Front Matter

Contributors List

Foreword

Fred R. Volkmar, M.D.

PART I Assessment, Evaluation, and Target Symptoms

Part 1A ASSESSMENT AND EVALUATION

1 Epidemiology

Heather MacFarlane, B.A.

Alexandra C. Salem, M.S.

Grace Olive Lawley, B.A.

Alison Presmanes Hill, Ph.D.

Katharine E. Zuckerman, M.D., M.P.H.

Eric Fombonne, M.D.

2 Psychiatric Assessment and Treatment

Casara Jean Ferretti, M.S., M.A.

Bonnie P. Taylor, Ph.D.

Eric Hollander, M.D.

3 Pediatric and Neurological Assessments

Jennifer M. Bain, M.D., Ph.D.

Randi J. Hagerman, M.D.

4 Gender Dysphoria, Gender Incongruence, and Sexual Identity

Aron Janssen, M.D.

Rebecca Shalev, Ph.D.

Katherine Sullivan, Ph.D.

5 Racial and Ethnic Disparities in Assessment and Evaluation

Melissa Maye, Ph.D.

David Mandell, Ph.D.

6 Digital Biomarkers in Diagnostics and Monitoring

Vera Nezgovorova, M.D.

Maksim Tsvetovat, Ph.D.

Eric Hollander, M.D.

Tatyana Kanzaveli, M.S.

Part 1B TARGET AND COMORBID SYMPTOMS

7 Social Communication

John N. Constantino, M.D.

8 Diet and Nutrition

Dannah Raz, M.D., M.P.H.

Ann Reynolds, M.D.

PART II Causes

Part IIA OVERVIEW

9 Genetics and Genomics

Tychele N. Turner, Ph.D.

Evan E. Eichler, Ph.D.

10 Epigenomics

Charles E. Mordaunt, Ph.D.

Janine M. LaSalle, Ph.D.

11 Prenatal, Perinatal, and Parental Risk Factors

Ori Kapra, B.A.

Alexander Kolevzon, M.D.

Abraham Reichenberg, Ph.D.

Raz Gross, M.D., M.P.H.

12 Animal Models

Stela P. Petkova, Ph.D.

Elizabeth L. Berg, Ph.D.

Nycole A. Copping, Ph.D.

Jill L. Silverman, Ph.D.

13 Electrophysiological Studies

Sarah Lippé, Ph.D.

Andrea Schneider, Ph.D.

Lauren M. Schmitt, Ph.D.

Craig A. Erickson, M.D.

14 Environmental Toxicity and Immune Dysregulation

Judy Van de Water, Ph.D.

Isaac N. Pessah, Ph.D.

Part IIB SYNDROMIC CAUSES

15 Overview of Syndromic Causes of ASD and Commonalities in Neurobiological Pathways

Debra L. Reisinger, Ph.D.

Walter E. Kaufmann, M.D.

Craig A. Erickson, M.D.

16 Fragile X Syndrome and Associated Disorders

Laura A. Potter, B.A.

Randi J. Hagerman, M.D.

17 Tuberous Sclerosis Complex

Siddharth Srivastava, M.D.

Mustafa Sahin, M.D., Ph.D.

18 16p11.2 and Other Recurrent Copy Number Variants Associated With ASD Susceptibility

Elise Douard, M.Sc.

Sebastien Jacquemont, M.D.

19 Rett Syndrome

Amitha L. Ananth, M.D.

Alan K. Percy, M.D.

20 Prader-Willi Syndrome

Kayla Applebaum Levine, M.D.

Anahid Kabasakalian, M.D.

Casara Jean Ferretti, M.S., M.A.

Eric Hollander, M.D.

Part IIC IMAGING AND ANATOMY

21 Neuroanatomical Findings

Verónica Martínez-Cerdeño, Ph.D.

22 The Amygdala in ASD

Jocelyne Bachevalier, Ph.D.

23 Neurobiology of ASD Informed by Structural Imaging Research

Heather Cody Hazlett, Ph.D.

Christine Wu Nordahl, Ph.D.

24 Positron Emission Tomography

Lalitha Sivaswamy, M.D.

Diane C. Chugani, Ph.D.

25 Functional Magnetic Resonance Imaging

Dorit Kliemann, Ph.D.

Daniel P. Kennedy, Ph.D.

PART III Treatments and Interventions

Part IIIA STANDARD PHARMACOLOGICAL TREATMENTS

26 Serotonergic Medication

Tomoya Hirota, M.D.

Jordan Brooks, Pharm.D.

Bryan H. King, M.D., M.B.A.

27 Antipsychotics

Robyn P. Thom, M.D.

Nora D.B. Friedman, M.D.

Christopher J. McDougle, M.D.

28 Treating Hyperactivity in Children With Pervasive Developmental Disorders

Lawrence Scahill, M.S.N., Ph.D.

Part IIIB EXPERIMENTAL THERAPEUTICS

29 Complementary and Integrative Approaches

Robert L. Hendren, D.O.

Felicia Widjaja, M.P.H.

Brittany Lawton, M.S.W., M.A.

30 Oxytocin

Marilena M. DeMayo, Ph.D.

Adam J. Guastella, Ph.D.

31 Vasopressin

Christophe Grundschober, Ph.D.

Marta del Valle Rubido, M.Pharm.

Paulo Fontoura, M.D., Ph.D.

Thomas Wiese, M.D.

Janice Smith, Ph.D.

32 N-Acetylcysteine

John P. Hegarty II, Ph.D.

Lawrence K. Fung, M.D., Ph.D.

Antonio Y. Hardan, M.D.

33 Arbaclofen

Paul P. Wang, M.D.

34 Cannabis, Cannabinoids, and Immunomodulatory Agents

Vera Nezgovorova, M.D.

Casara Jean Ferretti, M.S., M.A.

Bonnie P. Taylor, Ph.D.

Eric Hollander, M.D.

Part IIIC BEHAVIORAL AND EDUCATIONAL INTERVENTIONS

35 Behavioral Treatments

36 Early Start Denver Model

Sally J. Rogers, Ph.D.

37 The Developmental, Individual Difference, Relationship-Based Intervention Model

Serena Wieder, Ph.D.

38 School-Based Interventions

Christina Kang Toolan, Ph.D.

Connie Kasari, Ph.D.

39 Language and Communication

Angela John Thurman, Ph.D.

Leonard Abbeduto, Ph.D.

Part IIID FUTURE TREATMENT DEVELOPMENTS

40 Transcranial Magnetic Stimulation

Peter G. Enticott, Ph.D.

Stefano Pallanti, M.D., Ph.D.

Eric Hollander, M.D.

41 Stem Cell and Gene Therapy

Jill L. Silverman, Ph.D.

David J. Segal, Ph.D.

42 Gene Therapy and Molecular Interventions

Alexander W.M. Hooper, Ph.D.

Hayes Wong, Ph.D.

David R. Hampson, Ph.D.

PART IV Consortiums, Employment, and Advocacy

43 Consortiums

Eva Loth, Ph.D.

Ester Hamo, B.S.

James C. McPartland, Ph.D.

Paul H. Lipkin, M.D.

J. Kiely Law, M.D., M.P.H.

44 Autism Strengths and Neurodiversity

Sven Bölte, Ph.D.

45 Role of Patient Advocacy Groups in Treatment Development

Theresa V. Strong, Ph.D.

Index

Professor, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California

Assistant Professor, Division of Pediatric Neurology, Children’s of Alabama, Birmingham, Alabama

Professor, Department of Psychology and Division of Developmental and Cognitive Neuroscience, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia

Assistant Professor of Neurology and Pediatrics, Division of Child Neurology, Department of Neurology, Columbia University Irving Medical Center, New York, New York

Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California

Director, Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Head of Division, Department of Women’s and Children’s Health, and Professor of Child and Adolescent Psychiatric Science, Karolinska Institutet; and Clinical Psychologist, Department of Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm, Sweden; Research Academic, Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Western Australia

Postdoctoral Fellow, School of Pharmacy, University of California, San Francisco, San Francisco, California

Professor, Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark, Delaware

Blanche F. Ittleson Professor of Psychiatry and Pediatrics; Director, William Greenleaf Eliot Division of Child Psychiatry; and Director, Intellectual and Developmental Disabilities Research Center, Washington University School of Medicine, St. Louis, Missouri

Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California

F. Hoffmann-La Roche Ltd, Basel, Switzerland

Postdoctoral Research Associate, Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia

Ph.D. student, Department of Neurosciences, University of Montréal; Ph.D. student, Centre Hospitalier Universitaire Sainte-Justine Research Center, Montréal, Quebec, Canada

Health Sciences Clinical Assistant Professor, Department of Psychiatry and Behavioral Sciences, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, California

Professor and Investigator, Department of Genome Sciences, University of Washington School of Medicine, Howard Hughes Medical Institute, Seattle, Washington

Professor of Psychology (Cognitive Neuroscience), School of Psychology, Deakin University, Geelong, Victoria, Australia

Professor, Division of Psychiatry, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

Predoctoral Research Associate, Autism and Obsessive Compulsive Spectrum Program, Psychiatry Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York

Assistant Professor, Stem Cell Program and Department of Neurology, University of California, Davis, Sacramento, California

Professor of Psychiatry, Department of Psychiatry, Director of Autism Research, Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon

F. Hoffmann-La Roche Ltd, Basel, Switzerland

Research Assistant, Autism and Obsessive Compulsive Spectrum Program, Psychiatry Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York

Psychiatrist, Lurie Center for Autism, Massachusetts General Hospital, Lexington; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts

University of California, Davis, Sacramento, California

Assistant Professor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California

Division of Psychiatry, Sheba Medical Center, Tel Hashomer; Department of Epidemiology and Preventive Medicine and Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

F. Hoffmann-La Roche Ltd, Basel, Switzerland

Brain and Mind Centre, Children’s Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia

Distinguished Professor, Department of Pediatrics, and Endowed Chair in Fragile X Research, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Medical Center, Sacramento, California

Sara S. Sparrow Fellow in Clinical Neuroscience, Yale Child Study Center, Yale University, New Haven, Connecticut

Leslie Dan Faculty of Pharmacy, Department of Pharmaceutical Sciences, and Faculty of Medicine, Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada

Director, Autism and Developmental Disabilities Clinic, and Professor, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California

Assistant Professor, Department of Psychiatry, University of North Carolina–Chapel Hill; Faculty, Carolina Institute for Developmental Disabilities, Chapel Hill, North Carolina

Instructor, Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California

Professor, Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California

Data Scientist and Professional Educator, RStudio, Portland, Oregon

Assistant Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California

Director, Autism and Obsessive Compulsive Spectrum Program, and Professor of Psychiatry and Behavioral Sciences, Psychiatric Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine, Bronx, New York

Leslie Dan Faculty of Pharmacy, Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada

Associate Professor, Department of Pediatrics, University of Montréal; Medical Geneticist, Centre Hospitalier Universitaire Sainte-Justine Research Center, Montréal, Quebec, Canada

Associate Professor of Child and Adolescent Psychiatry and Vice Chair, Pritzker Department of Psychiatry and Behavioral Health, Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois

Research Fellow, Autism and Obsessive Compulsive Spectrum Program, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York

Chief Executive Officer, Open Health Network, Inc., Mountain View, California

Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Distinguished Professor, Human Development and Psychology, Graduate School of Education and Information Studies, and Center for Autism Research and Treatment, University of California, Los Angeles, Los Angeles, California

Adjunct Professor, Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia

Associate Professor, Department of Psychological and Brain Sciences, Program in Neuroscience, Cognitive Science Program, Indiana University, Bloomington, Indiana

Professor, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California

Assistant Professor, Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa

Department of Child and Adolescent Psychiatry, Seaver Autism Center, Icahn School of Medicine at Mount Sinai, New York, New York

Medical Microbiology and Immunology, Genome Center, and Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, California

Research Director, Autism Research and Engagement Core, Maryland Center for Developmental Disabilities, Kennedy Krieger Institute; Affiliate Faculty, Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins University, Baltimore, Maryland

Department of Computer Science and Electrical Engineering, Oregon Health & Science University, Portland, Oregon

Social Work Clinician, Department of Social Services, Lucile Packard Children’s Hospital Stanford, Palo Alto, California

Psychiatry Resident, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York

Principal Investigator, Interactive Autism Network; Associate Professor of Pediatrics, Kennedy Krieger Institute, Johns Hopkins University, Baltimore, Maryland

Professor, Psychology Department, University of Montreal; Scientist, Neuroscience of Early Development Lab, CHU Sainte-Justine Research Center, Montreal, Canada

Associate Professor, Institute of Psychiatry, Psychology, and Neuroscience, King’s College, London, England

Senior Program Director, Autism Infant Sibling Study, Southborough, Massachusetts

Department of Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon

Professor and Director, Center for Mental Health, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania

Professor, Department of Pathology and Laboratory Medicine, and Faculty, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis; Institute for Pediatric Regenerative Medicine and Shriners Hospitals for Children Northern California, Sacramento, California

Assistant Scientist, Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan

Director, Lurie Center for Autism, Massachusetts General Hospital, Lexington; Nancy Lurie Marks Professor of Psychiatry, Harvard Medical School, Boston, Massachusetts

Part-time Faculty, Department of Communication Disorders, California State University; Speech-Language Pathologist, Boone Fetter Clinic, Children’s Hospital, Los Angeles, California

Professor, Yale Child Study Center, Yale University, New Haven, Connecticut

Medical Microbiology and Immunology, Genome Center, and Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, California

Head, Department of Forensic and Neurodevelopmental Sciences; Director, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology, and Neuroscience, King’s College, London, England

Research Fellow, Albert Einstein College of Medicine, New York

Professor, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California

Istituto di Neuroscienze, Florence, Italy; Albert Einstein College of Medicine and Montefiore Medical Center, New York

Professor, Division of Pediatric Neurology, Children’s of Alabama, Birmingham, Alabama

Assistant Professor, Department of Applied Behavior Analysis, Regis College, Weston, Massachusetts

Professor and Associate Dean of Research and Graduate Education, Department of Molecular Biosciences, School of Veterinary Medicine; Faculty, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, California

Program Specialist for Homebased Services, The New England Center for Children, Southborough, Massachusetts

Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California

Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, California

Developmental and Behavioral Pediatrician, Phoenix Children’s Hospital; Clinical Assistant Professor, University of Arizona College of Medicine, Phoenix, Arizona

Assistant Professor, Center for Autism and Related Disorders, Kennedy Krieger Institute; Assistant Professor, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland

Department of Preventive Medicine, Friedman Brain Institute and The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York

Assistant Professor of Clinical Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana

Professor of Pediatrics, University of Colorado School of Medicine; Medical Director, Developmental Pediatrics, Children’s Hospital Colorado, Aurora, Colorado

Professor, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, California

Director, Rosamund Stone Zander Translational Neuroscience Center, and Director, Translational Research Program, Boston Children’s Hospital; Professor of Neurology, Harvard Medical School, Boston, Massachusetts

Department of Psychiatry, Institute on Development and Disability, Oregon Health & Science University, Portland, Oregon

Professor, Department of Pediatrics and Marcus Autism Center, Emory University School of Medicine, Atlanta, Georgia

Assistant Professor, Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

Associate Research Scientist, Department of Pediatrics, Fragile X Research and Treatment Center, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, California

Professor, Genome Center and Department of Biochemistry and Molecular Medicine, University of California, Davis, Sacramento, California

Assistant Professor of Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Hassenfeld Children’s Hospital of New York at NYU Langone, New York, New York

Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California

Professor of Pediatrics and Neurology, Central Michigan University; Division Chief of Child Neurology, Children’s Hospital of Michigan, Detroit, Michigan

Hoffmann-La Roche Ltd, Welwyn Garden City, United Kingdom

Assistant Professor, Department of Neurology, Boston Children’s Hospital; Instructor of Neurology, Harvard Medical School, Boston, Massachusetts

Director of Research Programs, Foundation for Prader-Willi Research, Walnut, California

Assistant Professor, Department of Child and Adolescent Psychiatry, Hassenfeld Children’s Hospital of New York at NYU Langone, New York, New York

Autism and Obsessive Compulsive Spectrum Program, Psychiatry Research Institute at Montefiore-Einstein, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York

Psychiatrist, Lurie Center for Autism, Massachusetts General Hospital, Lexington; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts

Associate Professor, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, California

Postdoctoral Scholar, Center for Autism Research and Treatment, University of California, Los Angeles, Los Angeles, California

Chief Technology Officer, Open Health Network, Inc., Mountain View, California; Adjunct Associate Professor, School of Engineering and Applied Science, George Washington University, Washington, DC

Senior Research Fellow, University of Washington School of Medicine, Seattle, Washington; Assistant Professor, Washington University School of Medicine, St. Louis, Missouri

Professor, Department of Internal Medicine, Division of Rheumatology, Allergy and Clinical Immunology, Center for Children’s Environmental Health; Director, Medical Investigation of Neurodevelopmental Disorders (MIND) Institute, University of California, Davis, Sacramento, California

Irving R. Harris Professor of Child Psychiatry, Pediatrics, and Psychology, Yale University, New Haven, Connecticut

Deputy Director for Clinical Research, Simons Foundation, New York; Associate Clinical Professor of Pediatrics, Yale School of Medicine, New Haven, Connecticut

Clinical Research Supervisor, Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California

Clinical Director, Profectum Foundation, Mendham, New Jersey

F. Hoffmann-La Roche Ltd, Basel, Switzerland

Leslie Dan Faculty of Pharmacy, Department of Pharmaceutical Sciences, University of Toronto, Toronto, Ontario, Canada

Associate Professor, Division of General Pediatrics, Oregon Health & Science University, Portland, Oregon

Fred R. Volkmar, M.D.

The year 2020 marked the 40th anniversary of the official recognition of infantile autism in DSM-III (American Psychiatric Association 1980). This official recognition reflected an accumulation of several important scientific advances in the prior decade. Several of these early lines of work should be highlighted. The first was the recognition of autism as a brain-based disorder that put individuals at high risk for developing seizures and other signs of neurological dysfunction (Minshew et al. 2005; Volkmar and Nelson 1990). This finding was incompatible with the mistaken (and, sadly, sometimes destructive) notion that parental caretaking had a role in the pathogenesis of autism (e.g., Bettelheim 1974). The second major finding, which continues to dominate much research activity, was the publication of the first twin study in autism showing a much higher concordance of autism in identical, as opposed to fraternal, twins (Folstein and Rutter 1977). A third important finding was that structured teaching was much more effective than unstructured psychotherapy in producing developmental change for children with autism (Rutter and Bartak 1973).

All three lines of work supported the validity of autism as a diagnostic concept. The need for official recognition became more imperative as research showed that the clinical phenomenology of autism was distinctive and that the early confusion of autism with childhood psychosis/schizophrenia could not be supported (Kolvin 1971; Rutter and Bartak 1973). In his influential article “Childhood Schizophrenia Reconsidered,” Rutter (1972) argued the importance of studying autism as a disorder in its own right. The recognition of autism in DSM-III stimulated an explosion of research that has continued to the current day (Volkmar 2019). The tremendous range and sophistication of this body of work is clear in this new volume, which is being published more than four decades after DSM-III.

Part I is devoted to issues of assessment and evaluation. Research on autism spectrum disorder (ASD) now involves many different disciplines and lines of research. Newly developing areas, such as biomarkers and sex differences, are recognized here and will be the foci of investigation in the future. The section on target (core) and associated symptoms addresses the diverse expression of ASD across many aspects of development. In addition to the core features of social impairment and resistance to change highlighted by Kanner (1943), ASD has increasingly been associated with a range of other problems in important aspects of development, such as communication, and the risk of comorbid conditions, such as depression and anxiety.

Part II focuses on cause of ASD. It begins with overview chapters that inform our understanding of etiology before turning to some of the more frequently recognized associations with other medical conditions. The section on imaging and anatomy rightly reflects the growing diversity of work in neuroimaging that has enhanced our understanding of the social neuroscience of ASD (McPartland et al. 2014)—a topic with broader implications for understanding the human social brain more generally (Brothers 1990).

Part III of this volume reviews both standard and experimental treatments in ASD. This is an area of great excitement, given the potential for applying our understanding of genetic or social neuroscience (or both) and mechanisms as they are translated into practical applications for treatment. This is an area in which knowledge is changing rapidly (Mooney et al. 2019), and current reviews of such as those presented here are greatly needed. The chapters on treatment provide excellent summaries of current well-established, evidence-based treatments and potential new emerging treatments. The chapters on potential areas for future treatment development are of special interest in this regard.

Social policy issues are the focus of Part IV. With earlier diagnosis and intervention, patient outcomes are improving, and more individuals with ASD are able to seek competitive employment or to enroll in college. However, many challenges remain. In contrast with other disabilities, underemployment is more common for individuals with ASD, even those who have completed college (Gerhardt et al. 2014; Smith et al. 2015).

Updates of this kind are sorely needed, and this volume presents a state-of-the-science approach that will be difficult to surpass!