Skip to main content Accessibility help
×
Home

Autistic spectrum disorders

  • Brian P Hallahan (a1) and Kieran C Murphy (a1)

Abstract

Autistic spectrum disorders (ASD), are a group of disorders characterised by qualitative abnormalities in social and emotional behaviour and are associated with restricted, stereotyped and repetitive interests and activities. There has been considerable understanding of ASD in recent years. This educational review paper focuses on four areas of interest and relevance to trainees preparing for the membership examination of the Royal College of Psychiatrists (MRCPsych): (a) diagnosing ASD; (b) epidemiology of ASD; (c) aetiology, including genetic, cognitive and neurochemical/neuropathological theories in ASD; and (d) treatment of ASD. Relevant papers are discussed and recommendations for further reading are provided.

Copyright

References

Hide All
1.World Health Organisation. The ICD-10 classification for mental and behavioural disorders: clinical description and diagnostic guidelines. Geneva, Switzerland: WHO, 1992.
2.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Association, 1994.
3.Rimland, B, Fein, D. Special talents of autistic savants. In: The exceptional brain, ed. Obier, LK, & Fein, D, New York: Guildford, 1988.
4.Hermelin, B. Bright splinters of the mind. A personal story of research with autism savants. London: Jessica Kingsley, 2002.
5.Kanner, L. Autistic disturbances of affective contact. Nervous Child 1943; 2: 217250.
6.Asperger, H. ‘Autistic psychopathy’ in childhood, in Autism and Asperger syndrome (ed. Frith, U), pp. 3792. Cambridge University Press, 1944.
7.Wing, L. Asperger's syndrome: a clinical account. Psychol Med 1981; 11: 115129.
8.Baird, Get al.A screening instrument for autism at 18 months of age: a 6 year follow-up study. J Am Acad Child Adolescent Psychiatry 2000; 39, 694702.
9.Chakrabarti, S, Fombonne, E. Pervasive developmental disorders in preschool children: confirmation of high prevalence. Am J Psychiatry 2005; 162: 1133–41.
10.Volkman, FR. Medical Problems, Treatments, and Professionals. In: Powers, MD, ed. Children with Autism: A Parent's Guide, Second Ed. Bethesda, MD: Woodbine House, 2000.
11.Russell, AJ, Mataix-Cols, D, Anson, M, Murphy, DG. Obsessions and compulsions in Asperger syndrome and high-functioning autism. Br J Psychiatry 2005; 186: 525528.
12.Piven, J, Landa, R, Gayle, J, Cloud, D, Chase, G, Folstein, S. Psychiatric disorders in the parents of autistic individuals. J Am Acad Child Adolesc Psychiatry 1991; 30: 471478
13.Piven, J, Palmer, P. Psychiatric disorder and the broad autism phenotype: evidence from a family study of multiple-incidence autism families Am J Psychiatry 1999; 156: 557563.
14.Chakrabarti, S, Fombonne, E. Pervasive developmental disorders in preschool children. JAMA 2001; 285.
15.Fombonne, E. The prevalence of autism. JAMA 2003; 289: 8789.
16.Bettelheim, B. The empty fortress: infantile autism and the birth of self. New York: The Free Press, 1967.
17.Bailey, Aet al.Autism as a strongly genetic disorder: evidence from a British twin study. Psycho Med 1995; 25: 6378.
18.Jorde, Let al.Complex segregation analysis of autism. Am J Hum Genet 1991; 49: 932938.
19.Ashley-Koch, Aet al.Genetic studies of autistic disorder and chromosome 7. Genomics 1999; 61: 227236.
20.Vincent, JBet al.Identification of a novel gene on chromosome 7q31 that is interrupted by a translocation breakpoint in an autistic individual. Am J Hum Genet 2000; 67: 510514.
21.Santangelo, SL, Tsatsanis, K, Risk factors for autism: genes, brain, and behavior. Am J Pharmacogenomics. 2005; 5: 7192.
22.Baron-Cohen, S, Tager-Flusberg, H, Cohen, DJ. Understanding other minds. Perspectives from cognitive neuroscience. Oxford University Press, 2000.
23.Castelli, F, Frith, C, Happé, F, Frith, U. Autism, Asperger syndrome and brain mechanisms for the attribution of mental states to animated shapes. Brain 2002; 125: 18391849
24.Russell, J. Autism as an executive disorder. Oxford University Press, 1997.
25.Murphy, DGet al.Asperger syndrome: a proton magnetic resonance spectroscopy study of the brain. Arch Gen Psychiatry 2002; 59: 885891.
26.Hill, EL, Frith, U. Understanding autism: insights from mind and brain. Philos Trans R Soc Lond B Biol Sci 2003; 28: 281289.
27.Happé, F. Autism: cognitive deficit or cognitive style? Trends Cogn Sci 1999; 3: 299307.
28.Schain, RJ, Freedman, DX. Studies on 5-hydroxyindole metabolism in autistic and other mentally retarded children. J Pediatr 1961; 58: 315320.
29.McDougle, CJet al.Effects of tryptophan depletion in drug-free adults with autistic disorder. Arch Gen Psychiatry 1996; 53: 9931000.
30.Chugani, DCet al.Developmental changes in brain serotonin synthesis capacity in autistic and nonautistic children. Annu Neurol 1999; 45: 287295.
31.Hollander, Eet al.A placebo controlled crossover trial of liquid fluoxetine on repetitive behaviors in childhood and adolescent autism. Neuropsychopharmacology 2005;30:582–9.
32.Veenstra-Vanderweele, J, Christian, SL, Cook, EH Jr, Autism as a paradigmatic complex genetic disorder. Annu Rev Genomics Hum Genet 2004; 5: 379405.
33.Murphy, DGMet al. Cortical 5-HT2A receptor binding and social communication in adults with Asperger syndrome; an in vivo SPET study Am J Psychiatry 2005 (in press).
34.Fombonne, E, Roge, B, Claverie, J, Courty, S, Fremolle, J. Microcephaly and macrocephaly in autism, J Autism Dev Disord 1999; 29:113119.
35.Bailey, A, Phillips, W, Rutter, M. Autism: towards an integration of clinical, genetic, neuropsychological, and neurobiological perspectives. J Child Psychol Psychiatry 1996 37: 89126.
36.Courchesne, E, Carper, R, Akshoomoff, N. Evidence of brain overgrowth in the first year of life in autism. JAMA 2003; 16: 337344.
37.Carper, RA, Moses, P, Tigue, ZD, Courchesne, E. Cerebral lobes in autism: early hyperplasia and abnormal age effects. Neuroimage 2002; 4: 10381051.
38.Sparks, BFet al.Brain structural abnormalities in young children with autism spectrum disorder. Neurology 2002; 59: 184192.
39.McAlonan, GMet al.Brain anatomy and sensorimotor gating in Asperger's syndrome. Brain 2002; 125: 15941606.
40.Deruelle, C, Rondan, C, Gepner, B, Tardif, C. Spatial frequency and face processing in children with autism and Asperger syndrome, J Autism Dev Disord 2004 34: 199210.
41.Grelotti, D, Gauthier, I, Schultz, RT. Social interest and the development of cortical face specialization: what autism teaches us about face processing, Dev Psychobiol 2002; 40: 213225.
42.Boucher, J, Lewis, V. Unfamiliar face recognition in relatively able autistic children, J. Child Psychol. Psychiatry 1992; 33: 843859.
43.Davies, S, Bishop, D, Manstead, ASR, Tantam, D. Face perception in children with autism and Asperger's syndrome, J. Child Psychol Psychiatry 1994; 35: 10331057.
44.Hauck, M, Fein, D, Maltby, N. Memory for faces in children with autism. Child Neuropsychol 1999; 4: 187198.
45.Haxby, JVet al.The functional organization of human extrastriate cortex: a PET-rCBF study of selective attention to faces and locations. J Neurosci 1994; 14: 63366353.
46.Haxby, JVet al.The effect of face inversion on activity in human neural systems for face and object perception. Neuron 1999; 22: 189199.
47.Kanwisher, N, McDermott, J, Chun, MM. The fusiform face area: a module in human extrastriate cortex specialized for face perception, J Neurosci 1997; 17: 43024311.
48.Schultz, RTet al.Abnormal ventral temporal cortical activity during face discrimination among individuals with autism and Asperger syndrome. Arch Gen Psychiatry 2000; 57: 331340.
49.Lord, C, Rutter, M, Le Couteur, A. Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord 1994; 24: 659685.
50.Lord, Cet al.The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord 2000; 30: 205223
51.de Bildt, Aet al.Interrelationship between Autism Diagnostic Observation Schedule-Generic (ADOS-G), Autism Diagnostic Interview-Revised (ADI-R), and the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) classification in children and adolescents with mental retardation. J Autism Dev Disord 2004 34: 129–37.
52.Lovaas, OI. 1987. Behavioral treatment and normal educational and intellectual functioning in young autistic children. J Consult Clin Psychol 1987; 55, 39.
53.McEachin, JJ, Smith, T, Lovaas, OI. Long-term outcome for children with autism who received early intensive behavioural treatment. Am J Ment Retardation 1993; 97: 359372.
54.Smith, T, Eikeseth, S, Klevstrand, M, Lovaas, OI. Intensive behavioral treatment for preschoolers with severe mental retardation and pervasive developmental disorder. Am J Ment Retard 1997; 102: 238249.
55.Howlin, P. The evidence base for psychological therapies for autism. Society for the Study of Behavioural Phenotypes 9th International Symposium, Cairns, Australia, 2005.
56.McDougle, CJet al.A double-blind, placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders. Arch Gen Psychiatry 1998; 55: 633641.
57.McCracken, JTet al, for Research Units on Pediatric Psychopharmacology Autism Network. Risperidone in children with autism and serious behavioral problems. N Engl J Med 2002;347:314321.
58.Shea, Set al.Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics 2004; 114: 634641.
59.Research Units on Pediatric Psychopharmacology Autism Network. Risperidone Treatment of Autistic Disorder: Longer-Term benefits and blinded discontinuation after 6 months. Am J Psychiatry 2005; 162: 13611369.
60.McDougle, CJet al.A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Arch Gen Psychiatry. 1996; 53: 10011008.

Diagnosis of AS D

1.American Psychiatric Association. Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Association, 1994.
2.Russell, AJ, Mataix-Cols, D, Anson, M, Murphy, DG. Obsessions and compulsions in Asperger syndrome and high-functioning autism. Brit J Psychiatry 2005; 186: 525528. Cognitive Theories in ASD
1.Hill, EL, Frith, U. Understanding autism: insights from mind and brain. Philosophical transactions of the Royal Society of London. Series B, Biological sciences 2003; 28: 281289.

Neurochemical/neuropathological theories of autism

1.Courchesne, E, Carper, R, Akshoomoff, N. Evidence of brain overgrowth in the first year of life in autism. JAMA 2003; 16: 337344.
2.Schultz, RT, Gauthier, I, Klin, Aet al.Abnormal ventral temporal cortical activity during face discrimination among individuals with autism and Asperger syndrome. Arch Gen Psychiatry 2000; 57: 331340

Therapeutics

1.McDougle, CJ, Homes, JO, Carlson, DC, Pelton, GH, Cohen, DJ, Price, LH. A double-blind, placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders. Arch Gen Psychiatry 1998; 55: 633641.
2.Hollander, E, Anagnostou, E, Chaplin, Wet al.Striatal volume on magnetic resonance imaging and repetitive behaviors in autism. Biol Psychiatry 2005; 58: 226–32.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed