Fact sheet on controversies around causes and diagnosis of Autism Spectrum Disorders


There is considerable disagreement over the exact nature of Autism, however it is generally considered to be a neurodevelopmental condition which manifests itself in markedly abnormal social interaction, communication ability, patterns of interests, and patterns of behavior. It encompasses a wide range of atypical conditions, none of which is well understood. Although there are common and specific physical conditions comorbid to Autism Spectrum Disorders, not all people diagnosed with Autism Spectrum Disorders experience these. The diagnostic criteria, as of 2007, are still generally limited to psychiatric and cognitive evaluation methods with IQ score and a particular patterns of abilities (common to those with Autism) featuring strongly in the formal diagnosis of Autism and distinguishing it from Asperger’s Syndrome at the time of diagnosis.



The cause(s) of Autism and the spectrum of pervasive developmental disorders (PDDs) are as yet unknown, as are the long-term outlooks, or best early intervention options. There is, however, widespread agreement that early diagnosis and intervention can often make a significant difference for the long-term prospects of a person with Autism because the human mind and nervous system are more plastic at a younger age; therefore, research for possible therapies and treatments is often focused toward children who have been diagnosed early with a spectrum disorder. However, many adults on the autism spectrum, as well as other interested parties, believe that this emphasis on the problems facing children has resulted in limited research and treatment options for adults with autism.


Today's medical community considers Autism to be essentially incurable, or at least to have life-long effects. Meanwhile, judging by the plethora of material on the Internet and elsewhere, many autism spectrum adults and neurotypical (non-autistic) allies in the autism rights movement do not consider Autism to be a disorder, but simply a different way of perceiving and behaving. These people believe that at least some of the difficulties encountered by people with Autism may result from prejudice and lack of accommodation from society.


With knowledge being so limited and scientific progress so slow, nearly all conjectures about Autism are hotly debated. Parents of autistic kids face a bewildering set of choices and attendant uncertainty about the merits of various diagnoses, prognoses, and alleged cures and treatments.


diagnosis of Autism

The 1994 DSM-IV criteria for the diagnosis of Autism are the result of several revisions, and consequently the psychiatric community is divided as to whether the condition should be ordered by severity along a spectrum or categorized into multiple distinct disorders that have similar symptoms. This division is exacerbated by the wide range of conditions comorbid to Autism spectrum disorders. Research and clinical experience suggests that, while Autism may appear to manifest itself as a psychiatric disorder, its underlying causes are neurological. Pervasive Developmental Disorder, or PDD, has emerged as an overarching descriptive term for the cluster of disorders that includes Autism.



A diagnosis of Autism is complicated by the fact that there is no definitive test for Autism due to the significant variance of symptoms among people with autistic traits, as well as a lack of knowledge about the etiology of the condition. Those with Asperger syndrome may be highly functional cognitively but lack ‘social’ skills, whereas others with so-called “profound Autism” may be non-verbal and deficient in elementary skills. Some autistic people are considered mentally retarded, having low IQs (Intelligence Quotients), while some have been ultimately found to have average or above average intelligence. A minority of people with Autism even have narrow, but exceptional autistic savant abilities.


This is not just an academic issue - treatment strategies and choices are based on definitions of what needs to be changed. Different treatment approaches have had widely divergent outcomes depending on each specific person. For example, some parents claim their children recovered with only behavioral approaches, some credit biomedical intervention as the best method for improvement, and others report little or no progress after trying many different approaches. Occasionally, parents claim their autistic children have simply “grown out of it”.


There are also those (primarily those on the autism spectrum themselves) who reject the premise that Autism is necessarily a disorder that should be cured. In their view, a diagnosis can sometimes result from a judgment of non-conformity that is followed by efforts to correct what are essentially personality traits.


diagnostic issues for Asperger’s Syndrome and Autism

Currently, Asperger’s syndrome is classified as a separate diagnosis from Autism in the DSM-IV, but it is still considered an Autism spectrum disorder. The primary distinction between the definitions of Autism and Asperger’s Syndrome in the DSM-IV is that Autism involves a speech delay and Asperger’s does not. Many people believe Autism and Asperger’s syndrome should not be given separate labels in the DSM-IV because they believe that differences in language acquisition are not significant enough to separate the disorders or that Autism and Asperger’s have no definitive differences. It is also unclear whether a child with high-functioning autism who learns to speak should have their diagnosis changed to that of Asperger’s Syndrome though it should be noted that late speech does occur in a minority of neurotypical children and, in itself, need not be indicative of Autism in a child with Asperger’s Syndrome who goes on to develop good functional language.


Non-medical views

Autism is not a disorder

There is a view that autism is not a disorder, but a normal, healthy variation in neurological hard-wiring, and therefore does not need to be cured. This "anti-cure perspective" supports the model of autism that claims that autism is a fundamental part of who the autistic person is and that autism is something that cannot be separated from the person.


A cure is seen as destroying the original personality of the individual and is perceived similar to attempts to "cure" homosexuality, therefore this perspective considers the disease classification insulting. In line with this belief an autistic culture has begun to develop similar to deaf culture. This view is usually held by autistic people themselves (Autism rights movement), and is mostly criticized by parents of autistic children.


There is no one condition called Autism

This view was put forward by autistic author Donna Williams in her ninth book in the autism field, The Jumbled Jigsaw, based on her work as an autism consultant working with over 600 people on the spectrum over 8 years. Here she presented a holistic model called Autism as a fruit salad model and demonstrated how the severity of someone's Autism could be linked to their degree of co-morbid communication, sensory-perceptual, gut/immune, neurological integration, mood, anxiety and compulsive disorders a person inherited or developed coupled with cognitive and learning style differences and unusual personality trait collections.


She suggested these challenges came about via different combinations of pathways including genetic inheritance, toxic exposure and clashing socio/sensory environments. She suggested that treatment and management, therefore, depended on mapping out which collection of co-morbid challenges were underpinning the autistic presentation for different individuals and addressing each with the most appropriate approaches to each individual underlying issue to maximize each person's potential. She also acknowledged that within this framework, individuals would exist for whom their greatest challenge would be cultural clashes between themselves and the neurotypical world.


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This autism fact sheet is licensed under the GNU Free Documentation. It is derivative of an Autism and Asperger's syndrome-related articles at http://en.wikipedia.org

A lack of rigorous research and funding means that debates over causes, diagnosis and best early interventions for Autism will continue for some time yet