1.2 Key concepts for this course
The word autism comes originally from ‘autos’, the Greek word for ‘self’ and means, literally, being absorbed in oneself. In 1943, the psychiatrist Leo Kanner adopted the term to describe some of his child patients: they appeared isolated from the world, withdrawn from social contact, and most had severe intellectual difficulties (Kanner, 1943). Kanner became convinced that these and other features of the children's behaviour reflected a syndrome, a specific disorder with a characteristic set of symptoms. Increasingly in recent years, the idea of an autistic syndrome has been elaborated to allow for a spectrum – a range or constellation of disorders reflecting slightly different patterns of symptoms, and collectively known as autistic spectrum disorders. The terms ‘autism’ and ‘autistic spectrum disorders’ (ASDs for short) will be used interchangeably throughout this chapter, as they are in much clinical work, as generic descriptions of this spectrum. Where the discussion deals specifically with the core or prototypical autistic syndrome, this will be referred to as classic autism; the terminology relevant to other sub-types of ASD will be introduced as necessary.
Despite individual variation in symptoms, ASDs are usually considered to involve a three-way pattern of impairment originally described by the psychiatrist Lorna Wing (Wing and Gould, 1979). This so-called triad consists of impairments in:
reciprocal social interaction;
scope and range of activities and interests.
Figure 1 illustrates key symptoms in the three areas of the triad. The central triangle gives examples of non-triad skills that may accompany the impairments.
A consistent finding is that males are more likely to be affected by ASDs than females: the ratio ranges from 4:1 for classic autism to as much as 10:1 for ‘milder’ conditions within the spectrum. It has so been noted that there is a similar male/female difference for dyslexia, and this is a typical feature of developmental disorders where communication is a central component.
Syndrome: A psychological or medical condition characterised by a specific set of symptoms that regularly occur together forming a recognisable pattern.
Symptoms: Characteristic manifestations of a psychological or medical condition that are observable to others and/or can be described by the person who experiences them.
Autistic spectrum disorders: Collective term for the group of closely related conditions all of which share some or many of the symptoms of classic autism.
Classic autism: The most typical type of autistic spectrum disorder, characterised by impairments in social interaction, verbal and non-verbal communication, and restricted scope of activities and interests.
Triad: Characteristic three-way pattern of impairments in autistic spectrum disorders.
National Autistic Society: Organisation for people with ASDs, their families and carers. Acts as a forum for exchange of ideas and information, spearheads national and international initiatives and raises public consciousness.