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First described in the early 1940s, autism was thought to be a rare disorder, with a prevalence of 1 in 2,500 to 4,000. In the past several decades, in part because of an expansion of the symptom concept of autism, its prevalence has exploded to a rate of almost 1% of the population. While a full understanding of the syndrome must await better delineation of the genetics and pathophysiology of the “social brain,” advances in our knowledge of the nature and development of social communication, and of its failure to develop, have afforded us an initial toehold to explore what is fundamental to the disorder. Autistic symptoms may be seen in the first year of life, they vary in severity from mild to severe, and in a few instances they may improve over time, even without treatment.
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Autism Spectrum Disorder
by Lisa Joseph, Latha Soorya, and Audrey Thurm. In book series: Advances in Psychotherapy—Evidence-Based Practice. Hogrefe Publishing, Boston, MA, 2015, 99 pages, $29.80 (paper).
First described in the early 1940s, autism was thought to be a rare disorder, with a prevalence of 1 in 2,500 to 4,000. In the past several decades, in part because of an expansion of the symptom concept of autism, its prevalence has exploded to a rate of almost 1% of the population. While a full understanding of the syndrome must await better delineation of the genetics and pathophysiology of the “social brain,” advances in our knowledge of the nature and development of social communication, and of its failure to develop, have afforded us an initial toehold to explore what is fundamental to the disorder. Autistic symptoms may be seen in the first year of life, they vary in severity from mild to severe, and in a few instances they may improve over time, even without treatment. Social and behavioral interventions can be useful in increasing social skills and communication. Pharmacologic intervention may primarily help to alleviate other symptoms often found in persons with autism: severe anxiety, aggressive outbursts, attention deficits, and hypersensitivity to sensory input.
What is most important today is that parents, educators, pediatricians, and the general public be aware of recent advances in our understanding of autism. This book is an excellent primer on the subject. It is practical, succinct, accurate, and inclusive in its review of what is current in the field. It is a book for busy clinicians who do not have time to wade through out-of-date textbook chapters and hundreds of articles in the general literature to gain an appreciation of what will help them in their everyday work with students or patients. The authors are aware of what has been identified on the pathophysiology of autism (limited as these findings may be), but, most important, they know the diagnostic and the treatment issues from firsthand experience.
Each chapter concludes with a succinct case summary illustrating the salient features of autism as revealed in the chapter text. Chapter 2 lists the most popular screening and diagnostic instruments for assessing social communication and language disorder as well as the ancillary symptoms often seen in autism. Those instruments that are practical for use in the clinic are noted; those that are best for research are singled out.
Chapters 3 and 4, which comprise the bulk of the text, discuss treatment. I was pleased to see that several of the behavioral treatments have been studied sufficiently that their strengths and weaknesses can be stated with some degree of confidence.
The book concludes with a list of more than 200 references, many published in 2010 or later.
Altogether, this is an excellent primer on autism spectrum disorder.