Autism from A to Z

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Photos: Emelie Asplund & Josefin Bergenholtz

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Autism from A to Z
• Christopher Gillberg, MD, PhD
• Gillberg Neuropsychiatry Centre at the Sahlgrenska Academy,
University of Gothenburg, and Queen Silvia Hospital and Kochi
Prefecture and University (Sweden and Japan) – GO TO www.gnc.gu.se
• University of Glasgow and University of Edinburgh, and Yorkhill
Hospital (Scotland)
• Institute of Child Health, University College London, and Young
Epilepsy (England)
• Diferenças, Lisboa (Portugal)
• Genetic Biobank, Torshavn (Faroe Islands, Denmark)
• Institut Pasteur, Paris (France)
SECOND MARY COLEMAN LECTURE SEPTEMBER 2017

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What is autism? The Autisms
• The autisms are a group of multifactorially determined conditions, currently defined on the
basis of the combination of two groups of symptoms (social and behavioural). The autisms
ALWAYS coexist with other developmental/neurological symptoms/problems in cases
with early impairment (SLI, DCD, ADHD, IDD, tics, “OCD”, epilepsy, other medical
disorders), and there are almost as many causes as there are cases. Cases with no
comorbidity at all are not recognized or impairing early in life, or may be
acknowledged as “loners”, “nerds”, “weirdos”, “geniuses”. The prevalence of the
phenotype is not increasing! Synapse and clock genes play a major role in cases with
impairment, but environmental factors (prematurity, fetal drug and toxin exposure,
infections, trauma, vitamin D deficiency) contribute to or are associated with the clinical
presentation in many cases and can themselves cause autism in some instances.
Abnormalities/variations of default network and aberrant connectivity almost universal
finding. Impaired social facial perception in large subgroup, related to specific brain areas.
Overarousal of certain subcortical areas while looking other people in the eye. Arousal and
sleep problems important in subgroup. No sharp boundary between ASD and autistic
traits or between autistic traits and “normality”. You do not grow out of it, but
impairment may increase or decrease and is usually, at least partly, an “effect” of
comorbidities. No good evidence that base rate of “core” autism symptoms has increased
in the population, but diagnosis has gone through the roof (heavily overdiagnosed in
some parts of the world)
• Iacoboni 2006, Buckner and Vincent 2007, Bourgeron 2007, Monk et al 2009, Gillberg 2010, Dinnstein et al 2010, Coleman and
Gillberg 2012, Lundström et al 2012, Leblond et al 2012, Delorme et al 2013, Kocovska et al 2013, Zürcher et al 2013, Lundström
and Gillberg 2014, Toro et al 2014, Lundström et al 2015; Posserud et al 2016, Arvidssonn et al 2017, Hadjikhani et al 2017

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Autism is but one of the ESSENCE
(neurodevelopmental/psychiatric disorders)
• ESSENCE - Early Symptomatic Syndromes Eliciting
Neurodevelopmental Clinical Examinations
• Predictors of academic failure, other school adjustment problems, social exclusion,
substance use, psychiatric disorder, eating disorders including obesity, accidents empathy
problems, antisocial lifestyle and criminality later in life, persistent autistic features “only”,
early death through accidents, criminality, substance abuse and physical health problems
– ASD (Autism Spectrum Disorder) with or without regression 1.2% (10-20% regression)
– ADHD with or without ODD/CD (Oppositional Defiant Disorder/Conduct Disorder) 5-7%
– SLI (Language disorder inlcuding antecedents of dyslexia) 5%
– DCD (Developmental Coordination Disorder) 5%
– IDD (Intellectual Disability/Intellectual Developmental Disorder) 2%
– TD/TS/OCD (Tic disorders/Tourette syndrome/OCD) 1%
– SELECTIVE MUTISM 0.2-2%
– RAD (Reactive Attachment Disorder/Disinhibited Social Engagement Disorder) 0.5-1.5%
– (BPS (Behavioural Phenotype Syndromes, including FAS and VAS) 2%)
– (EP/NEUROMUSC (Epilepsy syndromes and other neurological/neuromuscular disorders
(HC, CP, Sturge-Weber, Duchenne, myotonic dystrophy, neurometabolic): Landau-Kleffner
Syndrome, CSWS, FS+, FS? 0.6%)
– (PANS (Pediatric Acute-onset Neuropsychiatric Syndrome)? 0.1%)

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AUTISM A
• ABC
• ADHD
• ADI
• ADOS
• Amygdalae activated in autism when forced to look in the eye –
of huge clinical importance if replicated
• AQ
• ASSQ
• ASDASQ
• ASDI
• Asperger syndrome
• Autism Spectrum Disorder
• Autistic Spectrum Condition
• Autistic features extremely common in general population
• (Normal) autistic phase according to Margaret Mahler

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Boy 7 weeks
turn-taking and ”speaking”
with mother

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AUTISM B
• Behavioural Phenotype Syndrome underlying autism in
>10% of all cases – expert needs to be involved in all
young cases (at least)
• Borderline Intellectual Functioning
• Broader Autism Phenotype
• Bumetanide – a diuretic - holds promise for the treatment
of autism and some cases of epilepsy (because of its
effect on GABA/glutamate balance, and because it
”normalizes” brain activity in autism after several months
of treatment)

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AUTISM C
• Callous-Unemotional
• Central Coherence is probably, like joint attention, at the
root of the clinical phenomenon that we call autism
• Cerebral Palsy
• CMV infection
• Comorbidity universal in clinical autisms, always expect it
• Coleman Mary, the reason we are here
• Conciergerie
• Contactin genes
• Corpus Callosum

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AUTISM D
• Developmental Coordination Disorder (DCD) occurs in at least one in
two of all with autism (probably more) – it is ”treatable” and should be
diagnosed and attended to
• Developmental Disorder – is autism always a ”developmental disorder”?
• Diets – dangerous to put all children with autism on gluten- and casein-
free diets?
• DSM
• DISCO
• Disintegrative Disorder

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AUTISM E
• EEG
• EMG
• Epigenetics
• Epilepsy occurs (during the first fifty years of life) in one third
of people with autism, one in two of those with autism and IDD,
one in ten to one in eight of those with Asperger syndrome –
the link is – in many ways – the most fascinating of all between
autism and other ”disorders”
• Epileptogenic discharge
• ESES – similar to LKS, regressive autism and PANS – but what
are the links?
• Executive Function
• External Ears

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AUTISM F
• Febrile seizures 3-4 times higher risk for autism, 5 times for
ADHD, febrile seizures are probably markers of ESSENCE
• Feral Children
• Females with Autism
• Fetal Alcohol Syndrome

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FEMALES: Girls and women
• IT IS LIKELY THAT ADOLESCENT AND ADULT FEMALES (AND
SOME MALES) WHO HAVE HAD ASD AND/OR OTHER ESSENCE
ALL THEIR LIVES ARE OFTEN MISDIAGNOSED AS SUFFERING
FROM (ONLY):
“DEPRESSION”,
“EATING DISORDER”
“ANXIETY”
“SOCIAL PROBLEMS; FAMILY PROBLEMS; RISK MOTHER”
“BORDERLINE/OTHER PERSONALITY DISORDER/SELF-HARM”
“CHRONIC FATIGUE, CHRONIC PAIN”
GIRLS with autism more likely than boys to BECOME INVOLVED WITH
SOCIAL SERVICES, MALTREATMENT?
– Kopp et al 2010, work in progress

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AUTISM G
• GABA
• Gaze avoidance is usually a biological sign that has got nothing
to do with ”wanting” to look people in the eye, clinically
extremely important – what if we should not consider people´s
with autism gaze avoidance important to ”treat”?
• Genetics 70%-90% heritability in ”autism”, but this does not
mean that only genes are involved in the majority of cases
• Glutamate
• Glycine
• Goldenhar Syndrome

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AUTISM H
• Handedness – non-righthandedness much more frequent in the
autisms than in the general population
• Heller dementia, disintegrative psychosis/disorder/regressive autism
• Hemisphere
• Heritability
• Herpes infection/encephalitis later in life (after age 3, but also before)
can cause autism even in individuals who have no predisposition
genetically
• Hormone Disrupting Chemicals
• Hydrocephalus – commonly associated with autism as shown almost
30 years ago by Elisabeth Fernell
• Hypothyroidism
• Hypoxia

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AUTISM I
• Idiot Savant
• Imitation is not at the root of autism – some individuals with
”autism” are experts, others have no idea
• Individual work-up plan needed in all cases
• Intellectual Developmental Disorder
• IQ or whatever term you want to use when you talk about
cognitive functioning (and all that it stands for) is of the utmost
importance in the autisms and all other ESSENCE
• Influenza
• Interhemnispheric transfer

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AUTISM J
• Joint Attention is in many ways ”at the root” of the autisms,
the forerunner of ”Theory of Mind”
• Joubert Syndrome

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AUTISM K
• Kanner Syndrome is a misnomer in that Kanner ”stole”
the syndrome from Hans Asperger (and never even
mentioned him after), who, in turn, had no idea that Eva
Ssucharewa had described the syndrome in the 1920s
• Kleine-Levin Syndrome
• Klinefelter Syndrome
• Knock-out Mice

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AUTISM L
• Lactic Acidosis
• Landau-Kleffner Syndrome is underdiagnosed and treatable – one of the
examples why the autisms can never be considered a non-medical disorder
• Lamotrigine
• Language Disorder – as separate from autism - in 20%-40% of all ”autisms”
• Learning
• Lesch-Nyhan Syndrome
• Lithium

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AUTISM M
• Macrocephalus - or megalencephaly - is present in 20% of males with autism (but
microcephalus is also overrepresented) – do many cases of macrocephalic autism
represent a relatively large subgroup with higher IQ and fewer comorbidities? Or is it often
”syndromic”, e.g. PTEN-related? And is it instead associated with poor outcome?
• MAPP
• MEG
• MRI
• MAPP
• Marfan syndrome
• MECP2
• Mercury
• Microcephalus
• Mitochondrial disease (such as MELAS and MERRF) must be ruled out/in in the autisms
• Multiple Congenital Anomalies (MCA)
• Muscular dystrophies of other kinds
• Myotonic dystrophy
• Möbius syndrome

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AUTISM N
• Neurofibromatosis
• Neuroinflammation is possibly a very important factor in
cases with regression
• Neuroligin and Neurexin
• Neurodiversity (NORMAL IS WAY OVERRATED)
• Neurotoxicity
• NMDA receptor
• NVLD

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AUTISM O
• OCD can be very difficult to separate from autism
• OCPD
• Ocular
• ODD
• Olfactory
• Opioids
• Oxytocin may help in those with low oxytocin levels –
relationship with vitamin D receptor?

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AUTISM P
• PANS/PANDAS – autistic features common in ”premorbid history”
• p-arm of chromosome
• PDA/EDA affects at least one in seven of all children with autism
• PDD
• PDDNOS
• PKU
• Potocki Lupski syndrome
• Prader Willi syndrome
• Prevalence
• PTEN
• Puberty
• Pyridoxine

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Prevalence of phenotype and registered diagnosis
Lundström et al., 2015

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Number of symptoms required for autism diagnosis
Arvidsson et al., submitted

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AUTISM Q
• Queer
• Questionnaires are very useful both in screening and clinical
practice but can never be ”trusted” without clinical input
• q-arm of chromosome
• qPCR

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AUTISM R
• RAD – Reactive Attachment Disorder (and DSED – Disinhibited
Social Engagement Disorder) - is almost always associated with
other ESSENCE, sometimes autism
• Rett syndrome
• Risperidone
• Rubella embryopathy

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AUTISM S
• SCQ
• SDQ
• SIB (Self Injurious Behaviour) can be one of the most distressing and
difficult-to-treat problems in autism (including eye-poking in
hypocalcinuria – best treated with calcium supplementation)
• SHANK genes
• Sleep
• Smith-Lemli-Opitz syndrome
• Smith Magenis syndrome
• Sodium valproate
• Sotos syndrome
• Specific Language Impairment
• Synapses

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AUTISM T
• TEACCH
• Tourette syndrome
• Tics are not stereotypies and are extremely overrepresented in autism
(and ”Asperger syndrome”)
• Theory of mind with spontaneous attribution of mental states to others
is not well developed in autism
• Tuberous sclerosis
• Turner syndrome
• Tetrasomy
• 22q11del syndrome
• 22q13microdeletion syndrome

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AUTISM U
• Ubiquitin
• Uniparental disomy with imprinting in Prader Willi
syndrome and Angelman syndrome and some other rare
syndromes that can be associated with autism
• Ulysses – the title of James Joyce´s book and the name of
the 12-year-old boy with autism whose father slashed his
son´s throat

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AUTISM V
• Vaccines are not specifically associated with autism,
failure to vaccinate large group of children in a society
will lead to increased rates of autism and other ESSENCE
• Vitamin B
• Vitamin D is low in pregnant mothers who later have a
child with autism, in newborns who later get the
diagnosis, in preschool children, school children and
adults who have a diagnosis of autism – treatment with
vitamin D of 3-10-yr-old children with autism led to
improvement in one double blind placebo-controlled RCT
of 109 children
• Verbal auditory agnosia (LKS)

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AUTISM W
• WPS
• Wechsler scales WPPSI WISC WAIS should be used in the
assessment of autism whenever possible
• Williams syndrome

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AUTISM X
• X-chromosome
• XO
• XXX
• XXY
• XYY
• Fragile X syndrome is one of the most common ”causes”
of autism and needs to be ruled out/in in all cases
• X-inactivation

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AUTISM Y
• Y chromosome is relatively ”desert-like” when it comes to
the presence of genes but the presence or not of the SRY-
gene determines the sex of the individual, so sex/gender
are not ”social constructs” only

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AUTISM Z
• Zentropa – Lars von Trier
• Zolpidem (a benzodiazepine drug) worsens the autistic
behaviour shown by some mice and it leads to extreme
overarousal in some children (just like several other
benzodiazepines) – may indicate distorted
GABA/glutamate balance

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What are the “symptoms” of ESSENCE?
• Major childhood onset symptoms either lasting more than 6 months or of extremely
abrupt onset from one or more of the following domains are the markers of
developmental disorder/ESSENCE; the symptoms lead to concern and “specialist”
consultation
– General development – delayed mental development
– Motor coordination – delayed gross or fine motor development
– Perception/Sensory – hyper- or hyposensitive to sensory stimuli
– Communication/Language – delayed speech, few or no gestures
– Activity/Impulsivity – too active or too passive
– Attention – inattention, not listening, “not hearing”, distracted
– Social interaction/Reciprocity – little interest in (most) adults, children, play
– Behaviour including stereotypic, insistence on sameness, tics, and OCD
– Mood swings/emotional dysregulation – inability to control temper
– Sleep – disrupted sleep-wake cycle, sleep onset problems, night waking problems
– Feeding – food fads, selective or consistent food refusal
- Gillberg 2010, revised Gillberg 2013

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Early symptoms of ASD (<5 years)
• Motor control problems first year of life (“serious” face, relatively little smiling
(but social smile can be elicited), strange movements from back to front,
compartmentalised motor development, limpness, partial hypotonia) 50-100%
• Sensory-perceptual abnormalities/unusual preferences in 90-100%
• Behaviour problems (including insistence on sameness) in 90-100%
• Repetitive movements in 80-100%
• Language problems/pragmatic problems/strange voice in 90-100%
• No/little reaction to own name 30-100%
• No or limited initiation of joint attention ( => major social interaction problems),
no pointing to attract attention 80-100%
• Hyperactivity and impulsivity (often extreme) in 40-50%
• Hypoactivity in 10-25%
• Sleep problems in 40%
• Food fads and other feeding problems in 50%
• Delayed general development in 20%
• Major mood swings in 10%
• One or several of the above could be presenting complaint (n.b. except for joint
attention deficits, these symptoms are also the symptoms of other ESSENCE)
– Coleman and Gillberg 2012, Allely et al 2013, Höglund-Carlsson et al 2013,
Barnevik-Olsson et al 2013, 2014, Hatakenaka et al 2016, Höglund-Carlsson et al
2016

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How many people are affected by ESSENCE?
• At least 10% of school age children are or have been
affected by “neuropsychiatric/neurodevelopmental
disorders” (ESSENCE) (12% of boys, 8% of girls) -
including, ASD, ADHD, TS, CD, DCD, IDD – half this
group “discovered” by age 6 years; many more than half
this group will have persistent problems in adult life
• Overlap/”Comorbidity”/Co-existence is the rule; almost
never “one problem only”
• When looking back: vast majority had symptoms <5 years
• Girls usually are not recognized until adolescence/adult
age (and usually as non-ESSENCE)
• Half or (many?) more of all “chronic” adult psychiatric
patients have had ESSENCE?
Gillberg 1983, Nylander et al 2009, Gillberg 2010, Kopp et al 2010, Gillberg 2013

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PARENT REPORTS ON AUTISM SYMPTOMS (ASSQ)
IN 6200 CHILDREN AGED 7-9 YEARS DATA FROM
(LARGE GENERAL POPULATION) BERGEN CHILD STUDY
ASSQ score (Range 0-54, here shown 0-42)

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Autism
• Once (Kanner 1943, Rutter 1994), autism was considered a discrete disorder – the best
and most clearly delineated in child psychiatry, also the most severe
• Gillberg (1983) found autistic traits to be very common in ADHD with DCD and found
ASD in 0.7% of 7-year-olds in the mid 1970s
• Wing and Gillberg in the 1980s proposed a continuum/spectrum of autism
• Coleman and Gillberg proposed several different autism spectra (later “many different
varieties of autisms”) in the 1980s
• Gillberg (1991 and 1992) proposed that autism was on a spectrum with normally
distributed empathy skills and that some variants even of the “disorder” could be
considered mild, others moderate, yet others severe
• Gillberg (2010) proposed that autism is “hundreds of spectra” and a subgroup of
ESSENCE
• Some (=marked) scorn because of this proposition
• Gillberg and Fernell proposed Autism Plus as a clinically meaningful category (2013)
• Autism symptoms around 1% in general population (of twins), but diagnosis 2-3%
• Waterhouse, London and Gillberg propose that the ASD-diagnosis be abandoned in
research but not in the clinic
• Regressive autism something completely different – neuroinflammation?
– Kanner 1943, Gillberg 1983, Coleman and Gillberg 1985, Wing 1979, Gillberg 1983, Gillberg 1992, Rutter 1994, Gillberg 2010,
Coleman and Gillberg 2012, Gillberg and Fernell 2014, Gillberg et al 2017, Arvidsson et al 2017, Waterhouse et al 2017

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Autism
• L v Beethoven
• A Bruckner
• B Bartok
• E Satie
• HC Andersen
• S Kierkegaard
• A Conan Doyle
• I Kant
• L Wittgenstein
• A Einstein
• A Robbe-Grillet
• W Kandinskij
• P Klee
• E Hopper
• J Joyce
• G Garbo
• D Springfield
• S Kubrick
• S Boyle
• “ALL THE LONELY PEOPLE – WHERE DO THEY ALL COME FROM”
– Gillberg 1992, Baron-Cohen 2003, Fitzgerald 2005, Wing 2011, Gillberg & Coleman 2012

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From preschool to school and into adult life: what
predicts what in autism?
• In virtually all studies of the outcome of autism other symptoms than
those “defining” autism (e.g. language disorder/problems/delay and
low IQ) predict poor outcome
• Medical disorders, including epilepsy, predict poor outcome
• ADHD/EF dysfunction in ASD predicts poor outcome
• Persistent NVLD in ASD predicts poor outcome
• Intervention may or may not predict the very long-term outcome, the
jury is out, but we know it helps to do something (diagnosis + info) in
the early years as regards intermediate-term outcomes; can early
diagnosis prevent schizophrenia?
• But autism preschool or school “load” in itself does not predict long-
term outcome, maybe later persistence does
• SO IT IS AUTISM PLUS (i.e. OTHER SYMPTOMS THAN THOSE
BELIEVED TO DEFINE AUTISM) THAT MATTERS
• REGRESSIVE AUTISM ALWAYS MATTERS
– Gillberg and Steffenburg 1987, Billstedt et al 2007, Cededrlund et al 2008, Fernell et al 2011,
Eriksson et al 2013, Hagberg et al 2013, Helles et al 2014, 2016, Gillberg et al 2016, Thompson et al
2017

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How should we proceed if we suspect AUTISM PLUS
(but not if we suspect AUTISM ONLY)?
• Observation inside and outside clinic (if at all possible)
• Parent (and teacher) questionnaires plus follow-up interview – e.g.
FTF (Five To Fifteen) or TTF (Two To Five), ATAC, SDQ, SNAP,
ASSQ, most of these can probably be used for adults retrospectively
• Parent interview by doctor/psychologist
• Medical/neurologic/psychiatric examination of child
• Hearing, vision, height, weight, head circumference, MPA
screen, genetic discussion, screening for thyroid and metabolic
disorders, EEG sometimes (more often than currently), more if
needed
• Assessment of intellectual functioning/neuropsychological/speech
and language strengths and weaknesses
– Kadesjö et al 2004, Hansson et al 2005, Coleman and Gillberg 2012, Miniscalco
et al 2013, Gillberg 2013, Marinopoulou et al 2016

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How should we plan for best intervention in ASD PLUS, i.e.
Autism with comorbidity (and ESSENCE more generally)?
• We need to recognize all the problems - not just “the autism”, “the ADHD”, “the
DCD”, “the Tourette syndrome”, “the IDD”, “the SLI” and all interventions must be
individually tailored THROUGHOUT THE LIFESPAN
• Parent “training” and education plan perhaps most important of all (“understanding the
condition”), but parent ESSENCE problem needs to be taken into account (!)
• ADHD – whether or not combined with ASD, tic disorders, epilepsy or IDD - is usually
responsive to treatment (meds and computer/cognitive training, possibly small effect of
Omega-3)
• DCD is usually responsive to focused motor training regardless of comorbidity
• Epilepsy (possibly including “subclinical”), when present, should be treated as a top
priority in all ESSENCE
• Sleep disorders sometimes responsive to melatonin or dose adjustment of other meds
• Violent behaviours/SIB can be responsive to low-dose neuroleptics or mood stabilizers
• Do not treat tics per se unless extreme
• Do not treat autism per se with meds (Bumetanide? Oxytocin?)
• Psychoeducation, communication enhancement, ESSENCE-friendly environment
(“understanding the condition”), school and work place “adjustment”, and
behavioural approaches - sometimes only possible with medication - first and
foremost throughout life

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ASD and ESSENCE preliminary conclusions
• ESSENCE (not “autism per se”) is an extreme risk factor for
adolescent/adult social exclusion, academic failure, other
school adjustment problems, problems in the work-place
antisocial personality disorder (and depression/anxiety, drug
abuse, and criminality) – and for “non-handicapping” autistic
traits?
• We still know VERY little about early intervention
• The OVERFOCUS on ASD ONLY in young children is
possibly a big mistake; but AUTISM PLUS HAS HUGE
IMPLICATIONS, SO HAS REGRESSIVE AUTISM
• For some ESSENCE we can screen and intervene early
• All advanced societies need to increase/spread knowledge
about ESSENCE, including ADHD and IDD, not just ASD
• In research following children over time all aspects of
ESSENCE need to be taken into account – with screeners
such as ESSENCE-Q, A-TAC or TTF, FTF

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Final conclusions: What we need to think
about when setting up assessment routines
• ASD is but one of a group of ESSENCE that overlap genetically, symptomatically
and as regards brain dysfunction/variation, enivronmental factors also play a role,
but it is unclear how much of the variance they account for
• AUTISM PLUS (i.e. with comorbidity) is a severe disorder, AUTISM ONLY?
• ASD persists into adult life (as do most other ESSENCE), re-assessments needed
• ADHD is common (c. 5%), ASD is relatively common (c. 1%)
• Other psychiatric disorders/problems/academic failure emerge or become
“diagnosable” over time – these are the diagnoses that adult psychiatrists will make
• Autism in itself has different outcome, not necessarily poor, current focus on
autism only in screening, assessment and intervention programs a big mistake
• IDD has “poor” outcome, ADHD probably has worse outcome (including obesity,
pain syndrome, substance use, MCI?) than ASD “in itself”, SLI may also have
partly “poor outcome”
• Regressive autism and PANS need to better assessed and worked up
• Girls still usually missed or misdiagnosed

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ASD Validity in research
• “Taken together, the preponderance of evidence argues that using the
diagnosis of ASD in research is fruitless because the diagnosis is an
arbitrary unscientific “convenient fiction” that has blocked the
discovery of replicable neurobiological variation among individuals with
serious neurodevelopmental social impairment. Equally important,
maintaining the ASD diagnosis supports the impossible research goal
of finding a unitary cause for ASD, and supports the public's belief that a
single cure for ASD will be found. Maintaining the ASD diagnosis will also
continue to support the reifying business of ASD research funding,
journals, and societies. Unless the ASD diagnosis is clearly renounced as
scientifically arbitrary, the wide ASD coverage of 1% or more of the
population, along with the many errantly definitive diagnostic assessments
will continue to reify and prop up the ASD diagnosis. More than seventy
years of research studying the arbitrary diagnosis of autism has not
resulted in any targeted medical treatments. Now is the time to
abandon the ASD diagnosis in research.”
– Waterhouse, London, and Gillberg 2017 (Autism Research)

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Autism Validity in real life
• AUTISM EXISTS
• Much like hypertension, anxiety, or cancer
• A reality with many different causes
• Biodiversity and neurodiversity are for real
• AUTISM IS NOT A HOAX
– Gillberg (to be published)

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ESSENCE CONFERENCE
10-11 APRIL 2018
GOTHENBURG, SWEDEN

Autism from A to Z

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