Tazama chanzo cha Tawahudi

<small><sup>Kuhusu ugonjwa wa mifupa unaoweza kuitwa kwa jina hili angalia [[usonji]]</sup></small>

{{pp-move-indef}}
{{Infobox Disease
 | Name = Autism
 | Image = Autism-stacking-cans 2nd edit.jpg
 | Alt = Young red-haired boy facing away from camera, stacking a seventh can atop a column of six food cans on the kitchen floor. An open pantry contains many more cans.
 | Caption = Tabia ya kawaida: hupanga mfululizo vitu kimoja juu ya kingine au mstarini. 
 | DiseasesDB = 1142
 | ICD10 = {{ICD10|F|84|0|f|80}}
 | ICD9 =  299.00
 | ICDO =
 | OMIM =  209850
 | MedlinePlus = 001526
 | eMedicineSubj = med
 | eMedicineTopic = 3202
 | eMedicine_mult = {{eMedicine2|ped|180}}
 | MeshID = D001321
 | GeneReviewsID   = autism-overview
 | GeneReviewsName = Autism overview
}}
'''Usonji''' (pia '''tawahudi''', kwa [[Kiingereza]] '''autism''') ni [[tatizo la kinafsi]] na la kihisia linalowatokea [[watu]] tangu [[Utoto|utotoni]] na kuathiri uwezo wao wa kuwasiliana na wengine.

Wenye tatizo hilo hawaonekani watu wa kawaida. Muda mwingine hawapendi kuangalia wengine pale wanapozungumza nao, au hawapendi kushirikiana na watu wengine katika mambo kadhaa. Pia, hawako vizuri katika [[mawasiliano]]. Muda mwingine huwa hawawezi kuongea au kuzungumza na watu wengine. Mwishoni, hujijibu wenyewe. Wanaweza wakawa na shauku na [[kitu]] ambacho mtu mwingine (ambaye hana tatizo la usonji) hafikirii kina umuhimu.

Mtu mwenye tatizo hilo anaelekea mara nyingi kurudiarudia matendo kadhaa, na anaweza kuhofia vitu katika [[mazingira]] yake yasiyoeleweka kama tatizo na wengine.

Usonji ni [[ugonjwa]] wa ukuaji wa [[neva]] unaojumuisha kudhoofishwa kwa uwezo wa mwingiliano wa kijamii na [[mawasiliano]], na kwa [[tabia]] finyu na ya kujirudiarudia. [[Dalili]] hizo huanza kabla ya mtoto kutimiza miaka mitatu.<ref name="DSM-IV-TR-299.00"></ref> [[Ugonjwa wa akili]] kwa watoto huathiri uchakataji wa habari katika [[ubongo]] kwa kubadili jinsi [[seli]] za neva na [[sinepsi]] zake zinavyounganika na kujipanga; jinsi gani hilo hutokea haileleweki vizuri.<ref name="Levy"></ref> 

Ni moja ya matatizo matatu yanayotambulika katika wigo wa ugonjwa wa akili wa watoto (ASDs), nyingine mbili zikiwa [[maradhi]] ya [[Aspaja]], ambayo haicheleweshi <ref name="Johnson"></ref> ukuaji wa kiutambuzi na [[lugha]], na Tatizo la Ukuaji Ulioenea-Usiofafanulika Vinginevyo (PDD-NOS), ambao hutambuliwa kikamilifu wakati vigezo vyote vya kawaida au Aspaja havijatimizwa.<ref name="Johnson"></ref><ref>[[Istilahi]] ya Usonji inaweza kukanganya, huku usonji, ugonjwa wa Aspaja na PDD-NOS zikijulikana kama ''Wigo'' wa ''Magonjwa ya Akili ya Watoto'' (ASD) au wakati mwingine ''Magonjwa ya Usonji,'' {{vcite journal |author=Freitag CM |title=The genetics of autistic disorders and its clinical relevance: a review of the literature |journal=Mol Psychiatry |volume=12 |issue=1 |pages=2–22 |year=2007 |doi=10.1038/sj.mp.4001896 |pmid=17033636 }} huku usonji yenyewe mara nyingi ikitwa ''Ugonjwa wa akili wa watoto'', ''usonji utotoni,'' au ''usonji ya wakembe.'' Katika makala hii, ''Usonji'' inarejelea Ugonjwa ya Akili wa watoto unavyotambulika kimapokeo, japo katika matibabu, usonji, ASD na PDD mara nyingi hutumika kwa maana sawa. ASD, kwa hiyo, ni sehemu tu ya tapo pana la fenotaipu ya usonji, inayowarejelea watu ambao huenda hawana ASD lakini wana sifa bainishi ya usonji, kama vile kuepuka kuwatazama watu machoni. {{vcite journal |author=Piven J, Palmer P, Jacobi D, Childress D, Arndt S |title=Broader autism phenotype: evidence from a family history study of multiple-incidence autism families |journal=Am J Psychiatry |year=1997 |volume=154 |issue=2 |pages=185–90 |pmid=9016266 |url=http://ajp.psychiatryonline.org/cgi/reprint/154/2/185.pdf |format=PDF |accessdate=2010-10-18 |archivedate=2007-08-08 |archiveurl=https://web.archive.org/web/20070808072808/http://ajp.psychiatryonline.org/cgi/reprint/154/2/185.pdf }}</ref>

Usonji una msingi kamili katika [[jeni]], ingawa mpangilio wa jeni za ugonjwa wa akili kwa watoto ni changamano na si bayana kama ASD inaelezeka zaidi kwa mabadiliko makuu ya jeni yasiyo ya kawaida, au kwa mchanganyiko usio wa kawaida wa aina tofauti za jeni ya kawaida.<ref name="Abrahams"></ref> Katika matukio ya nadra, usonji unahusishwa sana na visababishi vya kasoro za kuzaliwa.<ref name="Arndt"></ref> Ubishi unakumba mapendekezo mengine ya visababishi vya kimazingira, kama vile [[metali]] nzito, viuawadudu au [[chanjo]] za utotoni;<ref name="Rutter"></ref> [[nadharia tete]] ya chanjo haiwezekani [[Biolojia|kibiolojia]] na inakosa [[ushahidi]] yakinifu wa [[Sayansi|kisayansi]]. 

Uenezi wa usonji ni karibu 1-2 kati ya watu 1,000, wakati uenezi wa ASD ni takriban matukio 6 kwa 1,000, huku idadi ya [[wanaume]] ikiwa mara [[nne]] kuliko ya [[wanawake]]. [[Idadi]] ya walioaguliwa kuwa na usonji umeongezeka kwa kasi tangu [[miaka ya 1980]], kwa kiwango kutokana na mabadiliko katika jinsi ya uaguaji, swali la kama [[maambukizi]] shadidi yameongezeka halijafumbuliwa.<ref name="Newschaffer"></ref>

[[Wazazi]] kwa kawaida hugundua [[dalili]] katika miaka miwili ya kwanza ya maisha ya mtoto wao.<ref name="CCD"></ref> Dalili hizo kwa kawaida huendelea hatua kwa hatua, lakini baadhi ya watoto wenye ugonjwa wa akili hukua kwa kawaida kijumla kabla ya ukuaji kubadilika.<ref name="Stefanatos"></ref> Ingawa mwingilio wa mapema wa kitabia au wa kitambuzi unaweza kuwasaidia watoto wenye ugonjwa wa akili kujihimili, kupata [[ujuzi]] wa kijamii, na mawasiliano, hakuna [[tiba]] inayojulikana.<ref name="CCD"></ref> Si watoto wengi wenye usonji huishi kwa kujitegemea wanapofikia [[utu uzima]], ingawa baadhi huwa wafanisi.<ref name="Howlin"></ref> Kumeibuka [[desturi]] ya usonji, huku watu wengine wakitafuta matibabu na wengine wakiamini lazima usonji ikubalike kuwa utofauti, si ugonjwa.<ref name="Silverman"></ref><ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786613/]</ref><ref>[https://www.nichd.nih.gov/health/topics/autism/conditioninfo/treatments/medication-treatment]</ref> 

== Dalili ==
=== Kukaa peke yake ===
[[Mtoto]] wa kawaida huwaangalia watu wakizungumza, hutazama wengine [[uso|usoni]], hutabasamu, na huwa na shauku na watu wengine. Watoto wenye usonji, wanaweza kupenda vitu kuliko sura au watu wengine. Wanaweza wakatazama usoni kwa [[sekunde]] tu, halafu mara moja wakageuka. Wanaweza wasitabasamu, au wanaweza wakatabasamu kwa kitu kile walichokipenda.

Watoto wenye tatizo hilo huwa na kawaida ya kukaa wenyewe tu, bila uwepo wa wengine. Wanaweza wasiwe na shauku ya kutaka [[urafiki]] na mtu yeyote. Pia, wanaweza wasiwe wanafanya mambo ya kawaida kama kukumbatiana na [[alama]] nyingine za [[upendo]] kwa [[wazazi]] wao. Hii haimaanishi hawawapendi wazazi wao, ni kwamba hawajui namna ya kuonyesha hivyo vitu.

Wanaweza wasione [[hisia]] za watu wengine; kwa [[mfano]], wanaweza wasione tofauti kubwa sana kati ya mzazi kuwa na [[furaha]] ama kuwa na [[huzuni]]. Wanaweza wakacheka na kulia mara zisizoeleweka.

=== Kutozungumza ===
Mtoto mwenye usonji anaweza asithubutu kuongea, maana, au kujaribu kuelewa maongezi kati ya mwenzie mwenye [[umri]] sawa. Baadhi yao huwa hawaongei kabisa. Wengi wao hawawezi kuongea vizuri na watu wengine.

=== Kufanya vitu tena na tena ===
Baadhi ya wenye usonji hutumia muda mwingi kufanya vitu vya aina moja mara nyingi zaidi na zaidi, au kuwa na shauku na vitu ambavyo si vya kawaida; baadhi yao wanaweza kutumia muda mwingi kujizungushia [[mkono]], kutembea na [[mwanaserere|wanaserere]] wao, au kupanga vitu kwa mpangilio mmoja. Watu wenye tatizo la usonji wanaweza wakatumia muda mrefu kupanga visanamu au vyumbavyumba vyao kwa mstari mmoja na wanaweza kusikia jazba mtu akivivuruga katika eneo lake.

Baadhi yao hawataki badiliko lolote lile, na wanaweza wakafanya mambo yaleyale kila siku bila kubadilisha — kama vile wanapokula, wanavaa, wanapiga [[mswaki]], au pale wanapokwenda [[shule]] — huwa na huzuni kama kuna badiliko lolote katika vitu hivyo. Pia, wanaweza wakawa na shauku na vitu vya ajabu na kutumia muda wao mwingi kujifunza vitu hivyo.

== Ugunduzi na jina ==
Autism lilipewa jina hilo la Kiingereza kwa mara ya kwanza mnamo [[1943]]. [[Leo Kanner]] alifanya [[utafiti]] huu kwa watoto wapatao 11 akagundua vitu ambavyo si vya kawaida kuhusu wao. Aliita ''early infantile autism''. 

Muda huohuo, [[daktari]] mwingine, [[Hans Asperger]], akafanya utafiti mwingine karibu sawa. Alichokigundua kinaitwa sasa ''[[Asperger syndrome]]'', wakati alichokigundua Leo Kanner kinaitwa ''autistic disorder'', ''childhood autism'', ''infantile autism'', au ''autism'' tu. 

==Sifa bainifu ==
Usonji ni [[maradhi]] ya ukuaji wa neva yaliyo na ugeugeu mwingi sana<ref name="Geschwind"></ref>ambayo huonekana kwanza wakati wa [[ukembe]] au utoto, na kwa jumla hufuata mkondo fulani bila kupungua.<ref name="ICD-10-F84.0"></ref> Dalili za kuonekana huanza polepole baada ya umri wa miezi [[sita]], huwa dhahiri katika umri wa miaka miwili au mitatu,<ref>{{vcite journal |author=Rogers SJ |title=What are infant siblings teaching us about autism in infancy? |title.= |journal=Autism Res |volume=2 |issue=3 |pages=125–37 |year=2009 |pmid=19582867 |doi=10.1002/aur.81 |pmc=2791538 }}</ref> na aghalabu huendelea hadi [[utu uzima]], ingawa mara nyingi katika kiwango kilichopungua.<ref name="Rapin"></ref> 

Haitambuliki kwa dalili moja tu, bali kwa sifa bainifu tatu: udhaifu katika mahusiano ya kijamii; udhaifu katika mawasiliano, hamu finyu ya mambo na tabia ya kujirudiarudia. Vipengele vingine, kama vile ulaji usio wa kawaida, vinatokea pia mara nyingi lakini si muhimu kwa ajili ya uaguzi.<ref name="Filipek"></ref> Dalili za mtu mwenye usonji hutokea katika jamii kijumla na huonekana hajihusishi sana, bila utenganisho wa sifa za kawaida na za kiambukizi.<ref name="London"></ref>

===Ukuaji kijamii===
Mapungufu ya kijamii hutofautisha usonji na maradhi mengine yaliyo katika wigo unaofanana (ASD) kutoka matatizo mengine ya ukuaji.<ref name="Rapin"></ref> Watu walio na usonji huwa na mapungufu ya kijamii na mara nyingi hukosa uwezo wa kufikiri haraka kuhusu wengine, jambo ambalo watu wengi huchukulia kwa mzaha. [[Temple Grandin]], mgonjwa wa akili mtambulika, alieleza hali yake ya kutoweza kuelewa mawasiliano ya kijamii ya watu wasio na matatizo ya neva, au watu wenye ukuaji wa kawaida wa mfumo wa neva, kama unaomwacha kujihisi "kama [[Anthropolojia|mwanaanthropolojia]] juu ya [[Mirihi]]".<ref>{{vcite book |title=[[An Anthropologist on Mars]]: Seven Paradoxical Tales |author=[[Oliver Sacks|Sacks O]] |publisher=Knopf |year=1995 |isbn=0679437851 }}</ref>

Ukuaji wa kijamii usio wa kawaida huanza kudhihirika mapema utotoni. Watoto wachanga wenye usonji huonyesha makini ndogo kwa michocheo ya kijamii, ni nadra kutabasamu na kuwaangalia wengine, aidha ni nadra kuitikia [[jina]] lao wenyewe. Watoto wachanga wenye usonji huenda kinyume kabisa na kanuni za kijamii, kwa mfano, hawaangalii sana watu [[Macho|machoni]] wala kujibu wengine katika mazungumzo, na upo uwezekano mkubwa wa kuwasiliana kwa kuchezea mkono wa mwingine.<ref name="Volkmar"></ref> Watoto wa umri wa kati ya miaka mitatu na mitano walio na ugonjwa wa akili huenda wasionyeshe uelewa wa masuala ya jamii, huenda wasijue kutangamana moja kwa moja, huiga na kuitikia hisia, hujieleza bila kuzungumza, na hawachangii inapofika zamu yao katika mazungumzo. Hata hivyo, huonyesha mapenzi kwa walezi wao.<ref>{{vcite journal |journal=Ment Retard Dev Disabil Res Rev |year=2004 |volume=10 |issue=4 |pages=221–33 |title=Early detection of core deficits in autism |author=Sigman M, Dijamco A, Gratier M, Rozga A |doi=10.1002/mrdd.20046 |pmid=15666338 }}</ref> Watoto wengi wenye ugonjwa wa akili huonyesha kiasi kidogo cha mapenzi wakilinganishwa na watoto wasio na ugonjwa, ingawa tofauti hii hutoweka kwa watoto walio na ukuaji mkuu wa [[akili]] au walio na athari ndogo ya ASD.<ref>{{vcite journal |journal=J Child Psychol Psychiatry |year=2004 |volume=45 |issue=6 |pages=1123–34 |title=Autism and attachment: a meta-analytic review |author=Rutgers AH, Bakermans-Kranenburg MJ, van IJzendoorn MH, van Berckelaer-Onnes IA |doi=10.1111/j.1469-7610.2004.t01-1-00305.x |pmid=15257669 }}</ref> Watoto wakubwa na watu wazima walio na ASD hufanya vibaya katika [[mtihani|mitihani]] ya utambuzi wa nyuso na hisia.<ref name="Sigman">{{vcite journal |journal=Annu Rev Clin Psychol |year=2006 |volume=2 |pages=327–55 |title=Autism from developmental and neuropsychological perspectives |author=Sigman M, Spence SJ, Wang AT |doi=10.1146/annurev.clinpsy.2.022305.095210 |pmid=17716073 }}</ref>

Watoto walio na kiwango kikubwa cha athari ya usonji hukabiliwa na upweke wa kiwango kikubwa na cha mara kwa mara wakilinganishwa na wale wa [[rika]] lao wasio na ugonjwa wa akili, licha ya [[imani]] ya kawaida kwamba watoto walio na usonji hupendelea kuwa peke yao. Kuanzisha na kudumisha urafiki mara nyingi huwa vigumu kwa walio na usonji. Kwao, ubora wa urafiki, wala si idadi ya marafiki, huchangia kiwango cha upweke wanachohisi. Urafiki amilifu, kama vile unaojumuisha mwaliko kwa [[karamu]], huweza kuathiri ubora wa maisha kwa undani zaidi.<ref name="Burgess"></ref>

Kuna taarifa nyingi za matukio ya kweli, lakini chunguzi chache za kijarabati, kuhusu uchokozi na vurugu unaotekelezwa na watu walio na ADS. [[Data]] chache zilizopo zinaonyesha kwamba, kwa watoto wenye akili [[taahira]], usonji unahusishwa na uchokozi, uharibifu wa mali, na hamaki. [[Utafiti]] mmoja wa mwaka [[2007]] uliowahoji wazazi wa watoto 67 walio na ASD uliarifu kuwa [[thuluthi]] [[mbili]] za watoto hao waliwahi kuwa na hamaki kali, takriban thuluthi moja wakiwa na [[historia]] ya uchokozi, huku wakiwa na uwezekano mkubwa wa hamaki kuliko watoto wasio na ugonjwa wa akili mbali na matatizo ya lugha.<ref name="Dominick"></ref> Utafiti uliofanyika [[Uswidi]] mwaka [[2008]] uligundua kwamba, kwa watu wenye umri wa miaka 15 au zaidi walioachiliwa kutoka [[Hospitali|hospitalini]] baada ya kutambuliwa kuwa na ASD, waliotekeleza [[uhalifu]] kwa nguvu pia walikuwa na uwezekano mkubwa wa kuwa na matatizo mengine ya [[saikolojia|kisaikolojia]] kama vile wendawazimu.<ref>{{vcite journal |journal=J Interpers Violence |year=2008 |title=Risk factors for violent offending in autism spectrum disorder: a national study of hospitalized individuals |author=Långström N, Grann M, Ruchkin V, Sjöstedt G, Fazel S |volume=24 |issue=8 |pages=1358–70 |doi=10.1177/0886260508322195 |pmid=18701743 }}</ref>

===Mawasiliano===
Takribani thuluthi au [[nusu]] ya watu walio na usonji hukosa umilisi wa mazungumzo wa kutosha kukidhi mahitaji yao ya mawasiliano ya kila siku.<ref>{{vcite journal |journal=J Intellect Disabil Res |year=2006 |volume=50 |issue=9 |pages=621–32 |title=The ComFor: an instrument for the indication of augmentative communication in people with autism and intellectual disability |author=Noens I, van Berckelaer-Onnes I, Verpoorten R, van Duijn G |doi=10.1111/j.1365-2788.2006.00807.x |pmid=16901289 }}</ref> Tofauti katika mawasiliano inaweza kuwepo katika mwaka wa kwanza wa [[uhai]], na inaweza kujumuisha kuchelewa kuanza kubwabwaja, ishara zisizo za kawaida, mwitikio mpungufu, na mifumo ya [[matamshi]] isiyooana na ya mlezi. Katika mwaka wa pili na wa tatu, watoto walio na ugonjwa wa akili hubwabwaja mara kidogo na [[Neno|maneno]] yao huwa machache iliyo uchache wa [[konsonanti]], maneno, na mchanganyiko wa maneno, ishara zao mara nyingi haziambatani na maneno. Watoto walio na usonji ni nadra kuomba kitu au kujieleza, kuna uwezekano wa wao kurudia tu maneno ya watu wengine (ekolalia)<ref name="Landa"></ref><ref name="Tager-Flusberg"></ref> au kugeuza kinyume viwakilishi.<ref name="Kanner1943"></ref> Mwongozo shirikishi wa makini unaonekana kuwa muhimu katika mazungumzo amilifu, na upungufu katika mwongozo shirikishi wa makini unaonekana kuwatofautisha watoto wachanga walio na ASD:<ref name="Johnson">{{vcite journal |journal=Pediatrics |year=2007 |volume=120 |issue=5 |pages=1183–215 |title=Identification and evaluation of children with autism spectrum disorders |author=Johnson CP, Myers SM, Council on Children with Disabilities |doi=10.1542/peds.2007-2361 |pmid=17967920 |url=http://pediatrics.aappublications.org/cgi/content/full/120/5/1183 |laysummary=http://aap.org/advocacy/releases/oct07autism.htm |laysource=AAP |laydate=2007-10-29 |accessdate=2010-10-18 |archivedate=2009-02-08 |archiveurl=https://web.archive.org/web/20090208013449/http://pediatrics.aappublications.org/cgi/content/full/120/5/1183 }}</ref> kwa mfano, wanaweza kuangalia mkono unaoashiria badala ya kifaa kinachoashiriwa,<ref name="Volkmar"></ref><ref name="Tager-Flusberg"></ref> na pia hushindwa mara nyingi kuashiria vitu ili kutoa maoni au kujieleza.<ref name="Johnson"></ref> Watoto walio na ugonjwa wa akili wanaweza kuwa na ugumu katika [[michezo]] ya [[ubunifu]] na kufanya ishara kuwa lugha.<ref name="Landa">{{vcite journal |journal=Ment Retard Dev Disabil Res Rev |year=2007 |volume=13 |issue=1 |pages=16–25 |title=Early communication development and intervention for children with autism |author=Landa R |doi=10.1002/mrdd.20134 |pmid=17326115 }}</ref><ref name="Tager-Flusberg">{{vcite journal |journal=Pediatr Clin North Am |year=2007 |volume=54 |issue=3 |pages=469–81 |title=Language disorders: autism and other pervasive developmental disorders |author=Tager-Flusberg H, Caronna E |doi=10.1016/j.pcl.2007.02.011 |pmid=17543905 }}</ref> 

Katika [[jozi]] la chunguzi, watoto walio na umri wa miaka 8-15 na wenye ugonjwa wa akili wa kiwango cha juu walifanya vizuri kuliko waliokuwa wakilinganishwa nao katika mtihani wa [[msamiati]] na [[tahajia]]. Jozi la watu wazima lilifanya vizuri zaidi. Makundi yote ya walio na ugonjwa wa akili yalifanya vibaya zaidi kuliko waliokuwa wakilinganishwa nao katika mitihani changamano ya lugha kama vile, jazanda, ufahamu na uchanganuzi. Kwa kuwa mara nyingi watu hutathminiwa kutokana na uelewa wao wa kimsingi wa lugha, chunguzi hizi zinaonyesha kwamba watu wanaozungumza na watu wenye ugonjwa wa akili wanaweza kukadiria juu zaidi kuhusu uelewa wa wasikilizaji wao.<ref name="Williams"></ref>

===Tabia radidi===
Watu walio na ugonjwa wa akili hudhihirisha aina mbalimbali ya [[tabia radidi]] au tabia finyu, ambayo Mizani ya Tabia Radidi-Iliyorekebishwa (RBS-R)<ref name="Lam-Aman"></ref> inainisha kama ifuatavyo.
[[File:Autistic-sweetiepie-boy-with-ducksinarow.jpg|thumb|alt=Young boy asleep on a bed, facing the camera, with only the head visible and the body off-camera. On the bed behind the boy's head is a dozen or so toys carefully arranged in a line, ordered by size.|Mvulana mdogo aliye na usonji, na msururu sahihi wa vijidude aliotengeneza.]]

*'''Uradidi''' ni msogezo wa kujirudiarudia, kama vile kupigapiga mkono, kufanya [[kelele]], kutikisa [[kichwa]], au kutikisa [[mwili]].
*'''Tabia ya kulazimisha''' inanuiwa na huonekana kufuata kanuni, kama vile kupanga vitu katika vitita au mistari.
*'''Uhafidhina''' ni kukataa kukubali mabadiliko, kwa mfano, kusisitiza kwamba [[samani]] isisongozwa au kukataa kukatizwa.
*'''Uhalisia''' unahusisha '''tabia''' isiyobadili mpangilio wa shughuli za kila siku, kama vile kutobadili [[chakula]] au [[mavazi]]. Hii huhusishwa kwa karibu na [[uhafidhina]] na wathibitishaji wa kujitegemea wamependekeza kuchanganya vipengele hivi viwili.<ref name="Lam-Aman">{{vcite journal |journal=J Autism Dev Disord |year=2007 |volume=37 |issue=5 |pages=855–66 |title=The Repetitive Behavior Scale-Revised: independent validation in individuals with autism spectrum disorders |author=Lam KSL, Aman MG |doi=10.1007/s10803-006-0213-z |pmid=17048092 }}</ref>
*'''Tabia vikwazo''' ni finyu katika lengo, nia, au kitendo, kama vile mshughuliko na kipindi kimoja cha [[runinga]], mwanasesere, au mchezo.
*'''Kujiumiza''' hujumuisha vitendo vya kudhuru au vinavyoweza kumdhuru mtu, kama vile kuchokora macho, kujichokoa [[ngozi]], kuuma mkono, na kugonga kichwa.<ref name="Johnson"></ref> Utafiti mmoja wa mwaka 2007 uliarifu kwamba [[jeraha|majeraha]] ya kujiumiza wakati fulani yaliathiri 30[[%]] ya watoto walio na ASD.<ref name="Dominick"></ref>
Hakuna tabia moja radidi au maumivu ya kujisabishia yanayoonekana kuwa mahsusi kwa walio na ugonjwa wa akili, lakini ni ugonjwa wa akili unaoonekana kuwa na mfumo wa ongezeko na ushadidi wa matukio ya tabia hizi.<ref>{{vcite journal |journal=J Autism Dev Disord |year=2000 |volume=30 |issue=3 |pages=237–43 |title=Varieties of repetitive behavior in autism: comparisons to mental retardation |author=Bodfish JW, Symons FJ, Parker DE, Lewis MH |doi=10.1023/A:1005596502855 |pmid=11055459 }}</ref>

===Dalili nyinginezo===
Walio na ugonjwa wa akili wanaweza kuwa na dalili zisizoonekana kwa uaguzi, lakini zinaweza kumwathiri mtu binafsi au [[familia]].<ref name="Filipek">[59] ^ {{vcite journal |author=Filipek PA, Accardo PJ, Baranek GT ''et al.'' |author.= |title=The screening and diagnosis of autistic spectrum disorders |journal=J Autism Dev Disord |year=1999 |volume=29 |issue=6 |pages=439–84 |doi=10.1023/A:1021943802493 |pmid=10638459 }} Chapisho hili linawakilisha makubaliano ya wawakilishi kutoka mashirika [[tisa]] ya wataalamu na [[nne]] za wazazi yaliyoko Marekani</ref>
Inakadiriwa kuwa 0.5% hadi 10% za watu walio na ASD hudhihirisha [[Kipaji|vipaji]] visivyo vya kawaida, kwa mfano [[ujuzi]] wa kukumbuka maswali madogomadogo pamoja na vipaji vya nadra sana na kuwa watumishi wa ajabu.<ref>{{vcite journal |author=Treffert DA |title=The savant syndrome: an extraordinary condition. A synopsis: past, present, future |journal=Philos Trans R Soc Lond B Biol Sci |volume=364 |issue=1522 |pages=1351–7 |year=2009 |pmid=19528017 |doi=10.1098/rstb.2008.0326 |url=http://rstb.royalsocietypublishing.org/content/364/1522/1351.full |laysummary=http://www.wisconsinmedicalsociety.org/savant_syndrome/overview_of_savant_syndrome |laysource=Wisconsin Medical Society |pmc=<!-- 2677584 embargoed until 2010-05-27 --> }}</ref> Watu wengi walio na ASD hudhihirisha ujuzi mkuu katika mtazamo na makini, wakilinganishwa na watu wa kawaida.<ref>{{vcite journal |author=Plaisted Grant K, Davis G |title=Perception and apperception in autism: rejecting the inverse assumption |journal=Philos Trans R Soc Lond B Biol Sci |volume=364 |issue=1522 |pages=1393–8 |year=2009 |pmid=19528022 |doi=10.1098/rstb.2009.0001 |pmc=<!-- 2677593 embargoed until 2010-05-27 --> |url=http://rstb.royalsocietypublishing.org/content/364/1522/1393.full }}</ref>
[[Ulemavu]] katika hisia hupatikana miongoni mwa zaidi ya 90% ya watu walio na usonji, na hudhaniwa na baadhi ya watu kuwa sifa msingi,<ref name="Geschwind-2009">{{vcite journal |author=Geschwind DH |title=Advances in autism |journal=Annu Rev Med |volume=60 |pages=367–80 |year=2009 |pmid=19630577 |doi=10.1146/annurev.med.60.053107.121225 }}</ref> ingawa hakuna ushahidi mzuri kwamba dalili za kihisia hutofautisha usonji na maradhi mengine ya ukuaji.<ref>{{vcite journal |journal=J Child Psychol Psychiatry |year=2005 |volume=46 |issue=12 |pages=1255–68 |title=Annotation: what do we know about sensory dysfunction in autism? A critical review of the empirical evidence |author=Rogers SJ, Ozonoff S |doi=10.1111/j.1469-7610.2005.01431.x |pmid=16313426 }}</ref> Tofauti ni kubwa katika mwitikio-chini (kwa mfano, kutembea kuelekea jambo) kuliko mwitikio-juu (kwa mfano, kuitikia [[sauti]] kubwa kutokana na taharuki) au kwa kutafuta [[mhemko]] (kwa mfano, misogezo yenye urari).<ref>{{vcite journal |journal=J Autism Dev Disord |year=2009 |title=A meta-analysis of sensory modulation symptoms in individuals with autism spectrum disorders |author=Ben-Sasson A, Hen L, Fluss R, Cermak SA, Engel-Yeger B, Gal E |doi=10.1007/s10803-008-0593-3 |pmid=18512135 |volume=39 |issue=1 |pages=1–11 }}</ref>
Takribani 60-80% za watu walio na ugonjwa wa akili huwa na matatizo katika mwendo ikiwa ni pamoja na [[misuli]] iliyodhoofika, mpangilio hafifu wa kusogeza [[viungo]], na kutembea kwa [[Kiganja|viganja]] vya [[miguu]], <ref name="Geschwind-2009"></ref> upungufu katika taratibu za kusogeza viungo ni chache kwa walio na ASD na ni kubwa miongoni mwa walio na usonji uliokithiri.<ref>{{vcite journal |author=Fournier KA, Hass CJ, Naik SK, Lodha N, Cauraugh JH |title=Motor coordination in autism spectrum disorders: a synthesis and meta-analysis |journal=J Autism Dev Disord |volume= |issue= |pages= |year=2010 |pmid=20195737 |doi=10.1007/s10803-010-0981-3 }}</ref>

Tabia isiyo ya kawaida katika ulaji hutokea katika robo tatu za watoto walio na ASD, kiasi kwamba awali ilikuwa moja ya viashiria vya uaguzi. Ubaguaji ndilo la tatizo la kawaida zaidi, ingawa desturi za ulaji na kukataa kula pia hutokea;<ref name="Dominick">{{vcite journal |journal=Res Dev Disabil |year=2007 |volume=28 |issue=2 |pages=145–62 |title=Atypical behaviors in children with autism and children with a history of language impairment |author=Dominick KC, Davis NO, Lainhart J, Tager-Flusberg H, Folstein S |doi=10.1016/j.ridd.2006.02.003 |pmid=16581226 }}</ref> hii haionekani kusababisha [[utapiamlo]]. Ingawa baadhi ya watoto walio na usonji pia huwa na dalili za ugonjwa wa [[tumbo]] na [[utumbo]] (GI), kuna ukosefu wa data madhubuti zilizochapishwa kuunga mkono nadharia kwamba watoto walio na ugonjwa wa akili wana tofauti au dalili zaidi za GI kuliko kawaida,<ref>{{vcite journal |journal=J Autism Dev Disord |year=2005 |volume=35 |issue=6 |pages=713–27 |title=Gastrointestinal factors in autistic disorder: a critical review |author=Erickson CA, Stigler KA, Corkins MR, Posey DJ, Fitzgerald JF, McDougle CJ |doi=10.1007/s10803-005-0019-4 |pmid=16267642 }}</ref> chunguzi zimeripoti matokeo yanayokinzana, na uhusiano kati ya GI na matatizo ya ASD si wazi.<ref>{{vcite journal |author=Buie T, Campbell DB, Fuchs GJ 3rd ''et al.'' |author.= |title=Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report |journal=Pediatrics |volume=125 |issue=Suppl 1 |pages=S1–18 |year=2010 |pmid=20048083 |doi=10.1542/peds.2009-1878C |url=http://pediatrics.aappublications.org/cgi/content/full/125/Supplement_1/S1 }}</ref>

Wazazi wa watoto wenye ASD huwa na viwango vya juu vya msongo.<ref>{{vcite journal |journal=Pediatrics |year=2007 |volume=119 |issue=5 |pages=e1040–6 |title=Psychological functioning and coping among mothers of children with autism: a population-based study |author=Montes G, Halterman JS |doi=10.1542/peds.2006-2819 |pmid=17473077 |url=http://pediatrics.aappublications.org/cgi/content/full/119/5/e1040 |accessdate=2010-10-18 |archivedate=2008-07-24 |archiveurl=https://web.archive.org/web/20080724154105/http://pediatrics.aappublications.org/cgi/content/full/119/5/e1040 }}</ref> [[Ndugu]] wa watoto walio na ASD wameripoti kupokea pongezi zaidi na migogoro michache kutoka kwa ndugu walioathirika kuliko ndugu wa watoto ambao hawajaathirika au wa wale walio na akili taahira, ndugu za watu walio na ASD wana hatari kubwa zaidi ya kutoendelea vizuri na kuwa uhusiano mbaya baina ya ndugu kama watu wazima.<ref>{{vcite journal |journal=Ment Retard Dev Disabil Res Rev |year=2007 |volume=13 |issue=4 |pages=313–20 |title=Siblings of individuals with autism spectrum disorders across the life course |author=Orsmond GI, Seltzer MM |doi=10.1002/mrdd.20171 |pmid=17979200 |url=http://www.waisman.wisc.edu/family/pubs/Autism/2007%20siblings_autism_life-course.pdf |format=PDF |accessdate=2010-10-18 |archivedate=2013-05-30 |archiveurl=https://web.archive.org/web/20130530100939/http://www.waisman.wisc.edu/family/pubs/Autism/2007%20siblings_autism_life-course.pdf }}</ref>

==Uainishaji==
Usonji ni moja kati ya aina tano za Magonjwa ya Ukuaji ya Kuenea Kote (PDD), ambayo huhusishwa na matatizo makubwa katika mwingiliano wa kijamii na mawasiliano, na kutojihusisha na mambo mengi mbali na tabia za kujirudiarudia sana.<ref name="ICD-10-F84.0"></ref> Dalili hizi haziashirii maradhi, udhaifu, au masumbuko ya hisia.<ref name="Rapin"></ref>

Kati ya hizo aina tano za magonjwa, Aspaja inakaribiana na usonji kwa ishara na sababu zinazodhaniwa kusababisha magonjwa haya; [[Ugonjwa wa Rett]] na ugonjwa wa uchangukaji utotoni yana ishara kadhaa zinazofanana na ugonjwa wa usonji, lakini yana visababishi tofauti, PDD isiyotambukika vinginevyo (PDD-NOS, pia hujulikana kama ''usonji usio wa kawaida)'' huaguliwa wakati vigezo vya kutambua magonjwa mengine maalum havikutimizwa.<ref>{{vcite journal |author=Volkmar FR, State M, Klin A |title=Autism and autism spectrum disorders: diagnostic issues for the coming decade |journal=J Child Psychol Psychiatry |volume=50 |issue=1–2 |pages=108–15 |year=2009 |doi=10.1111/j.1469-7610.2008.02010.x |pmid=19220594 }}</ref> Tofauti na usonji, watu walio na Aspaja hawana uchelewaji mkubwa katika ukuaji wa lugha.<ref name="DSM-IV-TR-299.00"></ref> Kujidhihirisha kwa usonji huchukua wigo mpana, ikiwa ni pamoja na [[ulemavu]] shadidi - unaowafanya kuwa kimya, wenye akili taahira, na wenye kupigapiga makofi na kubembea - na watu wanaotekeleza majukumu makubwa lakini wana njia zisizo za kawaida ya kijamii, wenye malengo finyu, na wenye kutumia [[istilahi]] nyingi, na sheria za vitabuni katika mawasiliano.<ref>{{vcite journal |author=Happé F |title=Understanding assets and deficits in autism: why success is more interesting than failure |journal=Psychologist |volume=12 |issue=11 |pages=540–7 |year=1999 |url=http://www.thepsychologist.org.uk/archive/archive_home.cfm/volumeID_12-editionID_46-ArticleID_133-getfile_getPDF/thepsychologist/psy_11_99_p540-547_happe.pdf |format=PDF }}</ref> Kwa sababu wigo wa tabia ni endelevu, mipaka baina ya vitengo vya uaguzi ni kama ya kubahatisha tu.<ref name="Geschwind-2009"></ref> Wakati mwingine dalili za ugonjwa hugawanywa katika viwango vya chini, kati-juu- na vya usonji au (TC, TK, na TJ), kulingana na Kiwango cha Akili (IQ),<ref>{{vcite journal |author=[[Simon Baron-Cohen|Baron-Cohen S]] |title=The hyper-systemizing, assortative mating theory of autism |journal=Prog Neuropsychopharmacol Biol Psychiatry |year=2006 |volume=30 |issue=5 |pages=865–72 |doi=10.1016/j.pnpbp.2006.01.010 |pmid=16519981 |url=http://autismresearchcentre.com/docs/papers/2006_BC_Neuropsychophamacology.pdf |format=PDF |accessdate=2010-10-18 |archivedate=2011-07-07 |archiveurl=https://web.archive.org/web/20110707191300/http://autismresearchcentre.com/docs/papers/2006_BC_Neuropsychophamacology.pdf }}</ref> au kiwango cha usaidizi anachohitaji katika [[maisha]] ya kila siku, vitengo hivi havijasanifishwa na ni tata. Usonji pia unaweza kugawanywa kuwa usonji usio na dalili na ulio na dalili; usonji ulio na dalili unahusishwa na ulemavu shadidi wa akili au dalili za kuzaliwa ulio na ishara za kimwili, kama vile [[sklerosisi]] ya [[mishipa]].<ref>{{vcite journal |journal=J Autism Dev Disord |year=2005 |volume=35 |issue=1 |pages=103–16 |title=Specific genetic disorders and autism: clinical contribution towards their identification |author=Cohen D, Pichard N, Tordjman S ''et al.'' |author.= |doi=10.1007/s10803-004-1038-2 |pmid=15796126 }}</ref> Ingawa watu walio na ugonjwa wa Aspaja aghalabu hufanya vizuri kuliko wenye usonji katika mitihani ya utambuzi, kiwango cha mwingiliano kati ya Aspaja, TJ, na usonji isiyo na dalili si wazi <ref>Ukweli wa vijitengo vya ASD:
*{{vcite journal |journal=Rev Bras Psiquiatr |year=2006 |volume=28 |issue=suppl 1 |pages=S3–S11 |title=Autism and Asperger syndrome: an overview |author=Klin A |doi=10.1590/S1516-44462006000500002 |pmid=16791390 |url=http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462006000500002&lng=en&nrm=iso&tlng=en }}
*{{vcite journal |journal=J Autism Dev Disord |volume=38 |issue=9 |pages=1611–24 |year=2008 |title=Examining the validity of autism spectrum disorder subtypes |author=Witwer AN, Lecavalier L |doi=10.1007/s10803-008-0541-2 |pmid=18327636 }} </ref>

Baadhi ya tafiti zimeripoti kuaguliwa kwa usonji miongoni mwa watoto kutokana na kupoteza uwezo wa kusema au ujuzi wa kutangamana, ikilinganishwa na kukosa kudhihirisha ukuaji, kwa kawaida kati ya umri wa miezi 15-30. Ufaafu wa tofauti hii ungali tata, inawezekana kwamba usonji ya kurudi nyuma ni kijiaina maalum,<ref name="Stefanatos">{{vcite journal |author=Stefanatos GA |title=Regression in autistic spectrum disorders |journal=Neuropsychol Rev |volume=18 |issue=4 |pages=305–19 |year=2008 |pmid=18956241 |doi=10.1007/s11065-008-9073-y }}</ref><ref name="Volkmar">[107] ^ {{vcite journal |author=Volkmar F, Chawarska K, Klin A |title=Autism in infancy and early childhood |journal=Annu Rev Psychol |year=2005 |volume=56 |pages=315–36 |doi=10.1146/annurev.psych.56.091103.070159 |pmid=15709938 }} Usasaishaji mdogo unapatikana kwa: {{vcite journal |journal=World Psychiatry |year=2008 |volume=7 |issue=1 |pages=19–21 |title=Autism in infants: an update |author=Volkmar FR, Chawarska K |pmid=18458791 |pmc=2366821 }}</ref><ref name="Landa"></ref><ref name="Landa3"></ref>au kwamba kuna uhusiano endelevu wa tabia kati ya usonji iliyo na, na isiyo na kurudi nyuma.<ref>{{vcite journal |author=Ozonoff S, Heung K, Byrd R, Hansen R, Hertz-Picciotto I |title=The onset of autism: patterns of symptom emergence in the first years of life |journal=Autism Res |volume=1 |issue=6 |pages=320–328 |year=2008 |pmid=19360687 |doi=10.1002/aur.53 }}</ref>

Tafiti kujua visababishi imekinzwa na kutokuwa na uwezo wa kutambua kundi maalum la wanajamii wenye umuhimu kibiolojia<ref>{{vcite journal |journal=Pediatrics |year=2008 |volume=121 |issue=6 |pages=1225–9 |title=Autism and the environment: challenges and opportunities for research |author=Altevogt BM, Hanson SL, Leshner AI |doi=10.1542/peds.2007-3000 |pmid=18519493 |url=http://pediatrics.aappublications.org/cgi/content/full/121/6/1225 }}</ref> na mipaka ya [[jadi]] kati ya [[taaluma]] za [[tiba ya maradhi ya akili]], [[elimunafsia]], [[nyurolojia]] na taaluma ya [[tiba ya watoto]].<ref>{{vcite journal |author=Reiss AL |title=Childhood developmental disorders: an academic and clinical convergence point for psychiatry, neurology, psychology and pediatrics |journal=J Child Psychol Psychiatry |volume=50 |issue=1-2 |pages=87–98 |year=2009 |pmid=19220592 |doi=10.1111/j.1469-7610.2008.02046.x }}</ref> [[Teknolojia]] mpya kama vile fMRI na upigaji [[picha tensa]] inaweza kusaidia kutambua aina za fenotaipu (sifa zinazoonekana) vinazoweza kutazamwa kupitia uchanganuzi [[elektroniki]] wa ubongo, ili kuzidisha utafiti wa [[niurojenetikia|kiniurojenetikia]] wa usonji.<ref>{{vcite journal |author=Piggot J, Shirinyan D, Shemmassian S, Vazirian S, Alarcón M |title=Neural systems approaches to the neurogenetics of autism spectrum disorders |journal=Neuroscience |volume=164 |issue=1 |pages=247–56 |year=2009 |pmid=19482063 |doi=10.1016/j.neuroscience.2009.05.054 }}</ref> Mfano mmoja ni kupungua kwa shughuli katika eneo la fusifomu wa ubongo, ambayo inahusishwa na mtazamo usio kamili wa watu na vitu.<ref name="Levy"></ref> Imependekezwa kuainisha usonji kutumia [[jenetikia]] pamoja na tabia.<ref>{{vcite journal |journal=Am J Hum Genet |year=2008 |volume=82 |issue=1 |pages=7–9 |title=Unraveling autism |author=Stephan DA |doi=10.1016/j.ajhg.2007.12.003 |pmid=18179879 |pmc=2253980 }}</ref>

==Visababishi==
Kwa muda mrefu imedhaniwa kuwa kuna sababu moja katika viwango vya kijenetikia, kitambuzi, na neva kinachosababisha dalili tatu baifinu za usonji.<ref name="Fractionable"></ref> Hata hivyo, kuna ongezeko la shaka kwamba usonji ni ugonjwa changamano ambao vipengee vyake vya kimsingi vina visababishi  tofauti ambavyo aghalabu hutokea pamoja.<ref name="Fractionable">{{vcite journal |author=Happé F, Ronald A |title=The 'fractionable autism triad': a review of evidence from behavioural, genetic, cognitive and neural research |journal=Neuropsychol Rev |volume=18 |issue=4 |pages=287–304 |year=2008 |pmid=18956240 |doi=10.1007/s11065-008-9076-8 }}</ref><ref name="HappeTime"></ref>
[[File:Single_Chromosome_Mutations.svg|thumb|alt=Three diagrams of chromosome pairs A, B that are nearly identical. 1: B is missing a segment of A. 2: B has two adjacent copies of a segment of A. 3: B's copy of A's segment is in reverse order.|Utanguaji (1), urudiaji (2) na upinduaji(3) yote ni ulemavu katika kromosomu iliyohusishwa katika usonji <ref name=Beaudet/>.]]
Usonji una msingi imara katika jenetikia, ingawa jenetikia ya usonji ni changamano na si wazi ikiwa ASD inaelezewa zaidi na mabadiliko makuu ya jeni au kwa kwa mwingiliano wa nadra wa aina mbalimbali za jenetikia aina moja.<ref name="Abrahams">{{vcite journal |journal=Nat Rev Genet |year=2008 |volume=9 |issue=5 |pages=341–55 |title=Advances in autism genetics: on the threshold of a new neurobiology |author=Abrahams BS, Geschwind DH |doi=10.1038/nrg2346 |pmid=18414403 |pmc=2756414 }}</ref><ref>{{vcite journal |author=Buxbaum JD |title=Multiple rare variants in the etiology of autism spectrum disorders |journal=Dialogues Clin Neurosci |year=2009 |volume=11 |issue=1 |pages=35–43 |pmid=19432386 |url=http://www.dialogues-cns.org/brochures/40/htm/40_34.asp |accessdate=2010-10-18 |archivedate=2011-07-25 |archiveurl=https://web.archive.org/web/20110725233641/http://www.dialogues-cns.org/brochures/40/htm/40_34.asp }}</ref> Uchangamano hutokana na mwingiliano kati ya jeni mablimbali, mazingira, na vipengele  vya ndani ya jeni visivyobadili viinitete [[DNA]] lakini vinaweza kurithika na huathiri wa mwonekano wa jeni.<ref name="Rapin">{{vcite journal |author=Rapin I, Tuchman RF |title=Autism: definition, neurobiology, screening, diagnosis |journal=Pediatr Clin North Am |volume=55 |issue=5 |pages=1129–46 |year=2008 |pmid=18929056 |doi=10.1016/j.pcl.2008.07.005 }}</ref> Uchunguzi wa mapacha unaonyesha kwamba uwezo wa kurithika kwa usonji ni 0.7 na kwa ASD uwezekano ni wa hadi 0.9, ndugu wa walio na usonji wanakabiliwa na uwezekano wa hadi mara 25 zaidi kupata usonji wakilinganishwa na watu wa kawaida.<ref name="Geschwind-2009"></ref> Hata hivyo, mabadiliko mengi ya viinitete vinavyoongeza uwezekano wa usonji hazijatambuliwa. Kwa kawaida, usonji hauwezi kuhusishwa na mabadiliko ya Mendeli (jeni moja) au kwa kasoro ya [[kromosomu]] moja kama vile [[kromosomu X]] dhaifu, na hakuna dalili zozote za kijenetikia zinazohusishwa na ASD ambazo zimethibitishwa kusababisha ASD.<ref name="Abrahams"></ref> Jeni mbalimbali zinazodhaniwa kuhusika zimetambuliwa, huku athari ndogo tu zikionekana kuhusishwa na jeni yoyote maalum.<ref name="Abrahams"></ref> Idadi kubwa ya watu wenye usonji walio na familia zisizoathirika inaoweza kutokana na mabadiliko ya idadi nakali - mabadiliko ya kujianzisha yenye ikiwemo kujifuta au kijizidisha kwa viungo vya kijenetikia wakati wa [[meyosisi]].<ref>{{vcite journal |author=Cook EH, Scherer SW |title=Copy-number variations associated with neuropsychiatric conditions |journal=Nature |volume=455 |issue=7215 |pages=919–23 |year=2008 |pmid=18923514 |doi=10.1038/nature07458 }}</ref> Kwa hiyo, kiwango kikubwa cha sababu za usonji kinaweza kuhusishwa na visababishi vya kijenetikia vilivyo na uwezo wa kurithika lakini havirithiki: yaani, mabadiliko katika jeni inayosababisha usonji hayako katika mkusanyiko wa jeni ya mzazi.<ref name="Beaudet">{{vcite journal |author=Beaudet AL |title=Autism: highly heritable but not inherited |journal=Nat Med |year=2007 |volume=13 |issue=5 |pages=534–6 |pmid=17479094 |doi=10.1038/nm0507-534 }}</ref>

Viwango kadhaa vya ushahidi vinaashiria utendakazi mbaya wa sinepsisi kuwa kisababishi cha usonji.<ref name="Levy"></ref> Baadhi ya mabadiliko nadra katika viinitete vinaweza kusababisha tawahidi kwa kuvuruga baadhi ya njia za sinepsisi, kama vile zinazohusika na unatishaji wa chembechembe.<ref name="Betancur">{{vcite journal |author=Betancur C, Sakurai T, Buxbaum JD |title=The emerging role of synaptic cell-adhesion pathways in the pathogenesis of autism spectrum disorders |journal=Trends Neurosci |volume=32 |issue=7 |pages=402–12 |year=2009 |pmid=19541375 |doi=10.1016/j.tins.2009.04.003 }}</ref> Tafiti za  ubadilishaji wa jeni miongoni mwa panya zinaonyesha kwamba dalili za usonji zinahusiana kwa karibu na hatua za ukuaji wa baadaye unaotegemea shughuli katika sinepsina kwa mabadiliko yanayotegemea mifanyiko.<ref name="Walsh">{{vcite journal |author=Walsh CA, Morrow EM, Rubenstein JL |title=Autism and brain development |journal=Cell |volume=135 |issue=3 |pages=396–400 |year=2008 |pmid=18984148 |doi=10.1016/j.cell.2008.10.015 |pmc=2701104 }}</ref> Teratojeni zote zinazojulikana (dutu zote zinazosababisha ulemavu wa kuzaliwa) zinazohusiana na uwezekano wa usonji huonekana kufanya kazi katika wiki ya nane ya kwanza ya kushika mimba, na japo hii hauzuii uwezekano kwamba usonji inaweza kuanza au kuathirika baadaye, ni ushahidi tosha kwamba usonji hujitokeza mapema sana katika ukuaji.<ref name="Arndt">{{vcite journal |journal=Int J Dev Neurosci |year=2005 |volume=23 |issue=2–3 |pages=189–99 |title=The teratology of autism |author=Arndt TL, Stodgell CJ, Rodier PM |doi=10.1016/j.ijdevneu.2004.11.001 |pmid=15749245 }}</ref> Japo sababu nyingine za kimazingira za kweli zimenakiliwa na hazijawahi kuthibitishwa kwa tafiti za kuaminika, <ref name="Rutter"></ref> chunguzi za kina zinaendelea.<ref name="Szpir">{{vcite journal |journal=Environ Health Perspect |year=2006 |volume=114 |issue=7 |pages=A412–8 |title=Tracing the origins of autism: a spectrum of new studies |author=Szpir M |url=http://www.ehponline.org/members/2006/114-7/focus.html |pmid=16835042 |pmc=1513312 |accessdate=2010-10-18 |archivedate=2008-07-08 |archiveurl=https://web.archive.org/web/20080708201740/http://www.ehponline.org/members/2006/114-7/focus.html }}</ref> Sababu za kimazingira  ambazo zimedaiwa kuchangia au kuzidisha usonji, au zinazoweza kuwa muhimu katika tafiti za siku zijazo, ni pamoja na aina fulani ya vyakula , magonjwa ya kuambukiza, metali nzito, viyeyusha, taka ya dizeli, PCB fithaleti, na fenoli zinazotumika katika bidhaa za [[Plastiki|plastiki]], viuadudu, vizima moto vilivyo na bromini , pombe, uvutaji sigara, mihadarati, chanjo<ref name="Newschaffer"></ref>, na msongo wa akili kwa mzazi<ref>{{vcite journal |journal=Neurosci Biobehav Rev |year=2008 |title=Prenatal stress and risk for autism |author=Kinney DK, Munir KM, Crowley DJ, Miller AM |doi=10.1016/j.neubiorev.2008.06.004 |pmid=18598714 |volume=32 |issue=8 |pages=1519–32 |pmc=2632594 }}</ref>, ingawa hakuna uhusiano uliopatikana, na baadhi kutupiliwa mbali kabisa. Wazazi wanaweza kufahamu kwa mara ya kwanza dalili za usonji katika mtoto wao wakati wa chanjo ya kawaida, na hii amechangia kuibuka kwa nadharia kwamba chanjo au kemikali zinazotumika kuzihifadhi husababisha usonji, na kupelekea utafiti wa kisayansi ambao tayari umethibitisha kuwa huo si ukweli. Ingawa nadharia hizi zinakosa ushahidi thabiti wa kisayansi na hazina mashiko kisayansi, wasiwasi wa wazazi kuhusu usonji imesababisha viwango vya chini vya kuchanjwa kwa watoto na uwezekano wa juu wa kuzuka kwa surua katika baadhi ya maeneo. <ref Name=vaccines>chanjo na usonji:
*{{vcite journal |journal=Can J Neurol Sci |year=2006 |volume=33 |issue=4 |pages=341–6 |title=Immunizations and autism: a review of the literature |author=Doja A, Roberts W |pmid=17168158 }}
*{{vcite journal |author=Gerber JS, [[Paul Offit|Offit PA]] |title=Vaccines and autism: a tale of shifting hypotheses |journal=Clin Infect Dis |volume=48 |issue=4 |pages=456–61 |year=2009 |pmid=19128068 |doi=10.1086/596476 |url=http://www.journals.uchicago.edu/doi/full/10.1086/596476 |laysummary=http://www.idsociety.org/Content.aspx?id=13336 |laysource=IDSA |laydate=2009-01-30 |accessdate=2010-10-18 |archivedate=2011-04-18 |archiveurl=https://archive.today/20110418194142/http://www.journals.uchicago.edu/doi/full/10.1086/596476 }}
*{{vcite journal |author=Gross L |title=A broken trust: lessons from the vaccine–autism wars |journal=PLoS Biol |volume=7 |issue=5 |pages=e1000114 |year=2009 |pmid=19478850 |doi=10.1371/journal.pbio.1000114 |url=http://www.plosbiology.org/article/info:doi/10.1371/journal.pbio.1000114 |pmc=2682483 |accessdate=2010-10-18 |archivedate=2014-12-25 |archiveurl=https://web.archive.org/web/20141225130424/http://www.plosbiology.org/article/info:doi/10.1371/journal.pbio.1000114 }}
*{{vcite journal |author=Paul R |title=Parents ask: am I risking autism if I vaccinate my children? |title.= |journal=J Autism Dev Disord |volume=39 |issue=6 |pages=962–3 |year=2009 |pmid=19363650 |doi=10.1007/s10803-009-0739-y }}</ref>

==Taratibu==
Dalili za usonji hutokana na mabadiliko yanayohusiana na upevukaji katika mifumo mbalimbali ya ubongo. Jinsi usonji inavyotokea haieleweki vizuri. Utaratibu wake unaweza kugawanywa katika viwango viwili: kiwango cha pathofisiolojia ya miundo ubongo na taratibu zinazohusiana na usonji, na miungano ya kinyurosaikolojia kati ya taratibu za ubongo na tabia.<ref name="Penn">{{vcite journal |author=Penn HE |title=Neurobiological correlates of autism: a review of recent research |journal=Child Neuropsychol |year=2006 |volume=12 |issue=1 |pages=57–79 |doi=10.1080/09297040500253546 |pmid=16484102 }}</ref> Tabia hizo huonekana kuwa na pathofisiolojia nyingi.<ref name="London"></ref>

===Pathofisiolojia===
[[File:Autismbrain.jpg|thumb|alt=Two diagrams of major brain structures implicated in autism. The upper diagram shows the cerebral cortex near the top and the basal ganglia in the center, just above the amygdala and hippocampus. The lower diagram shows the corpus callosum near the center, the cerebellum in the lower rear, and the brain stem in the lower center.|Usonji huathiri amidala , ubongonyuma , na sehemu nyingine nyingi ya ubongo <ref name=Amaral> </ref>.]]
Tofauti na nyigi ya maradhi mengine ya ubongo kama vile Ugonjwa wa Kikakamaa usonji  hauna utaratibu wazi wa kuunganisha iwe katika kiwango cha molekuli, chembe, au mifumo, haijulikana kama usonji ni hali chache zinazotatiza urazini unaosababishwa na mabadiliko katika viinitete vinavyokutanika katika njia chache za molekyuli, au ni (kama ulemavu wa akili) kama mkusanyiko mkubwa wa matatizo yaliyo na taratibu mbalimbali.<ref name="Geschwind">{{vcite journal |author=Geschwind DH |title=Autism: many genes, common pathways? |title.= |journal=Cell |volume=135 |issue=3 |pages=391–5 |year=2008 |pmid=18984147 |doi=10.1016/j.cell.2008.10.016 |pmc=2756410 }}</ref> Usonji yaonekana hutokana na vipengele vya ukuaji vinayoathiri ubongo au mifumo yote tekelezi ya ubongo,<ref>{{vcite journal |journal=Ment Retard Dev Disabil Res Rev |year=2007 |volume=13 |issue=1 |pages=85–95 |title=The study of autism as a distributed disorder |author=Müller RA |doi=10.1002/mrdd.20141 |pmid=17326118 }}</ref> na kuvuruga mipangilio wa muda ya ukuaji wa ubongo zaidi ya matokeo ya mwisho.<ref name="Amaral">{{vcite journal |journal=Trends Neurosci |year=2008 |volume=31 |issue=3 |pages=137–45 |title=Neuroanatomy of autism |author=[[David Amaral|Amaral DG]], Schumann CM, Nordahl CW |doi=10.1016/j.tins.2007.12.005 |pmid=18258309 }}</ref> Tafiti za nyuroanatomia na mahusiano ya teratojeni zinaonyesha sana kwamba utaratibu wa usonji hujumuisha kugeuza ukuaji wa ubongo punde tu baada ya mimba kutungwa.<ref name="Arndt"></ref> Ukiushi huu unaonekana kuanzisha msururu wa matukio ya kipatholojia katika ubongo ambayo kwa ukubwa yanaathiriwa na mambo ya kimazingira.<ref>{{vcite journal |journal=Brain Pathol |year=2007 |volume=17 |issue=4 |pages=422–33 |title=The neuropathology of autism |author=Casanova MF |doi=10.1111/j.1750-3639.2007.00100.x |pmid=17919128 }}</ref> Mara tu baada ya kuzaliwa, ubongo wa mtoto mwenye usonji hukua kwa kasi zaidi kuliko kawaida, ikifuatiwa na ukuaji wa kawaida au polepole kiasi utotoni. Haijulikani ikiwa ukuaji wa kasi zaidi mapema hutokea kwa watoto wote walio na usonji. Inaonekana kudhihirika zaidi katika maeneo ya ubongo yanayosimamia ukuaji mkuu wa ujuzi za kiutambuzi.<ref name="Geschwind-2009"></ref> Nadharia tete za ukuaji kasi usio  wa kawaida wa chembe na misingi ya molekyuli ya patholojia ni pamoja na ifuatayo:
* Uwingi kupita kiasi wa niuroni zinazosababisha miunganiko mingi kupindukia katika maeneo muhimu ya ubongo.<ref>{{vcite journal |journal=Neuron |year=2007 |volume=56 |issue=2 |pages=399–413 |title=Mapping early brain development in autism |author=Courchesne E, Pierce K, Schumann CM ''et al.'' |author.= |doi=10.1016/j.neuron.2007.10.016 |pmid=17964254 }}</ref>
* Uhamimiaji uliovurugwa wa niuroni katika kipindi cha mapema cha ujaouzito.<ref name="Schmitz"></ref><ref name="Persico">{{vcite journal |author=Persico AM, Bourgeron T |title=Searching for ways out of the autism maze: genetic, epigenetic and environmental clues |journal=Trends Neurosci |volume=29 |issue=7 |pages=349–58 |year=2006 |pmid=16808981 |doi=10.1016/j.tins.2006.05.010 }}</ref>
* Ukosefu wa ulinganisho baina ya mitandao sisimuzi na mitandao ya kudhibiti msisimko.<ref name="Persico"></ref>
* Miundo kasoro ya sinepsi na miba ya dendraiti,<ref name="Persico"></ref> kwa mfano, kwa ubadilikaji wa nureksini - mfumo wa chembe za unataji wa niurolijini, <ref>{{vcite journal |author=Südhof TC |title=Neuroligins and neurexins link synaptic function to cognitive disease |journal=Nature |volume=455 |issue=7215 |pages=903–11 |year=2008 |pmid=18923512 |doi=10.1038/nature07456 |pmc=2673233 }}</ref> au kwa udhibiti hafifu wa usanisi  protini za sinepi.<ref>{{vcite journal |author=Kelleher RJ 3rd, Bear MF |title=The autistic neuron: troubled translation? |title.= |journal=Cell |volume=135 |issue=3 |pages=401–6 |year=2008 |pmid=18984149 |doi=10.1016/j.cell.2008.10.017 }}</ref> Ukuaji wa sinepi uliovurugwa  pia unawekuchangia kifafa, ambayo inaweza kueleza kwa nini hali hizi mbili zinahusiana.<ref>{{vcite journal |author=Tuchman R, Moshé SL, Rapin I |title=Convulsing toward the pathophysiology of autism |journal=Brain Dev |volume=31 |issue=2 |pages=95–103 |year=2009 |pmid=19006654 |doi=10.1016/j.braindev.2008.09.009 |pmc=2734903 }}</ref>

Mwingiliano kati ya mfumo wa kinga na mfumo wa neva kuanza mapema katika hatua ya kiinitete cha maisha, na ukuaji uliofanikiwa wa mfumo wa neva unategemea mwitikio unauwiano wa kinga. Inawezekana kwamba shughulu potovu ya kinga katika vipindi muhimu vya ukuaji wa mfumo wa neva ni sehemu ya taratibu za aina fulani za ASD.<ref>{{vcite journal |journal=J Leukoc Biol |year=2006 |volume=80 |issue=1 |pages=1–15 |title=The immune response in autism: a new frontier for autism research |author=Ashwood P, Wills S, Van de Water J |doi=10.1189/jlb.1205707 |pmid=16698940 |url=http://www.jleukbio.org/cgi/content/full/80/1/1 |accessdate=2010-10-18 |archivedate=2006-10-05 |archiveurl=https://web.archive.org/web/20061005180253/http://www.jleukbio.org/cgi/content/full/80/1/1 }}</ref> Ingawa baadhi ya ulemavu katika mfumo wa kinga umepatikana katika vijikundi maalum vya watu wenye usonji, haijulikani kama ulemvu huo ni muhimu au huchangia mifanyiko ya ugonjwa wa usonji.<ref>{{vcite journal |journal=Res Autism Spectr Disord |volume=3 |issue=4 |year=2009 |pages=840–60 |doi=10.1016/j.rasd.2009.01.007 |author=Stigler KA, Sweeten TL, Posey DJ, McDougle CJ |title=Autism and immune factors: a comprehensive review }}</ref> Kwa kuwa zindikomwilinafsi hupatikana katika hali zingine ambazo si za ASD, na  si kila mara hupatikana katika ASD,<ref>{{vcite journal |journal=Ann N Y Acad Sci |year=2007 |volume=1107 |pages=79–91 |title=Autoantibodies in autism spectrum disorders (ASD) |author=Wills S, Cabanlit M, Bennett J, Ashwood P, Amaral D, Van de Water J |doi=10.1196/annals.1381.009 |pmid=17804535 }}</ref> uhusiano kati ya kuvurugwa kwa kinga mwili na usonji bado haujabainika na una utata.<ref name="Schmitz">{{vcite journal |journal=Neuropathol Appl Neurobiol |year=2008 |volume=34 |issue=1 |pages=4–11 |title=The neuropathology of autism: where do we stand? |title.= |author=Schmitz C, Rezaie P |doi=10.1111/j.1365-2990.2007.00872.x |pmid=17971078 }}</ref>

Uhusiano wa kemikali za neva na usonji haueleweki vizuri; kadhaa zimechunguzwa huku kukiwa na ushahidi zaidi katika jukumu la serotonini na tofauti za kimaumbile katika usafirishaji wake.<ref name="Levy">{{vcite journal |author=Levy SE, Mandell DS, Schultz RT |title=Autism |journal=Lancet |volume=374 |issue=9701 |pages=1627–38 |year=2009 |pmid=19819542 |doi=10.1016/S0140-6736(09)61376-3 }}</ref> Baadhi ya takwimu zinaonyesha ongezeko la ukuaji wa homoni kadhaa, takwimu zinaashiria kwa kupungua kwa vipengele  vya ukuaji.<ref>{{vcite journal |author=Hughes JR |title=A review of recent reports on autism: 1000 studies published in 2007 |journal=Epilepsy Behav |volume=13 |issue=3 |pages=425–37 |year=2008 |pmid=18627794 |doi=10.1016/j.yebeh.2008.06.015 }}</ref> Aidha, baadhi makosa ya kimetaboli ya kuzaliwa yanahusishwa na usonji lakini pengine huchangia chini ya 5% ya matukio.<ref name="Manzi"></ref>

Nadharia ya mfumo wa niuroni akisi (MNA) kuhusu usonji inakisia kwamba mabadiliko katika ukuaji wa MNA unahitilafiana na uigaji na husababisha sifa za msingi za usonji ambazo ni ulemavu katika mwingiliano wa kijamii na matatizo ya mawasiliano. MNA hufanya kazi wakati mnyama anapofanya kitendo au anapomtazama mnyama mwingine akifanya kitendo sawa na hicho. Mfumo wa Niuroni Akisi MAN unaweza kuchangia uelewa mtu fulani kuhusu watu wengine kuwezesha kubwia kimtazamo tabia zao kupitia kujumuishwa kwa mienendo yao, nia, na hisia <ref> MAN na usonji:
*{{vcite journal |journal=Autism Res |year=2008 |volume=1 |issue=2 |pages=73–90 |title=Self–other relations in social development and autism: multiple roles for mirror neurons and other brain bases |author=Williams JHG |doi=10.1002/aur.15 |pmid=19360654 }}
*{{vcite journal |journal=Curr Biol |year=2008 |volume=18 |issue=1 |pages=R13–8 |title=A mirror up to nature |author=Dinstein I, Thomas C, Behrmann M, Heeger DJ |doi=10.1016/j.cub.2007.11.004 |pmid=18177704 |pmc=2517574 }} </ref> Tafiti kadhaa zimetathmini nadharia tete hii kwa kuonyesha upungufu wa kimuundo katika sehemu za MAN ya watu walio na ASD, kuchelewa katika kuanzishwa kwa mfumo msingi wa kuiga kwa watu walio na ugonjwa wa Aspaja, na uwiano kati ya  shughuli za MAN zilizopunguzwa na ushadidi wa ugonjwa wa ASD kwa.<ref name="Iacoboni">{{vcite journal |journal=Nat Rev Neurosci |year=2006 |volume=7 |issue=12 |pages=942–51 |title=The mirror neuron system and the consequences of its dysfunction |author=Iacoboni M, Dapretto M |doi=10.1038/nrn2024 |pmid=17115076 }}</ref> Hata hivyo, watu walio na usonji wana msisimko usio wa kawaida katika mizunguko nyingi ya ubongo nje ya MAN<ref>{{vcite journal |author=[[Uta Frith|Frith U]], Frith CD |year=2003 |title=Development and neurophysiology of mentalizing |journal=Philos Trans R Soc Lond B Biol Sci |volume=358 |issue=1431 |pages=459–73 |doi=10.1098/rstb.2002.1218 |pmid=12689373 |pmc=1693139 |url=http://rstb.royalsocietypublishing.org/content/358/1431/459.full.pdf |format=PDF }}</ref> na nadharia MAN haieleza utendaji wa kawaida wa watoto walio na usonji katika majukumu ya kuiga yanayohusu lengo au kifaa.<ref>{{vcite journal |journal=Q J Exp Psychol |year=2008 |volume=61 |issue=1 |pages=101–15 |title=Emulation and mimicry for social interaction: a theoretical approach to imitation in autism |author=Hamilton AFdC |doi=10.1080/17470210701508798 |pmid=18038342 |first2=<!-- Work around Citation bot bug. --> |last2=<!-- Work around Citation bot bug. --> }}</ref>
[[File:Powell2004Fig1A.jpeg|thumb|upright|alt=A human brain viewed from above. About 10% is highlighted in yellow and 10% in blue. There is only a tiny (perhaps 0.5%) green region where they overlap.|Watu walio na usonji angalabu hutumia ya maeneo mbalimbali ya ubongo (njano) kwa kazi sogezi ikilinganishwa na kundi la kudhibiti (samawati) <ref name=Powell> [203] </ref>.]]

Mifumo ya ASD inayohusiana na  majukumu ya chini na kazi potovu ya ubongo ni hutofautiana kutegemea ikiwa ubongo unafanya kazi ya kijamii au  majukumu siyiyo ya kijamii.<ref>{{vcite journal |journal=Biol Psychiatry |year=2009 |volume=65 |issue=1 |pages=63–74 |doi=10.1016/j.biopsych.2008.09.022 |pmid=18996505 |author=Di Martino A, Ross K, Uddin LQ, Sklar AB, Castellanos FX, Milham MP |title=Functional brain correlates of social and nonsocial processes in autism spectrum disorders: an activation likelihood estimation meta-analysis }}</ref>
Katika usonji kuna ushahidi wa kupunguka kwa miunganiko akisi, mtandao mkubwa wa miungano ya ubongo inayohusika katika uchakataji wa masuala ya kijamii na kihisia, huku mitandao chanya, ikitumika katika kudhititi umakini na kufikiri kuliko na lengo. Kwa watu walio na usonji mitandao hiyo mwili haihusiani vibaya kiwakati, na hivyo kudokezea kukosa usawa wa kujibana katika mitandao hiyo miwili, na huenda kuashiria kuvuruga mrejeleo wa  kibinafsi wazo.<ref>{{vcite journal |author=Broyd SJ, Demanuele C, Debener S, Helps SK, James CJ, Sonuga-Barke EJS |title=Default-mode brain dysfunction in mental disorders: a systematic review |journal=Neurosci Biobehav Rev |year=2009 |volume=33 |issue=3 |pages=279–96 |pmid=18824195 |doi=10.1016/j.neubiorev.2008.09.002 }}</ref> Utafiti mmoja wa 2008 ulipata mtindo maalum wa ishara katika gamba la singulamu inayotofautiana katika watu waliona ASD.

Nadharia tete ya muungano wa chinichini wa usonji kwamba usonji inahusishwa na kutofanya kazi kikamilifu kwa viunganishi na uoanishaji wa hali ya juu wa niuro, pamoja na uziada wa michakato ya chini.<ref>{{vcite journal |journal=Cereb Cortex |year=2007 |volume=17 |issue=4 |pages=951–61 |title=Functional and anatomical cortical underconnectivity in autism: evidence from an FMRI study of an executive function task and corpus callosum morphometry |author=Just MA, Cherkassky VL, Keller TA, Kana RK, Minshew NJ |doi=10.1093/cercor/bhl006 |pmid=16772313 |url=http://cercor.oxfordjournals.org/cgi/content/full/17/4/951 }}</ref> Ushahidi wa nadharia hii imepatikana katika tafiti za picha  za niuro ya watu walio na usonji<ref name="Williams">{{vcite journal |author=Williams DL, Goldstein G, Minshew NJ |title=Neuropsychologic functioning in children with autism: further evidence for disordered complex information-processing |journal=Child Neuropsychol |volume=12 |issue=4–5 |pages=279–98 |year=2006 |pmid=16911973 |doi=10.1080/09297040600681190 |pmc=1803025 }}</ref> na kwa utafiti wa mawimbi ya ubongo yaliyopendekeza kuwa watu wazima walio na ASD wana miungano zaidi katika gamba na muunganiko akisi dhaifu kati tundu la mbele na katika gamba lote.<ref>{{vcite journal |author=Murias M, Webb SJ, Greenson J, Dawson G |title=Resting state cortical connectivity reflected in EEG coherence in individuals with autism |journal=Biol Psychiatry |volume=62 |issue=3 |pages=270–3 |year=2007 |pmid=17336944 |doi=10.1016/j.biopsych.2006.11.012 |pmc=2001237 }}</ref> Ushahidi mwingine unaonyesha miunganiko isiyo ya kawaida sana sana huwa katika kila kizio cha gamba na kwamba usonji ni ugonjwa unaohusishwa na gamba.<ref>{{vcite journal |journal=Arch Neurol |year=2007 |volume=64 |issue=7 |pages=945–50 |title=The new neurobiology of autism: cortex, connectivity, and neuronal organization |author=Minshew NJ, Williams DL |pmid=17620483 |doi=10.1001/archneur.64.7.945 |pmc=2597785 }}</ref>

Kutokana na tafiti zilizohusishwa na matukio, mabadiliko ya muda mfupi kwa utendakazi wa kielektroniki wa ubongo katika kuitikia michocheo, kuna ushahidi wa kutosha kuelezea tofauti katika watu walio na usonji katika masuala ya uangalifu, mkao, kusikiliza pamoja na michocheo ya kutazama, kugundua nupya, lugha na kutambua nyuso , na kuhifadhi habari, tafiti kadhaa zimepata upendeleo kwa michocheo isiyo ya kijamii.<ref>{{vcite journal |author=Jeste SS, Nelson CA 3rd |title=Event related potentials in the understanding of autism spectrum disorders: an analytical review |journal=J Autism Dev Disord |volume=39 |issue=3 |pages=495–510 |year=2009 |pmid=18850262 |doi=10.1007/s10803-008-0652-9 }}</ref> Kwa mfano, chunguzi ya michorosumaku ya ubongo zimegundua ushahidi wa watoto walio na usonji kuchelewa kuitikia uchakatai wa ujumbe wa sauti kutoka katika ubongo.<ref>{{vcite journal |author=Roberts TP, Schmidt GL, Egeth M ''et al.'' |author.= |title=Electrophysiological signatures: magnetoencephalographic studies of the neural correlates of language impairment in autism spectrum disorders |journal=Int J Psychophysiol |volume=68 |issue=2 |pages=149–60 |year=2008 |pmid=18336941 |doi=10.1016/j.ijpsycho.2008.01.012 |pmc=2397446 }}</ref>

===Niurosaikolojia===
Nadharia mbili kuu za utambuzi imependekezwa kuhusu mahusiano kati ya akili usonji na tabia.

Aina ya kwanza inalenga upungufu katika utambuzi wa kijamii. Nadharia ya kumwelewa mwingine na huruma pinadai kwamba watu walio na usonji wanaweza kuhurumia-yaani, wanaweza kuanzisha msharti ya utendaji ya kushughulikia matukio katika ubongo-lakini ina ufanisi mdogo katika kuelewa hali ya mwingine kwa kusimamia matukio yaliyoanzishwa na kitu kingine. Upanuzi wa nadharia tete ya ubongo wa mwanaume, inapendekeza kwamba usonji ni tikio baya la ubongo wa mwanamume, hufafanuliwa kwa vipimo vya nafsia kama watu ambao kwao uratibu ni vyema kuliko kuelewa hali za wengine,<ref name="E-S-theory"></ref> upanuzi huu ni tata, kwa kuwa tafiti nyingi inapinga wazo kwamba watoto wavulana na wasichana huitika tofauti kwa watu na vitu.<ref>{{vcite journal |author=Spelke ES |title=Sex differences in intrinsic aptitude for mathematics and science?: a critical review |journal=Am Psychol |volume=60 |issue=9 |pages=950–8 |year=2005 |pmid=16366817 |doi=10.1037/0003-066X.60.9.950 |url=http://www.wjh.harvard.edu/~lds/pdfs/spelke2005.pdf |format=PDF |accessdate=2010-10-18 |archivedate=2009-02-19 |archiveurl=https://web.archive.org/web/20090219133130/http://www.wjh.harvard.edu/~lds/pdfs/spelke2005.pdf }}</ref>

Nadharia hizi kwa kiasi fulani zinafanana na nadharia a akili ya awali katika mtazamo, inayodhahania kwamba tabia ya kiusonji inajitokeza kutokana na kukosa uwezo wa kujifafanulia hali kiakisliau watu wengine. Dhanio ya nadharia tete ya akili ina mhimili katika mwitikio usio wa kawaida wa watoto walio na usonji kwa  uchunguzi wa Anne-Sally wa kutathmini motisha ya wengine,<ref name="E-S-theory">{{vcite journal |author=Baron-Cohen S |title=Autism: the empathizing–systemizing (E-S) theory |journal=Ann N Y Acad Sci |volume=1156 |pages=68–80 |year=2009 |pmid=19338503 |doi=10.1111/j.1749-6632.2009.04467.x |url=http://autismresearchcentre.com/docs/papers/2009_BC_nyas.pdf |format=PDF |accessdate=2010-10-18 |archivedate=2010-09-23 |archiveurl=https://web.archive.org/web/20100923090423/http://autismresearchcentre.com/docs/papers/2009_BC_nyas.pdf }}</ref> na nadharia ya mfumo akisi wa niuro ya usonji ilivyoelezwa vizuri katika ramani za ''Pathofisiolojia''  dhana tete.<ref name="Iacoboni"></ref> Hata hivyo, uchunguzi nyingi hazijagundua ushahidi wa kuharibika uwezo wa watu walio na usonji kuelewa nia au malengo ya msingi ya watu wengine , badala yake, data zinaonyesha kwamba kasoro hupatikana katika kuelewa hisia changamano za kijamii au katika kuzingatia mitazamo ya wengine.<ref>{{vcite journal |author=Hamilton AFdC |title=Goals, intentions and mental states: challenges for theories of autism |journal=J Child Psychol Psychiatry |volume=50 |issue=8 |pages=881–92 |year=2009 |pmid=19508497 |doi=10.1111/j.1469-7610.2009.02098.x }}</ref>

Kitengo cha pili kinaangazia michakato ya isiyo ya kijamii katika utendakazi wa kijumla. Nadharia tete ya kasoro ya utendaji inakisia kuwa  tabia za tabia za kiusonji kwa kiwango chache hutokana na upungufu katika kumbukumbu ya kazi, upangaji, uzuiaji, na aina nyingine ya kazi tendaji.<ref name="Kenworthy"></ref> Chunguzi za michakato tendaji ya kimsingi kama vile tendo la jicho kuongasonga huonyesha kuboreka kutoka utoto hadi ujana, lakini  havifikii viwango vya kawaida vya utendaji wa kawaida kwa mtu mzima.<ref>{{vcite journal |author=O'Hearn K, Asato M, Ordaz S, Luna B |title=Neurodevelopment and executive function in autism |journal=Dev Psychopathol |volume=20 |issue=4 |pages=1103–32 |year=2008 |pmid=18838033 |doi=10.1017/S0954579408000527 }}</ref> Uziti wa nadharia hiyo ni kutabiri tabia zinazorudiwaridiwa na vivutio vichache;<ref>{{vcite journal |author=Hill EL |title=Executive dysfunction in autism |journal=Trends Cogn Sci |year=2004 |volume=8 |issue=1 |pages=26–32 |doi=10.1016/j.dr.2004.01.001 |pmid=14697400 }}</ref> mapungufu mawili ni kwamba nadharia ya jukumu tekelezi ni vigumu kupima<ref name="Kenworthy">{{vcite journal |author=Kenworthy L, Yerys BE, Anthony LG, Wallace GL |title=Understanding executive control in autism spectrum disorders in the lab and in the real world |journal=Neuropsychol Rev |volume=18 |issue=4 |pages=320–38 |year=2008 |pmid=18956239 |doi=10.1007/s11065-008-9077-7 }}</ref> na kwamba upungufu wa utenda jukumu haujapatikana miononi mwa watoto walio na usonji.<ref name="Sigman"></ref>

Nadharia ya udhaifu kati uwiano mkuu inakisia  kwamba uwezo wa kutoona picha kubwa ndio msingi wa usumbufu wa usonji. Nguvu moja ya nadharia hii ni kutabiri vipaji na vilele katika utendaji wa watu walio na usonji.<ref>{{vcite journal |author=Happé F, Frith U |title=The weak coherence account: detail-focused cognitive style in autism spectrum disorders |journal=J Autism Dev Disord |year=2006 |volume=36 |issue=1 |pages=5–25 |doi=10.1007/s10803-005-0039-0 |pmid=16450045 }}</ref> Nadharia nyingine inayofanana na hiyo-nadharia ya utambuzi akisi-inalenga zaidi ubora wa michakato iliyoanza mahala moja na shughuli tambuzi kwa watu walio na usonji.<ref>{{vcite journal |journal=J Autism Dev Disord |year=2006 |volume=36 |issue=1 |pages=27–43 |title=Enhanced perceptual functioning in autism: an update, and eight principles of autistic perception |author=Mottron L, [[Michelle Dawson|Dawson M]], Soulières I, Hubert B, Burack J |doi=10.1007/s10803-005-0040-7 |pmid=16453071 }}</ref> Nadharia hizi zinaelezeka vizuri kutoka katika nadharia ya ufiche ya usonji.

Hakuna nadharia inayoridhisha ikiwa peke yake, nadharia ya utambuzi kijamii haifafanui vyema tabia zisizobadilika na za kujirudiarudia kwa walio na usonji, huku nadharia zisizo za kijamii zina ugumu kueleza hitilafu za kijamii na matatizo ya kimawasiliano.<ref name="HappeTime">{{vcite journal |author=Happé F, Ronald A, [[Robert Plomin|Plomin R]] |title=Time to give up on a single explanation for autism |journal=Nat Neurosci |year=2006 |volume=9 |issue=10 |pages=1218–20 |doi=10.1038/nn1770 |pmid=17001340 }}</ref> Nadharia iliyochangnywa kwa kutegemea hitilafu mbalimbali inaweza kuwa muhimu zaidi.<ref>{{vcite journal |journal=Dev Rev |year=2007 |volume=27 |issue=2 |pages=224–60 |title=Cognitive theories of autism |author=Rajendran G, Mitchell P |doi=10.1016/j.dr.2007.02.001 }}</ref>

==Uchunguzi==
Takribani nusu ya wazazi wa watoto walio na ASD hutambua tabia isiyo ya kawaida kwa mtoto wao katika umri wa miezi 18, takriban khumusi nne hutambua abapofika umri wa miezi 24.<ref name="Landa3"></ref> Kwa kuwa kuahirisha matibabu kunaweza kuathiri matokeo ya hapo baadaye, ishara yoyote kati ya zifuatazo ni sababu ya  kuhakikisha mtoto anakaguliwa na mtaalamu bila kuchelewa:
*Kukosa kubwabwaja kufikia mwezi wa 12.
*Kukosa ishara (kuashiria kwa vidole, kupunga ishara ya kuaga, nk) kufikia mwezi wa 12.
*Kutoweza kutaja maneno ya neno moja kufikia mwezi wa 16.
*Kukosa virai vya maneno mawili ya kujianzia (mbali na matukio ya ukasuku) kufikia mwezi wa 24.
*Kupoteza ujuzi wowote wa lugha yoyote au ujuzi wa jamii, katika umri wowote.<ref name="Filipek"></ref>
Nchini Marekani na Ujapan mazoezi ni kuwachunguza watoto wote kubaini ASD wakitimia miezi 18 na 24, kwa kutumia vipimo maalum vya kuchunguza usonji kirasmi. Kinyume ni kwamba, nchini Uingereza, watoto ambao familia au madaktari wametambua ishara zinazoweza kuwa za usonji ndio hukaguliwa. Haijulikani njia gani bora zaidi.<ref name="Levy"></ref> Vifaa vya uchunguzi ni pamoja na Orodha ya Kuchunguza Usonji katika Watoto (M-CHAT), Hojaji ya Kuchunguza Ishara za Mapema ya Usonji, na Orodha ya Mwaka wa Kwanza, data ya awali ya M-CHAT na CHAT iliyoitangulia kwa watoto wenye umri wa miezi 18-30 inaonyesha kwamba inatumika vizuri katika mazingira ya kimatibabu na kwamba ina uwezo wa kuonyesha athari ndogondogo (hasi nyingi zisizo za kweli) lakini  ubayana mzuri (chanya chache zisizo za kweli).<ref name="Landa3"></ref> Inaweza kuwa sahihi zaidi kutatangulia vipimo hivi na uchunguzi mpana usiotofautisha ASD na matatizo mengine ya ukuaji.<ref>{{vcite journal |author=Wetherby AM, Brosnan-Maddox S, Peace V, Newton L |title=Validation of the Infant–Toddler Checklist as a broadband screener for autism spectrum disorders from 9 to 24 months of age |journal=Autism |volume=12 |issue=5 |pages=487–511 |year=2008 |pmid=18805944 |doi=10.1177/1362361308094501 |pmc=2663025 }}</ref> Vifaa vya uchunguzi viliyoundwa kwa ajili ya utamaduni wa jamii moja kuchunguza tabia kama vile kuangalia mwingine machoni vinaweza vikawa si muafaka katika utamaduni tofauti.<ref>{{vcite journal |journal=Acta Paediatr |year=2008 |volume=97 |issue=5 |pages=539–40 |title=The challenge of screening for autism spectrum disorder in a culturally diverse society |author=Wallis KE, Pinto-Martin J |doi=10.1111/j.1651-2227.2008.00720.x |pmid=18373717 }}</ref> Ingawa uchunguzi wa kijenetiki wa usonji kwa ujumla bado haiwezekani, inaweza kuzingatiwa katika baadhi ya matukio, kama vile kwa watoto walio na dalili za kinyurolojia na maumbile ya. ulemavu wa kuzaliwa<ref>{{vcite journal |author=Lintas C, Persico AM |title=Autistic phenotypes and genetic testing: state-of-the-art for the clinical geneticist |journal=J Med Genet |volume=46 |issue=1 |pages=1–8 |year=2009 |pmid=18728070 |pmc=2603481 |doi=10.1136/jmg.2008.060871 |url=http://jmg.bmj.com/content/46/1/1.long }}</ref>

==Uaguzi==
Uaguzi unategemea tabia, si sababu au utaratibu.<ref name="London">{{vcite journal |journal=Brain Pathol |year=2007 |volume=17 |issue=4 |pages=408–11 |title=The role of the neurobiologist in redefining the diagnosis of autism |author=London E |doi=10.1111/j.1750-3639.2007.00103.x |pmid=17919126 }}</ref><ref>{{vcite journal |journal=BMJ |year=2003 |volume=327 |issue=7413 |pages=488–93 |title=Diagnosis of autism |author=Baird G, Cass H, Slonims V |doi=10.1136/bmj.327.7413.488 |pmid=12946972 |pmc=188387 |url=http://www.bmj.com/cgi/content/full/327/7413/488 }}</ref> Usonji inafafanuliwa katika DSM-IV-TR kuwa na angalau jumla ya dalili sita, ikiwa ni pamoja na angaa dalili mbili za kulemaa kwa ubora wa mahusiano ya kijamii, angalau dalili moja ya kuharibika kwa ubora katika mawasiliano, na angalau dalili moja ya tabia finyu na kujirudiarudia. Mfano wa dalili ni pamoja na kukosa kuonyesha hisia sawa na wengine au za kijamii, utumizi wa lugha ya kurudiarudiaha au lugha ya kipekepeke, na uvutiwaji wa kuendelea na sehemu ya vitu. Mwanzo lazima uwe kabla ya umri wa miaka mitatu, huku kukiwa na ucheleweshaji au utendaji usio wa kawaida katika mahusiano ya kijamii, lugha kama inavyotumika katika mawasiliano ya kijamii, au ishara au micheza bunifu. Mvurugiko haufai kuelezeka kwa ubora kuwa uliosababishwa na ugonjwa wa Rett au Ugonjwa wa uchangukaji utotoni.<ref name="DSM-IV-TR-299.00">{{vcite book |title=Diagnostic and Statistical Manual of Mental Disorders |edition=4th, text revision ([[DSM-IV-TR]]) |author=American Psychiatric Association |year=2000 |isbn=0890420254 |chapter=Diagnostic criteria for 299.00 Autistic Disorder |chapterurl=http://cdc.gov/ncbddd/autism/hcp-dsm.html |publisher=<!--comment to foil Citation bot--> |location=<!--comment to foil Citation bot--> }}</ref> ICD-10 pia kimsingi hutumia ufafanuzi huo.<ref name="ICD-10-F84.0">{{vcite web |url=http://apps.who.int/classifications/apps/icd/icd10online/?gf80.htm+f84 |year=2007 |accessdate=2009-10-10 |work=ICD-10: International Statistical Classification of Diseases and Related Health Problems: Tenth Revision |publisher=World Health Organization |title=F84. Pervasive developmental disorders }}</ref>

Zana kadhaa za uagizi zinapatikana. Mbili hutumika sanasana katika kutafiti usonji: Mahojiano Aguzi ya Usonji-Yaliyorekebishwa (ADI-R), ni mahojiano yenye mwongozo kidogo yanayotumiwa na mzazi, na Jedwali la Uaguzi wa Usonji kwa Kutazama (ADOS) hutumia uchunguzi na mwingiliano na mtoto. Mizani ya Kukadiria Usonji Utotoni (CARS) hutumika sana katika mazingira ya kimatibabu kutathmini ushadidi wa usonji kwa kumchunguza watoto.<ref name="Volkmar"></ref>

Kwa kawaida daktari wa watoto hufanya uchunguzi wa awali kwa kutumia historia ya ukuaji na uchunguzi wa kimwili wa mtoto. Panapohitajika uaguzi na uchunguzi hufanyika kwa msaada wa wataalamu wa ASD, kuangalia na kukadiria vipengele vya kitambuzi, mawasiliano, familia, na sababu nyingine kwa kutumia zana sanifu, na kuzingatia hali yoyote ya kimatibabu inayohusiana na ugonjwa huo.<ref name="Dover"></ref> Mwana nyurosaikolojia wa watoto mara nyingi huombwa kutathmini tabia na ujuzi tambuzi, ili kusaidia uaguzi na kusaidia kupendekeza husaidizi wa kielimu.<ref name="Kanne">{{vcite journal |author=Kanne SM, Randolph JK, Farmer JE |title=Diagnostic and assessment findings: a bridge to academic planning for children with autism spectrum disorders |journal=Neuropsychol Rev |volume=18 |issue=4 |pages=367–84 |year=2008 |pmid=18855144 |doi=10.1007/s11065-008-9072-z }}</ref> Uaguzi tofautishi wa ASD katika kiwangi hiki pia unaweza kuzingatia ulemavu wa kiakili, matatizo ya kusikia, na ulemavu maalum wa lugha <ref name="Dover"></ref> kama vile ugonjwa wa Landau-Kleffner.<ref>{{vcite journal |journal=Dev Med Child Neurol |year=2000 |volume=42 |issue=5 |pages=349–53 |title=Autistic regression and Landau–Kleffner syndrome: progress or confusion? |title.= |author=Mantovani JF |doi=10.1017/S0012162200210621 |pmid=10855658 }}</ref> Uwepo wa usonji unewanaweza kuifanya vigumu kuagua matatizo ya kiakili yanayotokea pamoja kama vile unyogovu.<ref>{{vcite journal |author=Matson JL, Neal D |title=Cormorbidity: diagnosing comorbid psychiatric conditions |journal=Psychiatr Times |volume=26 |issue=4 |year=2009 |url=http://www.psychiatrictimes.com/display/article/10168/1403043 }}</ref>

Tathmini jenetiki ya kimatibabu mara nyingi hufanywa baada ya ASD imeaguliwa, hasa wakati dalili nyingine tayari zinaashiria sababu za kijenetiki.<ref name="Caronna"></ref> Ingawa teknolojia ya kijenetiki inaruhusu wataalamu wa jenetiki kuhusisha takribani 40% ya visi na visababishi vya kijenetiki,<ref>{{vcite journal |journal=Genet Med |year=2008 |volume=10 |issue=1 |pages=4–12 |title=Genetics evaluation for the etiologic diagnosis of autism spectrum disorders |author=Schaefer GB, Mendelsohn NJ |doi=10.1097/GIM.0b013e31815efdd7 |pmid=18197051 |laysummary=http://www.medicalnewstoday.com/articles/96448.php |laysource=Medical News Today |laydate=2008-02-07 }}</ref> mwongozo wa makubaliano katika mataifa ya Marekani na Uingereza unahusu picha zenye umadhubuti wa hali ya juu wa kromosomu na tathmini X unaohitaji uangalifu zaidi.<ref name="Caronna"></ref> Uaguzi wa kwanza wa mfano wa aina jeni umapendekezwa, ambao utakuwa ukichunguza mara kwa mara nakala kadhaa za jinomu moja.<ref>{{vcite journal |author=Ledbetter DH |title=Cytogenetic technology—genotype and phenotype |journal=N Engl J Med |volume=359 |issue=16 |pages=1728–30 |year=2008 |pmid=18784093 |doi=10.1056/NEJMe0806570 }}</ref> Jinsi vipimo vipya vya kijenetiki vinavyoundwa masuala kadhaa ya kimaadili, kisheria, na kijamii yatajitokeza. Upatikanaji wa kibiashara wa upimaji unaweza kutangulia uelewa wa kutosha wa jinsi ya kutumia matokeo ya upimaji, ikizingatiwa uchangamani wa jeni za usonji.<ref>{{vcite journal |journal=Am J Med Genet C Semin Med Genet |year=2006 |volume=142C |issue=1 |pages=52–7 |title=Genetic counseling and ethical issues for autism |author=McMahon WM, Baty BJ, Botkin J |doi=10.1002/ajmg.c.30082 |pmid=16419100 }}</ref> Vipimo vya kimetaboli na picha za neva wakati mwingine husaidia , lakini si mara kwa mara.<ref name="Caronna"></ref>

Wakati mwingine ASD inaweza kuaguliwa katika umri wa miezi 14, ingawa uaguzi huendelea kuwa imara katika kipindi cha miaka mitatu ya kwanza ya maisha: kwa mfano, mtoto wa mwaka moja anayetimiza viwango vya kuaguliwa kuwa na ASD anauwezekano mdogo kuliko wa mtoto wa miaka mitatu kuendelea kuonyesha dalili hizo kwa muda wa miaka michache baadaye.<ref name="Landa3">{{vcite journal |journal=Nat Clin Pract Neurol |year=2008 |volume=4 |issue=3 |pages=138–47 |title=Diagnosis of autism spectrum disorders in the first 3 years of life |author=Landa RJ |doi=10.1038/ncpneuro0731 |pmid=18253102 }}</ref> Nchini Uingereza Mpango wa Taifa wa Watoto wenye Usonji inapendekeza wiki zisizozidi 30 kutoka shaka ya kwanza hadi kukamilika kwa uaguzi na tathmini, hata hivyo ni visa vichache hushughulikiwa haraka hivyo kihalisia.<ref name="Dover">{{vcite journal |journal=Arch Dis Child |year=2007 |volume=92 |issue=6 |pages=540–5 |title=How to diagnose autism |author=Dover CJ, Le Couteur A |doi=10.1136/adc.2005.086280 |pmid=17515625 }}</ref> Uchunguzi mmoja wa 2009 nchini Marekani uligundua kwamba umri wastani wa uaguzi wa ASD ulikuwa miaka 5.7, juu kabisa ya mapendekezo, na kwamba 27% ya watoto walisalia bila kuaguliwa katika umri wa miaka 8.<ref>{{vcite journal |author=Shattuck PT, Durkin M, Maenner M ''et al.'' |author.= |title=Timing of identification among children with an autism spectrum disorder: findings from a population-based surveillance study |journal=J Am Acad Child Adolesc Psychiatry |volume=48 |issue=5 |pages=474–83 |year=2009 |pmid=19318992 |doi=10.1097/CHI.0b013e31819b3848 }}</ref> Ingawa dalili za usonji na ASD huanza mapema utotoni, wakati mwingine huwa hazipatikani; miaka baadaye, watu wazima wanaweza kutafuta uaguzi ili kuwasaidia au rafiki zao na familia kujielewa, kuwa saidia waajiri wao kufanya marekebisho au, katika baadhi ya maeneo kudai ulemavu posho ya walemavu au faida nyingine.<ref>{{vcite web |publisher=National Autistic Society |title=Diagnosis: how can it benefit me as an adult? |title.= |year=2005 |url=http://www.nas.org.uk/nas/jsp/polopoly.jsp?a=8018 |accessdate=2008-03-24 |archivedate=2012-02-08 |archiveurl=https://www.webcitation.org/65JFROiMy?url=http://www.autism.org.uk/global/content/error/404.aspx }}</ref>

Uaguzi unaoweka ushadidi wa ugonjwa chini au juu zaidi ni tatizo katika matukio ambayo hayajidhihirishi kikamilifu, na ongezeko la hivi karibuni katika idadi zilizoripotiwa za matukio ya ASD huenda imetokana na mabadiliko katika mbinu za uaguzi. Ongezeko la umaarufu wa matibabu kwa dawa na upanuzi wa faida umewapa motisha watoa huduma kuagua ASD na kusababisha baadhi ya uaguzi shadidi wa juu zaidi katika watoto walio na dalili zisizo za uhakika. Kinyume ni kwamba, gharama ya uchunguzi na uaguzi na changamoto ya kupata malipo inaweza kuzuia au kuchelewesha uaguzi.<ref>{{vcite journal |author=Shattuck PT, Grosse SD |title=Issues related to the diagnosis and treatment of autism spectrum disorders |journal=Ment Retard Dev Disabil Res Rev |year=2007 |volume=13 |issue=2 |pages=129–35 |doi=10.1002/mrdd.20143 |pmid=17563895 }}</ref> Ni vigumu hasa kuagua usonji miongoni mwa wasio na uwezo wa kuona, kwa kiwango fulani ni kwa sababu baadhi ya vigezo vya uaguzi hutegemea kuona, na kwa kiwango kwa sababu dalili za usonji huingiliana na yale ya maradhi ya upofu wa kawaida au mienendo pofu.<ref>{{vcite journal |title=Visual impairment and autism: current questions and future research |author=Cass H |journal=Autism |year=1998 |volume=2 |issue=2 |pages=117–38 |doi=10.1177/1362361398022002 }}</ref>

==Udhibiti==
[[File:Opening a window to the autistic brain.jpg|thumb|alt=A young child points, in front of a woman who smiles and points in the same direction.|Mtoto mwenye umri wa miaka mitatu mwenye usonji aashiria samaki katika hodhisamaki, kama sehemu ya majaribio ya athari ya mafunzo ya pamoja katika ukuaji wa lugha. <ref Name=Powell/>]]
Malengo kuu wakati wa kuwatibu watoto walio na usonji ni kupunguza mapungufu yanayohusishwa na ugonjwa huo na dhiki ya familia, na kuongeza ubora wa maisha na uhuru akisi. Hakuna tiba moja iliyo bora na matibabu kwa kawaida hutolewa kutegemea mahitaji ya mtoto.<ref name="CCD"></ref> Familia na mfumo wa elimu ndio vyanzo muhimu vya matibabu.<ref name="Levy"></ref> Chunguzi za hatua za udhibiti zina matatizo ya kimtindo yanayozuia  uthibitisho wa kamilifu kuhusu umadhubuti.<ref>{{vcite journal |author=Ospina MB, Krebs Seida J, Clark B ''et al.'' |author.= |title=Behavioural and developmental interventions for autism spectrum disorder: a clinical systematic review |journal=PLoS ONE |volume=3 |issue=11 |pages=e3755 |year=2008 |pmid=19015734 |pmc=2582449 |doi=10.1371/journal.pone.0003755 |url=http://www.plosone.org/article/info:doi/10.1371/journal.pone.0003755 }}</ref> Ingawa hatua nyingi za udhibiti wa kisaikojamii zimeonysha kiwango fulani cha matokeo mema , na kuashiria kwamba matibabu ya aina yoyote yanafaa kuliko kutotubu, ubora wa utaratibu wa mapitio ya chunguzi hizi kwa jumla hayajakuwa mazuri, matokeo yao ya kimatibabu huwa ya kimajaribio zaidi, na kuna ushahidi mdogo wa umadhubuti linganifu katika mbinu za matibabu.<ref>{{vcite journal |author=Krebs Seida J, Ospina MB, Karkhaneh M, Hartling L, Smith V, Clark B |title=Systematic reviews of psychosocial interventions for autism: an umbrella review |journal=Dev Med Child Neurol |volume=51 |issue=2 |pages=95–104 |year=2009 |pmid=19191842 |doi=10.1111/j.1469-8749.2008.03211.x }}</ref> Mipango shadidi na endelevu ya elimu maalum na tabia tiba mapema katika maisha yanaweza kuwasaidia watoto kupata ujuzi wa, kujimudu, kijamii, na ujuzi wa kazi,<ref name="CCD">{{vcite journal |journal=Pediatrics |year=2007 |volume=120 |issue=5 |pages=1162–82 |title=Management of children with autism spectrum disorders |author=Myers SM, Johnson CP, Council on Children with Disabilities |doi=10.1542/peds.2007-2362 |pmid=17967921 |url=http://pediatrics.aappublications.org/cgi/content/full/120/5/1162 |laysummary=http://aap.org/advocacy/releases/oct07autism.htm |laysource=AAP |laydate=2007-10-29 |accessdate=2010-10-18 |archivedate=2009-06-12 |archiveurl=https://web.archive.org/web/20090612191201/http://pediatrics.aappublications.org/cgi/content/full/120/5/1162 }}</ref> na aghalabu kuboresha utendaji na kupunguza ukali wa dalili na tabia zisizo za kawaida,<ref name="Rogers">{{vcite journal |journal=J Clin Child Adolesc Psychol |year=2008 |volume=37 |issue=1 |pages=8–38 |title=Evidence-based comprehensive treatments for early autism |author=Rogers SJ, Vismara LA |doi=10.1080/15374410701817808 |pmid=18444052 }}</ref> madai kwamba udhibiti kuanzia umri wa miaka mitatu ni muhimu hayajathibitishwa.<ref>{{vcite journal |author=Howlin P, Magiati I, Charman T |title=Systematic review of early intensive behavioral interventions for children with autism |journal=Am J Intellect Dev Disabil |volume=114 |issue=1 |pages=23–41 |year=2009 |pmid=19143460 |doi=10.1352/2009.114:23;nd41 }}</ref> Mbinu zilizopo ni pamoja na Uchambuzi Tabia Kimatumizi (ABA), vilinganishi vya ukuaji, mafundisho yaliyopangiliwa, matibabu ya uzungumzaji na lugha, matibabu ya ujuzi wa kijamii, na tiba kwa ulemavu.<ref name="CCD"></ref> Baadhi ya miingilio ya kielimu yana ufanisi fulani kwa watoto: matibabu ya ABA yamethibitisha umadhubuti  katika kuongezeka kijumla kwa utendaji kwa watoto ambao hawajaenda shuleni<ref>{{vcite journal |journal=Res Dev Disabil |year=2009 |title=Outcome of comprehensive psycho-educational interventions for young children with autism |author=Eikeseth S |doi=10.1016/j.ridd.2008.02.003 |pmid=18385012 |volume=30 |issue=1 |pages=158–78 }}</ref> na yameimarishwa ili kuboresha utendaji wa kiakili wa watoto wadogo.<ref name="Rogers"></ref> Taarifa za wataalamu wa nyurosaikolojia mara nyingi hayafikii vizuri waelimishaji, hali inayosababisha pengo kati ya kile ripoti inapendekeza na elimu inayotolewa.<ref name="Kanne"></ref> Haijulikana kama harakati za matibabu kwa watoto husababisha uboreshwaji mkubwa baada ya watoto kukua,<ref name="Rogers"></ref> na utafiti mdogo kuhusu ufanisi wa mipango ya mafunzo ya kinyumbani kwa watu wazima unaonyesha matokeo mchanganyiko.<ref>{{vcite journal |journal=J Autism Dev Disord |year=2003 |volume=33 |issue=2 |pages=131–40 |title=Effects of a model treatment approach on adults with autism |author=Van Bourgondien ME, Reichle NC, [[Eric Schopler|Schopler E]] |doi=10.1023/A:1022931224934 |pmid=12757352 }}</ref>

Dawa nyingi zinazotumika kutibu dalili za ASD huathiri  kuingiliana kwa mtoto na nyumba au shule wakati tabia matibabu yameshindwa.<ref name="Rapin"></ref><ref>{{vcite journal |journal=Harv Rev Psychiatry |year=2008 |volume=16 |issue=2 |pages=97–112 |title=Pharmacological treatment options for autism spectrum disorders in children and adolescents |author=Leskovec TJ, Rowles BM, Findling RL |doi=10.1080/10673220802075852 |pmid=18415882 }}</ref> Zaidi ya nusu ya watoto wa Marekani walioaguliwa kuwa na ASD hupewa dawa  za kuathiri akili au kinza-msukosuko, huku aina za dawa zinazotumika mara kwa mara zikiwa tibamfadhaiko, vichangamshi, na vizuia magonjwa ya akili.<ref>{{vcite journal |journal=J Child Adolesc Psychopharmacol |year=2007 |volume=17 |issue=3 |pages=348–55 |title=Medication use among children with autism spectrum disorders |author=Oswald DP, Sonenklar NA |doi=10.1089/cap.2006.17303 |pmid=17630868 }}</ref> Mbali na dawa za kuzuia magonjwa ya akili,<ref>{{vcite journal |journal=J Clin Invest |year=2008 |volume=118 |issue=1 |pages=6–14 |title=Antipsychotics in the treatment of autism |author=Posey DJ, Stigler KA, Erickson CA, McDougle CJ |doi=10.1172/JCI32483 |pmid=18172517 |pmc=2171144 |url=http://www.jci.org/articles/view/32483/version/1 }}</ref> kuna utafiti mchache wa kuaminika kuhusu umadhubuti au usalama wa matibabu ya dawa kwa vijana na watu wazima walio na ASD <ref>. Ukosefu wa utafiti wa matibabu kwa dawa:
*{{vcite journal |journal=Aust Fam Physician |year=2007 |volume=36 |issue=9 |pages=741–4 |title=Children and autism—part 1—recognition and pharmacological management |author=Angley M, Young R, Ellis D, Chan W, McKinnon R |pmid=17915375 |url=http://www.racgp.org.au/afp/200709/200709angley.pdf |format=PDF |accessdate=2010-10-18 |archivedate=2013-04-07 |archiveurl=https://web.archive.org/web/20130407205054/http://www.racgp.org.au/afp/200709/200709angley.pdf }}
*{{vcite journal |journal=Autism |year=2007 |volume=11 |issue=4 |pages=335–48 |title=Systematic review of the effectiveness of pharmacological treatments for adolescents and adults with autism spectrum disorder |author=Broadstock M, Doughty C, Eggleston M |doi=10.1177/1362361307078132 |pmid=17656398 }} </ref> Mtu aliye na ASD anaweza kuitikia kwa namna isiyo ya kawaida matibabu, matibabu yanaweza kuwa na athari mbaya,<ref name="CCD"></ref> na hakuna dawa inayojulikana hupunguza dalili za kimsingi za usonji ambazo ni ulemavu wa kijamii na mawasiliano.<ref>{{vcite journal |journal=Novartis Found Symp |year=2003 |volume=251 |pages=235–44; discussion 245–9, 281–97 |title=Why have drug treatments been so disappointing? |title.= |author=Buitelaar JK |doi=10.1002/0470869380.ch14 |pmid=14521196 }}</ref> Majaribio katika panya yamerudisha nyuma au kupunguza baadhi ya dalili zinazohusishwa na usonji kwa kuondoa au kurekebisha kazi za jeni baada ya kuzaliwa,<ref name="Walsh"></ref> hii inapendekeza uwezekano wa kulenga matibabu katika mabadiliko mahsusi ya jeni nadra inayojulikana kusababisha usonji.<ref name="Betancur"></ref>

Ingawa matibabu mengi na udhibiti mbadala unapatiakna, ni chache zinaushahidi wa uchunguzi wa kisayansi.<ref name="Sigman"></ref><ref>[333] ^ Ukosefu wa msaada kwa uingiliaji kati:
*{{vcite journal |journal=Dev Med Child Neurol |year=2005 |volume=47 |issue=7 |pages=493–9 |title=Autism interventions: a critical update |author=Francis K |doi=10.1017/S0012162205000952 |pmid=15991872 |url=http://journals.cambridge.org/production/action/cjoGetFulltext?fulltextid=313204 |format=PDF |accessdate=2010-10-18 |archivedate=2019-10-17 |archiveurl=https://web.archive.org/web/20191017031345/https://www.cambridge.org/core/journals/developmental-medicine-and-child-neurology/article/autism-interventions-a-critical-update/B9585FE9AB76B713AD1497886BD57B25 }}
*{{vcite journal |author=Levy SE, Hyman SL |title=Complementary and alternative medicine treatments for children with autism spectrum disorders |journal=Child Adolesc Psychiatr Clin N Am |volume=17 |issue=4 |pages=803–20, ix |year=2008 |pmid=18775371 |pmc=2597185 |doi=10.1016/j.chc.2008.06.004 }}
*{{vcite journal |journal=J Autism Dev Disord |year=2008 |volume=38 |issue=2 |pages=353–61 |title=Social skills interventions for children with Asperger's syndrome or high-functioning autism: a review and recommendations |author=Rao PA, Beidel DC, Murray MJ |doi=10.1007/s10803-007-0402-4 |pmid=17641962 }}</ref> Mbinu za matibabu zina ushahidi mdogo wa kijarabati katika ubora wa hali za maisha , na mipango nyingi huzingatia hatua za mafanikio ambazo hukosa ukweli wa kubashirika na umuhimu katika dunia halisi.<ref name="Burgess"></ref> Ushahidi wa kisayansi unaonekana jambo lisilo la muhimu kwa watoa huduma ikilinganishwa na mpango wa uuzaji, upatikanaji wa mafunzo, na maombi ya wazazi.<ref>{{vcite journal |journal=Focus Autism Other Dev Disabl |year=2005 |volume=20 |issue=2 |pages=66–79 |title=Early intervention practices for children with autism: descriptions from community providers |author=Stahmer AC, Collings NM, Palinkas LA |pmid=16467905 |pmc=1350798 |doi=10.1177/10883576050200020301 }}</ref> Ingawa matibabu mengi mbadala, kama vile melatonin, yana madhara kidogo tu <ref>{{vcite journal |journal=Aust Fam Physician |year=2007 |volume=36 |issue=10 |pages=827–30 |title=Children and autism—part 2—management with complementary medicines and dietary interventions |author=Angley M, Semple S, Hewton C, Paterson F, McKinnon R |pmid=17925903 |url=http://www.racgp.org.au/afp/200710/200710angley.pdf |format=PDF |accessdate=2010-10-18 |archivedate=2011-07-06 |archiveurl=https://web.archive.org/web/20110706125837/http://www.racgp.org.au/afp/200710/200710angley.pdf }}</ref> yanaweza kumhatarisha mtoto. Utafiti mmoja wa 2008 iligundua kuwa ikilinganishwa na rika zao, wavulana walio na usonji huwa na mifupa konde sana ikiwa hawali chakula kilicho na kasini,<ref>{{vcite journal |journal=J Autism Dev Disord |year=2008 |volume=38 |issue=5 |pages=848–56 |title=Reduced bone cortical thickness in boys with autism or autism spectrum disorder |author=Hediger ML, England LJ, Molloy CA, Yu KF, Manning-Courtney P, Mills JL |doi=10.1007/s10803-007-0453-6 |pmid=17879151 |laysummary=http://www.nih.gov/news/health/jan2008/nichd-29.htm |laysource=NIH News |laydate=2008-01-29 }}</ref> mnamo 2005, matibabu ya kelesheni yalimuua mvulana wa umri wa miaka mitano aliyekuwa na usonji.<ref>{{vcite journal |journal=Pediatrics |year=2006 |volume=118 |issue=2 |pages=e534–6 |title=Deaths resulting from hypocalcemia after administration of edetate disodium: 2003–2005 |author=Brown MJ, Willis T, Omalu B, Leiker R |doi=10.1542/peds.2006-0858 |pmid=16882789 |url=http://pediatrics.aappublications.org/cgi/content/full/118/2/e534 |accessdate=2010-10-18 |archivedate=2009-07-27 |archiveurl=https://web.archive.org/web/20090727080307/http://pediatrics.aappublications.org/cgi/content/full/118/2/e534 }}</ref>

Matibabu ni ghali, gharama yasiyo ya moja kwa moja pia ni ghali. Kwa mtu aliyezaliwa mwaka 2000, utafiti mmoja wa Marekani ulikadirio matumizi ya wastani maishani ya dola {{formatprice|{{inflation|US|3160384|2003}}}} (thamani halisi ya sasa ni {{CURRENTYEAR}} dola, marekebiso ya liyofanyiwa mfumuko wa bei kutoka makisio ya 2003{{inflation-fn|US}}), kukiwa na takriban 10% ya huduma ya matibabu, 30%  elimu ya ziada na huduma nyingine, na 60% kwa tija ya kiuchumi iliyopotea.<ref>{{vcite journal |journal=Arch Pediatr Adolesc Med |year=2007 |volume=161 |issue=4 |pages=343–9 |title=The lifetime distribution of the incremental societal costs of autism |author=Ganz ML |pmid=17404130 |url=http://archpedi.ama-assn.org/cgi/content/full/161/4/343 |laysummary=http://www.hsph.harvard.edu/news/press-releases/2006-releases/press04252006.html |laysource=Harvard School of Public Health |laydate=2006-04-25 |doi=10.1001/archpedi.161.4.343 }}</ref> Mipango inayosimamiwa na serikali mara nyingi haitoshi au hazifai kwa watoto fulani, na gharama ya dawa au tiba inayotumiwa na wazazi bila kurejeshewa fedha na serikali imehusishwa na matatizo ya kifedha katika familia,<ref>{{vcite journal |journal=J Fam Econ Iss |year=2007 |volume=28 |issue=2 |pages=247–64 |doi=10.1007/s10834-007-9059-6 |title=Financial issues associated with having a child with autism |author=Sharpe DL, Baker DL }}</ref> uchunguzi mmoja wa Marekani 2008 ulipata hasara ya wastani 14% ya mapato ya kila mwaka katika familia ya watoto walio na ASD,<ref>{{vcite journal |journal=Pediatrics |year=2008 |volume=121 |issue=4 |pages=e821–6 |title=Association of childhood autism spectrum disorders and loss of family income |author=Montes G, Halterman JS |doi=10.1542/peds.2007-1594 |pmid=18381511 |url=http://pediatrics.aappublications.org/cgi/content/full/121/4/e821 |accessdate=2010-10-18 |archivedate=2010-03-04 |archiveurl=https://web.archive.org/web/20100304071520/http://pediatrics.aappublications.org/cgi/content/full/121/4/e821 }}</ref> na uchunguzi mwingine unaohusiana na huo ulipata kwamba ASD inahusishwa na uwezekano mkubwa kwamba matatizo ya ulezi wa watoto  yanaathiri uwezekano wa wazazi kuajiriwa.<ref>{{vcite journal |journal=Pediatrics |year=2008 |volume=122 |issue=1 |pages=e202–8 |title=Child care problems and employment among families with preschool-aged children with autism in the United States |author=Montes G, Halterman JS |doi=10.1542/peds.2007-3037 |pmid=18595965 |url=http://pediatrics.aappublications.org/cgi/content/full/122/1/e202 }}</ref> Majimbo ya Marekani yanazidi kuhitaji kuwa bima ya afya ya kibinafsi ishughulikie huduma za kiusonji, kuhamisha gharama kutoka mipango ya unafadhili wa elimu ya umma hadi katika mipango ya kibinafsi ya kufadhili bima ya afya.<ref>{{vcite journal |journal=Manag Care |year=2008 |volume=17 |issue=8 |pages=35–6, 39 |title=States increasingly mandate special autism services |author=Reinke T |pmid=18777788 |url=http://managedcaremag.com/archives/0808/0808.autism.html |accessdate=2010-10-18 |archivedate=2014-03-24 |archiveurl=https://web.archive.org/web/20140324083435/http://managedcaremag.com/archives/0808/0808.autism.html }}</ref> Baada ya utotoni, masuala makuu ya kimatibabu ni pampja na ulinzi wa mahala pa makazi, mafunzo ya kazi na kuajiriwa, kujamiiana, ujuzi wa kijamii, na mipango ya mali pa kuishi.<ref>{{vcite journal |journal=J Clin Psychiatry |year=2005 |volume=66 |issue=Suppl 10 |pages=38–45 |title=Treatment planning for patients with autism spectrum disorders |author=Aman MG |pmid=16401149 }}</ref>

==Ubashiri==
Hakuna tiba inajulikana.<ref name="Levy"></ref><ref name="CCD"></ref> Mara moja moja watoto hupona, hivi kwamba hupoteza uaguzi wa ASD, <ref name="Helt"></ref> hii hutokea wakati mwingine baada ya matibabu makali na wakati mwingine bila matibabu. Haijulikani uponyaji hufanyika vipi;<ref name="Rogers"></ref> viwango vilivyoripotiwa katika sampuli zisizochaguliwa za watoto walio na ASD zimekuwa kati ya  3% hadi 25%.<ref name="Helt">{{vcite journal |author=Helt M, Kelley E, Kinsbourne M ''et al.'' |author.= |title=Can children with autism recover? if so, how? |title.= |journal=Neuropsychol Rev |volume=18 |issue=4 |pages=339–66 |year=2008 |pmid=19009353 |doi=10.1007/s11065-008-9075-9 }}</ref> Watoto wachache waliokuwa na usonji wamepata uwezo wa kuongea katika umri miaka 5 au zaidi.<ref>{{vcite journal |author=Pickett E, Pullara O, O'Grady J, Gordon B |title=Speech acquisition in older nonverbal individuals with autism: a review of features, methods, and prognosis |journal=Cogn Behav Neurol |volume=22 |issue=1 |pages=1–21 |year=2009 |pmid=19372766 |doi=10.1097/WNN.0b013e318190d185 }}</ref> Watoto wengi wengi walio na usonji hukosa misaada ya kijamii, mahusiano thabiti, fursa za ajira baadaye au uwezo wa kujifanyia maamuzi ya kibinafsi. Ingawa matatizo ya kimsingi ni kana kwamba huendelea, ushadidi wa dalili aghalabu hupungua kulingana na umri.<ref name="Rapin"></ref> Chunguzi chache za hali ya juu hushughulikia ubashiri wa muda mrefu.  Baadhi ya watu wazima kuonyesha maendeleo ya wastani katika ujuzi wa mawasiliano, lakini wachache hudorora, hakuna utafiti umelenga usonji baada ya umakamo.<ref>{{vcite journal |journal=Ment Retard Dev Disabil Res Rev |volume=10 |issue=4 |pages=234–47 |year=2004 |title=Trajectory of development in adolescents and adults with autism |author=Seltzer MM, Shattuck P, Abbeduto L, Greenberg JS |doi=10.1002/mrdd.20038 |pmid=15666341 }}</ref> Kumudu lugha kabla ya umri miaka sita, kuwa na Kiwango cha Akili cha zaidi ya 50, na kuwa na ujuzi unaoweza kumpatia mtu ajira ni utabiri wa matokeo bora, maisha ya kujitegemea huenda yasiwezekane kwa walio na usonji shadidi.<ref>{{vcite journal |author=Tidmarsh L, Volkmar FR |title=Diagnosis and epidemiology of autism spectrum disorders |journal=Can J Psychiatry |volume=48 |issue=8 |pages=517–25 |year=2003 |pmid=14574827 |url=http://ww1.cpa-apc.org:8080/Publications/Archives/CJP/2003/september/tidmarsh.asp }}</ref> Uchunguzi mmoja mnamo 2004 nchini Uingereza kwa watu wazima 68 waliokuwa wameaguliwa kabla ya 1980 kuwa watoto wenye usonji walio na Kiwango cha Akili, IQ cha zaidi ya 50 uligundua kwamba 12% walifanikiwa kupata kiwango cha juu cha uhuru katika utu uzima, 10% walikuwa na idadi fulani ya marafiki na kijumla walikuwa na kazi japo walihitaji kiwango fulani cha msaada, 19% walikuwa na kiasi fulani cha uhuru lakini kijumla walikuwa wakiishi nyumbani na walihitaji msaada na usimamizi mkubwa katika maisha ya kila siku, 46% walihitaji makazi maalum katika vituo vya ASD wakihitaji kiwango cha juu cha msaada na uhuru mdogo sana, na 12% walihitajika kiwango cha juu cha utunzi hospitalini.<ref name="Howlin">{{vcite journal |author=Howlin P, Goode S, Hutton J, Rutter M |title=Adult outcome for children with autism |journal=J Child Psychol Psychiatry |year=2004 |volume=45 |issue=2 |pages=212–29 |pmid=14982237 |doi=10.1111/j.1469-7610.2004.00215.x }}</ref> Uchunguzi mmoja wa 2005 nchini Uswidi wa watu wazima 78 ambao haukuwatenga watu waliokuwa na Kiwango cha Akili, IQ cha chini ulipata ubashiri mbaya zaidi, kwa mfano,  4% tu walipata uhuru.<ref>{{vcite journal |journal=J Autism Dev Disord |year=2005 |volume=35 |issue=3 |pages=351–60 |title=Autism after adolescence: population-based 13- to 22-year follow-up study of 120 individuals with autism diagnosed in childhood |author=Billstedt E, Gillberg C, Gillberg C |doi=10.1007/s10803-005-3302-5 |pmid=16119476 }}</ref> Uchunguzi mmoja nchini Kanada mwaka wa 2008 wa watu wazima 48 walioaguliwa kuwa na ASD wakiwa watoto kabla ya kuenda shule ulipata matokeo kama yafuatavyo, vibaya (46%), kadiri (32%), vizuri (17%), na vizuri sana (4%), 56% ya watu hao walikuwa wameajiriwa wakati fulani katika maisha yao, wengi wao katika kujitolea, na katika sehemu zilizolindwa au kazi za muda.<ref>{{vcite journal |journal=J Autism Dev Disord |year=2008 |volume=38 |issue=4 |pages=739–47 |title=Young adult outcome of autism spectrum disorders |author=Eaves LC, Ho HH |doi=10.1007/s10803-007-0441-x |pmid=17764027 }}</ref> Mabadiliko katika mikakati ya uaguzi na kuongeza katika upatikanaji wa tiba za mapema madhubuti inaifanya vigumu kubaini kama matokeo haya yanaweza kuchukuliwa kuwakislisha watoto walioaguliwa hivi karibuni.<ref name="Newschaffer"></ref>

==Epidemolojia==
[[File:US-autism-6-17-1996-2007.png|thumb|left|alt=Bar chart versus time. The graph rises steadily from 1996 to 2007, from about 0.7 to about 5.3. The trend curves slightly upward.|Ripoti za matukio ya usonji kwa watoto 1,000 ziliongezeka kwa kasi Marekani kuanzia 1996 hadi 2007. Haijulikani ni kiasi gani, kama ipo, cha ongezeko kilitokana na mabadiliko katika uenezi wa tawahidi.]]
Mapitio ya hivi karibuni zaidi yanakisia uenezi kuwa kati ya mtu 1-2 kwa kila 1,000 kwa usonji na takribani 6 kwa kila 1,000 kwa ASD,<ref name="Newschaffer">{{vcite journal |author=Newschaffer CJ, Croen LA, Daniels J ''et al.'' |author.= |title=The epidemiology of autism spectrum disorders |journal=Annu Rev Public Health |year=2007 |volume=28 |pages=235–58 |pmid=17367287 |doi=10.1146/annurev.publhealth.28.021406.144007 |url=http://idea.library.drexel.edu/bitstream/1860/2632/1/2006175339.pdf |format=PDF |accessdate=2010-10-18 |archivedate=2013-09-03 |archiveurl=https://web.archive.org/web/20130903024137/http://idea.library.drexel.edu/bitstream/1860/2632/1/2006175339.pdf }}</ref> kwa sababu ya ukosefu wa data, takwimu hizi zinaweza kutoa makisio ya chini ya uenezi wa ASD.<ref name="Caronna">{{vcite journal |journal=Arch Dis Child |year=2008 |volume=93 |issue=6 |pages=518–23 |title=Autism spectrum disorders: clinical and research frontiers |author=Caronna EB, Milunsky JM, Tager-Flusberg H |doi=10.1136/adc.2006.115337 |pmid=18305076 }}</ref> Uenezi wa PDD-NOS munakisiwa kuwa 3.7 kwa kila 1,000, Aspaja kuwa 0.6 kwa kila 1,000, na ugonjwa wa uchangukaji utotoni kuwa 0.02 kwa kila 1,000.<ref name="Fombonne-2009">{{vcite journal |author=Fombonne E |title=Epidemiology of pervasive developmental disorders |journal=Pediatr Res |volume=65 |issue=6 |pages=591–8 |year=2009 |pmid=19218885 |doi=10.1203/PDR.0b013e31819e7203 }}</ref> Idadi ya matukio ya usonji yaliyoripotiwa yaliongezeka katika miaka ya 1990 na mapema miaka ya 2000. Ongezeko hili kwa kiasi kikubwa kinasemekana kutokana na mabadiliko katika mikakati ya uaguzi, mielekeo wa rufaa, upatikanaji wa huduma, umri wakati wa uaguzi, na uhamasishaji umma,<ref name="Fombonne-2009"></ref><ref>{{vcite journal |author=Wing L, Potter D |title=The epidemiology of autistic spectrum disorders: is the prevalence rising? |title.= |journal=Ment Retard Dev Disabil Res Rev |volume=8 |issue=3 |year=2002 |pages=151–61 |pmid=12216059 |doi=10.1002/mrdd.10029 }}</ref> ingawa athari za kimazingira ambazo hazijatambulika haziwezi kupuuziliwa mbali.<ref name="Rutter">{{vcite journal |author=Rutter M |title=Incidence of autism spectrum disorders: changes over time and their meaning |journal=Acta Paediatr |volume=94 |issue=1 |year=2005 |pages=2–15 |pmid=15858952 |doi=10.1080/08035250410023124 }}</ref> Ushahidi uliopo haufutilii uwezekano kwamba uenezi wa kweli wa usonji umeongezeka; <ref name="Fombonne-2009"></ref> ongezeko halisi linaweza kupendekeza kuelekeza makini na ufadhili zaidi katika vipengele vya mabadiliko ya kimazingira badala ya kuendelea kuzingatia vipengele vya kijenetiki.<ref name="Szpir"></ref>

Wavulana wana hatari kubwa kuwa na ASD kuliko wasichana. Wastani wa uwiano wa kijinsia ni 4.3:1 na inaweza kuathirika sana na ulemavu wa kitambuzi: inaweza kuwa na ukaribu wa 2:1 na walio na akili taahira na zaidi ya 5.5:1 psipo na akili taahira.<ref name="Newschaffer"></ref> Ingawa ushahidi hauhusishi hatari zozote zinazofungamanishwa na ujauzito na kusababisha ya usonji, hatari ya usonji inahusishwa na umri mkubwa wa mmoja wa wazazi, ugonjwa wa kisukari, kutokwa na damu, na matumizi ya dawa za magonjwa ya akili kwa mama wakati wa ujauzito.<ref>{{vcite journal |author=Gardener H, Spiegelman D, Buka SL |title=Prenatal risk factors for autism: comprehensive meta-analysis |journal=Br J Psychiatry |volume=195 |issue=1 |pages=7–14 |year=2009 |pmid=19567888 |doi=10.1192/bjp.bp.108.051672 }}</ref> Hatari ni kubwa zaidi kwa baba mwenye umri mkubwa kuliko mama mwenye umri mkubwa, maelezo mawili ya uwezekano yanajulikana, kuongeza kwa uwezekano wa mabadiliko ya kijenetiki katika manii kongwe, na nadharia tete kwamba wanaume huchelewa kuoa ikiwa wana upungufu wa kijenetiki na kuonyesha baadhi ya ishara za usonji.<ref name="Geschwind-2009"></ref> Wataalam wengi wanaamini kuwa rangi, kabila, na usuli wa kiuchumi haziathiri uwepo wa usonji.<ref>{{vcite journal |author=Bertoglio K, Hendren RL |title=New developments in autism |journal=Psychiatr Clin North Am |volume=32 |issue=1 |pages=1–14 |year=2009 |pmid=19248913 |doi=10.1016/j.psc.2008.10.004 }}</ref>

Hali nyingine kadhaa ni ya kawaida kwa watoto walio na usonji.<ref name="Levy"></ref> Hizi ni pamoja na:
*'''Matatizo ya Kijenetiki.'''  Takribani 10-15% ya matukio ya usonji yana hali ya Mendeli (jeni moja) inayoweza kutambulika, ulemavu wa kromosomu, au dalili nyingine za kijenetiki,<ref>{{vcite journal |author=Folstein SE, Rosen-Sheidley B |title=Genetics of autism: complex aetiology for a heterogeneous disorder |journal=Nat Rev Genet |year=2001 |volume=2 |issue=12 |pages=943–55 |doi=10.1038/35103559 |pmid=11733747 }}</ref> na ASD inahusishwa na matatizo kadhaa ya kijenetiki.<ref>{{vcite journal |journal=Brain Dev |year=2007 |volume=29 |issue=5 |pages=257–72 |title=Childhood autism and associated comorbidities |author=Zafeiriou DI, Ververi A, Vargiami E |doi=10.1016/j.braindev.2006.09.003 |pmid=17084999 }}</ref>
*'''Akili taahira.'''  Kiwango cha watu watu walio na usonji ambao pia wanatimiza  vigezo vya akili taahira kimeripotiwa kuwa popote kati ya  25%-70%, utofauti mkubwa unaashiria ugumu wa kutathmini akili ya walio na usonji.<ref>{{vcite book |chapter=Learning in autism |author=Dawson M, Mottron L, Gernsbacher MA |title=Learning and Memory: A Comprehensive Reference |volume=2 |pages=759–72 |editor=Byrne JH, editor-in-chief, Roediger HL 3rd, volume editor |publisher=Academic Press |year=2008 |doi=10.1016/B978-012370509-9.00152-2 |isbn=0-12-370504-5 |chapterurl=http://psych.wisc.edu/lang/pdf/Dawson_AutisticLearning.pdf |chapterformat=PDF |=https://web.archive.org/web/20120303191513/http://psych.wisc.edu/lang/pdf/Dawson_AutisticLearning.pdf }} {{Cite web |url=http://psych.wisc.edu/lang/pdf/Dawson_AutisticLearning.pdf |title=Nakala iliyohifadhiwa |accessdate=2010-10-18 |archivedate=2012-03-03 |archiveurl=https://web.archive.org/web/20120303191513/http://psych.wisc.edu/lang/pdf/Dawson_AutisticLearning.pdf }}</ref> Kwa maradhi mengie ya ASD mbali na usonji, uhusiano na akili taahira ni dhaifu sana.<ref>{{vcite journal |author=Chakrabarti S, Fombonne E |title=Pervasive developmental disorders in preschool children |journal=JAMA |year=2001 |volume=285 |issue=24 |pages=3093–9 |pmid=11427137 |url=http://jama.ama-assn.org/cgi/content/full/285/24/3093 |doi=10.1001/jama.285.24.3093 }}</ref>
*'''Matatizo ya wasiwasi s'''  ni ya kawaida miongoni mwa watoto walio na ASD, hakuna takwimu imara, lakini uchunguzi umeripoti ueneze wa kuanzia 11% hadi 84%. Matatizo mengi ya wasiwasi yana dalili yanayoelezeka vyema kwa ASD yenyewe, au ni vigumu kutofautisha na za dalili ASD.<ref>{{vcite journal |author=White SW, Oswald D, Ollendick T, Scahill L |title=Anxiety in children and adolescents with autism spectrum disorders |journal=Clin Psychol Rev |volume=29 |issue=3 |pages=216–29 |year=2009 |pmid=19223098 |doi=10.1016/j.cpr.2009.01.003 |pmc=<!-- 2692135 embargoed until 2010-04-01 --> }}</ref>
*'''Kifafa,'''  kukiwa na tofauti katika uwezekano wa  kupata kifafa kutegemea umri, kiwango cha utambuzi, na aina ya tatizo la lugha.<ref>{{vcite journal |journal=Pediatr Res |year=2009 |volume=65 |issue=6 |pages=599–606 |title=The role of epilepsy and epileptiform EEGs in autism spectrum disorders |author=Spence SJ, Schneider MT |doi=10.1203/PDR.0b013e31819e7168 |pmid=19454962 |pmc=<!-- 2692092 embargoed until 2010-06-01 --> }}</ref>
*'''Ulemavu kadhaa wa  kimetaboli,'''  Kama vile feniliketonuria, unahusishwa na dalili za kiusonji.<ref name="Manzi">{{vcite journal |journal=J Child Neurol |year=2008 |volume=23 |issue=3 |pages=307–14 |title=Autism and metabolic diseases |author=Manzi B, Loizzo AL, Giana G, Curatolo P |doi=10.1177/0883073807308698 |pmid=18079313 }}</ref>
*'''Ulemavu mdogo wa'''  '''kimwili'''  huongezeka kwa kiasi kikubwa miongoni mwa walio na usonji.<ref>{{vcite journal |journal=Mol Psychiatry |year=2010 |volume=15 |issue=3 |pages=300–7 |title=Minor physical anomalies in autism: a meta-analysis |author=Ozgen HM, Hop JW, Hox JJ, Beemer FA, van Engeland H |doi=10.1038/mp.2008.75 |pmid=18626481 }}</ref>
*'''Uaguzi wa mbelembele.'''  Ingawa sheria ya DSM-IV inafutilia mbali uaguzi wa pamoja wa hali nyingine nyingi pamoja na usonji, kigezo kamili cha ADHD, ugonjwa wa Tourette, na hali nyingine kama hizi mara nyingi huwa zipo na uaguzi wa pamoja unazidi kukubalika.<ref>{{vcite journal |journal=Eur J Pediatr |year=2008 |title=What's new in autism? |title.= |author=Steyaert JG, De La Marche W |doi=10.1007/s00431-008-0764-4 |pmid=18597114 |volume=167 |issue=10 |pages=1091–101 }}</ref>
*'''Matatizo ya usingizi '''  huathiri takribani thuluthi mbili ya watu walio na ASD wakati fulani katika utoto. Kwa kawaida haya huwa ni pamoja na dalili za Kukosa usingizi kama vile matatizo ya kupata usingizi, kuamka usiku, na kupoteza usingizi mapema asubuhi. Matatizo ya usingizi yanayohusishwa na tabia zisizo za kawaida na msongo wa kifamilia, na mara nyingi huangaziwa katika matibabu mbali na uaguzi wa kimsingi wa ASD.<ref>{{vcite journal |author=Richdale AL, Schreck KA |title=Sleep problems in autism spectrum disorders: prevalence, nature, & possible biopsychosocial aetiologies |journal=Sleep Med Rev |volume=13 |issue=6 |pages=403–11 |year=2009 |pmid=19398354 |doi=10.1016/j.smrv.2009.02.003 }}</ref>

==Historia==
Mifano michache ya dalili za usonji na matibabu yalifafanuliwa kitambo kabla ya usonji kutajwa. Kitabu cha ''Table Talk''  cha [[Martin Luther]] kina hadithi ya mvulana wa umri wa miaka 12 ambaye yawezekana alikuwa usonji shadidi.<ref>{{vcite journal |journal=Autism |volume=1 |issue=1 |pages=13–23 |year=1997 |doi=10.1177/1362361397011004 |title=The history of ideas on autism: legends, myths and reality |author=[[Lorna Wing|Wing L]]}}</ref> Kwa mujibu wa katibu wa Luther, Mathesius, Luther alidhani mvulana huyo alikuwa pande la mtu aliye na roho ngumu aliyepagawa shetani, na akashauri kwamba asongwe pumzi.<ref>{{vcite web |author=Miles M |year=2005 |title=Martin Luther and childhood disability in 16th century Germany: what did he write? what did he say? |title.= |publisher=Independent Living Institute |url=http://www.independentliving.org/docs7/miles2005b.html |accessdate=2008-12-23 }}</ref> Kumbukumbu nzuri ya awali ya tukio la usonji ni ile ya Hugh Blair wa Borgue, kama inavyoelezwa katika kesi ya mahakama ya 1747 ambapo ndugu yake kwa ufanisi alibatilisha ndoa ya Blair ili kupata urithi wa Blair.<ref>{{vcite book |author=Houston R, Frith U |title=Autism in History: The Case of Hugh Blair of Borgue |year=2000 |publisher=Blackwell |isbn=0-631-22089-5 }}</ref> The Wild Boy of Aveyron, mtoto mwitu aliyekamatwa mwaka wa 1798, alionyesha ishara kadhaa za usonji; mwanafunzi wa fani ya kimatibabu Jean Itard alimtibu kwa kutumia mipangilio ya kitabia iliyoundwa kumsaidia kuwa na utangamano wa kijamii na kuchochea uzungumzaji kwa njia ya kuiga.<ref name="Wolff">{{vcite journal |journal=Eur Child Adolesc Psychiatry |year=2004 |volume=13 |issue=4 |pages=201–8 |title=The history of autism |author=Wolff S |doi=10.1007/s00787-004-0363-5 |pmid=15365889 }}</ref>

Neno la Kilatini Kipya ''autismus'' (Tafsiri ya Kiingereza ''Autism)'' liliasisiwa na mtaalamu wa magonjwa ya akili wa Kiswizi Eugen Bleuler mwaka wa 1910 alipokuwa akifafanua dalili za skizofrenia. Aliunyumbua kutoka neno la Kigiriki ''autós''  (αὐτός, maana yake ''-mwenyewe),''  na kulitumia kumaanisha uvutiwaji wa kibinafsi usio mwema, akimaanisha "kujitenga kwa mgonjwa wa usonji na kuwa katika kaputi zake mwenyewe,  ambapo ushawishi mwingine kutoka nje unakuwa ni usumbufu usiovumilika".<ref>[431] ^ {{vcite journal |author=Kuhn R; tr. Cahn CH |title=Eugen Bleuler's concepts of psychopathology |journal=Hist Psychiatry |volume=15 |issue=3 |year=2004 |pages=361–6 |doi=10.1177/0957154X04044603 |pmid=15386868 }} nukuu ni tafsiri ya halisi ya kitabu cha Bleuler cha 1910.</ref>
[[File:Leo-Kanner.jpeg|thumb|upright|alt=Head and shoulders of a man in his early 60s in coat and tie, facing slightly to his right. He is balding and has a serious but slightly smiling expression.|Leo Kanner ilianzisha kauli early infantile Autism katika 1943.]]

Neno ''Autism''  kwa mara ya kwanza lilichukua maana yake ya kisasa mwaka wa 1938 wakati Hans Asperger wa Chuo Kikuu cha Vienna Hospital alipochukua istilahi ya Bleuler ''autistic psychopaths''  katika mhadhara nchini Ujerumani kuhusu saikolojia ya watoto.<ref>{{vcite journal |journal=Wien Klin Wochenschr |year=1938 |volume=51 |pages=1314–7 |trans_title=The psychically abnormal child |author=[[Hans Asperger|Asperger H]] |language=German }}</ref> Asperger alikuwa akichunguzi aina ya ASD ambayo sasa inajulikana kama dalili za Aspaja, japo kwa sababu mbalimbali haikutambuliwa kuwa uaguzi tofauti hadi 1981.<ref name="Wolff"></ref> Leo Kanner wa John Hopkins Hospital kwa mara ya kwanza alitumia ''Autism''  katika maana yeke ya kisasa katika Kiingereza wakati alipoanzisha kauli '' infantile Autism''  katika ripoti ya 1943 ya watoto 11 waliokuwa na tabia zinazofanana sana.<ref name="Kanner1943">[437] ^ {{vcite journal |author=[[Leo Kanner|Kanner L]] |title=Autistic disturbances of affective contact |journal=Nerv Child |volume=2 |pages=217–50 |year=1943 }} Imechapishwa tena katika {{vcite journal |year=1968 |journal=Acta Paedopsychiatr |volume=35 |issue=4 |pages=100–36 |pmid=4880460 |author=<!-- Pacify Citation bot. --> |title=<!-- Pacify Citation bot. --> }}</ref> Takribani sifa zote zilivyoelezewa katika maandiko ya kwanza ya Kanner kuhusu, hasa "upweke wa kiusonji" na "matukio ya kutobadilika" bado yanachukuliwa kuwa matatizo ya wigo wa usonji.<ref name="HappeTime"></ref> Haijulikani ikiwa Kanner alibuni neno hilo bila kutegemea mtazamo wa Asperger.<ref name="Lyons">{{vcite journal |journal=J Autism Dev Disord |year=2007 |volume=37 |issue=10 |pages=2022–3 |title=Asperger (1906–1980) and Kanner (1894–1981), the two pioneers of autism |author=Lyons V, Fitzgerald M |doi=10.1007/s10803-007-0383-3 |pmid=17922179 }}</ref>

Utumizi upya wa Kanner wa ''Autism''  ulisababisha miongo kadhaa ya kuchanganyikiwa kiistilahi kama vile ''skizofrenia ya utotoni,''  na mkazo wa wataalamu wa akili za watoto kuhusu mapungufu ya ulezi wa mama yalipelekea uelewa mbaya wa usonji jisni mtoto alivyoitikia akina "mama majokofu ". Kuanzia mwishoni mwa miaka ya 1960 usonji ilitengwa kuwa ugonjwa tofauti kwa kudhihirisha kuwa ni tatizo la maisha yote, na kuutofautisha na taahira ya akili na skizofrenia na tofauti na matatizo mengine ya ukuaji, na kuonyesha faida ya kuwashirikisha wazazi katika mipango kakamavu ya matibabu.<ref>{{vcite journal |journal=Can J Psychiatry |year=2003 |volume=48 |issue=8 |pages=503–5 |title=Modern views of autism |author=Fombonne E |pmid=14574825 |url=http://ww1.cpa-apc.org:8080/Publications/Archives/CJP/2003/september/guesteditorial.asp }}</ref> Hata katikati ya miaka ya 1970 kulikuwa na ushahidi mdogo wa wa athari ya kijenetiki katika usonji, sasa inadhaniwa kuwa mmoja ya matatizo ya akili inayoweza kurithika.<ref>{{vcite book |chapter=Genetic epidemiology of autism spectrum disorders |author=[[Peter Szatmari|Szatmari P]], Jones MB |pages=157–78 |title=Autism and Pervasive Developmental Disorders |edition=2nd |editor=Volkmar FR |publisher=Cambridge University Press |year=2007 |isbn=0521549574 }}</ref> Ingawa kuchipuka kwa mashirika ya wazazi na kutonyanyapaliwa kwa ASD ya utotoni yameathiri pakubwa jinsi tunavyoichukulia ASD,<ref name="Wolff"></ref> wazazi wanaendelea kuhisi unyanyapaa wa kijamii katika hali ambapo tabia za watoto wao wenye usonji yanachukuliwa vibaya na wengine,<ref>{{vcite journal |journal=J Autism Dev Disord |year=2008 |title=Adult attitudes toward behaviors of a six-year-old boy with autism |author=Chambres P, Auxiette C, Vansingle C, Gil S |doi=10.1007/s10803-007-0519-5 |pmid=18297387 |volume=38 |issue=7 |pages=1320–7 }}</ref> na wengi wa madaktari wa huduma za msingi na madaktari bingwa bado huonyesha baadhi huzingati amani inayooana na utafiti wa zamani kuhusu usonji.<ref>{{vcite journal |journal=J Autism Dev Disord |year=2005 |volume=35 |issue=3 |pages=323–30 |title=A survey of autism knowledge in a health care setting |author=Heidgerken AD, Geffken G, Modi A, Frakey L |doi=10.1007/s10803-005-3298-x |pmid=16119473 }}</ref> [[Intaneti|Mtandao]] imewasaidia watu wenye usonji kusambaziana jumbe zisizo za mazungumzo na kubadilishana hisia ambazo wao hupata ugumu kukabiliana nazo, na imewapa njia ya kuunda jamii za tovuti na kazi kutoka mbali.<ref>{{vcite journal |author=Biever C |title=Web removes social barriers for those with autism |journal=New Sci |issue=2610 |pages=26–7 |date=2007 |url=http://www.newscientist.com/article/mg19426106.100 }}</ref> Mielekeo ya kijamii na kidesturi ya usonji imesitawi: wengine katika jamii hutafuta tiba, huku wengine wakiaamini kwamba usonji ni njia nyingine tu ya maisha.<ref name="Silverman">{{vcite journal |journal=Biosocieties |year=2008 |volume=3 |issue=3 |pages=325–41 |title=Fieldwork on another planet: social science perspectives on the autism spectrum |author=Silverman C |doi=10.1017/S1745855208006236 }}</ref><ref>{{vcite news |author=Harmon A |title=How about not 'curing' us, some autistics are pleading |date=2004-12-20 |work=New York Times |url=http://www.nytimes.com/2004/12/20/health/20autism.html }}</ref>

==Marejeo==
{{reflist|colwidth=30em}}

== Viungo vya nje ==
{{Commonscat|Autism}}
* {{dmoz|Health/Mental_Health/Disorders/Neurodevelopmental/Autism_Spectrum}}
* [http://www.nichcy.org/resources/autism.asp National Dissemination Center for Children with Disabilities] {{Wayback|url=http://www.nichcy.org/resources/autism.asp |date=20080704175524 }}

[[Jamii:Saikolojia]]
[[Jamii:Magonjwa]]
[[Jamii:Ulemavu]]
[[Category:Mawasiliano]]
[[Category:Neva]]