**1. Introduction**

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The terms Autism and ASD (Autism Spectrum Disorders) can be interchangeable in the clinical setting, and have been used to describe one of the most intriguing neurobehavioral syndromes, that include the so-called "triad of Wing": problems in communication, social skills, and restrict repertoire of interests. However, it is somewhat difficult to precisely define autism, because of the imprecise boundaries between different kinds of ASD as well as the fact that there is no biological marker to date (Gottfried and Riesgo 2011).

By definition, in autism the social deficits are characterized by lack of interest in spontaneously sharing feelings, different levels of communication deficits, difficulties in imaginative plays, restrictive repertoire of interests, non-functional routine fixations, as well as stereotypies and other motor alterations, such as flapping with hands, circular movements and others (Nikolov, Jonker, and Scahill 2006; Gadia, Tuchman, and Rotta 2004).

While the criteria of the DSM-V (Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition) are not yet published, we still have to use the "older version". According with the DSM–IV criteria, there are five clinical situations that could be encompassed by the term "PDD" (Pervasive Developmental Disorders) or "ASD" (Autism Spectrum Disorders) with the same meaning of PDD or autism (Association 2002).

Although it will change in the near future, the five current clinical ASD diagnosis admitted by DSM-IV-TR (Gadia et al., 2004) are: a) Autistic Disorder; b) Asperger Disorder (AD); c) Rett Disorder; d) Childhood Disintegrative Disorder; e) PDD-NOS (Pervasive Developmental Disorder – Not Otherwise Specified).

© 2013 Riesgo et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

According with DSM-IV-TR, and in agreement with previous epidemiological data, our group found that the most prevalent ASD is the PDD-NOS, followed by Autistic Disorder, and then by Asperger Disorder. Accordingly, the Rett Disorder and the Childhood Disintegrative Disorder for sure are less frequently seen in the clinical practice (Longo et al. 2009).

diagnosis confirmation, the best initial approach could be done by an interdisciplinary team

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Obviously, before initiating any kind of intervention, several steps must be done as follows. First of all, the final diagnosis must be confirmed by a careful anamnesis as well doublechecked using the DSM-IV criteria as well as a reliable clinical instrument such as Autism Diagnosis Interview-Revised (ADI-R) (Becker et al. 2012). The ADI-R is frequently used as a gold standard instrument for publication purposes, but it is problematic in the clinical practice for several reasons, such as it can miss same ASD cases as well as it need at least two hours to be completed. Then, the intensity of the ASD could be defined both from the clinical perspec‐ tive and by one instrument such as CARS (Pereira, Riesgo, and Wagner 2008). Another critical issue is to delimitate if there is any associated mental disability and its degree of intensity. As clinicians, we know the prognostic importance of an unaffected intelligence in ASD patients.

The second step includes the definition of the parent's doubts, fears, and degree of awareness. Usually, after diagnosis confirmation, parents became stressed. Not infrequently they go to internet in order to search every kind of available information regarding autism. Because some information coming from internet can be inaccurate, at this point, it is very important to clarify

The third step could be the delimitation of environmental variables that needs to be addressed, starting from the home and family. Neighborhood and school needs to be evaluated both in terms of potential stressors and also because they can facilitates choosing a given type of

The next step is done by the identification of the target behaviors needing treatment. After core symptoms definition in each case, the different professional specialties that need to be involved are selected. In general, the team includes a physician specialized in ASD patients as well as one speech therapist and others professionals arising from health care and/or education with

All professionals who treat children and adolescents, both coming from health care as well as from education must know how behaviors can normally change during the normal neuro‐ psychological development. In other words: there is an ontogenetic evolution on each one of

For example: in terms of gender versus behavior, usually hyperactivity is more prevalent in normal boys when compared with normal girls. The humor control, the language skills and the social competence usually improves in normally developed children as long as time passes. Usually, normal girls tend to improve faster their language skills and their social competence when compared with normal boys. This knowledge is crucial to identify how different

which are the evidence-based types of therapies to date.

**3. How ASD symptoms change during lifetime**

the behavioral manifestations in the normally developed children.

behavioral symptoms change during lifetime in ASD patients.

therapy on an individual basis.

experience in children with ASD.

including professionals coming from medicine, psychology and social sciences.

The increasing levels of prevalence in ASD probably is due to several reasons, such as the changes in diagnostic criteria, the high level of awareness, the underestimation of former data, the massive information exchange regarding ASD, the public strategies, etc. The first descrip‐ tion of autism was made by Hans Asperger, in 1938. In 1943, when Leo Kanner described a sample with 11 children, autism was a rare condition affecting not more than 4 in 10.000 children (Kanner 1943).

However, childhood autism is much more frequent and is identified in at least one in each 100 children nowadays. For instance, a recent paper describes prevalence of 2.6% of ASD in children aging from seven to twelve years of age (Kim et al. 2011).

Autism and ASD certainly have different kinds of approaches. These neurobehavioral syndromes can be addressed, for example, both from the clinical and from the experimental field. To our knowledge, at least in the academic environment, the best approach could be the translational type because it made us able to rapidly build a bridge between the experimental and the clinical field (Gottfried and Riesgo 2011).

Obviously, the earlier results usually came from the experimental research for several reasons. In general, the time spent in each one experiment can be shorter compared to clinical research; the environmental variables can be in part controlled, etc. By the other side, clinical research can be more time consuming and potentially more complicated to be performed. There is no doubt that both approaches are not mutually exclusive. Actually they are complementary.

Strictly speaking from the clinical perspective in autism, we can divide the clinical approach into two basic and complementary issues. The first one is the general management, including the confirmation of the correct diagnosis, the determination of the intensity of the compromise, and the evaluation of intensity level of eventual core behavioral symptoms. The last one encompasses several treatment options, which includes psychopharmacotherapy and differ‐ ent types of non-medical treatments.

As the first cases of autism were described in the early 40's, now we have adults with ASD. That is the reason to keep in mind how ASD symptoms usually change during lifetime. As time pass, different symptoms change differently and it is crucial to clinicians to know these differences.

In this context, the present chapter aimed to review (i) the general management of ASD from the clinical perspective; (ii) the lifetime changes in ASD symptoms; and (iii) the evidence-based treatment options.
