Qu'est-ce (qui) est autism - définition
![Reports of autism cases per 1,000 children grew dramatically in the U.S. from 1996 to 2007. It is unknown how much, if any, growth came from changes in autism's [[prevalence]].<ref name=Prevalence />](https://commons.wikimedia.org/wiki/Special:FilePath/US autism 6 17 1996-2007.svg?width=200 "Reports of autism cases per 1,000 children grew dramatically in the U.S. from 1996 to 2007. It is unknown how much, if any, growth came from changes in autism's [[prevalence]].<ref name=Prevalence />")
![[[Charles Ferster]] was a pioneer of what would become known as [[applied behavior analysis]].](https://commons.wikimedia.org/wiki/Special:FilePath/CB Ferster circa1972.jpg?width=200 "[[Charles Ferster]] was a pioneer of what would become known as [[applied behavior analysis]].")
![[[Eugen Bleuler]] created the concept of "autism".](https://commons.wikimedia.org/wiki/Special:FilePath/Eugen Bleuler.png?width=200 "[[Eugen Bleuler]] created the concept of \"autism\".")
![[[Leo Kanner]] introduced the label ''early infantile autism'' in 1943.](https://commons.wikimedia.org/wiki/Special:FilePath/Leo-Kanner.jpeg?width=200 "[[Leo Kanner]] introduced the label ''early infantile autism'' in 1943.")
![[[Temple Grandin]] became a prominent example of a person with autism.](https://commons.wikimedia.org/wiki/Special:FilePath/Temple Grandin at TED.jpg?width=200 "[[Temple Grandin]] became a prominent example of a person with autism.")
The autism spectrum is a range of neurodevelopmental conditions generally characterized by difficulties in social interactions and communication, repetitive behaviors, intense interests, and unusual responses to sensory stimuli. It is commonly referred to as autism or, in the context of a professional diagnosis, autism spectrum disorder (ASD).
A spectrum disorder is one that can manifest very differently from person to person: any given person with the disorder is likely to show some but not all of the characteristics associated with it, and may show them to very different degrees. Different autistic people might show strikingly different characteristics, and the same person might also present differently at different times. Historically, the autism spectrum was divided into sub-categories, but questions persisted over the validity of these divisions. The most recent editions of the major English-language diagnostic manuals, Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR, published in 2022) and International Classification of Diseases (ICD-11, released in 2021) both list ASD as a single disorder.
While psychiatry traditionally classifies autism as a neurodevelopmental disorder, many autistic people, most autistic advocates and a rapidly increasing number of researchers see autism as part of neurodiversity, the natural diversity in human thinking, and experience, with strengths, differences, and weaknesses. On this view, promoted by the autism rights movement, autism is not pathological, but this does not preclude autistic individuals from being disabled and potentially having high support needs due to co-occurring conditions and lack of person-environment fit. This relatively positive and holistic view of autism has led to a certain degree of friction between autistic individuals, advocates, charities, researchers and practitioners.
Other controversies in autism are scientific, sociological, political, or philosophical, and some have aspects of all four. First, it is controversial and uncertain if social-communication difficulties of autistic people are inherent core deficits (see empathizing-systemizing theory developed by Simon Baron-Cohen), or due to mismatch in social communication styles, cognition, and experiences resulting in bidirectional misunderstanding between autistic people and non-autistic people (see double empathy problem theory developed by autistic researcher Damien Milton and recent growing evidence that found that autistic people empathize, communicate and socialize well with autistic people), or a combination of both factors. A 2018 study has shown that autistic people are more prone to object personification, suggesting that autistic empathy may be not only more complex but also more all-encompassing, contrary to the popular belief that autistic people lack empathy.
Scientists are still trying to determine what causes autism; it is highly heritable and believed to be mainly genetic, but there are many genes involved, and environmental factors may also be relevant. There is also no cure for autism, so interventions focus on, for example, finding and learning other modes of communication in a non-verbal autistic person, or applied behavior analysis interventions. It is unclear why autism commonly co-occurs with ADHD, epilepsy and a range of other conditions. There are ongoing disagreements about what should be included as part of the autism spectrum, whether meaningful sub-types of autism exist, and the significance of autism-associated traits in the wider population. The combination of broader criteria and increased awareness has led to a trend of steadily increasing estimates of autism prevalence, causing a common misconception that there is an autism epidemic and perpetuating the myth that it is caused by vaccines.
Wikipédia
The epidemiology of autism is the study of the incidence and distribution of autism spectrum disorders (ASD). A 2022 systematic review of global prevalence of autism spectrum disorders found a median prevalence of 1% in children in studies published from 2012 to 2021, with a trend of increasing prevalence over time. However, the study's 1% figure may reflect an underestimate of prevalence in low- and middle-income countries.
ASD averages a 4.3:1 male-to-female ratio in diagnosis, not accounting for ASD in gender diverse populations, which overlap disproportionately with ASD populations. The number of children known to have autism has increased dramatically since the 1980s, at least partly due to changes in diagnostic practice; it is unclear whether prevalence has actually increased; and as-yet-unidentified environmental risk factors cannot be ruled out. In 2020, the Centers for Disease Control's Autism and Developmental Disabilities Monitoring (ADDM) Network reported that approximately 1 in 54 children in the United States (1 in 34 boys, and 1 in 144 girls) is diagnosed with an autism spectrum disorder (ASD), based on data collected in 2016. This estimate is a 10% increase from the 1 in 59 rate in 2014, 105% increase from the 1 in 110 rate in 2006 and 176% increase from the 1 in 150 rate in 2000. Diagnostic criteria of ASD has changed significantly since the 1980s; for example, U.S. special-education autism classification was introduced in 1994.
ASD is a complex neurodevelopmental disorder, and although what causes it is still not entirely known, efforts have been made to outline causative mechanisms and how they give rise to the disorder. The risk of developing autism is increased in the presence of various prenatal factors, including advanced paternal age and diabetes in the mother during pregnancy. In rare cases, autism is strongly associated with agents that cause birth defects. It has been shown to be related to genetic disorders and with epilepsy. ASD is believed to be largely inherited, although the genetics of ASD are complex and it is unclear which genes are responsible. ASD is also associated with several intellectual or emotional gifts, which has led to a variety of hypotheses from within evolutionary psychiatry that autistic traits have played a beneficial role over human evolutionary history.
Other proposed causes, such as childhood vaccines, are controversial. The vaccine hypothesis has been extensively investigated and shown to be false, lacking any scientific evidence. Andrew Wakefield published a small study in 1998 in the United Kingdom suggesting a causal link between autism and the trivalent MMR vaccine. After data included in the report was shown to be deliberately falsified, the paper was retracted, and Wakefield was struck off the medical register in the United Kingdom.
It is problematic to compare autism rates over the last three decades, as the diagnostic criteria for autism have changed with each revision of the Diagnostic and Statistical Manual (DSM), which outlines which symptoms meet the criteria for an ASD diagnosis. In 1983, the DSM did not recognize PDD-NOS or Asperger's syndrome, and the criteria for autistic disorder (AD) were more restrictive. The previous edition of the DSM, DSM-IV, included autistic disorder, childhood disintegrative disorder, PDD-NOS, and Asperger's syndrome. Due to inconsistencies in diagnosis and how much is still being learnt about autism, the most recent DSM (DSM-5) only has one diagnosis, autism spectrum disorder (ASD), which encompasses each of the previous four disorders. According to the new diagnostic criteria for ASD, one must have both struggles in social communication and interaction and restricted repetitive behaviors, interests and activities (RRBs).
ASD diagnoses continue to be over four times more common among boys (1 in 34) than among girls (1 in 154), and they are reported in all racial, ethnic and socioeconomic groups. Studies have been conducted in several continents (Asia, Europe and North America) that report a prevalence rate of approximately 1 to 2 percent. A 2011 study reported a 2.6 percent prevalence of autism in South Korea.
