1. Definition and history
Autism
Definition and history

2. Information supplied by National Autistic Society
Displays indifference
Joins in only if adult insists and assists
Indicates needs by using an adult's hand
One-sided interaction
Does not play with other children
Echolalic – copies words like a parrot
Talks incessantly about one topic
Bizarre behaviour
Handles or spins objects
Lack of creative, pretend play
Variety is not the spice of life
Eye contact is odd
Inappropriate laughing or giggling
But some can do some things very well, very quickly but not tasks involving social understanding

3. History Asperger (1944); Kanner (1943)
Innate inability to form the usual biologically provided affective contact with people
Poverty of facial expression
Many stereotypical movements that do not convey meaning
Impulsive and stimulus driven
Can have excellent logical and abstract thought
Kanner’s cardinal features:
Autistic aloneness
Obsessive insistence on sameness
Wing’s (1979) triad of impairments
Socialization, communication, imagination

4. Diagnosis ICD 10 (International classification of disorders)
DSM IV (Diagnostic and statistical manual)
DISCO (Diagnostic Interview for Social and Communication Disorders)
ADI (Autistic Diagnostic Instrument)
1 Impairment of social interaction
The most severe form is aloofness and indifference to other people although most enjoy certain forms of active physical contact and show attachment on a simple level to parents or carers.
2 Impairment of social communication
A lack of appreciation of the social uses and the pleasure of communication is always present in one form or another
3 Impairment of imagination
In children, inability to play imaginatively with objects or toys or with other children or adults is an outward manifestation of this impairment.

5. Stereotyped activities
Simple stereotyped activities include:
flicking fingers, objects, pieces of string watching things that spin
tapping and scratching on surfaces
inspecting, walking along and tracing lines and angles
feeling special textures
rocking, especially standing up and jumping from back foot to front foot
tapping, scratching or otherwise manipulating parts of the body
repetitive head banging or self injury
teeth grinding
repetitive grunting, screaming or other noises

6. Other stereotyped activities
Complex stereotyped activities involving objects include:
intense attachment to particular objects for no apparent purpose
a fascination with regular repeated patterns of objects, sounds
arranging objects in lines or patterns
the collection, for no apparent purpose, of large numbers of particular objects, such as plastic bottles, pebbles, or the tops from tubes of Smarties
Complex stereotyped activities involving routines include:
insistence on a lengthy bedtime ritual
repetition of a sequence of odd bodily movements
Complex verbal or abstract repetitive activities include:
fascination with certain topics, such as electricity, astronomy, birds, train timetables, even specific persons, asking the same series of questions and demanding standard answers

7. Incidence Baird et al (2006)
Within a total population cohort of 56 946 children aged 9–10 years, we screened all those with a current clinical diagnosis of ASD (n=255) or those judged to be at risk for being an undetected case (n=1515).
The prevalence of childhood autism was 38·9 per 10 000 (95% CI 29·9–47·8) and that of other ASDs was 77·2 per 10 000 (52·1–102·3), making the total prevalence of all ASDs 116·1 per 10 000 (90·4–141·8).
Prevalence of autism and related ASDs is substantially greater than previously recognised. Whether the increase is due to better ascertainment, broadening diagnostic criteria, or increased incidence is unclear.

8. Causes Girls with Turner’s syndrome (Skuse et al, 1997)
Concordance rates (Bailey et al, 2000)
36% in identical twins, with 82% language and/or intellectual impairments
0% in fraternal twins, with 10% language/or intellectual impairment
Wider phenotype
Comorbidity
PKU
Fragile X
Learnining disabilities
A third of adolescents have epileptic seizures
Many have abnormal EEG
Persistence of infantile reflexes
Stereotypic movements