Autism is a developmental disorder of the brain. People with autism have problems communicating and interacting socially with other people. They also may have unusual patterns of behavior, interests and activities.

There are five kinds of autism, which is why doctors use the term autism spectrum disorder. The three main types of autism include:

• Classic autism
• Asperger's syndrome � A milder form
• Nonspecific pervasive developmental disorder (PDD-NOS) � Used to describe a group of children who don't quite fit the criteria for the other types

There are also two rare autism disorders:

• Rett syndrome � A neurodevelopmental disorder that affects mostly girls. It includes problems with movement and speech, along with autistic features
• Childhood disintegrative disorder � A severe type in which the child loses more physical, language and social skills than in classic autism

Signs of autism spectrum disorder are typically first seen in toddlers before a child's third birthday, but only half the children with it are diagnosed before kindergarten. Rett syndrome appears to be caused by a genetic mutation. The causes of the other types of autism remain a mystery despite many studies. Some studies suggest that other forms of autism may be inherited (genetic), while other evidence points to infection or the effects of an environmental toxin (poison). Some doctors believe autism may result from a brain injury or brain abnormality that occurs during development in the womb or in early infancy. Others have reported evidence that the disorder is a result of abnormal levels of chemicals called neurotransmitters, such as dopamine and serotonin, which send messages between cells in the brain and nerves.

Autism spectrum disorder affects about 6 out of 1,000 children, from all racial, ethnic and social backgrounds, according to the Autism Society of America. All the types except Rett syndrome are three to four times more common in boys than in girls.

At birth, a child with autism spectrum disorder often appears normal. Symptoms may appear as early as the first year of life, but it may not be until the child is 2 or 3 years old that the parents realize something is not quite right.

Infants with autism spectrum disorder may respond abnormally to being touched. Instead of cuddling when they are picked up, they may stiffen or go limp. In addition, they may not show normal developmental behaviors during the first year of life, such as smiling at the sound of their mother's voice, pointing out objects to catch someone's attention, reaching out to others with their hands or attempting one-syllable conversations. The child may not maintain eye contact, may appear unable to distinguish parents from strangers and typically shows little interest in others. Symptoms vary from mild to severe.

Some behaviors associated with autism include:

• Disordered play � A toddler with autism spectrum disorder usually ignores other children and prefers to play alone. The child may spend hours repeatedly laying out objects in lines, sitting silently in an apparent trance-like state or concentrating on only one object or topic. Any attempt to divert the child can provoke an emotional outburst. Children with autism spectrum disorder usually do not engage in make-believe play.



• Disordered speech � A child with autism spectrum disorder may not speak much or may remain silent. When the child does speak, the words may be an echo of what another person said. Speech patterns may be different. Instead of saying, "I want a sandwich," the child may ask, "Do you want a sandwich?"



• Repetitive behaviors � A child with autism spectrum disorder may perform repetitive behaviors, such as repeating the same phrase or a particular motion. Clapping, finger snapping, rocking, swaying and hand flapping are common.



• Abnormal behaviors � Children with autism spectrum disorder may develop obsessive routines, such as wanting to take the same route to school every day or turning around before entering a room, or may become intensely preoccupied with something, such as parts of objects or a particular activity. Some may become hyperactive, aggressive, destructive or impulsive. Others may intentionally injure themselves.

The diagnosis is based on your child's developmental history over time, observations of your child's behavior (alone and with others) and the results of tests that evaluate your child's language skills, motor coordination, hearing and vision. In some cases, tests will be ordered to check for other medical conditions that can sometimes look like autism, such as fragile X syndrome.

Autism spectrum disorder is a lifelong condition.

Because the causes of most types of autism spectrum disorder remain unknown, there is no way to prevent them.

While there is no cure for autism spectrum disorder, a child's symptoms may improve with intense treatment that generally includes:

• Education � Educators develop an individualized education program to address the child's specific problems. This typically includes speech and language therapy, and also may include social skills and life-skills training.



• Behavioral management � Behavior modification strategies include positive reinforcement (rewarding "good" behavior), "time out" and comprehensive behavioral interventions. The goal is to enhance appropriate behavior and reduce inappropriate behaviors, such as self-inflicted injuries.



• Medications � There is not one drug that treats all symptoms of autism effectively. In some children, antipsychotic medications � for example, thioridazine (Mellaril), risperidone (Risperdal) and olanzapine (Zyprexa, Zydis) � may reduce some symptoms associated with autism, such as aggression, irritability and repetitive behavior. However, these medications also have unwanted side effects. Antidepressants such as fluoxetine (Prozac) and clomipramine (Anafranil) may treat depression and repetitive (obsessive-compulsive) behaviors. Antianxiety medications such as lorazepam (Ativan) may be used for anxiety-related behavior. Methylphenidate (Ritalin) may be used to treat hyperactive or impulsive behavior.

Some people believe that diet changes, herbal medicines, and other forms of complementary medicines can help autistic children. Researchers are studying these treatments, but as of now there isn't enough information to recommend them. Some of the treatments used can be dangerous or have side effects, so be sure to talk to your doctor about any treatment you may be considering.

Call your doctor if your toddler does not try to communicate with others, repeats words or certain actions over and over and over again, or does not seem to want to play with other children as you would expect. Call your doctor right away if your child tries to injure himself or herself.

The difficult behaviors seen in autistic toddlers tend to improve between ages 6 and 10. However, problems may resurface during the teen and young adult years, eventually calming down again in middle and later life. Some children with autism are able to live independently. Others may struggle to maintain normal social interactions, communication and behaviors.

Experts believe that the earlier a diagnosis of autism spectrum disorder is made and treatment begins, the prognosis might be better.

Life expectancy depends on whether the person has other conditions (such as epilepsy), as well as the person's overall general health.

Autism Society of America
7910 Woodmont Ave.
Suite 300
Bethesda, MD 20814-3067
Toll-Free: 1-800-328-8476
Phone: 301-657-0881
http://www.autism-society.org/