Autism spectrum disorder: 70 years on and the plot thickens

Abstract

In 1943, Leo Kanner described 11 children with autistic disturbances of affective contact. A year later, he called this condition Early Infantile Autism. He described with great clarity, the basic symptoms, which still define the condition. In 70 years, we have not improved on the inclusion criteria for the diagnosis. Autism continues to be a disorder characterised by patterns of delay and deviance in the development of social and communicative skills with problems of repetitive and restricted behaviour, often with exceptional skills, arising in the first few years of life. Everything else about autism is a controversy. As a postgraduate student or resident, my first seminar in child psychiatry was on autism and I believe my abiding interest in autism began in 1975. At that time, the incidence was 1:40,000 children. It is hard to believe that the reported incidence of today, varying from 1 in 500 children to 1 in 88 children is only a matter of smarter doctors, teachers and parents.