Autism spectrum disorder is not as certain as implied

doi:10.1136/bmj.326.7396.986

BMJ 2003;326:986 ( 3 May )

Letters

Autism spectrum disorder is not as certain as implied

The first 150 words of the full text of this article appear below.

EDITOR $---$ Szatmari's editorial implies more certainty about the existence of an autism spectrum and causes of autism than iswarranted.¹ Debate remains about the validity and usefulnessof a broad definition of autism.²

Autism and Asperger's syndrome are distinct, and although they share common difficulties in social relatedness and obsessiveness,they can be distinguished inthese.

In autism children are withdrawn, whereas in Asperger's syndrome they desire social contact but cannot negotiaterules.

In autism, which, unlike Asperger's syndrome, is associated with mental retardation, obsessiveness commonly entails routinebehaviours and physical objects, whereas in Asperger's syndromeit entails idiosyncratic and often highly intellectualinterests.

The distinction is comparable to that between schizophrenia and schizoid personality disorder. Like autism and Asperger'ssyndrome they share common features and genetic loading, but clinicallytheir distinction is crucial. A broad definition risks confusionand overdiagnosis, an increasing problem when worried parentsdemand diagnostic. . . [Full text of this article]