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First identified by Leo Kanner in the early 1940s, autism is a biologically based developmental disorder that impairs an individual’s ability to communicate, build relationships, and relate appropriately to the environment (Kanner, 1943). Diagnosis is usually made in early childhood after a multi-disciplinary assessment of behavior, developmental level, and communication ability. Boys are four times as likely as girls to be affected (Fombonne, 2003a, 2005).

Initially, autism was considered a rare disorder. An early epidemiological study conducted in England in the 1960s documented a 0.05% prevalence rate (4.5 per 10,000)(Lotter, 1966). Prior to the 1980s, recorded incidence of autism disorder in the United States was also low, affecting about 1 in every 2,000 children (Fombonne, 2009; Rutter, 2005). In the 1990s, the American Psychiatric Association broadened diagnostic criteria and included Asperger’s syndrome and Pervasive Developmental Disorder–Not Otherwise Specified (PDD-NOS) with Autism Disorder under Autism Spectral Disorder (ASD)(Centers for Disease Control, 2009). In this article, the terms autism and ASD are used interchangeably.