Lecture 1 – Introduction to Autism
Ilan Dinstein
History of Autism
In the past autism was often diagnosed as schizophrenia and
individuals were placed in psychiatric asylums.
1943: Dr. Leo Kaner describes 11 cases of autism and promotes
the “refrigerator mother” theory.
1944: Dr. Hans Asperger describes Asperger’s syndrome.
1964: First discussions of autism as a biological disorder
1977: First study showing that autism has a genetic component.
1980s: First structured therapy (Applied Behavioral Analysis).
1990s: ADOS and ADI standardized diagnostic tests are published.
2000s: Large scale biological research into autism begins.
History of Autism
1998: Vaccine panic after an article claims a causal relationship
between vaccines and the development of autism.
2000: Previously eliminated Rubella, Mumps, and Measles
diseases resurface in Europe and the US. Several children
die and others are left handicapped.
2010: The original article is retracted and the physician who
authored it loses his medical license.
Current clinical definition – DSM IV TR
Language delay and dysfunction
Social difficulties
Repetitive behaviors and confined interests
Autism – all three
Asperger – no language delay
PDD NOS – mild symptoms
Upcoming definition – DSM V
Language delay and dysfunction
Social and communication difficulties
Repetitive behaviors and confined interests
Sensory abnormalities
Mild, moderate, and severe autism
Asperger – no language delay
PDD NOS – mild symptoms
Future definitions?
Autism usually means a lot more…
1. 25-70% have low IQ (<70).
2. 20-30% have clinical epilepsy.
3. Over 90% have sensory hypo and hyper sensitivities.
4. Motor clumsiness, balance, and gait problems.
5. Sleeping and digestive problems.
6. Differences in memory and learning.
7. Mood disorders
Extreme heterogeneity
“If you’ve met one person with autism, you’ve
met one person with autism”
Example #1 – Rainman (min 18)
Example #2 – Carly
Example #3 – Temple Grandin
Common symptoms
Eye contact
Joint attention
Abnormal affect
Tantrums
Lack of initiation
No imitation
Low responsiveness
Obsession with order
Difficulty with changes
Avoid interactions
Over-sensitivities
Repetitiveness
Tantrums
“golden standard” behavioral tests
ADOS
Communication
Social
Stereotyped behaviors
“golden standard” behavioral tests
ADI
Communication
Social
Stereotyped behaviors
Prevalence
The number of children diagnosed with
ASD has been rising steadily.
Developmental disorder
Symptoms change throughout life
Behavioral therapies
Applied behavioral analysis (ABA)
Floortime by Greenspan
Actual therapy