Autism Spectrum Disorders (ASD) are pervasive developmental disorders or conditions that affect communication and other social interactions as well as inflexibility in thoughts and behaviour patterns (APA, DSM-IV-TR, 2000). The estimated prevalence rate across all age groups is approx 1:100 (CDC, 2010). Despite recent advances in brain imagery (Anderson et al., 2010; Dosenbach et al., 2010) and discovery of certain genetic linkages (Szatmari et al., 2007), presently there are no medical tests that reliably identify individuals with ASD and consequently diagnosis is based purely on behavioural data, such as direct observations and parental/caregiver reports (Keenan, Dillenburger, Doherty, Byrne, & Gallagher, 2010).
The number of people diagnosed with Autism Spectrum Disorder has risen dramatically over the past decade. Whether this is caused by diagnoses becoming more precise, over-diagnosing, or an actual rise in incidents is a much-debated issue (Fombonne, 2005). In any case, recent studies have estimated that if not adequately treated the lifetime cost to care for an individual with an ASD can amount to as much as $3.2 million (CDC, 2010). Therefore the issue of what constitutes the most appropriate response to diagnosis is very important (Freeman, 2003, 2007). Getting it right can save enormously, not only fiscally (Knapp, Romeo, & Beecham, 2007) but even more importantly, it has major impact both socially and emotionally, i.e., in terms of quality of life for individuals, families, and therefore society as a whole (Dillenburger, Keenan, Doherty, Byrne, & Gallagher, 2010).
There are some who think that there is no need for interventions at all and that accepting neurodiversity is the key (Fenton & Krahn, 2009). Of course, there is no doubt that acceptance and awareness of differences are crucial. But parents, individuals affected by ASD, and professionals realize that most individuals diagnosed with ASD need some kind of specifically tailored education or intervention (Baron-Cohen, 2008; Helt et al., 2008; Jordan, 2008; Lamb, 2009; Markram, Rinaldi, & Markram, 2007). The UNESCO Salamanca Statement (CSIE, 2010) is evidence of the international agreement that inclusion is the best way to show acceptance. However, inclusion is not to be equated with contact per se. Contact per se clearly is not enough (Pettigrew & Tropp, 2006) and specific conditions and skills are necessary for contact (e.g., everyone physically in the same classroom) to translate to full social inclusion (CSIE, 2010; Oxoby, 2009).
Currently there is much confusion and debate about what kind of education is necessary for inclusion to work with regard to children with ASD (Dillenburger, Keenan, Doherty, Byrne, & Gallagher, 2011). A large number of interventions for ASD are available requiring a range of skills that are based on disciplines from psychiatry, psychology, regular education, special education, social work, speech pathology, and physical therapy (Archart-Treichel, 2010), and, of course, neuroscience, medicine, psychotherapy, family therapy, occupational therapy, architecture, pharmacy, and many more. In addition, a number of parents have developed interventions for their own children that are not based on a particular discipline but that have become popular with other parents (e.g., Son Rise, Hanen). For some of these, elaborate manualised programmes have been developed that are sold at free market prices and require strict and often exclusive programme adherence and training.
(This section is cited from K. Dillenburger / Research in Autism Spectrum Disorders 5 (2011) 1119–1128). Reprinted with permission: www.elsevier.com