[The autistic spectrum. An epidemiological study and analysis of possible subgroups]

Abstract

Introduction: Although the concept of autistic spectrum may be useful to explain and describe the heterogeneity of the syndrome, its aetiology is still unknown. Different disorders have been reported as the biological basis of autism. Early diagnosis and a multi disciplinary approach to the condition are essential for effective psychopaedagogic treatment.

Objective: To determine whether there is a relationship between the severity of the syndrome of autism and the course of the disorder, as a function of the presence or absence of neurological features, and to define homogeneous subgroups by detecting etiological variables which may be common to them.

Patients and methods: 46 children defined as being within the spectrum of autism, in whom the diagnosis was confirmed on the autistic spectrum inventory (IDEA/Rivi re 97). Parameters studied: family history, perinatal risk, age of onset, complementary investigations and neurological features.

Results: The diagnosis was confirmed in 18 children; of the others 14 had a specific defect of the development of language. There was an almost complete absence of underlying neurological disorders, although this may have been due to dispersion of the complementary investigations done.

Conclusions: Specific disorders of the development of language are the main differential diagnoses to be considered together with the autistic spectrum. The diagnosis of autism is clinical, but the heterogeneity of the medical approach interferes with the overall assessment of the spectrum favoring behavioural and underestimating the biological aspects. This means that the problem should be reconsidered so as to obtain uniform guidelines for action.