Autism

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Autism spectrum disorder^[a] (ASD), or simply autism, is a neurodevelopmental disorder "characterized by persistent deficits in social communication and social interaction across multiple contexts" and "restricted, repetitive patterns of behavior, interests, or activities".^[11] Sensory abnormalities are also included in the diagnostic manuals. Common associated traits such as motor coordination impairment are typical of the condition but not required for diagnosis. A formal diagnosis requires that symptoms cause significant impairment in multiple functional domains; in addition, the symptoms must be atypical or excessive for the person's age and sociocultural context.^[12][13]

Autism is a spectrum, meaning it manifests in various ways, with its severity and support needs varying widely across different autistic people.^[12][13][14] For example, some autistic people are nonverbal, while others have proficient spoken language. Furthermore, the spectrum is multi-dimensional and not all dimensions have been identified as of 2024^[update].^[15][16]

Public health authorities and guideline developers classify autism as a neurodevelopmental disorder,^{[12][17][13][18][19]} but the autism rights movement (and some researchers) disagree with the classification. From the latter point of view, autistic people may be diagnosed with a disability, but that disability may be rooted in the structures of a society rather than the person.^[20][21][22] On the contrary, other scientists argue that autism impairs functioning in many ways that are inherent to the disorder itself and unrelated to society.^[23][24] The neurodiversity perspective has led to significant controversy among those who are autistic and advocates, practitioners, and charities.^[25][26]

The precise causes of autism are unknown in most individual cases. Research shows that the disorder is highly heritable and polygenic, and neurobiological risks from the environment are also relevant.^[27][28][29] Boys are also significantly far more frequently diagnosed than girls.^[30]

Autism frequently co-occurs with attention deficit hyperactivity disorder (ADHD), epilepsy, and intellectual disability.^[31][32][33] Disagreements persist about what should be part of the diagnosis, whether there are meaningful subtypes or stages of autism,^[34] and the significance of autism-associated traits in the wider population.^[35][36]

The combination of broader criteria, increased awareness, and the potential increase of actual prevalence has led to considerably increased estimates of autism prevalence since the 1990s.^[37][38] The WHO estimates about 1 in 100 children had autism between 2012 and 2021, as that was the average estimate in studies during that period, with a trend of increasing prevalence over time.^[b][9][10] This increasing prevalence has contributed to the myth perpetuated by anti-vaccine activists that autism is caused by vaccines.^[39]

There is no known cure for autism. Some advocates dispute the need to find one.^[40][41] Interventions such as applied behavior analysis (ABA), speech therapy, and occupational therapy can help these children gain self-care, social, and language skills.^[42][43] Guidelines from the US Centers for Disease Control and Prevention (CDC) and European Society for Child & Adolescent Psychiatry endorse the use of ABA on the grounds that it reduces symptoms impairing daily functioning and quality of life,^[42][44] but the National Institute for Health and Care Excellence cites a lack of high-quality evidence to support its use.^[45] Additionally, some in the autism rights movement oppose its application due to a perception that it emphasizes normalization.^[46][47][48] No medication has been shown to reduce ASD's core symptoms,^[44] but some can alleviate comorbid issues.^[49][50][51]

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