The Autism Spectrum, Autism Spectrum Disorders, and more recently, Autism Spectrum Conditions, are terms used to describe various neurodevelopmental conditions that include autism, Asperger Syndrome, and other associated conditions. Autism Spectrum Conditions were considered rare just two decades ago (Lai, Lombardo, & Baron-Cohen, 2014; Pennington, Cullinan, & Southern, 2014). Since then, reported prevalence rates have increased substantially. Zahorodny et al. (2014), report that epidemiologic studies have converged at a 1% estimated level of ASC prevalence, whereas they argue that it is actually as high as 2%. Wallis (2011), however, reported on a study that put prevalence rates even higher at 2.6%. Regardless, Zahorodny et al. (2014), maintain that “all the epidemiologic and administrative studies confirm that ASD is now among the most common, severe, developmental disorders” (p. 124). Accordingly, while a lot of progress had been made in the global awareness of ASC, determining true prevalence figures is still a major challenge. When considering developing nations, factors such as deficits in diagnostic skills, mal-adaptation of diagnostic criteria as it relates to cultural differences in behaviour, or under sampling, can contribute to international differences in prevalence rates (Fein, 2015; Onaolapo & Onaolapo, 2017).
Understanding of the autism spectrum has undergone numerous adaptations since being first formally identified early in the twentieth century. However, autism existed long before it attracted a label. Autism Spectrum Conditions are found worldwide, with considerable evidence to indicate their existence throughout human history (Deisinger, 2011). One of the earliest accounts was found in a 13th century book describing, the behaviour of a Franciscan monk indicative of a person with an ASC (Deisinger, 2011). Likewise, although officially inconclusive due to a lack of extensive history, it has been said that many famous historical figures would probably have been diagnosed with an ASC if they had lived today. Albert Einstein, Amadeus Mozart, Sir Isaac Newton, Charles Darwin, and Michelangelo are among many celebrated and brilliant figures who have exhibited considerable behaviours suggestive of ASC (Elder & Thomas, 2006; James, 2005).
In addition to knowledge and awareness, the present-day notion of the term autism, has evolved over time. Brennan (2015), explains that while the term has only been in use for approximately 100 years, its original use by a Swiss psychiatrist around 1911 referred to one group of symptoms of schizophrenia. In the 1940s, Leo Kanner, an Austrian specialist in child psychiatry living in the USA, adopted it to describe the withdrawn behaviour of children with emotional or social problems. Around the same time, Hans Asperger, an Austrian psychiatrist and paediatrician whose work was not internationally recognised until the 1990s, first identified what is known as Asperger’s Syndrome (ASD Level 1), describing what he called autistic psychopathy, a sub-category of autism. Lorna Wing coined the term Asperger’s Syndrome in her medical paper in 1981, naming the syndrome after Hans Asperger. The English-speaking world tended to use Kanner’s idea of “infantile autism” as the definition of autism. However, once Asperger’s work became recognised, it was realised that autism was far more extensive and complex than first thought (Jacobs, 2006).
Despite marked differences in verbal abilities between the children that Kanner studied, and those that Asperger examined, both Kanner and Asperger described the same core deficit in social interaction (Smith, Reichow, & Volkmar, 2015). The addition of AS into diagnostic manuals, such as the International Statistical Classification of Diseases and Related Health Problems (ICD-10th revision; Centres for Disease Control and Prevention, 1992), and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) improved the capacity of professionals and society to better understand the extent and range of the autism spectrum. However, certain similarities between Kanner’s and Asperger’s groups of children, together with particular differences, have caused considerable debate as to whether they were the same or different conditions ever since. Following the 2013 release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the integration of Asperger’s Syndrome into a diagnosis of autism spectrum disorder, that is now more commonly referred to as Autism Spectrum Conditions, also continues to create considerable worldwide disagreement as to whether they are the same or different conditions.
Dr. Bronwyn Wilson
References
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Brennan, D. (Producer). (2015, 1st January 2016). History of autism. [Article] Retrieved from http://www.webmd.com/brain/autism/history-of-autism
Deisinger, J. A. (2011). Chapter 10 History of autism spectrum disorders. In A. Rotatori (Ed.), History of Special Education (Vol. 21, pp. 237-267): Emerald Group Publishing Limited.
Elder, J., & Thomas, M. (2006). Different like me: my book of autism heroes. London: Jessica Kingsley.
Fein, E. (2015). “No one has to be your friend”: Asperger’s Syndrome and the vicious cycle of social disorder in late modern identity markets. Ethos, 43(1), 82-107. doi:10.1111/etho.12073
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Jacobs, B. (2006). Loving Mr Spock. Undertsanding an aloof lover. Could it be Asperger’s Syndrome? London: Jessica Kingsley Publishers.
James, I. (2005). Asperger’s Syndrome and high achievement : Some very remarkable people [1 online resource (226 pages)]. Retrieved from https://ebookcentral.proquest.com/lib/ECU/detail.action?docID=290867
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Wallis, C. (2011). Study in Korea puts autism’s prevalence at 2.6%, surprising experts. The New York Times. Retrieved from http://www.nytimes.com/2011/05/09/health/research/09autism.html?_r=3
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