Editing Controversies in autism

{{Short description|Controversies about both the cause of autism and its diagnoses}}
{{Use dmy dates|date=July 2024}}
{{Autism rights movement|issues}}

Diagnoses of [[autism]] have become more frequent since the 1980s, which has led to various controversies about both the cause of autism and the nature of the diagnoses themselves. Whether autism has mainly a [[heritability of autism|genetic or developmental cause]], and the degree of coincidence between autism and [[intellectual disability]], are all matters of current [[scientific controversy]] as well as inquiry. There is also more sociopolitical debate as to whether autism should be considered a [[disability]] on its own.<ref>{{Cite journal|last=Morgan|first=Jules|date=1 October 2016|title=Autism spectrum disorder: difference or disability?|url=https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(16)30002-3/abstract|journal=The Lancet Neurology|language=en|volume=15|issue=11|pages=1126|doi=10.1016/S1474-4422(16)30002-3|s2cid=54341655|issn=1474-4422|url-access=subscription}}</ref>

== Epidemiology ==
{{Main|Epidemiology of autism}}

The current accepted prevalence of [[autism spectrum disorder]] (ASD) are around 1%,<ref>{{Cite journal |last1=Lai |first1=Meng-Chuan |last2=Lombardo |first2=Michael V |last3=Baron-Cohen |first3=Simon |date=March 2014 |title=Autism |url=https://linkinghub.elsevier.com/retrieve/pii/S0140673613615391 |journal=The Lancet |language=en |volume=383 |issue=9920 |pages=896–910 |doi=10.1016/S0140-6736(13)61539-1|pmid=24074734 |url-access=subscription }}</ref> although previous research has shown far lower rates of incidence.<ref name="Newschaffer">{{Cite journal |last1=Newschaffer |first1=Craig J. |last2=Croen |first2=Lisa A. |last3=Daniels |first3=Julie |last4=Giarelli |first4=Ellen |last5=Grether |first5=Judith K. |last6=Levy |first6=Susan E. |last7=Mandell |first7=David S. |last8=Miller |first8=Lisa A. |last9=Pinto-Martin |first9=Jennifer |last10=Reaven |first10=Judy |last11=Reynolds |first11=Ann M. |date=1 April 2007 |title=The Epidemiology of Autism Spectrum Disorders |journal=Annual Review of Public Health |language=en |volume=28 |issue=1 |pages=235–258 |doi=10.1146/annurev.publhealth.28.021406.144007 |pmid=17367287 |issn=0163-7525|doi-access=free }}</ref> ASD averages a 4.3:1 male-to-female ratio. The number of children diagnosed with the autism spectrum has increased dramatically since the 1980s, at least partly due to changes in diagnostic practice; it is unclear whether prevalence has actually increased;<ref name="Newschaffer" /> and as-yet-unidentified environmental risk factors cannot be ruled out.<ref name=Rutter>{{cite journal | vauthors = Rutter M | title = Incidence of autism spectrum disorders: changes over time and their meaning | journal = Acta Paediatrica | volume = 94 | issue = 1 | pages = 2–15 | date = January 2005 | pmid = 15858952 | doi = 10.1111/j.1651-2227.2005.tb01779.x | s2cid = 79259285 | author-link = Professor Sir Michael Rutter }}</ref> The risk of autism is associated with several prenatal factors, including advanced parental age and diabetes in the mother during pregnancy.<ref name=Gardener>{{cite journal | vauthors = Gardener H, Spiegelman D, Buka SL | title = Prenatal risk factors for autism: comprehensive meta-analysis | journal = The British Journal of Psychiatry | volume = 195 | issue = 1 | pages = 7–14 | date = July 2009 | pmid = 19567888 | pmc = 3712619 | doi = 10.1192/bjp.bp.108.051672 }}</ref> ASD is associated with several [[genetic disorder]]s<ref name=Zafeiriou>{{cite journal | vauthors = Zafeiriou DI, Ververi A, Vargiami E | title = Childhood autism and associated comorbidities | journal = Brain & Development | volume = 29 | issue = 5 | pages = 257–72 | date = June 2007 | pmid = 17084999 | doi = 10.1016/j.braindev.2006.09.003 | s2cid = 16386209 }}</ref> and epilepsy.<ref name=Levisohn>{{cite journal | vauthors = Levisohn PM | title = The autism-epilepsy connection | journal = Epilepsia | volume = 48 | issue = Suppl 9 | pages = 33–5 | date = 2007 | pmid = 18047599 | doi = 10.1111/j.1528-1167.2007.01399.x | s2cid = 25651749 | doi-access = free }}</ref>

==Genetics==
{{further|Heritability of autism}}
The role of genetic influence on ASD has been heavily researched over the past few years. ASD is considered to have polygenic traits since there is not a single risk factor, but multiple ones.<ref name=":12">{{cite journal | vauthors = Robinson EB, Neale BM, Hyman SE | title = Genetic research in autism spectrum disorders | journal = Current Opinion in Pediatrics | volume = 27 | issue = 6 | pages = 685–91 | date = December 2015 | pmid = 26371945 | pmc = 4650984 | doi = 10.1097/MOP.0000000000000278 }}</ref>

Multiple twin and family studies have been conducted in order to observe any genetic influence in diagnosing ASD. The chance of both twins having ASD was significantly higher in identical twins than fraternal twins, concluding that ASD is heritable.<ref name=":02">{{cite journal | vauthors = Bourgeron T | title = Current knowledge on the genetics of autism and propositions for future research | journal = Comptes Rendus Biologies | volume = 339 | issue = 7–8 | pages = 300–7 | date = 1 July 2016 | pmid = 27289453 | doi = 10.1016/j.crvi.2016.05.004 | doi-access = free }}</ref>  A reoccurring finding is that ''de novo'' (new mutation) [[Copy-number variation|copy number variants]] (CNVs) are a primary cause of ASD&nbsp;– they alter synaptic functions; [[Germline mutation|germ line mutations]] can produce ''de novo'' CNVs.<ref>{{cite journal | vauthors = Ronemus M, Iossifov I, Levy D, Wigler M | title = The role of de novo mutations in the genetics of autism spectrum disorders | language = En | journal = Nature Reviews. Genetics | volume = 15 | issue = 2 | pages = 133–41 | date = February 2014 | pmid = 24430941 | doi = 10.1038/nrg3585 | s2cid = 9073763 }}</ref> These mutations can only be passed on to offspring; this explains the phenomenon that occurs when the child has symptoms of ASD, but the parents have no symptoms or history of ASD. ''De novo'' variants differ from person to person, i.e. one variant can cause ASD in one person, whereas another person would need multiple variants to cause the same disorder.<ref name=":02" /> Loss of function variants occur in 16-18% of ASD diagnoses, which is nearly double the normal population.<ref name=":12" /> These loss of function variants reduce function in the protein [[neurexin]], which connects neurons at the synapse and is important for neurological development; [[Deletion (genetics)|deletion mutations]] of neurexin are also very common in people with autism, as well as other neurological disorders like [[schizophrenia]], [[bipolar disorder]], and [[Attention deficit hyperactivity disorder|ADHD]].<ref>{{cite journal | vauthors = Chen J, Yu S, Fu Y, Li X | title = Synaptic proteins and receptors defects in autism spectrum disorders | journal = Frontiers in Cellular Neuroscience | volume = 8 | pages = 276 | date = 11 September 2014 | pmid = 25309321 | pmc = 4161164 | doi = 10.3389/fncel.2014.00276 | doi-access = free }}</ref>

There is also controversy over the [[Nature versus nurture|Nature vs. Nurture]] debate. According to family studies, genetic and environmental factors have an equal influence on risk of ASD.<ref name=":02" />

==Bacteria==

Gut [[Microbiota|microbiome]] has a relation to ASD. Excessive ''Clostridia'' spp. was found in children with ASD and gastrointestinal difficulties; ''Clostridia'' spp produces [[propionic acid]], which is impaired or in excess in people with ASD.<ref>{{cite journal | vauthors = Frye RE, Rose S, Slattery J, MacFabe DF | title = Gastrointestinal dysfunction in autism spectrum disorder: the role of the mitochondria and the enteric microbiome | journal = Microbial Ecology in Health and Disease | volume = 26 | pages = 27458 | date = 7 May 2015 | pmid = 25956238 | pmc = 4425813 | doi = 10.3402/mehd.v26.27458 }}</ref> Specifically, ''C. tetani'' and ''C. histolyticum'' are two species of this bacteria that affect people with ASD. ''C. tetani'' produces tetanus [[neurotoxin]] in the intestinal tract; ''C. histolyticum'' is a toxin producer that is abundant in people diagnosed with ASD.<ref name="pmid28503135">{{cite journal | vauthors = Li Q, Han Y, Dy AB, Hagerman RJ | title = The Gut Microbiota and Autism Spectrum Disorders | journal = Frontiers in Cellular Neuroscience | volume = 11 | pages = 120 | date = 2017 | pmid = 28503135 | pmc = 5408485 | doi = 10.3389/fncel.2017.00120 | doi-access = free }}</ref> Both of these could contribute to neurological symptoms.

==Vaccines==
{{main|Vaccines and autism}}
<!-- summary at Vaccines and autism/Summary -->
A later-retracted article from ''[[The Lancet]]'' making false claims provoked concern about vaccines among parents. Its author was found to be on the payroll of litigants against vaccine manufacturers.<ref name="retraction">{{cite journal|author=((The Editors of The Lancet)) |date=February 2010|title=Retraction--Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children|journal=Lancet|volume=375|issue=9713|pages=445|doi=10.1016/S0140-6736(10)60175-4|pmid=20137807|s2cid=26364726}}
*{{cite news |vauthors=Triggle N |date=2 February 2010 |title=Lancet accepts MMR study 'false' |work=BBC News |url=http://news.bbc.co.uk/2/low/health/8493753.stm}}</ref>

The idea of a link between vaccines and autism was extensively investigated and shown to be false.<ref name = vaccines>{{Cite journal |last1=Taylor |first1=Luke E. |last2=Swerdfeger |first2=Amy L. |last3=Eslick |first3=Guy D. |date=17 June 2014 |title=Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies |journal=Vaccine |volume=32 |issue=29 |pages=3623–3629 |doi=10.1016/j.vaccine.2014.04.085 |issn=1873-2518 |pmid=24814559}}</ref> The [[scientific consensus]] is that there is no relationship, causal or otherwise, between vaccines and incidence of autism,<ref name="BH">{{cite journal | vauthors = Bonhoeffer J, Heininger U | title = Adverse events following immunization: perception and evidence | journal = Current Opinion in Infectious Diseases | volume = 20 | issue = 3 | pages = 237–46 | date = June 2007 | pmid = 17471032 | doi = 10.1097/QCO.0b013e32811ebfb0 | s2cid = 40669829 | url = http://lib.ajaums.ac.ir/booklist/955899.pdf | access-date = 7 February 2019 | archive-date = 14 February 2019 | archive-url = https://web.archive.org/web/20190214212020/http://lib.ajaums.ac.ir/booklist/955899.pdf | url-status = dead }}</ref><ref>{{cite news |url=https://www.theguardian.com/society/2010/feb/02/lancet-retracts-mmr-paper |title=Lancet retracts 'utterly false' MMR paper |last=Boseley |first=Sarah | name-list-style = vanc |date=2 February 2010 |work=The Guardian |access-date=2 February 2010}}</ref><ref name = vaccines/> and vaccine ingredients do not cause autism.<ref>{{Cite web |url=https://www.cdc.gov/vaccinesafety/concerns/autism.html |title=Vaccines Do Not Cause Autism Concerns|date=12 December 2018 |website=[[Centers for Disease Control and Prevention]] |language=en-us |access-date=7 February 2019}}</ref>

Nevertheless, the anti-vaccination movement continues to promote myths, [[conspiracy theory|conspiracy theories]] and misinformation linking the two.<ref>{{Cite magazine |first=Eleanor |last=Cummins |date=1 February 2019 |title=How autism myths came to fuel anti-vaccination movements |magazine=Popular Science |url=https://www.popsci.com/timeline-autism-myth-anti-vaccine |language=en}}</ref> A developing tactic appears to be the "promotion of irrelevant research [as] an active aggregation of several questionable or peripherally related research studies in an attempt to justify the science underlying a questionable claim."<ref>{{cite journal |last1=Foster |first1=Craig A. |last2=Ortiz |first2=Sarenna M. |title=Vaccines, Autism, and the Promotion of Irrelevant Research: A Science-Pseudoscience Analysis |journal=[[Skeptical Inquirer]] |date=2017 |volume=41 |issue=3 |pages=44–48 |url=https://www.csicop.org/si/show/vaccines_autism_and_the_promotion_of_irrelevant_research_a_science-pseudosc |archive-url=https://web.archive.org/web/20181006204019/https://www.csicop.org/si/show/vaccines_autism_and_the_promotion_of_irrelevant_research_a_science-pseudosc |access-date=6 October 2018|archive-date=6 October 2018 }}</ref>

==Intelligence==
The percentage of autistic individuals who also meet criteria for intellectual disability has been reported as anywhere from 25% to 70%, a wide variation illustrating the difficulty of assessing autistic intelligence.<ref>{{cite book |chapter=Learning in autism |vauthors=Dawson M, Mottron L, Gernsbacher MA |title=Learning and Memory: A Comprehensive Reference |volume=2 |pages=759–72 |editor=Byrne JH (-in-chief), Roediger HL III (vol.) |publisher=Academic Press |year=2008 |doi=10.1016/B978-012370509-9.00152-2 |isbn=978-0-12-370504-4 |chapter-url=http://psych.wisc.edu/lang/pdf/Dawson_AutisticLearning.pdf |access-date=7 September 2009 |archive-date=3 March 2012 |archive-url=https://web.archive.org/web/20120303191513/http://psych.wisc.edu/lang/pdf/Dawson_AutisticLearning.pdf |url-status=dead }}</ref> For [[pervasive developmental disorder not otherwise specified]] (PDD-NOS), the association with intellectual disability is much weaker.<ref name="Chakrabarti">{{cite journal |vauthors=Chakrabarti S, Fombonne E |date=June 2001 |title=Pervasive developmental disorders in preschool children |journal=JAMA |volume=285 |issue=24 |pages=3093–9 |doi=10.1001/jama.285.24.3093 |pmid=11427137 |doi-access=}}</ref> The diagnosis of [[Asperger syndrome]] excludes clinically significant delays in mental or cognitive skills.<ref>{{cite book | title=DSM-IV-TR Diagnostical and Statistical Manual of Mental Disorders Fourth edition text revision | publisher=American Psychiatric Association, Washington DC | year=2000 | pages=80}}</ref>

A 2007 study suggested that [[Raven's Progressive Matrices]] (RPM), a test of abstract reasoning, may be a better indicator of intelligence for autistic children than the more commonly used [[Wechsler Intelligence Scale for Children]] (WISC). Researchers suspected that the WISC relied too heavily on language to be an accurate measure of intelligence for autistic individuals. Their study revealed that the neurotypical children scored similarly on both tests, but the autistic children fared far better on the RPM than on the WISC. The RPM measures abstract, general and fluid reasoning, an ability autistic individuals have been presumed to lack.<ref>{{cite journal | vauthors = Dawson M, Soulières I, Gernsbacher MA, Mottron L | title = The level and nature of autistic intelligence | journal = Psychological Science | volume = 18 | issue = 8 | pages = 657–62 | date = August 2007 | pmid = 17680932 | pmc = 4287210 | doi = 10.1111/j.1467-9280.2007.01954.x}}
*{{cite press release |date=5 August 2007 |title=The Matrix Of Autism |website=ScienceDaily |url=https://www.sciencedaily.com/releases/2007/08/070803151245.htm}}</ref> A 2008 study found a similar effect, but to a much lesser degree and only for individuals with IQs less than 85 on the Wechsler scales.<ref>{{cite journal | vauthors = Bölte S, Dziobek I, Poustka F | title = Brief report: The level and nature of autistic intelligence revisited | journal = Journal of Autism and Developmental Disorders | volume = 39 | issue = 4 | pages = 678–82 | date = April 2009 | pmid = 19052857 | doi = 10.1007/s10803-008-0667-2 | doi-access = free | hdl = 11858/00-001M-0000-0024-F80B-3 | hdl-access = free }}</ref>

== Facilitated communication ==
{{Further|Facilitated communication}}
Facilitated communication (FC) is a scientifically discredited technique<ref name="Autism Wars">{{cite web|url=https://www.csicop.org/specialarticles/show/autism_wars_science_strikes_back|title=Autism Wars: Science Strikes Back|last1=Vyse|first1=Stuart|website=Skeptical Inquirer Online|date=7 August 2018 |publisher=Skeptical Inquirer|access-date=28 November 2018}}</ref> that attempts to facilitate communication by people with severe educational and communication disabilities. The facilitator holds or gently touches the disabled person's arm or hand during this process and attempts to help them move to type on a special keyboard. It was used by many hopeful parents of individuals with autism when it was first introduced during the early 1990s by [[Douglas Biklen]], a professor at Syracuse University.<ref name=":1">{{Cite web|url=http://soe.syr.edu/centers_institutes/institute_communication_inclusion/default.aspx|title=Institute on Communication and Inclusion |website=Syracuse University School of Education|access-date=28 April 2017}}</ref>

There is widespread agreement within the scientific community and multiple disability advocacy organizations that FC is not a valid technique for authentically augmenting the communication skills of those with autism spectrum disorder.<ref name="Review 2018">{{cite journal |last1=Hemsley |first1=Bronwyn |author-link=Bronwyn Hemsley |last2=Bryant |first2=Lucy |last3=Schlosser |first3=Ralf |last4=Shane |first4=Howard |last5=Lang |first5=Russell |last6=Paul |first6=Diane |last7=Benajee |first7=Meher |last8=Ireland |first8=Marie |date=2018 |title=Systematic review of facilitated communication 2014-2018 finds no new evidence that messages delivered using facilitated communication are authored by the person with the disability |journal=Autism and Developmental Language Impairments |volume=3 |pages=1–8 |doi=10.1177/2396941518821570 |doi-access=free}}</ref> Instead, research indicates that the facilitator is the source of the messages obtained through FC (involving [[ideomotor effect]] guidance of the arm of the patient by the facilitator).<ref name="Why debunked autism treatment fads persist">{{cite web|url=https://www.sciencedaily.com/releases/2015/02/150226154644.htm|title=Why debunked autism treatment fads persist|last1=Lilienfeld|website=Science Daily|publisher=Emory University|access-date=10 November 2015|display-authors=etal}}</ref><ref name="Ganz/Katsiyannis/Morin">{{cite journal|last1=Ganz|first1=Jennifer B.|last2=Katsiyannis|first2=Antonis|last3=Morin|first3=Kristi L.|date=February 2017|title=Facilitated Communication|journal=Intervention in School and Clinic|volume=54|pages=52–56|doi=10.1177/1053451217692564|doi-access=free}}</ref> Thus, studies have consistently found that patients are unable to provide the correct response to even simple questions when the facilitator does not know the answers to the questions (e.g., showing the patient but not the facilitator an object).<ref name="An experimental analysis of facilitated communication">{{cite journal|last1=Montee|first1=B B|last2=Miltenberger|first2=R G|last3=Wittrock|first3=D|last4=Watkins|first4=N|last5=Rheinberger|first5=A|last6=Stackhaus|first6=J|date=1995|title=An experimental analysis of facilitated communication.|journal=Journal of Applied Behavior Analysis|volume=28|issue=2|pages=189–200|doi=10.1901/jaba.1995.28-189|pmc=1279809|pmid=7601804}}</ref> In addition, numerous cases have been reported by investigators in which disabled persons were assumed by facilitators to be typing a coherent message while the patient's eyes were closed or while they were looking away from or showing no particular interest in the letter board.<ref name="Making contact with a helping hand">{{cite news|url=https://www.theguardian.com/commentisfree/2009/dec/05/bad-science-ben-goldacre-column|title=Making contact with a helping hand|last1=Goldacre|first1=Ben|date=5 December 2009|newspaper=[[The Guardian]]|access-date=10 November 2015}}</ref> Despite the evidence opposing FC, many continue to use and promote this technique.<ref name="Review 2018" />

Note that facilitated communication is separate and different from a range of scientifically supported [[Augmentative and alternative communication|augmentative and alternative communication (AAC)]] devices and processes that facilitate communication for people with communication difficulties.

==Advocacy initiatives==
{{Discrimination sidebar|Related}}{{Outdated|part=section|date=February 2025|reason=There are many more up-to-date sources on this topic, see the article [[Neurodiversity]] instead}}
There are two major conceptualizations of autism within autism advocacy. Those who favour the pathology paradigm, which aligns with the [[medical model of disability]], see autism as a disorder to be treated or cured. Those who favor the pathology paradigm argue that atypical behaviors of autistic individuals are detrimental and should therefore be reduced or eliminated through [[behavior modification]] therapies. Their advocacy efforts focus primarily on medical research to identify genetic and environmental risk factors in autism. Those who favour the neurodiversity paradigm, which aligns with the [[social model of disability]], see autism as a naturally-occurring variation in the brain. Neurodiversity advocates argue that efforts to eliminate autism should not be compared, for example, to curing cancer, but instead to the antiquated notion of curing [[left-handedness]]. Their advocacy efforts focus primarily on acceptance, accommodation, and support for autistic people as "neuro-minorities" in society.<ref name="Bloomsbury">{{Cite book|url=https://books.google.com/books?id=PV95DwAAQBAJ|title=The Bloomsbury Companion to Philosophy of Psychiatry|last=Chapman|first=Robert|publisher=Bloomsbury Academic|year=2019|isbn=9781350024069|editor-last=Tekin|editor-first=Serife|pages=371–387|chapter=Neurodiversity Theory and Its Discontents: Autism, Schizophrenia, and the Social Model of Disability|editor-last2=Bluhm|editor-first2=Robyn|chapter-url=https://books.google.com/books?id=PV95DwAAQBAJ&pg=PA371}}</ref> These two paradigms are not fully exclusive, and many people hold a combination of these viewpoints.{{Citation needed|date=November 2021}}

===Pathology paradigm===
The pathology paradigm is the traditional view of [[autism]] through a [[medical model of disability|biomedical lens]], in which it is seen as a disorder characterized by various impairments, mainly in communication and social interaction.<ref>{{Cite journal|last1=Liu|first1=Ka-Yuet|last2=King|first2=Marissa|last3=Bearman|first3=Peter S.|date=March 2010|title=Social influence and the autism epidemic|journal=American Journal of Sociology|volume=115|issue=5|pages=1387–1434|issn=0002-9602|pmc=2927813|pmid=20503647|doi=10.1086/651448}}</ref><ref>{{Cite web|url=https://autismsciencefoundation.org/what-is-autism/|title=What is Autism?|website=Autism Science Foundation|language=en-US|access-date=3 August 2019}}</ref> Those taking this perspective believe that autism is generally a harmful dysfunction.<ref name="Bloomsbury" /> Ways of functioning which diverge from a typical brain are perceived as harmful and disordered and must therefore be treated or cured.<ref>{{Cite web|url=http://blogs.exeter.ac.uk/exploringdiagnosis/files/2017/03/Adam-Feinstein-notes-for-neurodiversity-talk-for-Exeter-December-11-2017.pdf|title=Neurodiversity: the cases for and against|archive-url = https://web.archive.org/web/20190515031444/http://blogs.exeter.ac.uk/exploringdiagnosis/files/2017/03/Adam-Feinstein-notes-for-neurodiversity-talk-for-Exeter-December-11-2017.pdf |  archive-date = 15 May 2019 |format = Notes for presentation |last=Feinstein|first=Adam|date=11 December 2017}}</ref> The atypical behaviors of autistic individuals are considered a detriment to social and professional success and should therefore be reduced or eliminated through [[Behavior modification|therapy]].<ref>{{Cite web|url=https://www.autismspeaks.org/science-news/autism-speaks-releases-new-strategic-plan-science|title=Autism Speaks releases new strategic plan for science|website=Autism Speaks|language=en|access-date=3 August 2019}}</ref><ref>{{Cite web|url=https://www.autismspeaks.org/sites/default/files/2018-09/autism-speaks-strategic-plan-science-2018-2012.pdf|title=Strategic Plan for Science 2018-2020|date=13 December 2017|website=Autism Speaks}}</ref>

Advocates with this view include both a small but significant minority of autistic adults and large majority of parents of autistic children, but contain a higher percentage of parents when compared to those adopting the neurodiversity paradigm.<ref name="Solomon">{{Cite web|url=http://nymag.com/news/features/47225/|title=The Autism Rights Movement|last=Solomon|first=Andrew|date=23 May 2008|website=New York Magazine|language=en|access-date=3 August 2019}}</ref>{{Citation needed|reason=Claim is not substantiated in cited source|date=May 2023}} These advocates believe that medical research is necessary to address the rapid rise in autism diagnoses (sometimes referred to as the "autism epidemic"),<ref name="Solomon" /> reduce suffering, and provide the best outcomes for autistic individuals. In addition to etiological research, other areas of focus may include biology, diagnosis, and treatment, including medication, behavioural and psychological interventions, and the treatment of co-existing medical conditions.<ref name="Dawson">{{cite journal |journal= Autism Spectr Q |year=2008 |issue=16 |pages=8–11 |url=http://asquarterly.com/articles/dawson_interview.pdf |archive-url=https://web.archive.org/web/20090530061231/http://www.asquarterly.com/articles/dawson_interview.pdf |archive-date=30 May 2009 |title= Dr. Geraldine Dawson: setting the research agenda for Autism Speaks |author= Twachtman-Cullen D}}</ref>

Advocacy groups that focus primarily on medical research include [[Autism Speaks]], the [[Autism Science Foundation]], and its predecessor organizations, the Autism Coalition for Research and Education, the [[National Alliance for Autism Research]], and [[Cure Autism Now]], and the former [[Autism Research Institute]].

===Neurodiversity paradigm===
{{further|Autism rights movement}}

The neurodiversity paradigm is a view of autism as a different way of being rather than as a disease or disorder that must be cured.<ref name="Solomon" /><ref name="Different">{{Cite web|url=https://ideas.ted.com/autistic-people-are-not-failed-versions-of-normal-theyre-different-not-less/|title=Autistic people are not failed versions of "normal." They're different, not less|last=Silberman|first=Steve|date=4 April 2016|website=ideas.ted.com|language=en|access-date=3 August 2019}}</ref> Autistic people are considered to have [[neurodiversity|neurocognitive differences]]<ref name="Bloomsbury" /> which give them distinct strengths and weaknesses, and are capable of succeeding when appropriately accommodated and supported.<ref name="Solomon" /><ref name="Different" /> The belief is that efforts to eliminate autism should not be compared, for example, to curing cancer but instead to the antiquated notion of curing [[left-handedness]].<ref>{{Cite news|url=https://www.nytimes.com/2004/12/20/health/how-about-not-curing-us-some-autistics-are-pleading.html|title=How About Not 'Curing' Us, Some Autistics Are Pleading|last=Harmon|first=Amy|date=20 December 2004|work=The New York Times|access-date=3 August 2019|language=en-US|issn=0362-4331}}</ref>

There is no leader of the neurodiversity movement and little academic research has been conducted on it as a social phenomenon.<ref name="Bloomsbury" /> As such, proponents of the neurodiversity paradigm have heterogenous beliefs,<ref name="Bloomsbury" /> but are consistent in the view that autism cannot be separated from an autistic person.<ref name="Solomon" /> Advocacy efforts may include accommodations in schools and work environments,<ref name="Future">{{Cite web|url=https://greatergood.berkeley.edu/article/item/does_neurodiversity_have_a_future|title=Does Neurodiversity Have a Future?|last=Nerenberg|first=Jenara|date=21 November 2016|website=Greater Good Magazine|language=en|access-date=3 August 2019}}</ref> lobbying for the [[Nothing About Us Without Us|inclusion of autistic people]] when making decisions that affect them,<ref>{{Cite web|url=https://autisticadvocacy.org/about-asan/position-statements/|title=Position Statements|website=Autistic Self Advocacy Network|language=en|access-date=3 August 2019|archive-date=16 April 2016|archive-url=https://web.archive.org/web/20160416032240/http://autisticadvocacy.org/policy-advocacy/position-statements/|url-status=dead}}</ref> and opposition to therapies that aim to make children "indistinguishable from their peers".<ref name="Solomon" />

Neurodiversity advocates are opposed to medical research for a cure, believing that it will lead to [[eugenics]], and instead support research that helps autistic people thrive as they are.<ref name="Solomon" /> For example, ''[[NeuroTribes]]'' author [[Steve Silberman]] noted a lack of research in regards to seizure-controlling drugs and autistic brains; that sensory differences in autistic people were unheard of until [[Temple Grandin]] spoke about her experiences; and that only a small percentage of research funding goes towards the needs of autistic adults.<ref name="Different" /><ref name="Future" /><ref>{{Cite web|url=https://www.macleans.ca/society/science/steve-silberman-on-autism-and-the-neurodiversity-movement/|title=Steve Silberman on autism and 'neurodiversity'|last=Teitel|first=Emma|date=25 August 2015|website=Macleans|  archive-url =   https://web.archive.org/web/20210123052239/https://www.macleans.ca/society/science/steve-silberman-on-autism-and-the-neurodiversity-movement/ | publisher = Rogers Media|location = Toronto | archive-date =23 January 2021   	|issn =0024-9262|access-date=3 August 2019}}</ref>

Advocacy groups that focus primarily on acceptance and accommodation include [[Autism Network International]], Autism National Committee, [[Autistic Self Advocacy Network]], and Autistic Women & Nonbinary Network.

== Further reading ==

* Decoteau, C. L., & Daniel, M. (2020). [[doi:10.1177/0003122420922531|Scientific Hegemony and the Field of Autism]]. ''American Sociological Review''.

== See also ==

* [[Neurodiversity]]
* [[Employment of autistic people]]

== References ==
{{reflist|2}}

{{Pervasive developmental disorders}}
{{Autism resources}}

[[Category:Autism]]
[[Category:Medical controversies]]
[[Category:Open problems]]