دانلود کتاب تشخیص افتراقی اختلال طیف اوتیسم

Although cases of autism can, in retrospect, be identified before Kanner’s 1943 classic report (also see Donvan & Zucker, 2016), it was Kanner’s genius to put together the core features that we continue to associate with autism: autistic aloneness and restricted interests/ difficulties with change. This description was straightforward and atheoretical and has stood the test of time even as we debate the boundaries of autism today. The early years following Kanner’s initial presentation were plagued by a lack of consistency in diagnosis and several mistaken beliefs about autism, for example, associations with childhood schizophrenia and inappropriate parenting. This changed dramatically in the 1970s as three lines of evidence helped establish the validity of autism as a diagnostic concept. These included (1) the awareness that autism was a brain- based disorder associated with high rates of epilepsy with peaks of onset in early childhood and adolescence, (2) the first twin studies of autism made it clear that there was a very strong genetic component of autism with high concordance in monozygotic twins, and (3) children with autism responded best to structured teaching rather than unstructured psychotherapy (see Jackson & Volkmar, 2019, for a discussion). Attempts were made in the 1970s to provide better and more accurate clinical guidelines to diagnosis, notably those of Rutter (1978). At the same time, major changes were happening in the overall approach to psychiatric diagnosis with the advent of research diagnostic criteria and the more developmentally friendly multiaxial approaches to diagnosis (see Jackson & Volkamr, 2019, for a discussion). These developments led to the decision to include autism as a new category of the condition in the third edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM- III) (American Psychiatric Association [APA], 1980). The official recognition of autism stimulated what became an explosion of research on the condition (Jackson & Volkmar, 2019). However, some difficulties quickly became apparent, particularly due to a lack of developmental orientation (Volkmar & McPartland, 2014). These were addressed in a new revision of DSM, the DSM- III- R (APA, 1987), that appeared only a few years later; in this edition this revised DSM- III- R had a much greater developmental and flexible orientation with a polythetic (i.e., different combinations of features could be present) rather than monothetic approach. Lorna Wing’s broader views heavily influenced the diagnostic concept (Wing & Gould, 1979). For DSM- IV, several important issues were addressed in the development of the definition. These included the attempt to have convergence with the tenth edition of International Classification of Diseases (ICD- 10) (World Health Organization, 1994) as well as a series of preliminary reviews, data reanalysis, and so forth. A large international field trial was undertaken that lasted for a year and eventually included nearly 1,000 cases and over 100 raters from over 20 sites worldwide (Volkmar et al., 1994). As part of this effort, the convergence of the DSM and ICD definitions was largely achieved with considerable diagnostic flexibility. Its polythetic approach and grouping of items into the traditional three realms of difficulty (social, communication play, and restricted interests) meant that any of over 22,000 combinations of criteria could result in an autism diagnosis. In addition, some new diagnostic categories, including Asperger’s disorder, were now included in DSM- IV. This definition endured for nearly two decades.