Early View
Annual Research Review

Annual Research Review: Looking back to look forward – changes in the concept of autism and implications for future research

Francesca Happé

Corresponding Author

E-mail address: Francesca.happe@kcl.ac.uk

Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK

Correspondence

Francesca Happé, Social, Genetic & Developmental Psychiatry Centre, KCL Institute of Psychiatry, Psychology & Neuroscience (PO 80) De Crespigny Park, Denmark Hill, London SE5 8AF, UK; Email: Francesca.happe@kcl.ac.uk

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Uta Frith

Institute of Cognitive Neuroscience, University College London, London, UK

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First published: 28 January 2020
Conflict of interest statement: No conflicts declared.

Abstract

The concept of autism is a significant contribution from child psychiatry that has entered wider culture and public consciousness, and has evolved significantly over the last four decades. Taking a rather personal retrospective, reflecting on our own time in autism research, this review explores changes in the concept of autism and the implications of these for future research. We focus on seven major changes in how autism is thought of, operationalised, and recognised: (1) from a narrow definition to wide diagnostic criteria; (2) from a rare to a relatively common condition, although probably still under‐recognised in women; (3) from something affecting children, to a lifelong condition; (4) from something discreet and distinct, to a dimensional view; (5) from one thing to many ‘autisms’, and a compound or ‘fractionable’ condition; (6) from a focus on ‘pure’ autism, to recognition that complexity and comorbidity is the norm; and finally, (7) from conceptualising autism purely as a ‘developmental disorder’, to recognising a neurodiversity perspective, operationalised in participatory research models. We conclude with some challenges for the field and suggestions for areas currently neglected in autism research.

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