Nursing of Autism Spectrum Disorder - Springer Publishing

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Autism Spectrum Disorder:
Core Features and Medical Comorbidities
Cordelia Robinson Rosenberg
HISTORY
According to the Centers for Disease Control and Preventions, the condition called autism
spectrum disorder (ASD) affects approximately 1 in every 88 children and has received considerable
attention over the last decade (Centers for Disease Control and Prevention [CDC], 2012).
Media of all types provide us almost weekly with some new piece of information about the
diagnosis, prognosis, or interventions for this complex disorder. The media attention given to
the prevalence of ASD, as well as its social and economic impacts, have been largely influenced
by the work of parent- and grandparent-driven advocacy efforts. In addition to media attention,
these advocates have influenced the U.S. Congress. The Child Health Act passed in 2000
gave considerable impetus to federal action by authorizing initiatives at the CDC, which
included autism surveillance, a multisite case-cohort study (Centers for Autism and Developmental
Disabilities Research and Epidemiology—Study to Explore Early Development), and a
public awareness campaign around screening (Learn the Signs, Act Early [CDC, 2010]).
In 2006, the U.S. Congress passed the Combating Autism Act, which mandated the
reactivation of an Interagency Autism Coordinating Committee (IACC) charged with developing
and overseeing a strategic plan. This plan was organized around critical questions
framed from the point of view of families: (1) When should I be concerned? (2) How can
I understand what is happening? (3) What caused this to happen and can it be prevented?
(4) Which treatments and interventions will help? (5) Where can I turn for services? (6)
What does the future hold? (Combating Autism Act, 2006).
In December 2010, the Congressional Autism Caucus released a report on the status of
the strategic plan. This level of government effort around a specific condition is unprecedented.
The number of individuals and families affected by autism, the access to comprehensive
care, and the predicted economic impact of a failure to attend to the issues raised by the
IACC strategic plan appear to be the primary drivers of this bipartisan government action
(Ganz, 2007; Kogan et al., 2008).
In this chapter, we examine the history of diagnosing conditions on the autism spectrum.
We will examine the evolution of the criteria used to diagnose autism, the symptoms and behaviors
considered to be core features, and the frequency of co-occurring conditions. Before
considering these topics, we look at where we are now with respect to the diagnosis of ASD.
DIAGNOSING AUTISM
One of the critical aspects of the work to be done in the field concerns how a diagnosis of
autism is made. It is essential to realize that there is no definitive biological test at this time