My name is Fred Volkmar.
I'm a Child Psychiatrist and the Irving B. Harris Professor of Child Psychiatry,
Pediatrics, and Psychology at
Yale University located at the Child Study Center at the School of Medicine.
I'm also the editor of the "Journal of Autism and Developmental Disorders".
This morning, I'm going to be doing a brief overview of autism and related disorders,
talking about its etiology, diagnosis, and treatment.
We're going to be talking about the origins of the diagnostic concepts,
early findings that were really key in terms of directing subsequent research.
We'll do a quick summary of diagnostic approaches,
both categorical and dimensional,
a brief summary of the genetics and neurobiology of the condition,
its treatment, course, and outcome.
Origins of interest in autism.
Probably, the first reports of what we now would see as children with
autism or related disorders were some of the reports of feral or wild children,
for example, by Itard in France in the early 1800.
There were other reports as well including in the US in the late 18th,
19th century reports of children with
developmental disabilities when retrospect likely, also had autism.
The really major landmarks in the field can be summarized relatively briefly.
In 1943, Leo Kanner,
the first child psychiatrist in the United States,
wrote a paper which he described "Early Infantile Autism".
We'll spend a lot of time talking about Kanner's concept.
He thought there were two key features,
one was autism, living in your own world,
being oblivious to other people from
the first days of life if not from the beginning of life itself,
and also he talked about the trouble these children had with change.
They resisted change, they engaged in repetitive behaviors
that he saw as an attempt on their part to keep the world the same.
A year later, a viennese medical student,
Hans Asperger, wrote about what he called 'autistic personality disorder'.
This is interesting as he used the same word,
autism that Leo Kanner had used.
However, he was talking about this less as a developmental disorder,
and more as a personality disorder.
In some ways, certainly the interest now is what seen as
the broader autism spectrum concept to
the broad autism phenotype really can be traced directly back to Asperger.
The commonalities of these two reports had was the use of the word autism,
difficulties understanding social interaction.
As I mentioned, Kanner thought that the important features
of autism was first of all was the autism,
the social lack of interest.
He also talked about communication problems and emphasized unusual behaviors.
A point of fact, however, there was early confusion about autism,
was it a version of childhood schizophrenia?
Which the answer was no.
Was it some other condition or was it really its own thing, in its own right?
By 1980, sufficient research had come that was officially recognized in DSM-III.
After that time, there's been an explosion of research on
these related conditions. What's in a name?