Abstract

The concept of autism continues to evolve. Not only have the central diagnostic criteria that define autism evolved but understanding of the label and how autism is viewed in research, clinical and sociological terms has also changed. Several key issues have emerged in relation to research, clinical and sociological aspects of autism. Shifts in research focus to encompass the massive heterogeneity covered under the label and appreciation that autism rarely exists in a diagnostic vacuum have brought about new questions and challenges. Diagnostic changes, increasing moves towards early diagnosis and intervention, and a greater appreciation of autism in girls and women and into adulthood and old age have similarly impacted on autism in the clinic. Discussions about autism in socio-political terms have also increased, as exemplified by the rise of ideas such as neurodiversity and an increasingly vocal dialogue with those diagnosed on the autism spectrum. Such changes are to be welcomed, but at the same time bring with them new challenges. Those changes also offer an insight into what might be further to come for the label of autism.

Highlights

  • There is still debate in some quarters about who first formally defined autism [1], most people accept that Kanner [2] should be credited as offering the first recognised description of the condition in the peer-reviewed scientific literature

  • The idea that autism is something to be researched as stand-alone issue separate from the person is something else that is being slowly being eroded by such a theory

  • The concept of autism continues to evolve in relation to research, clinical practice and sociological domains

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Summary

INTRODUCTION

There is still debate in some quarters about who first formally defined autism [1], most people accept that Kanner [2] should be credited as offering the first recognised description of the condition in the peer-reviewed scientific literature. Several authors have talked about autism as part of a wider clinical picture [9, 10] and how various behavioural/psychiatric/somatic issues seem to follow the diagnosis Such a shift mirrors what is happening in other areas of science, such as the establishment of the Research Domain Criteria (RDoC) project [11]. Some authors have talked about the potentially negative aspects of masking in terms of the use of cognitive resources to “maintain the mask,” one could view such as adaptation in a more positive light relating to the learning of such a strategy as a coping mechanism Both the themes of possible sex differences in presentation and masking add to the clinical complexity of reliably assessing for autism. The idea that autism is something to be researched as stand-alone issue separate from the person is something else that is being slowly being eroded by such a theory

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