Autism is more common now

Psychiatry, Psychosomatics & Psychotherapy

What are Autism Spectrum Disorders?

Autism spectrum disorders are profound developmental disorders that are caused by, among other things, a reduced interest in social contacts as well as one reduced understanding of social situations Marked are. In addition, there are linguistic peculiarities and restrictions, especially language development, but also the pragmatic use of language. Within the autism spectrum disorders there are different symptoms, manifestations and degrees of severity. Although the cause of these diseases cannot be treated to this day, targeted therapy can reduce the impairments in social interaction, significantly increase communication skills, and treat stereotypical behaviors and psychological concomitant diseases (comorbid psychological disorders) relatively well.

The term "autism" (Greek: autos = self; ismos = condition / orientation) was first used by the child psychiatrist Leo Kanner in 1943. The clinical picture he described at the time is today as early childhood autism or Kanner syndrome known. This disorder is always noticeable before the age of 3 and is usually meant when classic "autism" is mentioned in general. The Austrian pediatrician Hans Asperger also documented a more pronounced form of autism in the mid-1940s, in which the ability to speak is less impaired, the so-called Asperger syndrome. Besides these two manifestations there is also the atypical autism relatively common, which is characterized by limitations in two of the three central areas of social interaction, communication or stereotypical behavior. It can be variable with or without language development delay.

In the newly published version of the DSM, the DSM-5 (May 2013), the above-mentioned autism spectrum disorders are summarized in a category with different degrees of severity. This reflects findings from research on phenotypes, but also from genetic studies, that the underlying cause of the disorder (etiology) and the severity of the symptoms do not adhere to the previous diagnostic limits, but rather smooth transitions and an overlapping etiology are to be assumed.

Whereas in the past a frequency of occurrence (prevalence) of autism of 4 to 5 in 10,000 children was assumed, more recent studies speak of a frequency of all autism spectrum disorders of around 1% in children, adolescents and adults. The most common is atypical autism, followed by early childhood autism and then Asperger's syndrome. The decisive factor for the increase in the frequency of occurrence is only to a very small extent a real increase in the number of diseases. Rather, the intellectually better gifted children with autism spectrum disorders seem to have been overlooked earlier, i.e. those without the simultaneous handicap of an intellectual disability. This is also supported by the information that currently around a quarter to half of children with autism spectrum disorders are considered to be mentally handicapped, compared to earlier information of three quarters and more. Boys and men are three to four times more likely to be affected by autistic disorders than girls or women. The disease occurs worldwide in all social classes.

If an autism spectrum disorder is suspected, parents should definitely see a child and adolescent psychiatrist. Child and adolescent psychiatrists know the central differential diagnoses, such as anxiety and obsessive-compulsive disorders, intellectual disabilities without autism, disorders of social behavior or ADHD. You can also identify comorbid mental disorders, such as depressive episodes, and treat them in a targeted manner. The earlier the disease is discovered, the sooner the person affected can be treated and supported individually.

Technical support: Prof. Dr. med. Dipl. Theol. Christine M. Freitag, Frankfurt (DGKJP)