Autism stands out from the crowd. The child seems aloof, a little anxious and withdrawn, preferring to engage in solitary activities rather than to mix in with children of the same age. Some, because of their inward focus and devotion, have extraordinary mastery of facts and figures. For these children, autism is not a disability, rather a different way of looking at the world.
But it is not always like that. A majority of those with autism and related disorders are more seriously affected. [At 12 months Austin began to box his ears at loud noises and cry for no apparent reason.] Sometimes with [intermittent rhythmic, repetitive movements of the head and entire body.]1 At 18 months, Austin spoke only a few words (e.g. Mama, Daddy, juice), yet these few words soon disappeared from his speech. Austin's parents were frightened and concerned – his father observed, [I knew that something was different about him. My wife and I were very nervous about bringing him to the evaluation.] This is how one autism expert recounts the story of a young subject.1 The severe type of autism is, unfortunately, the most common.
Even so, the tendency to social withdrawal and self-absorption are features both of high-functioning autism and of this more severe type. This has led many to argue that these are part of a continuum, and the term autistic spectrum disorder2,3 (or autism spectrum disorder) has entered common parlance.
The specific term [autistic] was introduced in the 1940s by Hans Asperger in Vienna4,5 and Leo Kanner in Baltimore6– 8 who described the key features of autism for the first time. The use of the word [autism] reflects the unusual self-absorption (autos is Greek for self) to the exclusion of others. However, the term had been used earlier – [Das autistische Denken]9 – and this description of a similar if not identical condition probably predated both Kanner and Asperger.9,10
Autism and autistic spectrum disorders (ASDs) are now defined by a triad of impairments – in social interaction, in communication including language, and in