On the Spectrum: High-Functioning Autism and Its Contemporary Relevance

Area of Science:

• Neurodevelopmental Disorders
• Psychiatry
• Public Health

Background:

• The DSM-5 revision in 2013 expanded the definition of autism spectrum disorder (ASD).
• This reconceptualization led to a near doubling of ASD prevalence in the United States.
• Asperger disorder, now part of ASD, is frequently diagnosed in adulthood due to subtle presentation.

Purpose of the Study:

• To highlight the diagnostic shift and increased prevalence of autism spectrum disorder post-DSM-5.
• To describe the characteristics and challenges faced by adults with undiagnosed autism spectrum disorder.
• To inform nonpsychiatric providers about recognizing and managing ASD comorbidities in adults.

Main Methods:

• Review of diagnostic criteria changes in DSM-5.
• Analysis of prevalence data shifts following DSM-5 publication.
• Discussion of clinical manifestations and management strategies for adult ASD.

Main Results:

• Autism spectrum disorder prevalence increased to over 2% of the US population.
• Adults with high-functioning autism often present with social and occupational difficulties.
• Comorbid psychiatric and physical conditions are common in adults with ASD.

Conclusions:

• Adult diagnosis of autism spectrum disorder is increasingly recognized, often presenting with social and employment challenges.
• Addressing comorbidities and providing targeted support services are crucial for mitigating suffering and enhancing function in adults with ASD.
• Interdisciplinary care, including referrals for employment support, occupational therapy, and psychotherapy, can improve outcomes for adults with autism spectrum disorder.