Autism today Have we put the cart before the horse?

In a seminal article published in 1943, Leo Kanner1 described cases of school-aged children with notable impairments in social interaction and the presence of somewhat atypical, often repetitive, behaviors, which he characterized as “inborn autistic disturbances of affective contact.” While the term “autism” was coined by Bleuler in the early 1900s in connection with schizophrenia, it was Kanner (and then Asperger) who laid the foundation for autism being considered a neurodevelopmental disorder. Not until 1980, however, did autism become a formal clinical diagnosis (American Psychiatric Association, DSM-III, 1980). Since then, the term has evolved to encompass a wide range of cognitive abilities, comorbidities, and developmental stages known collectively as autism spectrum disorder (ASD), and increased awareness and broadening of this spectrum have been accompanied by a rapid rise in prevalence, now estimated to be 1:68 children.2

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