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ASD includes a wide variety of characteristics. Some of these include behavioral characteristics which widely range from slow development of social and learning skills to difficulties creating connections with other people. Autistic individuals may experience these challenges with forming connections due to anxiety or ...
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Other behavioral characteristics include abnormal responses to sensations (such as sights, sounds, touch, taste and smell) and problems keeping a consistent speech rhythm. The latter problem influences an individual's social skills, leading to potential problems in how they are understood by communication partners. Beh...
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The second core symptom of autism spectrum is a pattern of restricted and repetitive behaviors, activities, and interests. In order to be diagnosed with ASD under DSM-5 or DSM-5-TR, a person must have at least two of the following behaviors:
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Autistic individuals can display many forms of repetitive or restricted behavior, which the Repetitive Behavior Scale-Revised (RBS-R) categorizes as follows.
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Self-injurious behaviors (SIB) are relatively common in autistic people, and can include head-banging, self-cutting, self-biting, and hair-pulling. Some of these behaviors can result in serious injury or death. Following are theories about the cause of self-injurious behavior in children
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Autistic individuals may have symptoms that do not contribute to the official diagnosis, but that can affect the individual or the family. Some individuals with ASD show unusual abilities, ranging from splinter skills (such as the memorization of trivia) to the rare talents of autistic savants. One study describes how ...
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There is tentative evidence that gender dysphoria occurs more frequently in autistic people (see Autism and LGBT identities). As well as that, a 2021 anonymized online survey of 16–90 year-olds revealed that autistic males are more likely to identify as bisexual, while autistic females are more likely to identify as ho...
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Gastrointestinal problems are one of the most commonly co-occurring medical conditions in autistic people. These are linked to greater social impairment, irritability, language impairments, mood changes, and behavior and sleep problems.
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Parents of children with ASD have higher levels of stress. Siblings of children with ASD report greater admiration and less conflict with the affected sibling than siblings of unaffected children and were similar to siblings of children with Down syndrome in these aspects of the sibling relationship. However, they repo...
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It had mostly long been presumed that there is a common cause at the genetic, cognitive, and neural levels for the social and non-social components of ASD's symptoms, described as a triad in the classic autism criteria. However, there is increasing suspicion that autism is instead a complex disorder whose core aspects ...
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Research into causes has been hampered by the inability to identify biologically meaningful subgroups within the autistic population and by the traditional boundaries between the disciplines of psychiatry, psychology, neurology and pediatrics. Newer technologies such as fMRI and diffusion tensor imaging can help identi...
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Autism has a strong genetic basis, although the genetics of autism are complex and it is unclear whether ASD is explained more by rare mutations with major effects, or by rare multi-gene interactions of common genetic variants. Complexity arises due to interactions among multiple genes, the environment, and epigenetic ...
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, it appeared that between 74% and 93% of ASD risk is heritable. After an older child is diagnosed with ASD, 7–20% of subsequent children are likely to be as well. If parents have one autistic child, they have a 2% to 8% chance of having a second child who is also autistic. If the autistic child is an identical twin th...
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, understanding of genetic risk factors had shifted from a focus on a few alleles to an understanding that genetic involvement in ASD is probably diffuse, depending on a large number of variants, some of which are common and have a small effect, and some of which are rare and have a large effect. The most common gene d...
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Some ASD is associated with clearly genetic conditions, like fragile X syndrome; however, only around 2% of autistic people have fragile X. Hypotheses from evolutionary psychiatry suggest that these genes persist because they are linked to human inventiveness, intelligence or systemising.
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Current research suggests that genes that increase susceptibility to ASD are ones that control protein synthesis in neuronal cells in response to cell needs, activity and adhesion of neuronal cells, synapse formation and remodeling, and excitatory to inhibitory neurotransmitter balance. Therefore, despite up to 1000 di...
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All these genetic variants contribute to the development of the autistic spectrum; however, it cannot be guaranteed that they are determinants for the development.
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ASD may be under-diagnosed in women and girls due to an assumption that it is primarily a male condition, but genetic phenomena such as imprinting and X linkage have the ability to raise the frequency and severity of conditions in males, and theories have been put forward for a genetic reason why males are diagnosed mo...
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Several prenatal and perinatal complications have been reported as possible risk factors for autism. These risk factors include maternal gestational diabetes, maternal and paternal age over 30, bleeding during pregnancy after the first trimester, use of certain prescription medication (e.g. valproate) during pregnancy,...
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There are also studies being done to test if certain types of regressive autism have an autoimmune basis.
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Maternal nutrition and inflammation during preconception and pregnancy influences fetal neurodevelopment. Intrauterine growth restriction is associated with ASD, in both term and preterm infants. Maternal inflammatory and autoimmune diseases may damage fetal tissues, aggravating a genetic problem or damaging the nervou...
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Exposure to air pollution during child pregnancy, especially heavy metals and particulates, may increase the risk of autism. Environmental factors that have been claimed without evidence to contribute to or exacerbate autism include certain foods, infectious diseases, solvents, PCBs, phthalates and phenols used in plas...
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Parents may first become aware of ASD symptoms in their child around the time of a routine vaccination. This has led to unsupported and disproven theories blaming vaccine "overload", a vaccine preservative, or the MMR vaccine for causing autism spectrum disorder. In 1998, British physician and academic Andrew Wakefield...
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Several hypotheses have been presented that try to explain how and why autism develops by integrating known causes (genetic and environmental effects) and findings (neurobiological and somatic). Some are more comprehensive, such as the Pathogenetic Triad, which proposes and operationalizes three core features (an autis...
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Research exploring the evolutionary benefits of autism and associated genes has suggested that autistic people may have played a "unique role in technological spheres and understanding of natural systems" in the course of human development. It has been suggested that it may have arisen as "a slight trade off for other ...
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In 2011, a paper in "Evolutionary Psychology" proposed that autistic traits, including increased abilities for spatial intelligence, concentration and memory, could have been naturally selected to enable self-sufficient foraging in a more (although not completely) solitary environment, referred to as the "Solitary Fora...
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Conversely, some multidisciplinary research suggests that recent human evolution may be a driving force in the rise of a number of medical conditions in recent human populations, including autism. Studies in evolutionary medicine indicate that as biological evolution becomes outpaced by cultural evolution, disorders li...
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Autism's symptoms result from maturation-related changes in various systems of the brain. How autism occurs is not yet well understood. Its mechanism can be divided into two areas: the pathophysiology of brain structures and processes associated with autism, and the neuropsychological linkages between brain structures ...
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There is evidence that gut–brain axis abnormalities may be involved. A 2015 review proposed that immune, gastrointestinal inflammation, malfunction of the autonomic nervous system, gut flora alterations, and food metabolites may cause brain neuroinflammation and dysfunction. A 2016 review concludes that enteric nervous...
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Several lines of evidence point to synaptic dysfunction as a cause of autism. Some rare mutations may lead to autism by disrupting some synaptic pathways, such as those involved with cell adhesion. All known teratogens (agents that cause birth defects) related to the risk of autism appear to act during the first eight ...
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In general, neuroanatomical studies support the concept that autism may involve a combination of brain enlargement in some areas and reduction in others. These studies suggest that autism may be caused by abnormal neuronal growth and pruning during the early stages of prenatal and postnatal brain development, leaving s...
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In functional neuroimaging studies, when performing theory of mind and facial emotion response tasks, the median person on the autism spectrum exhibits less activation in the primary and secondary somatosensory cortices of the brain than the median member of a properly sampled control population. This finding coincides...
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Brains of autistic individuals have been observed to have abnormal connectivity and the degree of these abnormalities directly correlates with the severity of autism. Following are some observed abnormal connectivity patterns in autistic individuals:
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Listed below are some characteristic findings in ASD brains on molecular and cellular levels regardless of the specific genetic variation or mutation contributing to autism in a particular individual:
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46% to 84% of autistic individuals have GI-related problems like reflux, diarrhea, constipation, inflammatory bowel disease, and food allergies. It has been observed that the makeup of gut bacteria in autistic people is different than that of neurotypical individuals which has raised the question of influence of gut ba...
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The mirror neuron system consists of a network of brain areas that have been associated with empathy processes in humans. In humans, the mirror neuron system has been identified in the inferior frontal gyrus and the inferior parietal lobule and is thought to be activated during imitation or observation of behaviors. Th...
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A number of discrete brain regions and networks among regions that are involved in dealing with other people have been discussed together under the rubric of the social brain. , there is a consensus that autism spectrum is likely related to problems with interconnectivity among these regions and networks, rather than p...
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Functions of the temporal lobe are related to many of the deficits observed in individuals with ASDs, such as receptive language, social cognition, joint attention, action observation, and empathy. The temporal lobe also contains the superior temporal sulcus and the fusiform face area, which may mediate facial processi...
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ASD could be linked to mitochondrial disease, a basic cellular abnormality with the potential to cause disturbances in a wide range of body systems. A 2012 meta-analysis study, as well as other population studies show that approximately 5% of autistic children meet the criteria for classical mitochondrial dysfunction. ...
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Serotonin is a major neurotransmitter in the nervous system and contributes to formation of new neurons (neurogenesis), formation of new connections between neurons (synaptogenesis), remodeling of synapses, and survival and migration of neurons, processes that are necessary for a developing brain and some also necessar...
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Autism spectrum disorder is a clinical diagnosis that is typically made by a physician based off reported and directly observed behavior in the affected individual. According to the updated diagnostic criteria in the DSM-5-TR, in order to receive a diagnosis of autism spectrum disorder, one must present with “persisten...
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There are several factors that make autism spectrum disorder difficult to diagnose. First off, there are no standardized imaging, molecular or genetic tests that can be used to diagnose ASD. Additionally, there is a lot of variety in how ASD affects individuals. The behavioral manifestations of ASD depend on one's deve...
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Ideally the diagnosis of ASD should be given by a team of clinicians (e.g. pediatricians, child psychiatrists, child neurologists) based on information provided from the affected individual, caregivers, other medical professionals and from direct observation. Evaluation of a child or adult for autism spectrum disorder ...
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The age at which ASD is diagnosed varies. Sometimes ASD can be diagnosed as early as 18 months, however, diagnosis of ASD before the age of two years may not be reliable. Diagnosis becomes increasingly stable over the first three years of life. For example, a one-year-old who meets diagnostic criteria for ASD is less l...
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The presentation and diagnosis of autism spectrum disorder may vary based on sex and gender identity. Most studies that have investigated the impact of gender on presentation and diagnosis of autism spectrum disorder have not differentiated between the impact of sex versus gender. There is some evidence that autistic w...
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Considering the unique challenges in diagnosing ASD using behavioral and observational assessment, specific US practice parameters for its assessment were published by the American Academy of Neurology in the year 2000, the American Academy of Child and Adolescent Psychiatry in 1999, and a consensus panel with represen...
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, psychologists wait until a child showed initial evidence of ASD tendencies, then administer various psychological assessment tools to assess for ASD. Among these measurements, the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) are considered the "gold standards" for ...
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About half of parents of children with ASD notice their child's atypical behaviors by age 18 months, and about four-fifths notice by age 24 months. If a child does not meet any of the following milestones, it "is an absolute indication to proceed with further evaluations. Delay in referral for such testing may delay ea...
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The Japanese practice is to screen all children for ASD at 18 and 24 months, using autism-specific formal screening tests. In contrast, in the UK, children whose families or doctors recognize possible signs of autism are screened. It is not known which approach is more effective. The UK National Screening Committee doe...
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Screening tools include the Modified Checklist for Autism in Toddlers (M-CHAT), the Early Screening of Autistic Traits Questionnaire, and the First Year Inventory; initial data on M-CHAT and its predecessor, the Checklist for Autism in Toddlers (CHAT), on children aged 18–30 months suggests that it is best used in a cl...
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There is a significant level of misdiagnosis of autism in neurodevelopmentally typical children; 18–37% of children diagnosed with ASD eventually lose their diagnosis. This high rate of lost diagnosis cannot be accounted for by successful ASD treatment alone. The most common reason parents reported as the cause of lost...
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Many of the children who were later found not to meet ASD diagnosis criteria then received diagnosis for another developmental disorder. Most common was ADHD, but other diagnoses included sensory disorders, anxiety, personality disorder, or learning disability. Neurodevelopment and psychiatric disorders that are common...
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ASDs tend to be highly comorbid with other disorders. Comorbidity may increase with age and may worsen the course of youth with ASDs and make intervention and treatment more difficult. Distinguishing between ASDs and other diagnoses can be challenging because the traits of ASDs often overlap with symptoms of other diso...
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There is no treatment as such for autism, and many sources advise that this is not an appropriate goal, although treatment of co-occurring conditions remains an important goal. There is no cure for autism as of 2022, nor can any of the known treatments significantly reduce brain mutations caused by autism, although tho...
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The main goals of treatment are to lessen associated deficits and family distress, and to increase quality of life and functional independence. In general, higher IQs are correlated with greater responsiveness to treatment and improved treatment outcomes. Behavioral, psychological, education, and/or skill-building inte...
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Intensive, sustained special education programs and behavior therapy early in life can help children acquire self-care, language, and job skills. Although evidence-based interventions for autistic children vary in their methods, many adopt a psychoeducational approach to enhancing cognitive, communication, and social s...
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Intensive, sustained special education or remedial education programs and behavior therapy early in life can help children acquire self-care, social, and job skills. Available approaches include applied behavior analysis, developmental models, structured teaching, speech and language therapy, social skills therapy, and...
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There has been increasing attention to the development of evidence-based interventions for autistic young children. Two theoretical frameworks outlined for early childhood intervention include applied behavior analysis (ABA) and the developmental social-pragmatic model (DSP). Although ABA therapy has a strong evidence ...
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Another evidence-based intervention that has demonstrated efficacy is a parent training model, which teaches parents how to implement various ABA and DSP techniques themselves. Various DSP programs have been developed to explicitly deliver intervention systems through at-home parent implementation.
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In October 2015, the American Academy of Pediatrics (AAP) proposed new evidence-based recommendations for early interventions in ASD for children under 3. These recommendations emphasize early involvement with both developmental and behavioral methods, support by and for parents and caregivers, and a focus on both the ...
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Generally speaking, treatment of ASD focuses on behavioral and educational interventions to target its two core symptoms: social communication deficits and restricted, repetitive behaviors. If symptoms continue after behavioral strategies have been implemented, some medications can be recommended to target specific sym...
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While there are a number of parent-mediated behavioral therapies to target social communication deficits in children with autism, there is uncertainty regarding the efficacy of interventions to treat RRBs.
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Educational interventions often used include applied behavior analysis (ABA), developmental models, structured teaching, speech and language therapy and social skills therapy. Among these approaches, interventions either treat autistic features comprehensively, or focalize treatment on a specific area of deficit.
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The quality of research for early intensive behavioral intervention (EIBI)—a treatment procedure incorporating over thirty hours per week of the structured type of ABA that is carried out with very young children—is currently low, and more vigorous research designs with larger sample sizes are needed. Two theoretical f...
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A 2018 Cochrane meta-analysis database concludes how some recent research is beginning to suggest that because of the heterology of ASD, there is two varying ABA teaching approaches to acquiring spoken language: children with more general expressive language delays respond sufficiently to the naturlistic approach, wher...
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Similarly, a teacher-implemented intervention that utilizes a more 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. Neuropsycho...
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Medications may be used to treat ASD symptoms that interfere with integrating a child into home or school when behavioral treatment fails. They may also be used for associated health problems, such as ADHD or anxiety. However, their routine prescription for the core features of ASD is not recommended. More than half of...
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A multitude of researched alternative therapies have also been implemented. Many have resulted in harm to autistic people. A 2020 systematic review on adults with autism has provided emerging evidence for decreasing stress, anxiety, ruminating thoughts, anger, and aggression through mindfulness-based interventions for ...
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Although popularly used as an alternative treatment for autistic people, there is no good evidence to recommend a gluten- and casein-free diet as a standard treatment. A 2018 review concluded that it may be a therapeutic option for specific groups of children with autism, such as those with known food intolerances or a...
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The preference that autistic children have for unconventional foods can lead to reduction in bone cortical thickness with this risk being greater in those on casein-free diets, as a consequence of the low intake of calcium and vitamin D; however, suboptimal bone development in ASD has also been associated with lack of ...
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Results of a systematic review on interventions to address health outcomes among autistic adults found emerging evidence to support mindfulness-based interventions for improving mental health. This includes decreasing stress, anxiety, ruminating thoughts, anger, and aggression. An updated Cochrane review (2022) found e...
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While infection with rubella during pregnancy causes fewer than 1% of cases of autism, vaccination against rubella can prevent many of those cases.
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There is currently no evidence of a cure for autism. The degree of symptoms can decrease, occasionally to the extent that people lose their diagnosis of ASD; this occurs sometimes after intensive treatment and sometimes not. It is not known how often this outcome happens, with reported rates in unselected samples rangi...
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Many autistic people face significant obstacles in transitioning to adulthood. Compared to the general population, autistic people are more likely to be unemployed and to have never had a job. About half of people in their 20s with autism are not employed. Some autistic adults are unable to live independently.
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The number of students identified and served as eligible for autism services in the United States has increased from 5,413 children in 1991–1992 to 370,011 children in the 2010–2011 academic school year. The United States Department of Health and Human Services reported approximately 1 in 68 children are diagnosed with...
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The increasing number of students diagnosed with ASD in the schools presents significant challenges to teachers, school psychologists, and other school professionals. These challenges include developing a consistent practice that best support the social and cognitive development of the increasing number of autistic stu...
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Attempts to identify and use best intervention practices for students with autism also pose a challenge due to over dependence on popular or well-known interventions and curricula. Some evidence suggests that although these interventions work for some students, there remains a lack of specificity for which type of stud...
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A difficulty for academic performance in students with ASD is the tendency to generalize learning. Learning is different for each student, which is the same for students with ASD. To assist in learning, accommodations are commonly put into place for students with differing abilities. The existing schema of these studen...
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The cost of educating a student with ASD in the US is about $8,600 a year more than the cost of educating an average student, which is about $12,000.
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Though much of the focus on early childhood intervention for ASD has centered on high-income countries like the United States, some of the most significant unmet needs for autistic individuals are in low- and middle-income countries. In these contexts, research has been more limited but there is evidence to suggest tha...
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In the United States, about half of people in their 20s with autism are unemployed, and one third of those with graduate degrees may be unemployed. While employers state hiring concerns about productivity and supervision, experienced employers of autistics give positive reports of above average memory and detail orient...
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The World Health Organization (WHO) estimates that about 1 in 100 children have autism. The number of people diagnosed has increased considerably since the 1990s, which may be partly due to increased recognition of the condition.
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While rates of ASD are consistent across cultures, they vary greatly by gender, with boys diagnosed far more frequently than girls: 1 in 70 boys, but only 1 in 315 girls at eight years of age. Girls, however, are more likely to have associated cognitive impairment, suggesting that less severe forms of ASD are likely be...
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Using DSM-5 criteria, 92% of the children diagnosed per DSM-IV with one of the disorders which is now considered part of ASD will still meet the diagnostic criteria of ASD. However, if both ASD and the social (pragmatic) communication disorder categories of DSM-5 are combined, the prevalence of autism is mostly unchang...
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In the UK, from 1998 to 2018, the autism diagnoses increased by 787%. This increase is largely attributable to changes in diagnostic practices, referral patterns, availability of services, age at diagnosis, and public awareness (particularly among women), though unidentified environmental risk factors cannot be ruled o...
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Males have higher likelihood of being diagnosed with ASD than females. The sex ratio averages 4.3:1 and is greatly modified by cognitive impairment: it may be close to 2:1 with intellectual disability and more than 5.5:1 without. Several theories about the higher prevalence in males have been investigated, but the caus...
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The risk of developing autism is greater with older fathers than with older mothers; two potential explanations are the known increase in mutation burden in older sperm, and the hypothesis that men marry later if they carry genetic liability and show some signs of autism. Most professionals believe that race, ethnicity...
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In the United States it is estimated to affect more than 2% of children (about 1.5 million) . According to the latest CDC prevalence reports, 1 in 44 children (2.3%) in the United States had a diagnosis of ASD in 2018. Prevalence is estimated at 6 per 1,000 for ASDs as a whole.
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A few examples of autistic symptoms and treatments were described long before autism was named. The "Table Talk" of Martin Luther, compiled by his notetaker, Mathesius, contains the story of a 12-year-old boy who may have been severely autistic. The earliest well-documented case of autism is that of Hugh Blair of Borgu...
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The Wild Boy of Aveyron, a feral child found in 1798, showed several signs of autism. He was non-verbal during his teenage years, and his case was widely popular among society for its time. Such cases brought awareness to autism, and more research was conducted on the natural dimensions of human behavior. The medical s...
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The New Latin word "autismus" (English translation "autism") was coined by the Swiss psychiatrist Eugen Bleuler in 1910 as he was defining symptoms of schizophrenia. He derived it from the and used it to mean morbid self-admiration, referring to "autistic withdrawal of the patient to his fantasies, against which any in...
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Autism spectrum disorder, as it is known today, can be traced back to the late 1930s, when two separate psychiatrists – Leo Kanner of Johns Hopkins Hospital and Hans Asperger of the Vienna University Hospital – used the word "autism" to describe the patients they were studying in their own clinical research and practic...
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Kanner's reuse of "autism" led to decades of confused terminology like "infantile schizophrenia", and child psychiatry's focus on maternal deprivation led to misconceptions of autism as an infant's response to "refrigerator mothers". Starting in the late 1960s, autism was established as a "separate" syndrome from schiz...
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The discussion of autism prior to the twentieth century brought about much controversy. Without researchers being able to meet a consensus on the varying forms of condition, there was a lack of research being conducted on the disorder. Discussing the syndrome and its complexity frustrated researchers at the time. Contr...
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As late as the mid-1970s there was little evidence of a genetic role in autism, however by 2007 it was recognised as one of the most heritable psychiatric conditions. Although the rise of parent organizations and the destigmatization of childhood ASD have affected how ASD is viewed, parents continue to feel social stig...
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It took until 1980 for the DSM-III to differentiate autism from childhood schizophrenia. In 1987, the DSM-III-R provided a checklist for diagnosing autism. In May 2013, the DSM-5 was released, updating the classification for pervasive developmental disorders. The grouping of disorders, including PDD-NOS, autism, Asperg...
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The Internet has helped autistic individuals bypass nonverbal cues and emotional sharing that they find difficult to deal with, and has given them a way to form online communities and work remotely. Societal and cultural aspects of autism have developed: some in the community seek a cure, while others believe that auti...
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An autistic culture has emerged, accompanied by the autistic rights and neurodiversity movements who argue autism should be accepted as a difference to be accommodated instead of cured, although a minority of autistic individuals do continue seeking a cure. Worldwide, events related to autism include World Autism Aware...
https://en.wikipedia.org/wiki?curid=29113700
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Some autistic people, as well as a number of researchers, have advocated a shift in attitudes toward the view that autism spectrum disorder is a difference, rather than a disease that must be treated or cured. Critics have bemoaned the entrenchment of some of these groups' opinions.
https://en.wikipedia.org/wiki?curid=29113700
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The neurodiversity movement and the autism rights movement are social movements within the context of disability rights, emphasizing the concept of neurodiversity, which describes the autism spectrum as a result of natural variations in the human brain rather than a disorder to be cured. The autism rights movement advo...
https://en.wikipedia.org/wiki?curid=29113700