Autism: Medical History

The medical history (history of illness) represents an important component in the diagnosis of autism.

Family history

  • Are there any inherited disorders in your family?

Social history

  • What is your profession?
  • Is there any evidence of psychosocial stress or strain due to your family situation?

Current medical history/systemic history (somatic and psychological complaints).

  • What symptoms have you noticed?
  • Does your child exhibit a contact disorder, an isolating disorder, and/or a fear of change?
  • Is the development age-appropriate?
  • Does your child speak? If so, when did he or she first speak?
  • What is the course of motor development?
  • Does your child show stereotypies?
  • Is your child irritable, distant, has ritualized routines?
  • What hobbies does your child have?
  • Does your child have friends / friendships?

Vegetative anamnesis including nutritional anamnesis.

  • Did you drink alcohol during pregnancy?
  • Do you use drugs? If yes, what drugs and how often per day or per week?

Self history incl. medication history.

  • Pre-existing conditions (early childhood brain damage; rubella infection of the mother during pregnancy).
  • Surgeries
  • Vaccination status
  • Allergies
  • Pregnancies (course, complications)
  • Developmental history
  • Care and education situation from infancy to adolescence.
  • Educational history

Medication history

  • Antidepressants?
    • Ingestion in second and/or third trimester (third trimester of pregnancy); 87% increase over children without exposure.
    • A meta-analysis and two registry studies find no differences for autism in exposed and unexposed siblings after SSRI ingestion by pregnant women.
  • Misoprostol – active ingredient used for gastric ulcers.
  • Thalidomide – sedative / sleeping pill, which became known through the so-called thalidomide scandal.
  • Valproic acid / valproate – active substance used in epilepsy.

Environmental history

  • Dichlorodiphenyltrichloroethane (DDT) – pregnant women had significantly higher blood concentrations of DDT and its major metabolite dichlorodiphenyltrichloroethane p,p′-dichlorodiphenyl-dichloroethylene (p,p′-DDE).
  • Exposure to particulate matter and nitrogen dioxide during pregnancy and the first year of life.
  • Air pollution (diesel particulates, mercury, and lead, nickel, manganese and methylene chlorides).
  • Prenatal (pre-natal) exposure to pesticides.
    • Polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs)Note: Polychlorinated biphenyls are among the endocrine disruptors (synonym: xenohormones) that can harm health even in minute amounts by altering the endocrine system.
    • Glyphosate (odds ratio 1.16; 95% confidence interval 1.06 to 1.27), chlorpyrifos (odds ratio 1.13; 1.05-1.23), diazinon (odds ratio 1.11; 1.01-1.21), malathion (odds ratio 1.11; 1.01-1.22), avermectin (odds ratio 1.12; 1.04-1.22), and permethrin (odds ratio 1.10; 1.01-1.20).

When autism is suspected, the following test psychology examinations may be helpful.

  • Autism diagnostic interviews
  • Language development test
  • Intelligence tests