How has autism changed over the years? Autism has changed over time as research has supported new understandings and developments.
Research investigating biological and physical basics of autism has led to controversies, the most notorious being the article Wakefield, Murch, Anthony, Linnell, Casson, et al. in 1988. The article suggested that the Measles, Mumps and Rubella (MMR) vaccine was causing autism (Rao, 2011; Wakefield et al., 1998).
It also claimed that the preservative thimerosal found in the vaccine was a cause. Subsequent studies by government bodies debunked the claim as there was no evidence. Consequently, the preservative thimerosal was removed in 1999 (Thimerosal in Vaccines, 2014), and any existing vaccines that contained thimerosal expired in 2003 (Thimerosal in Vaccines, 2014). The article was branded as fraudulent (Rao, 2011) and to date there is no reliable proof that vaccines can cause autism.
Together with the focus toward biological origins, there was also efforts to concentrate on the management of autistic behaviours. In 1965 Lovaas, developed Applied Behaviour Analysis (ABA) therapy which was guided by behaviourist principles. The general purpose of ABA is to chunk skills into manageable teachings and then develop those skills “so that a child learns how to learn in a natural environment” (Lovaas Institute, 2005).
The Treatment and Education of Autistic and Related Communication Handicapped Children (TEACCH) is another intervention program that was developed by Eric Schopler in 1972 and continues to be used today. This program provides intervention and guidance and uses caregivers as “co-therapists” to help treat individuals with ASD (Mesibov et al., 2005).
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With all this in mind, it is evident that autism has changed over time. The definition of autism and the diagnostic criteria for autism have changed several times in the last hundred years.
Autism was initially listed as a form of childhood schizophrenia in the DSM-I (American Psychiatric Association, 1952) and under this diagnostic criterion, the first study was conducted in 1966 and found that 4.5/10,000 children had autism (Lotter, 1967), suggesting that it was a rare disorder.
Autism was not officially separated from schizophrenia until 1980 when it was labelled infantile autism in the DSM-III and 6 main criterions were necessary for diagnosis (Gernsbacher, Dawson, & Goldsmith, 2005). In 1987, another revision occurred to the definition and diagnostic criteria and the “infantile autism” definition expanded to become “autism spectrum disorder” in the DSM-III-R (American Psychiatric Association, 1987).
The clinical definition of autism changed yet again in 1994 when Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) & Asperger’s syndrome were added to the DSM-IV through the expansion of the diagnostic criteria to include subtypes of autism (Baker, 2013).
Another study conducted by the Centers for Disease Control in 2009 estimated that 1 in 110 children have autism spectrum disorder, which was an increase from the 1 in 150 estimate calculated in 2007 (Baio, 2012).
The CDC notes that prevalence rates increased partially from improved screening and diagnostic techniques. Finally, in 2013, the DSM-5 was published which again changed the definition of autism by consolidating the five subcategories of autism spectrum disorder (ASD) into one umbrella diagnosis of ASD with Asperger’s no longer being a separate condition.
Autism Spectrum Disorder is now defined by two categories: impaired social communication and/or interaction and restricted and/or repetitive behaviours (American Psychological Association, 2013). As of 2014, the Centers for Disease Control and Prevention estimate that autism affects 1 in 68 children (CDC, 2014). In April 2018 it was estimated that autism now affects 1 in 59 children.
Along with the changes in the definition and diagnosis of autism and an increased prevalence of autism, autism research and advocacy groups have also increased. The Organization for Autism Research was created in 2001 by parents and grandparents of autistic children who believed that applied research could help answer many of the questions they encountered in their daily lives (Research Autism, 2001).
Later in 2003, the National Autism Association, another parent run organization, formed to focus on issues related to severe autism such as safety and crisis prevention by providing family support (National Autism Association, 2015). Another organization also formed in 2005 when Autism Speaks was founded by Bob & Suzanne Wright to fund research, increase awareness, and advocate for autistic individuals and their families (Autism Speaks, 2013).
Stay tuned for a continuation of how autism has evolved throughout the years in my next blog post.
Voula Valanidas