to educators, resulting in a gap between what a report recommends and what education is provided.<ref name="Kanne 2008">{{cite journal |vauthors=Kanne SM, Randolph JK, Farmer JE |date=December 2008 |title=Diagnostic and assessment findings: a bridge to academic planning for children with autism spectrum disorders |journal=Neuropsychology Review |volume=18 |issue=4 |pages=367–384 |doi=10.1007/s11065-008-9072-z |pmid=18855144 |s2cid=21108225}}</ref> The appropriateness of including children with varying severity of autism spectrum disorders in the general education population is a subject of current debate among educators and researchers.<ref>{{cite journal |vauthors=Simpson RL, de Boer-Ott SR, Smith-Myles B |year=2003 |title=Inclusion of Learners with Autism Spectrum Disorders in General Education Settings |url=http://www.nursingcenter.com/pdf.asp?AID=520301 |journal=Topics in Language Disorders |volume=23 |issue=2 |pages=116–133 |doi=10.1097/00011363-200304000-00005 |archive-url=https://web.archive.org/web/20110714215923/http://www.nursingcenter.com/pdf.asp?AID=520301 |archive-date=14 July 2011 |s2cid=143733343}}</ref>

There continues to be a debate over the differential outcomes based on these two developmental courses. Some studies suggest that regression is associated with poorer outcomes and others report no differences between those with early gradual onset and those who experience a regression period.<ref name="Mash & Barkley">{{cite book |url=https://archive.org/details/childpsychopatho00mash_735 |title=Child Psychopathology |vauthors=Mash EJ, Barkley RA |publisher=The Guilford Press |year=2003 |isbn=9781572306097 |location=New York |pages=[https://archive.org/details/childpsychopatho00mash_735/page/n421 409]–454 |url-access=limited}}</ref> While there is conflicting evidence surrounding language outcomes in autism, some studies have shown that cognitive and language abilities at age {{frac|2|1|2}} may help predict language proficiency and production after age 5.<ref>{{cite journal |vauthors=Ellis Weismer S, Kover ST |date=December 2015 |title=Preschool language variation, growth, and predictors in children on the autism spectrum |journal=Journal of Child Psychology and Psychiatry, and Allied Disciplines |volume=56 |issue=12 |pages=1327–37 |doi=10.1111/jcpp.12406 |issn=0021-9630 |eissn=1469-7610 |oclc=01307942 |pmc=4565784 |pmid=25753577}}</ref> Overall, the literature stresses the importance of early intervention in achieving positive longitudinal outcomes.<ref name="Dawson & Osterling">{{cite book |title=The effectiveness of early intervention |vauthors=Dawson G, Osterling J |publisher=Brookes |year=1997 |isbn=1-55766-255-X |veditors=Guralnick MJ |location=Baltimore |pages=307–326 |chapter=Early Intervention in Autism |oclc=34411043 |id={{ERIC|ED414694}}}}</ref>