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For further information, see CMDT Part 25-14: Autism Spectrum Disorders

Key Features

  • A neurodevelopmental disorder in which patients suffer from pervasive difficulties with social communication and have repetitive, restricted interests and behaviors

  • Affects about 1% of the adult population with an estimated heritability of about 90%

  • Approximately 20–30% of individuals in whom autism is diagnosed also have a substance use problem as well as a higher risk of attention deficit hyperactivity disorder, mood, or obsessive-compulsive disorders

Clinical Findings

  • Persistent issues with social communication and interactions

  • Repetitive behaviors, interests, or activities

  • Symptoms interfere with functioning

  • May or may not have accompanying language or intellectual impairment

Diagnosis

  • National Institute of Clinical Excellence (U.K.) guidelines recommend that assessment be a comprehensive and multidisciplinary approach that includes

    • Interrogation of core autism spectrum disorders difficulties

    • Early development

    • Medical and family history

    • Behavior

    • Education

    • Employment

    • Needs assessment

    • Risks

    • Physical examination, with laboratory testing as indicated

    • Feedback to the individual

Treatment

  • No treatments for core symptoms have been validated

  • Risperidone and paliperidone

    • Approved for treating irritability

    • Can help with some behavioral symptoms but also carry a risk of metabolic side effects and extrapyramidal symptoms

  • Use of repetitive transcranial magnetic stimulation and vasopressin are under investigation

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