Neurobiologic Correlates in the Classification and Study of Autism
Eric Schopler University of North Carolina Medical School
This volume grew out of an exciting workshop on neurocognitive deficits in children, with special emphasis on the most current methods for studying localization of cognitive functions in the brain and the stability of these patterns and their biological substrates with age and development. As an introduction to the autism section, it seems most useful to provide a historical perspective on the autism syndrome, on its official diagnostic classification, and on psychobiological research on autism. Because there have been such striking advances in the scientific methodology for studying some of the biological substrates of cognitive functions, a historical perspective may offer some guidelines for assessing which research prospects and strategies may provide better understanding and treatment in the future.
Infantile autism has had a relatively short scientific history beginning with Kanner ( 1943) classic introduction of the syndrome into the mental health literature. During these last five decades, two intriguing paradoxes have been reflected and debated in the field. The first has been the question of whether autism was primarily an emotional reactive disorder, a child's social withdrawal from unconscious hostility and misguidance by the parents, or was it better understood as a biological disorder? The second paradox has to do with the official diagnosis of autism. Should the official definition of autism in the Diagnostic and Statistical Manual of Mental Disorders ( DSM) of the American Psychiatric Association (APA) conform to the most precise definition available from current research knowledge or should it reflect the clinical, administrative, and legal needs for which the Manual is used in the United States. For the last part of this chapter, I discuss the implications of the resolution of these two paradoxes for future research strategies.