Skip to main content Accessibility help
  • Print publication year: 2007
  • Online publication date: August 2009

9 - Autism spectrum disorders and social disabilities


Autism was first described by Leo Kanner in 1943. He described 11 children with “extreme autistic aloneness” p. 242, failure to use language in a communicative fashion, and an obsessive desire for the maintenance of sameness. In the 60 years since this classic paper, there have been numerous studies on every aspect of autism, with the pace of research accelerating greatly in the last 15 years. Kanner's original description has held up remarkably well, and forms the basis for the three domains of diagnostic criteria found in DSM-IV-TR (American Psychiatric Association, 2000).

Impairment in social relationships, the first domain, has four behavioral markers: (a) impaired nonverbal communication, including eye contact and gesture, (b) poor peer relationships, including lack of interest in peers when young, and odd, one-sided relationships later on, (c) lack of joint attention (pointing to indicate interest, bringing items to show others, following a point), and (d) lack of emotional reciprocity, such as failure to notice or share another's distress.

The second domain is impairment in language and symbolic capacity, and includes: (a) language delay, (b) impaired ability to carry on a two-way conversation (when there is sufficient language), (c) perseverative and repetitive language, such as repeating what others say or what the child has heard in commercials or videos, or repeating favorite phrases over and over, and (d) absent, delayed, or repetitive pretend play.

Akshoomoff, N. (2005). The neuropsychology of Autistic Spectrum Disorder. Introduction to special issue. Developmental Neuropsychology, 27, 307–10.
Akshoomoff, N. & Stahmer, A. C. (2006). Early intervention programs and policies for children with autistic spectrum disorders. In Fitzgerald, H. E., Lester, B. M. & Zuckerman, B., eds., The Crisis in Youth Mental Health: Critical Issues and Effective Programs, Vol 1: Childhood DisordersWestport, CT: Praeger, pp. 109–31.
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th Ed, Text Revision (DSM-IV-TR). Washington, DC: American Psychiatric Press.
Baron-Cohen, S., Allen, J. & Gillberg, C. (1992). Can autism be detected at 18 months? The needle, the haystack, and the CHAT. British Journal of Psychiatry, 161, 839–43.
Bondy, A. & Frost, L. (2001). The Picture Exchange Communication System. Behavior Modification, 25, 725–44.
Bryson, S. E., Rogers, S. J. & Fombonne, E. (2003). Autism spectrum disorders: early detection, intervention, education, and psychopharmacological management. Canadian Journal of Psychiatry – Revue Canadienne de Psychiatrie, 48, 506–16.
Carper, R. A., Moses, P., Tigue, Z. D. & Courchesne, E. (2002). Cerebral lobes in autism: Early hyperplasia and abnormal age effects. NeuroImage, 16, 1038–51.
Carter, A. S., Volkmar, F. R., Sparrow, S. al. (1998). The Vineland Adaptive Behavior Scales: Supplementary norms for individuals with autism. Journal of Autism and Developmental Disorders, 28, 287–302.
Casanova, M. F., Buxhoeveden, D. P., Switala, A. E. & Roy, E. (2002). Minicolumnar pathology in autism. Neurology, 58, 428–32.
Castelli, F., Frith, C., Happe, F. & Frith, U. (2002). Autism, Asperger syndrome and brain mechanisms for the attribution of mental states to animated shapes. Brain: A Journal of Neurology, 125, 1839–49.
Chakrabarti, S. & Fombonne, E. (2005). Pervasive developmental disorders in preschool children: confirmation of high prevalence. American Journal of Psychiatry, 162, 1133–41.
Cohen, I. L., Schmidt-Lackner, S., Romanczyk, R. & Sudhalter, V. (2003). The PDD Behavior Inventory: A rating scale for assessing response to intervention in children with pervasive developmental disorder. Journal of Autism and Developmental Disorders, 33, 31–45.
Comings, D. E. & Comings, B. G. (1991). Clinical and genetic relationships between autism-pervasive developmental disorder and Tourette syndrome: A study of 19 cases. American Journal of Medical Genetics, 39, 180–91.
Constantino, J. N. (2002). The Social Responsiveness Scale. Los Angeles, CA: Western Psychological Services.
Courchesne, E., Carper, R. & Akshoomoff, N. (2003). Evidence of brain overgrowth in the first year of life in autism. Journal of the American Medical Association, 290, 337–44.
Courchesne, E., Townsend, J., Akshoomoff, N. al. (1994). Impairment in shifting attention in autistic and cerebellar patients. Behavioral Neuroscience, 108, 848–65.
Critchley, H. D., Daly, E. M., Bullmore, E. al. (2000). The functional neuroanatomy of social behaviour: changes in cerebral blood flow when people with autistic disorder process facial expressions. Brain, 123, 2203–12.
Croen, L. A., Grether, J. K. & Selvin, S. (2002). Descriptive epidemiology of autism in a California population: Who is at risk?Journal of Autism and Developmental Disorders, 32, 217–24.
Cuccaro, M. L., Wright, H. H., Abramson, R. K., Marsteller, F. A. & Valentine, J. (1993). Whole-blood serotonin and cognitive functioning in autistic individuals and their first-degree relatives. Journal of Neuropsychiatry and Clinical Neurosciences, 5, 94–101.
Delprato, D. J. (2001). Comparisons of discrete-trial and normalized behavioral language intervention for young children with autism. Journal of Autism and Developmental Disorders, 31, 315–25.
Dumont-Mathieu, T. & Fein, D. (2005). Screening for autism in young children: The Modified Checklist for Autism in Toddlers (M-CHAT) and other measures. Mental Retardation and Developmental Disabilities Research Reviews, 11, 253–62.
Dunn, L. M. & Dunn, L. M. (1997). Peabody Picture Vocabulary Test, 3rd edn. Circle Pines, MN: AGS Publishing.
Dunn, M. (2006). S.O.S. Social Skills in our Schools. Shawnee Mission, Kansas: Autism Asperger Publishing Co.
Fein, D., Dixon, P., Paul, J. & Levin, H. (2005). Brief Report: Pervasive Developmental Disorder Can Evolve into ADHD: Case Illustrations. Journal of Autism and Developmental Disorders, 35, 525–34.
Feinberg, E. & Vacca, J. (2000). The drama and trauma of creating policies on autism: Critical issues to consider in the new millennium. Focus on Autism and Other Developmental Disabilities, 15, 130–7.
Frith, U. (1989). Autism: Explaining the Enigma, 2nd edn. Malden, MA: Blackwell Publishing.
Garretson, H. B., Fein, D. & Waterhouse, L. (1990). Sustained attention in children with autism. Journal of Autism and Developmental Disorders, 20, 101–14.
Ghaziuddin, M. & Mountain-Kimchi, K. (2004). Defining the intellectual profile of Asperger Syndrome: comparison with high-functioning autism. Journal of Autism and Developmental Disorders, 34, 279–84.
Greenspan, S. I. & Weider, S. (1997). Developmental patterns and outcomes in infants and children with disorders in relating and communicating: A chart review of 200 cases of children with autistic spectrum diagnosis. The Journal of Developmental and Learning Disorders, 1, 87–141.
Griffith, E. M., Pennington, B. F., Wehner, E. A. & Rogers, S. J. (1999). Executive functions in young children with autism. Child Development, 70, 817–32.
Herbert, M. R., Harris, G. J., Adrien, K. al. (2002). Abnormal asymmetry in language association cortex in autism. Annals of Neurology, 52, 588–96.
Howard, J. S., Sparkman, C. R., Cohen, H. G., Green, G. & Stanislaw, H. (2005). A comparison of intensive behavior analytic and eclectic treatments for young children with autism. Research in Developmental Disabilities, 26, 359–83.
Iovannone, R., Dunlap, G., Huber, H. & Kincaid, D. (2003). Effective educational practices for students with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 18, 150–65.
Jennett, H. K., Harris, S. L. & Mesibov, G. B. (2003). Commitment to philosophy, teacher efficacy, and burnout among teachers of children with autism. Journal of Autism and Developmental Disorders, 33, 583–93.
Jolliffe, T. & Baron-Cohen, S. (2001). A test of central coherence theory: Can adults with high-functioning autism or Asperger syndrome integrate objects in context?Visual Cognition, 8, 67–101.
Just, M. A., Cherkassky, V. L., Keller, T. A. & Minshew, N. J. (2004). Cortical activation and synchronization during sentence comprehension in high-functioning autism: evidence of underconnectivity. Brain, 127, 1811–21.
Kaiser, A. P., Yoder, P. J. & Keetz, A. (1992). Evaluating milieu training. In Warren, S. F. & Reichle, J., eds., Causes and Effects in Communication and Language Intervention. Baltimore, MD: P. H. Brookes, pp. 9–47.
Kanner, L. (1943). Autistic disturbances of affective contact. The Nervous Child, 2, 217–50.
Khouzam, H. R., El Gabalawi, F., Pirwani, N. & Priest, F. (2004). Asperger's disorder: a review of its diagnosis and treatment. Comprehensive Psychiatry, 45, 184–91.
Kim, J. A., Szatmari, P., Bryson, S. E., Streiner, D. L. & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism, 4, 117–32.
Kjelgaard, M. M. & Tager-Flusberg, H. (2001). An investigation of language impairment in autism: Implications for genetic subgroups. Language and Cognitive Processes, 16, 287–308.
Kleinhans, N., Akshoomoff, N. & Delis, D. C. (2005). Executive functions in autism and Asperger's disorder: flexibility, fluency, and inhibition. Developmental Neuropsychology, 27, 379–401.
Klin, A., Volkmar, F. R., Sparrow, S. S., Cicchetti, D. V. & Rourke, B. P. (1995). Validity and neuropsychological characterization of Asperger syndrome: convergence with nonverbal learning disabilities syndrome. Journal of Child Psychology and Psychiatry and Allied Disciplines, 36, 1127–40.
Kravits, T. R., Kamps, D. M., Kemmerer, K. & Potucek, J. (2002). Brief report: increasing communication skills for an elementary-aged student with autism using the Picture Exchange Communication System. Journal of Autism and Developmental Disorders, 32, 225–30.
Kubina, R. M. J. & Wolfe, P. (2005). Potential Applications of Behavioral Fluency for Students with Autism. Exceptionality, 13, 35–44.
Lainhart, J. E. (1999). Psychiatric problems in individuals with autism, their parents and siblings. International Review of Psychiatry, 11, 278–98.
Liss, M., Fein, D., Allen, al. (2001). Executive functioning in high-functioning children with autism. Journal of Child Psychology and Psychiatry and Allied Disciplines, 42, 261–70.
Liss, M., Saulnier, C., Fein, D. & Kinsbourne, M. (2006). Sensory and attention abnormalities in autistic spectrum disorders. Autism. 10(2), 155–72.
Lord, C., Pickles, A., McLennan, al. (1997). Diagnosing autism: Analyses of data from the Autism Diagnostic Interview. Journal of Autism and Developmental Disorders, 27, 501–17.
Lord, C., Risi, S., Lambrecht, al. (2000). The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–23.
Lord, C., Rutter, M., DiLavore, P. C. & Risi, S. (2002). Autism Diagnostic Observation Schedule. Los Angeles, CA: Western Psychological Services.
Lord, C., Wagner, A., Rogers, S. et al. (2005). Challenges in evaluating psychosocial interventions for autistic spectrum disorders. Journal of Autism and Developmental Disorders, 35(6), 695–708.
Luna, B., Minshew, N. J., Garver, K. al. (2002). Neocortical system abnormalities in autism: an fMRI study of spatial working memory. Neurology, 59, 834–40.
McDougle, C. J. & Posey, D. J. (2003). Autistic and other pervasive developmental disorders. In Charney, D. S. & Leckman, J. F., eds., Pediatric Psychopharmacology. New York: Oxford University Press, pp. 563–79.
McEachin, J. J., Smith, T. & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal of Mental Retardation, 97, 359–72.
McGee, G. G., Krantz, P. J. & McClannahan, L. E. (1985). The facilitative effects of incidental teaching on preposition use by autistic children. Journal of Applied Behavior Analysis, 18, 17–31.
McGee, G. G., Morrier, M. & Daly, T. (2000). The Walden preschool. In Handleman, J. S. & Harris, S. L., eds., Preschool Education Programs for Children with Autism, 2nd edn. Austin, TX: PRO-ED, Inc.
McGinnis, E. & Goldstein, A. P. (1997). Skillstreaming the Elementary School Child: New Strategies and Perspectives for Teaching Prosocial Skills, rev. edn. Champaign, IL: Research Press.
Mesibov, G. B. (1997). Formal and informal measures on the effectiveness of the TEACCH programme. Autism, 1, 25–35.
Miller, J. N. & Ozonoff, S. (2000). The external validity of Asperger disorder: Lack of evidence from the domain of neuropsychology. Journal of Abnormal Psychology, 109, 227–38.
Millward, C., Powell, S., Messer, D. & Jordan, R. (2000). Recall for self and other in autism: children's memory for events experienced by themselves and their peers. Journal of Autism and Developmental Disorders, 30, 15–28.
Mottron, L., Burack, J. A., Iarocci, G., Belleville, S. & Enns, J. T. (2003). Locally oriented perception with intact global processing among adolescents with high-functioning autism: evidence from multiple paradigms. Journal of Child Psychology and Psychiatry and Allied Disciplines, 44, 904–13.
Muhle, R., Trentacoste, S. V. & Rapin, I. (2004). The genetics of autism. Pediatrics, 113, e472–e486.
Nation, K. & Norbury, C. F. (2005). Why reading comprehension fails: insights from developmental disorders. Topics in Language Disorders, 25, 21–32.
National Research Council, (2001). Educating children with autism. Washington, DC: National Academy Press.
Newschaffer, C. J., Falb, M. D. & Gurney, J. G. (2005). National autism prevalence trends from United States special education data. Pediatrics, 115, e277–e282.
O'Shea, A. G., Fein, D. A., Cillessen, A. H., Klin, A. & Schultz, R. T. (2005). Source memory in children with autism spectrum disorders. Developmental Neuropsychology, 27, 337–60.
Ozonoff, S. & Jensen, J. (1999). Brief report: Specific executive function profiles in three neurodevelopmental disorders. Journal of Autism and Developmental Disorders, 29, 171–7.
Ozonoff, S. & Strayer, D. L. (2001). Further evidence of intact working memory in autism. Journal of Autism and Developmental Disorders, 31, 257–63.
Panerai, S., Ferrante, L. & Zingale, M. (2002). Benefits of the Treatment and Education of Autistic and Communication Handicapped Children (TEACCH) programme as compared with a non-specific approach. Journal of Intellectual Disability Research, 46, 318–27.
Pascualvaca, D. M., Fantie, B. D., Papageorgiou, M. & Mirsky, A. F. (1998). Attentional capacities in children with autism: is there a general deficit in shifting focus?Journal of Autism and Developmental Disorders, 28, 467–78.
Phelps-Terasaki, D. & Phelps-Gunn, T. (1992). Test of pragmatic language. San Antonio, TX: Harcourt Assessment, Inc.
Pierce, K., Muller, R. A., Ambrose, J., Allen, G. & Courchesne, E. (2001). Face processing occurs outside the fusiform “face area” in autism: evidence from functional MRI. Brain, 124, 2059–73.
Piven, J., Arndt, S., Bailey, J. & Andreasen, N. (1996). Regional brain enlargement in autism: a magnetic resonance imaging study. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 530–6.
Robins, D. L., Fein, D., Barton, M. L. & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31, 131–44.
Rogers, S. J., Hall, Y., Osaki, D., Reaven, J. & Herbison, J. (2000). The Denver model: A comprehensive, integrated educational approach to young children with autism and their families. In Harris, S. & Handleman, J., eds., Preschool Programs for Children with Autism, 2nd edn. Austin, TX: PRO-ED, Inc.
Rutter, M., Bailey, A. & Lord, C. (2003 a). SCQ: The Social Communication Questionnaire Manual. Los Angeles, CA: Western Psychological Services.
Rutter, M., LeCouteur, A. & Lord, C. (2003 b). The Autism Diagnostic Interview – Revised. Los Angeles, CA: Western Psychological Services.
Saemundsen, E., Magnusson, P., Smari, J. & Sigurdardottir, S. (2003). Autism Diagnostic Interview – Revised and the Childhood Autism Rating Scale: convergence and discrepancy in diagnosing autism. Journal of Autism and Developmental Disorders, 33, 319–28.
Sallows, G. O. & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: Four-year outcome and predictors. American Journal on Mental Retardation, 110, 417–38.
Schopler, E., Reichler, R. J. & Renner, B. R. (1986). Childhood Autism Rating Scale. Circle Pines, MN: AGS Publishing.
Schreibman, L. (2005). The science and fiction of autism. Cambridge, MA: Harvard University Press.
Schreibman, L. & Koegel, R. L. (2005). Training for parents of children with autism: Pivotal responses, generalization, and individualization of interventions. In Hibbs, E. D. & Jensen, P. S., eds., Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice, 2nd edn. Washington, DC: American Psychological Association, pp. 605–31.
Schultz, R. T., Grelotti, D. J., Klin, al. (2001, November). An fMRI study of face recognition, facial expression detection, and social judgment in autism spectrum conditions. Proceedings of International Meeting for Autism Research, San Diego, CA.
Schultz, R. T., Romanski, L. M. & Tsatsanis, K. D. (2000). Neurofunctional models of autistic disorder and Asperger syndrome: Clues from neuroimaging. In Klin, A., Volkmar, F. & Sparrow, S. S. eds., Asperger syndrome. New York, NY: Guilford Press, pp. 172–209.
Schuntermann, P. (2002). Pervasive developmental disorder and parental adaptation: previewing and reviewing atypical development with parents in child psychiatric consultation. Harvard Review of Psychiatry, 10, 16–27.
Sherer, M. & Schreibman, L. (2005). Individual behavior profiles and predictors of treatment effectiveness for children with autism. Journal of Clinical Child and Consulting Psychology, 73, 525–38.
Sofronoff, K. & Farbotko, M. (2002). The effectiveness of parent management training to increase self-efficacy in parents of children with Asperger syndrome. Autism, 6, 271–86.
Sparrow, S. S., Cicchetti, D. & Balla, D. A. (2005). Vineland Adaptive Behavior Scales, 2nd edn. Circle Pines, MN: AGS Publishing.
Stahmer, A. C., Collings, N. M. & Palinkas, L. A. (2005). Early intervention practices for children with autism: Descriptions from community providers. Focus on Autism and Other Developmental Disabilities, 20, 66–79.
Stahmer, A. C., Ingersoll, B. & Koegel, R. L. (2004). Inclusive programming for toddlers autism spectrum disorders: Outcomes from the Children's Toddler School. Journal of Positive Behavior Interventions, 6, 67–82.
Stone, W. L. & Ousley, O. Y. (1997). Screening tool for autism in two-year-olds. Nashville, TN: Vanderbilt University.
Tidmarsh, L. & Volkmar, F. R. (2003). Diagnosis and epidemiology of autism spectrum disorders. Canadian Journal of Psychiatry – Revue Canadienne de Psychiatrie, 48, 517–25.
Toichi, M. & Kamio, Y. (1998). Verbal memory in autistic adolescents. Japanese Journal of Child and Adolescent Psychiatry, 39, 364–73.
Townsend, J., Courchesne, E. & Egaas, B. (1996). Slowed orienting of covert visual–spatial attention in autism: Specific deficits associated with cerebellar and parietal abnormality. Development and Psychopathology, 8, 563–84.
Trevathan, E. (2004). Seizures and epilepsy among children with language regression and autistic spectrum disorders. Journal of Child Neurology, 19, S49–S57.
Ventola, P., Kleinman, J., Pandey, al. (2006). Agreement among four diagnostic instruments for autism spectrum disorders in toddlers. Journal of Autism and Developmental Disorders, 36 (7), 839–47.
Volkmar, F. R. & Nelson, D. S. (1990). Seizure disorders in autism. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 127–9.
Williams, D. L., Goldstein, G. & Minshew, N. J. (2005). Impaired memory for faces and social scenes in autism: Clinical implications of memory dysfunction. Archives of Clinical Neuropsychology, 20, 1–15.
Williams, G. P., Sears, L. L. & Allard, A. (2004). Sleep problems in children with autism. Journal of Sleep Research, 13, 265–8.
Wing, L., Leekam, S. R., Libby, S. J., Gould, J. & Larcombe, M. (2002). The Diagnostic Interview for Social and Communication Disorders: background, inter-rater reliability and clinical use. Journal of Child Psychology and Psychiatry and Allied Disciplines, 43, 307–25.
Young, E. C., Diehl, J. J., Morris, D., Hyman, S. L. & Bennetto, L. (2005). The use of two language tests to identify pragmatic language problems in children with autism spectrum disorders. Language, Speech and Hearing Services in the Schools, 36, 62–72.