Autism

Autism spectrum disorder^[a] (ASD), or simply autism, is a neurodevelopmental disorder characterized by repetitive, restricted, and inflexible patterns of behavior, interests, and activities; deficits in social communication and social interaction; and the presence of high or low sensory sensitivity. A formal diagnosis requires that symptoms cause significant impairment in multiple functional domains, in addition to being atypical or excessive for the person's age and sociocultural context.^[11][12]

Autism manifests in various ways, with its severity and support needs varying widely across the underlying spectrum.^[11][12][13] For example, some autistic people are nonverbal, while others have proficient spoken language. Furthermore, the spectrum is multi-dimensional and not all dimensions have been identified as of 2024^[update].^[14][15]

Public health authorities and guideline developers classify autism as a neurodevelopmental disorder,^{[11][16][12][17][18]} but the autism rights movement (and some researchers) disagree with the classification. From this point of view, autistic people are representatives of human neurodiversity where their social problems are caused by social stigma, and that they should be accepted rather than cured.^[19][20][21] On the contrary, other scientists argue that autism impairs functioning in many ways inherent to the disorder itself and unrelated to society.^[22][23] The neurodiversity perspective has led to significant controversy among those who are autistic and advocates, practitioners, and charities.^[24][25]

The precise causes of autism are unknown in most individual cases. Research shows that the disorder is highly heritable and polygenic, and neurobiological risks from the environment are also relevant.^[26][27][28] Autism frequently co-occurs with attention deficit hyperactivity disorder (ADHD), epilepsy, and intellectual disability, and research indicates that autistic people have significantly higher rates of LGBTQ+ identities and feelings than the general population.^[29][30][31] Disagreements persist about what should be part of the diagnosis, whether there are meaningful subtypes or stages of autism,^[32] and the significance of autism-associated traits in the wider population.^[33][34]

The combination of broader criteria, increased awareness, and the potential increase of actual prevalence has led to considerably increased estimates of autism prevalence since the 1990s.^[35][36] The WHO estimates about 1 in 100 children had autism between 2012 and 2021, as that was the average estimate in studies during that period, with a trend of increasing prevalence over time.^[b][9][10] This increasing prevalence has reinforced the myth perpetuated by anti-vaccine activists that autism is caused by vaccines.^[37] Boys are also significantly far more frequently diagnosed than girls.^[38]

There is no known cure for autism, and some advocates dispute the need to find one.^[39][40] Interventions such as applied behavior analysis (ABA), speech therapy, and occupational therapy aim to teach children self-care, social and communicative skills.^[41][42] Guidelines from the Centres for Disease Control (CDC), and European Society for Child & Adolescent Psychiatry endorse the use of ABA on the grounds that it reduces symptoms impairing daily functioning and quality of life,^[41][43] but the National Institute for Health and Care Excellence cites a lack of high-quality evidence to support its use.^[44] Additionally, some in the autism rights movement oppose its application due to a perception that it emphasises normalisation.^[45][46][47] No medication has been shown to reduce ASD's core symptoms,^[43] but some can alleviate comorbid issues.^[48][49][50]

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