Azeen Ghorayshi

And as this shift is underway in the year 1980, autism gets added to the Diagnostic and Statistical Manual of Mental Disorders.

And this is considered the Bible of psychiatry.

The fact that the diagnosis was added in that year was really significant.

Yeah.

So at the time, the definition for autism was very narrow.

The DSM said that the essential features were a lack of responsiveness to other people, language problems, and, quote, bizarre responses to various aspects of the environment.

And all of that had to develop in the first 30 months of their lives.

The DSM specifically said that autism was considered very rare and

And it estimated that something like two to four kids in every 10,000 would have this diagnosis.

But pretty much from the get-go, there were questions around what autism actually was, how it should be defined.

Clinicians were asking really sharp questions about what autism really was.

They were asking, what if the kid does not have a language delay?

What if they are able to speak, but they speak differently?

How do we sort of draw lines around this disorder when there seem to be all sorts of kids with sort of different manifestations of what seems like the same thing?

And that's sort of when this idea of the autism spectrum gets introduced for the first time, that maybe this is sort of a continuum of traits and we're thinking a little too narrowly in the definition of autism that we have.

So the way the medical community deals with this is in 1994, two really big changes happen.

One, they loosen the criteria for autism itself.

And second, they create a new related diagnosis called Asperger's.

And that sort of captures a lot of the edge cases that we were just talking about.

So it's the first step in really a broadening of what we think of as the sort of constellation of autism.