Assessment and intervention in autism: An historical perspective

Debates have dominated the field in almost every area since the inception of autism as a distinctive diagnosis. These debates range from diagnosis to assessment methodology to treatments. Historical accounts indicate that autism has always formed part of the human condition. This chapter attempts to provide a history of autism while revealing some of the debates and controversies related to this developmental disorder. It includes the evolution of the concept of "autism," from Kanner's and Asperger's syndromes to the development of the more recent term "autism spectrum disorder" (ASD). It also attempts to elucidate the historical context and debates related to the emergence of autistic disorder and Asperger's disorder as clinical diagnostic categories. The assessment methods used within ASD are also discussed. As in most venues, the debates concerning etiology and diagnostic categories have influenced treatment choices for people with autism. It is now agreed that early intensive educational and behavioral intervention provides the best evidence for good outcomes; however, scientifically unsupported and potentially dangerous approaches to intervention are still peddled and many potentially promising interventions require further research before being safe for children with autism. This chapter concludes with a brief discussion of the historical evolution of interventions for ASD and the debate concerning treatment methodologies.