Key Points

• Autistic disorder has onset before age 3 years and is characterized by impaired social interaction, impaired communication, and repetitive, stereotyped patterns of behavior.

• Autism is not caused by thimerosal-containing vaccines.

• Standard developmental screening tests have poor sensitivity for autism.

• Early intervention with a multidisciplinary approach improves autism outcomes.

The term autism refers to a spectrum of pervasive developmental disorders characterized by various degrees of impaired social interaction and communication and repetitive, stereotyped patterns of behavior. Patients may have relatively good skills in one area and very poor skills in others. The specific diagnosis of "autistic disorder" has an onset before 3 years of age and requires the presence of impairments in all three categories, whereas "Asperger's disorder" includes impaired social interaction and autistic behaviors but excludes language delay. The incidence of autistic disorder is 5 to 20 per 10,000 persons, with a much higher occurrence among siblings of affected patients (3%-7%) (Schaefer and Mendelsohn, 2008). Mental retardation, typically in the moderate range (IQ 35-50), accompanies the disorder in 75% of affected children (DSM-IV-TR, 2000).

Evidence is mounting that both genetic and environmental factors influence the etiology of autism (Kolevzon 2007; Schaefer and Mendelsohn, 2008). Assertions that autism is caused by thimerosal-containing vaccines have been discounted by a comprehensive meta-analysis (Parker et al., 2004) (SOR: A).

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