"From Autism to ESSENCE"
The 2019 Mary Coleman Lecture, titled ”From Autism to ESSENCE”, was given by senior professor Christopher Gillberg. Mary Coleman herself kicked things off, starting with a short historical exposé of the conceptualisation of autism and then stressing the critical importance of early detection and intervention in order to ensure optimal development for children with autism and the broad constellation of symptoms that the diagnosis entails.
Professor Gillberg took over from there, and began by talking about how much Mary Coleman has helped us understand the role of biology on autism. Both Gillberg and Coleman also pointed out that individuals with autism exhibit difficulties from “other” diagnostic domains like intellectual disability and language disorders. Gillberg then continued by describing how the term Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations (ESSENCE) was coined in 2010 based on a combination of clinical observations and the research of both himself and others. ESSENCE refers to the entire group of neurodevelopmental/neuropsychiatric disorders and includes ADHD with or without ODD, ASD, DCD, IDD, SLI or Tourette’s syndrome. Professor Gillberg gave a thorough rundown of how some of these disorders can manifest, and emphasized how crucial it is to identify the huge clinical variation of ESSENCE found across different individuals with autism, as this has major implications on treatment and also provides valuable prognostic information. He also highlighted the fact that girls with autism are often overlooked in clinical situations or misdiagnosed with e.g. depression, leaving their autism undetected. One of the lecture’s key messages was that the autism itself is rarely the cause of negative outcomes, but rather symptoms of whatever “other” conditions are present (which are often not only overlooked in clinical examinations but also highly treatable). Professor Gillberg also described how a number of “adult psychiatric” diagnoses might actually stem from autism spectrum disorders. He concluded the lecture by talking about the best ways to detect and assess ESSENCE, as well as current and future treatment methods.