Rethinking Autism

Rethinking Autism

Variation and Complexity

1st Edition - September 12, 2012

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  • Author: Lynn Waterhouse
  • Hardcover ISBN: 9780124159617
  • eBook ISBN: 9780123914132

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The media, scientific researchers, and the Diagnostic and Statistical Manual all refer to "autism" as if it were a single disorder or a single disorder over a spectrum. However, autism is unlike any single disorder in a variety of ways. No single brain deficit is found to cause it, no single drug is found to affect it, and no single cause or cure has been found despite tremendous research efforts to find same. Rethinking Autism reviews the scientific research on causes, symptomology, course, and treatment done to date…and draws the potentially shocking conclusion that "autism" does not exist as a single disorder. The conglomeration of symptoms exists, but like fever, those symptoms aren’t a disease in themselves, but rather a result of some other cause(s). Only by ceasing to think of autism as a single disorder can we ever advance research to more accurately parse why these symptoms occur and what the different and varied causes may be.

Key Features

  • Autism is a massive worldwide problem with increasing prevalence rates, now thought to be as high as 1 in 38 children (Korea) and 1 in 100 children (CDC- US)
  • Autism is the 3rd most common developmental disability; 400,000 people in the United States alone have autism
  • Autism affects the entire brain, including communication, social behavior, and reasoning and is lifelong
  • There is no known cause and no cure
  • Funding for autism research quadrupled from 1995 to 2000 up to $45 million, and the Interagency Autism Coordinating Committee has recommended $1 billion funding from 2010-2015


Developmental psychologists, child clinical psychologists, child psychiatrists, pediatric neurologists, and autism researchers.

Table of Contents

  • Foreword



    Chapter 1. Autism Heterogeneity

    Autism Heterogeneity is Extensive and Unexplained

    Autism Heterogeneity has Blocked Medical Treatment Discovery

    Diagnostic Criteria have not Constrained Autism Heterogeneity

    Variation in Autism Diagnostic Features

    Variation in Genetic Risk Factors for Autism

    Variation in Environmental Risk Factors for Autism

    Summary: Variation Exists in all Autism Domains

    Autism Subgroups and Unifying Theories for Autism have Addressed Heterogeneity

    Subgroups and Unifying Theories have not Explained the Variation in Autism

    Has Autism been Reified?

    Saving the Phenomena of Autism Variation

    How Should We View the Variation in Autism?

    Serious Concerns for Maintaining the Autism Diagnosis

    Eight Claims Concerning Autism Variation and the Autism Diagnosis


    Chapter 2. Autism Symptom Heterogeneity Exists in Family Members

    Four Pairs of Siblings with Varying Autism Symptoms

    Important Research Questions Raised by Variation in the Four Sibling Pairs

    Infant Sibling, Twin, and Family Studies of Autism

    Autism Symptoms in Identical and Fraternal Twins

    Heterogeneity in the Broader Phenotype of Autism

    Two Alternate Hypotheses about the Structure of the Broader Autism Phenotype

    Conclusions: Recurrence Risk Rates and Family Phenotypes Reflect Aggregates


    Chapter 3. The Social Brain is a Complex Super-Network

    The Phrenology Problem

    What Brain Circuits Support Social Behaviors?

    Mechanisms of The “Dark Matter” of Human Social Cognition

    Current Findings for “Social Brain” Deficits in Autism

    The Range and Variation in Autism Social Brain Deficits Suggest that Multiple Disorders have been Aggregated in Autism

    Conclusion: No Plausible Comprehensive Model of Social Deficits in Autism


    Chapter 4. Genetic Risk Factors Link Autism to Many Other Disorders

    Many Gene Variants Contribute to Autism

    Many Types of Genetic Mutations Contribute to Autism

    Three Fundamental Questions for Autism Genetics

    Question One: What are the Genetic Causal Patterns for Autism?

    Question Two: How Do Gene Variants Cause Autism Brain Deficits?

    Question Three: What Does it Mean that Autism Shares Genes with Other Disorders?


    Chapter 5. Environmental Risk Factors Link Autism to Many Other Outcomes

    The Lingering Effects of Two False but Influential Theories of Environmental Cause

    Environmental Causes Link Autism Symptoms to Symptoms of Many Other Outcomes

    Epigenetic Risk Factors for Autism Symptoms

    Immune System Reactivity, Dysfunction, and Neuroinflammation in Autism

    Conclusion: Prenatal, Perinatal, Epigenetic, and Immune System Risk Factors Link Autism to Other Outcomes and Lack Causal Specificity for Autism


    Chapter 6. Savant Skills, Special Skills, and Intelligence Vary Widely in Autism

    Unanswered Questions Regarding Savant, Prodigious, and Special Skills

    What are the Prevalence Rates of Savant and Prodigious Skills?

    Practice, Practice-Induced Brain Changes, and Atypical Brain Function Contributions to Savant, Prodigious, and Special Skills

    Intelligence, Savant and Superior Skills, and Sensory Abnormalities in Autism

    Conclusions: Theories of Savant Skills Do Not Explain Variation, and Public Attention to Savant Skills Supports an Unhelpful Stereotype of Autism


    Chapter 7. Increasing Prevalence and the Problem of Diagnosis

    Pressing Problems for the Diagnosis of Autism

    Conflicts in Stakeholder Ownership of the Diagnosis of Autism

    The Difficulties Inherent in the DSM System of Classification

    Problems with DSM-5 Autism Spectrum Diagnostic Criteria

    Conclusion: An Originalist View of Autism Avoids the Complexity of Evidence


    Chapter 8. Autism Symptoms Exist but the Disorder Remains Elusive

    The Autism Male to Female Ratio is Likely to be a Composite

    Much Research is Still Focused on Trying to Unify Autism as a Single Disorder

    Abandoning Autism as a Single Disorder Would Eliminate Three Inferential Problems in Autism Research

    The Existing Quandary and the Argument for Autism as Symptoms

    Conclusion: Autism Symptoms without a Disorder


    Subject Index

Product details

  • No. of pages: 480
  • Language: English
  • Copyright: © Academic Press 2012
  • Published: September 12, 2012
  • Imprint: Academic Press
  • Hardcover ISBN: 9780124159617
  • eBook ISBN: 9780123914132

About the Author

Lynn Waterhouse

Lynn Waterhouse
Dr. Lynn Waterhouse was the Director of Child Behavior Study at The College of New Jersey for 31 years, and is currently a Professor in Global Graduate Programs at the College. NIMH, NICHD, and private funding agencies supported her autism research. She worked with Dr. Lorna Wing on the APA DSM-III-R diagnostic criteria for autism.

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