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Autism — an evolving concept

Northgate and Prudhoe NHS Trust, Prudhoe Hospital, Prudhoe, Northumberland NE42 5NT

Declaration of interest None.

See editorial pp. 10—11, this issue.

Background The rapid increase in research endeavour has not kept pace with the advent of well-publicised theories and treatments for autism.

Aims To explore some of the newer developments in biological research into autism.

Method A review of recent publications and presentations.

Results The concept is shifting from the narrow perception of aloof autism, described by Kanner, to a wider one that includes a spectrum extending to a broader, subclinical phenotype. The genetic basis has been established; now we need to discover the location and interaction of the relevant sites. There is considerable interest in the bowel as a pathogenetic agent, particularly in the effects of exogenous opioids and multiple viral infection (the latter posing a public health problem). Also of concern is the role of (potentially treatable) epilepsy, analogous to the Laudau-Kleffner syndrome.

Conclusions In the absence of a cure, the implementation of ideas will continue to outstrip factual evidence. Clinicians are challenged by the availability of information (and misinformation), particularly on the internet.

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