Redefinering af autisme i det 21. århundrede
Professor, Leder af Behavioural and Brain Sciences
Institut for Child Health, på Great Ormond Street Hospital i London
The term Autism first became a separate diagnostic category in 1980 (DSM-III), although the characteristic features had first been described by Kanner and Asperger nearly 40 years previously. Until recently, the classification systems used by the USA and the WHO have defined the condition in terms of a triad of impairments; these comprised features of social reciprocity and social communication, as well as a mix of repetitive and stereotyped behaviours. In later revisions to the diagnostic systems of the USA and WHO subtypes, such as Asperger syndrome, gained entry. Yet in May 2013, after reviewing scientific literature about autism and its variants that had accumulated over several decades, the American Psychiatric Association produced a revised definition (DSM-5). The new rubric described just one over-arching diagnosis: Autism Spectrum Disorders (ASD). Subcategories were no longer recognized. DSM-5 described ASD as comprising many conditions, of heterogeneous origin, that share characteristic features of behaviour and cognitive traits. The WHO has recently (2018) published online its own guidelines for classifying Autism Spectrum Disorders; these are currently incomplete, and provisional. An international group of autism experts advised the WHO and produced criteria for ASD; their guidelines have not yet been fully implemented. In this lecture, I will review those recommendations, how they align with, and where they diverge from the DSM-5. In conclusion, I will discuss why autism should be reconceptualized for the 21st Century.