We argue that there will be no single (genetic or cognitive) cause for the diverse symptoms defining autism. We present recent evidence of behavioral fractionation of social impairment, communication difficulties and rigid and repetitive behaviors. Twin data suggest largely nonoverlapping genes acting on each of these traits. At the cognitive level, too, attempts at a single explanation for the symptoms of autism have failed. Implications for research and treatment are discussed.
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American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, Washington, DC, 1994).
Kanner, L. Autistic disturbances of affective contact. Nervous Child 2, 217–250 (1943).
Wing, L. & Gould, J. Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification. J. Autism Dev. Disord. 9, 11–29 (1979).
Goodman, R. Infantile autism: a syndrome of multiple primary deficits? J. Autism Dev. Disord. 19, 409–424 (1989).
Bishop, D.V. Autism, Asperger's syndrome and semantic-pragmatic disorder: where are the boundaries? Br. J. Disord. Commun. 24, 107–121 (1989).
Bishop, D.V. in Autism: Neural Basis and Treatment Possibilities 213–234 (Wiley, Chicester, 2003).
Constantino, J.N., Przybeck, T., Friesen, D. & Todd, R.D. Reciprocal social behavior in children with and without pervasive developmental disorders. J. Dev. Behav. Pediatr. 21, 2–11 (2000).
Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J. & Clubley, E. The autism-spectrum quotient (AQ): evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. J. Autism Dev. Disord. 31, 5–17 (2001).
Ronald, A. et al. Genetic heterogeneity between the three components of the autism spectrum: a twin study. J. Am. Acad. Child Adolesc. Psychiatry 45, 691–699 (2006).
Constantino, J.N. & Todd, R.D. Autistic traits in the general population: a twin study. Arch. Gen. Psychiatry 60, 524–530 (2003).
Skuse, D.H., Mandy, W.P. & Scourfield, J. Measuring autistic traits: heritability, reliability and validity of the Social and Communication Disorders Checklist. Br. J. Psychiatry 187, 568–572 (2005).
Baron-Cohen, S., Tager-Flusberg, H. & Cohen, D. Understanding Other Minds: Perspectives from Autism and Developmental Cognitive Neuroscience (Oxford Univ. Press, Oxford, 2000).
Ronald, A., Happé, F., Price, T.S., Baron-Cohen, S. & Plomin, R. Phenotypic and genetic overlap between autistic traits at the extremes of the general population. J. Am. Acad. Child Adolesc. Psychiatry (in press).
Charman, T. & Swettenham, J. Repetitive behaviors and social-communicative impairmanets in autism: implications for developmental theory and diagnosis. in The Development of Autism: Perspectives from Theory and Research (eds. Burack, J.A., Charman, T., Yirmiya, N. & Zelazo, P.R.) 325–345 (Lawrence Erlbaum, Hillsdale, New Jersey, 2001).
Charman, T. et al. Predicting language outcome in infants with autism and pervasive developmental disorder. Int. J. Lang. Commun. Disord. 38, 265–285 (2003).
Lord, C. & Pickles, A. Language level and nonverbal social-communicative behaviors in autistic and language-delayed children. J. Am. Acad. Child Adolesc. Psychiatry 35, 1542–1550 (1996).
Aldred, C., Green, J. & Adams, C. A new social communication intervention for children with autism: pilot randomised controlled treatment study suggesting effectiveness. J. Child Psychol. Psychiatry 45, 1420–1430 (2004).
Constantino, J.N. et al. The factor structure of autistic traits. J. Child Psychol. Psychiatry 45, 719–726 (2004).
Ronald, A., Happé, F. & Plomin, R. The genetic relationship between individual differences in social and nonsocial behaviours characteristic of autism. Dev. Sci. 8, 444–458 (2005).
Pickles, A. et al. Variable expression of the autism broader phenotype: findings from extended pedigrees. J. Child Psychol. Psychiatry 41, 491–502 (2000).
Piven, J., Palmer, P., Jacobi, D., Childress, D. & Arndt, S. Broader autism phenotype: evidence from a family history study of multiple-incidence autism families. Am. J. Psychiatry 154, 185–190 (1997).
Moldin, S.O. & Rubenstein, J.L.R. Understanding Autism: From Basic Neuroscience to Treatment (Taylor & Francis, Boca Raton, Florida 2006).
Klin, A., Volkmar, F.R. & Sparrow, S.S. Autistic social dysfunction: some limitations of the theory of mind hypothesis. J. Child Psychol. Psychiatry 33, 861–876 (1992).
Hill, E.L. Executive dysfunction in autism. Trends Cogn. Sci. 8, 26–32 (2004).
Happé, F. & Frith, U. The weak coherence account: detail-focused cognitive style in autism spectrum disorders. J. Autism Dev. Disord. 36, 5–25 (2006).
Mottron, L., Dawson, M., Soulieres, I., Hubert, B. & Burack, J. Enhanced perceptual functioning in autism: an update, and eight principles of autistic perception. J. Autism Dev. Disord. 36, 27–43 (2006).
Belmonte, M.K. & Yurgelun-Todd, D.A. Functional anatomy of impaired selective attention and compensatory processing in autism. Brain Res. Cogn. Brain Res. 17, 651–664 (2003).
Happé, F. Cognition in autism: one deficit or many? Novartis Found. Symp. 251, 198–207 (2003).
Turner, M. Annotation: repetitive behaviour in autism: a review of psychological research. J. Child Psychol. Psychiatry 40, 839–849 (1999).
Pellicano, E., Maybery, M., Durkin, K. & Maley, A. Multiple cognitive capabilities/ deficits in children with an autism spectrum disorder: 'weak' central coherence and its relationship to theory of mind and executive control. Dev. Psychopathol. 18, 77–98 (2006).
Lopez, B.R., Lincoln, A.J., Ozonoff, S. & Lai, Z. Examining the relationship between executive functions and restricted, repetitive symptoms of Autistic Disorder. J. Autism Dev. Disord. 35, 445–460 (2005).
Briskman, J., Happé, F. & Frith, U. Exploring the cognitive phenotype of autism: weak “central coherence” in parents and siblings of children with autism: II. Real-life skills and preferences. J. Child Psychol. Psychiatry 42, 309–316 (2001).
Amodio, D.M. & Frith, C.D. Meeting of minds: the medial frontal cortex and social cognition. Nat. Rev. Neurosci. 7, 268–277 (2006).
Kuhl, P.K., Coffey-Corina, S., Padden, D. & Dawson, G. Links between social and linguistic processing of speech in preschool children with autism: behavioral and electrophysiological measures. Dev. Sci. 8, F1–F12 (2005).
Gervais, H. et al. Abnormal cortical voice processing in autism. Nat. Neurosci. 7, 801–802 (2004).
Sears, L.L. et al. An MRI study of the basal ganglia in autism. Prog. Neuropsychopharmacol. Biol. Psychiatry 23, 613–624 (1999).
Shao, Y. et al. Fine mapping of autistic disorder to chromosome 15q11-q13 by use of phenotypic subtypes. Am. J. Hum. Genet. 72, 539–548 (2003).
Buxbaum, J.D. et al. Evidence for a susceptibility gene for autism on chromosome 2 and for genetic heterogeneity. Am. J. Hum. Genet. 68, 1514–1520 (2001).
Newschaffer, C.J., Fallin, D. & Lee, N.L. Heritable and nonheritable risk factors for autism spectrum disorders. Epidemiol. Rev. 24, 137–153 (2002).
We would like to thank all the families who participate in Twins Early Development Study, which is supported by Medical Research Centre grant G0500079 to R.P.
The authors declare no competing financial interests.
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