Autism

• Published in: Lancet Vol. 374; no. 9701; pp. 1627 - 1638
• Main Authors: Levy, Susan E, Prof, Mandell, David S, ScD, Schultz, Robert T, Prof
• Format: Journal Article Book Review
• Language: English
• Published: Kidlington Elsevier Ltd 07-11-2009; Elsevier; Elsevier Limited
• Subjects: Alternative medicine; Autism; Autistic Disorder - diagnosis; Autistic Disorder - epidemiology; Autistic Disorder - etiology; Autistic Disorder - therapy; Behavior; Behavior Therapy; Biological and medical sciences; Causality; Child; Child clinical studies; Child, Preschool; Children & youth; Communication; Comorbidity; Developmental disorders; Diagnosis, Differential; Early Diagnosis; Early intervention; Early Intervention (Education); Education; Effectiveness; Forecasting; General aspects; Genetic Predisposition to Disease - genetics; Genetic Variation - genetics; Health surveillance; Humans; Infantile autism; Internal Medicine; Magnetic Resonance Imaging; Mass Screening - methods; Medical imaging; Medical sciences; Methods; Neurobiology; Occupational therapy; Preschool children; Prevalence; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health; Risk; Risk Assessment; Risk factors; Sample size; Socialization; Stereotyped Behavior; Studies; Medicine; Autism; Developmental disorder
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(09)61376-3

Summary Autism spectrum disorders are characterised by severe deficits in socialisation, communication, and repetitive or unusual behaviours. Increases over time in the frequency of these disorders (to present rates of about 60 cases per 10 000 children) might be attributable to factors such as new administrative classifications, policy and practice changes, and increased awareness. Surveillance and screening strategies for early identification could enable early treatment and improved outcomes. Autism spectrum disorders are highly genetic and multifactorial, with many risk factors acting together. Genes that affect synaptic maturation are implicated, resulting in neurobiological theories focusing on connectivity and neural effects of gene expression. Several treatments might address core and comorbid symptoms. However, not all treatments have been adequately studied. Improved strategies for early identification with phenotypic characteristics and biological markers (eg, electrophysiological changes) might hopefully improve effectiveness of treatment. Further knowledge about early identification, neurobiology of autism, effective treatments, and the effect of this disorder on families is needed.