Rare de novo single nucleotide variants in brain-expressed genes are found to be associated with autism spectrum disorders and to carry large effects. Although it is well accepted that genetics makes a strong contribution to autism spectrum disorder, most of the underlying causes of the condition remain unknown. Three groups present large-scale exome-sequencing studies of individuals with sporadic autism spectrum disorder, including many parent–child trios and unaffected siblings. The overall message from the three papers is that there is extreme locus heterogeneity among autistic individuals, with hundreds of genes involved in the condition, and with no single gene contributing to more than a small fraction of cases. Sanders et al. report the association of the gene SCN2A, previously identified in epilepsy syndromes, with the risk of autism. Neale et al. find strong evidence that CHD8 and KATNAL2 are autism risk factors. O'Roak et al. observe that a large proportion of the mutated proteins have crucial roles in fundamental developmental pathways, including β-catenin and p53 signalling. Multiple studies have confirmed the contribution of rare de novo copy number variations to the risk for autism spectrum disorders1,2,3. But whereas de novo single nucleotide variants have been identified in affected individuals4, their contribution to risk has yet to be clarified. Specifically, the frequency and distribution of these mutations have not been well characterized in matched unaffected controls, and such data are vital to the interpretation of de novo coding mutations observed in probands. Here we show, using whole-exome sequencing of 928 individuals, including 200 phenotypically discordant sibling pairs, that highly disruptive (nonsense and splice-site) de novo mutations in brain-expressed genes are associated with autism spectrum disorders and carry large effects. On the basis of mutation rates in unaffected individuals, we demonstrate that multiple independent de novo single nucleotide variants in the same gene among unrelated probands reliably identifies risk alleles, providing a clear path forward for gene discovery. Among a total of 279 identified de novo coding mutations, there is a single instance in probands, and none in siblings, in which two independent nonsense variants disrupt the same gene, SCN2A (sodium channel, voltage-gated, type II, α subunit), a result that is highly unlikely by chance.

De novo mutations revealed by whole-exome sequencing are strongly associated with autism