Introduction

Reviewing psychological factors in autism presents a major challenge, given the vast amount of research that has accumulated over the past 50 years. In that time we have moved from largely speculative notions of what underlies the puzzling set of symptoms that children with autism present to us (Kanner, 1943) to a comprehensive knowledge of their strengths and weaknesses in a broad range of psychological domains. Our understanding of psychological factors has informed increasingly well-designed and productive approaches to the education and treatment of children with autism, so that theory and practice can build on each other in a synergistic way. This review of psychological aspects of autism is divided into sections covering the major domains of perception, cognition, affect, language, social behaviors, and neuropsychological factors.

One important issue that needs to be kept in mind concerns the powerful and pervasive influence of level of functioning on the symptoms, behaviors, and capabilities of children with autism. Low- and high-functioning children with autism are both similar in their core deficits, and very different in their adaptive level, and this makes some of our conclusions about psychological factors rather qualified. While the central social and communicative deficits may be common, there are clear differences in levels and profiles of abilities across the range of severity of autistic conditions; these differences affect adaptive behavior as well as intervention opportunities and outcome in later life.