Diagnosis of autism

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Abstract
Introduction Autistic spectrum disorders have been the subject of increasing attention over the past few years–from the media, from clinicians, and from the general public. Stories of savants who excel in such skills as calendar calculations and detailed drawings have long been a fascination to public and clinician alike, exemplified in Dustin Hoffman's portrayal of a young man with autism in the film Rainman. Most recently, public anxiety about autism has been raised as a result of reports linking the measles, mumps, and rubella (MMR) vaccine with autism and inflammatory bowel disorder and a rise in the prevalence of autism.1 2 This has resulted in a serious fall in immunisation rates,3 despite the epidemiological evidence of a lack of association,4 and strong reassurance from the Department of Health and the Royal College of Paediatrics and Child Health about the safety of the MMR vaccine. Parents of children with autism continue to express the view that the medical profession does not take their concerns about possible causes of autism seriously. “Miracle cures” for autism–for example, with secretin–have received wide publicity through television and raised enormous hopes before being placed in their proper context by double blind trials that have not confirmed a curative effect. We consulted recent reviews, specialist journals, and recent Medline papers on the diagnosis of autism. Footnotes Contributors GB is the primary author. HC and VS contributed to all aspects of the review. Competing interests None declared by HC and VS. GB has acted as an expert witness in cases about the needs of children with autism (but never in diagnostic disputes).