Autism

History

Etymology

Before the 20th century, autism was not readily distinguished from other forms of mental disorder, and autistic people were frequently referred to as "idiots" or "intellectually disabled".

In the 1910s, psychiatrist Eugen Bleuler invented the term autism as an alternative term for "schizophrenia". The same term was reused in its modern sense in the 1940s, notably by psychiatrists L. Kanner and Hans Asperger, to describe children suffering from an "innate disorder of emotional contact".

Idiot was a medical term employed by psychiatrists of the 19th century, who called themselves "alienists" at that time.

Asperger syndrome

In the 1940s, Hans Asperger first identified the significant variation in intellectual capacity among autistic individuals. Some individuals posses apparently an intelligence superior to average, and can participate fully in society. One person, as he noted, even built a university career. Other individuals, however, demonstrated much more limited intelligence. Some individual, for example, were always unable to communicate with speech.

Under the context of eugenics, Asperger was uncomfortable grouping the high-functioning autistic individuals more-or-less living autonomously and other autistic individuals needing extensive, continuous care under the same category. However, he did not employ the term "Asperger's syndrome" to designate high-functioning autistic individuals. It was the British pyschiatrist Lorna Wing, herself mother of an autistic child, who coined the term in her 1981 publication to designate high-functioning autistic people.

Today, the dinstinction of "Asperger syndrome" from other forms of autism is no longer made.

Diagnostic criteria

DSM-5-TR defines the diagnostic criteria for autism under F84.0:

A. Persistent deficits in communication and social interaction

Such deficit can be either observed in the current period or previously, and must be across various contexts.

1. Deficits in social or emotional reciprocity, in milder forms an incapacity to hold bidirectional conversations, a difficulty in sharing one's interests and emotions, and in severe forms incapacity to initiate or respond to social requests
2. Deficits in non-verbal communication, in expression or comprehension
3. Deficits in development, maintenance, and comprehension of relations, in milder forms difficulty to adapt one's behaviour according to social context or difficulty in participating in imaginative games or making friends, and in severe forms a complete lack of interest to making connections.

B. Repetitive and restricted behaviour, interest, or activity

As witnessed by at least two elements of the list below, either observed in the current period or previously:

1. repetitive movements or speech
2. intolerance to change: unwavering adherence to routines or verbal/non-verbal behaviour modes
3. extremely restricted and fixed special interests, special either in intensity or goal
4. hyper or hyporeactivity to sensorial stimulations, or unusual interest in certain sensorial stimulations

C. The symptoms must be present from the early stages of development

The symptoms may not be fully manifested until social expectations exceed the limited capacity of the individual, and may be masked in later life by learnt strategies.

D. The symptoms cause a current, clinically significant impact on life

In terms of social or academic/professional function, or other important areas of life.

Treatment

To date (2026), there is no scientifically-proven medication dedicated to autism.

However, various treatment have been proposed to aid autistic individuals to better live and integrate into society.

ABA

Applied behaviour analysis (ABA) seeks to teach desired behaviour to autistic children through reinforcement learning, similar to in pet training: punishment for undesired behaviour, and reward for desirable behaviour.

TEACCH

First proposed by German-American psychologist Eric Schopler in the 1960s, unlike the ABA method, the Treatment and Education of Autistic and related Communication-handicapped Children (TEACCH) method does not seek to force the adoption of "normal" behaviour by autistic individuals, but rather provide them with a structured environment adapted to their special needs where they can develop their competences.

Core elements of a TEACCH environment include:

• Highly predictable spatial and temporal organisation
  • decided before hand
  • clearly, visually communicated

Example:

Time period	Space	Activity
$t_1$	$S_1$	Work
$t_2$	$S_2$	Break
$t_3$	$S_1$	Work
$t_4$	$S_3$	Lunch

• Adaptation to individual sensitivity to environmental distractions
  • e.g., minimised noise for those sensitive to noise