In the last decade, autism and autism spectrum disorders have received an enormous amount of attention in the media and with it attracted a significant increase in research funding. This book provides a comprehensive overview over the latest research find-ings. In 81 chapters, divided up into 11 sections, it illuminates autism from widely different angles.
Following on from a historical overview by Professor Michael Rutter, who has shaped large parts of the science of autism, the book provides a detailed overview of the diagnosis and epidemiology of autism spectrum disorders (section I). The core features of social and language impairments and repetitive and stereotyped behaviours in the context of their development across the lifespan are discussed in separate chapters in section II. One of the highlights of the book is the detailed overview on the psychiatric and medical comorbidities associated with autism in section III, a topic that has been often overlooked and until recently has not received the attention it deserves. The editors did not restrict the discussion to intellectual disabilities and epilepsy, but broadened the view to anxiety, mood disorders, motor functioning and dyspraxia, immune system dysfunction, gastrointestinal, and sleep problems. One of the most controversial top-ics, the broader autism phenotype, is presented from different research perspectives in section IV. About a third of the book is dedicated to neurobiology (section IV), genetics (section V), and animal models (section VII), while environmental factors (section VI) take up a meagre 42 pages. While this reflects the current state of the field with its heavy emphasis on genetics and neurobiology, there is some redundancy in these sections, especially in the genetics section. Two full chapters are dedicated to isolated populations: one covering isolated populations and rare variants, the second isolated populations and common variants. The second chapter is not warranted by the results and could have easily been incorporated in the other chapters. Not surprisingly mouse models of autism receive the most attention, but non-human primate and zebrafish models are covered as well. The final sections of the book are dedicated to treatment approaches, best practice, and public policy. The 16 chapters on treatment cover the more traditional treatments such as applied behaviour therapy as well as dietary, complementary, and alternative treatments. Pharmacological treatments are well represented and the last chapter of the section deals with mGluR5 antagonists, a very promising group of drugs for the treatment of patients with fragile X. Recommendations for best practices are given for early diagnosis and psychological assessments, diagnosis, and behavioural and psychosocial interventions. While written from a research perspective, these chapters will be of great interest to the clinicians trying to stay on top of the latest developments. The book ends with perspectives for future autism research. First, the director of NIMH, Dr Insel, describes the framework developed by the Interagency Autism Coordinating Committee for future research and its implications for future research funding. Next follows the view from a parent's advocacy group. Finally, the book ends with a sobering perspective on top priorities for autism/Asperger's research from a person with autism (Temple Grandin). Sobering – because the three top priorities have barely been touched upon in the previous 1376 pages: sensory oversensitivity, preparation for successful employment, and research on different kinds of autism. Despite the huge progress in autism research in the last decades, the scientists still seem unable to grasp what the most important research top-ics are in the view of a person with an autism spectrum disorder.
In summary, this is an outstanding book that brings together the latest research results, discusses them and puts them into an overall perspective. A book of such breadth cannot address all issues evenly and there is a strong emphasis on the biological underpinnings of autism spectrum disorders. Without doubt many of the results discussed in the chapters will be out of date in a short time. This will be especially the case for the chapters covering genetics, immunology, and neuroscience. Researchers will profit most from this book. The chapters provide a reliable and balanced overview of a wide variety of topics, which will be difficult to get even in our Google-dominated times. Clinicians and service providers interested in the scientific progress that has been made in the field will also profit immensely. The negative sides of the book are few: a drawback is the relatively high price. The colour graphics are in the middle of the book rather than in the chapters themselves. This requires the student to go backwards and forwards while reading. Finally the book would have profited from a separate chapter discussing the overlap between intellectual handicap and autism spectrum disorders, rather than restricting it to a ‘cautionary note’. However, these are really minor quibbles and the editors must be congratulated on having assembled such a stellar cast of scientists covering the entire spectrum of autism research.
