The role of the neurobiologist in redefining the diagnosis of autism.

Until recently, autism, along with the other developmental disabilities, was largely ignored by the medical and research community. At this early point in our understanding of the syndrome, neurobiologists and especially those who work with human brain tissue have a great deal to offer. A thorough understanding of the clinically defined syndrome is essential. Along with the other psychiatric diseases listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), autism is defined by gross behavioral macros that, in all probability, are only indirectly related to basic biological systems. The diagnostic schema is not etiologically based. The diagnostic triad of symptoms that defines autism-impaired communication, impaired social interaction, and restricted and repetitive interests and activities-has been found to be present in the general population with no clear demarcation between pathological severity and being a common trait. In addition, the three basic symptoms of autism appear not to associate highly, thus leaving undetermined the validity of studying autism in its currently defined triad of symptoms. It is proposed that a close working relationship between neurobiologists and clinicians is necessary in order to identify etiologically based diagnostic schemas that would complement, rather than replace, the clinical diagnosis.