About four in 10,000 children suffer from autism, and it is about four times more common in boys than in girls. No one knows for sure what causes this disorder, but experts have several theories. Genetics may play a role. Eighty percent of identical twins and 20 percent of fraternal twins show a similar state. Brain injury and other speculative reasons have been proposed as a basis for autism. There is also evidence that relatives of autistic children tend to also have problems in language and communication, but that these problems are less severe than in the autistic child. And still other theories suggest that the disorder is somehow linked to higher than normal levels of the brain chemical serotonin.

Several decades ago many "experts" incorrectly blamed parents for causing autism in their children. Now we know better. Parents of autistic children did not create their child's problem; in fact, most parents are the child's greatest helpers and advocates.

What to look for

Children who suffer from autism begin to have symptoms before they are 2½ years old. They are withdrawn, like to play alone and have difficulty playing with others. They have problems in using language, so their ability to speak may be delayed or may never develop at all. When autistic children interact with others, there is usually no normal eye-to-eye contact, no normal "give-and-take" in play or conversation, and no spontaneous desire to share or to get others interested in what they are doing. They also have trouble pretending and playing games that use their imagination.

Some autistic children spend long parts of their day repeating the same movement or routine over and over.

About 70 percent of autistic children also have signs of mental retardation.

What to do

Any child with symptoms of autism needs to be seen by a medical specialist, usually a neurologist or psychiatrist who has experience in treating children. Since some of the symptoms of autism may also be found in other types of medical problems, your doctor will need to rule out these other problems before making a definite diagnosis of autism.

Your child will have a thorough physical examination, along with vision and hearing tests, possibly a brain scan, and an EEG (an electroencephalogram, a painless recording of brain wave patterns). Your doctor may also order genetic testing, blood tests to rule out metabolic problems (problems with the way your child's body processes nutrients and other body chemicals), and blood tests to check for lead poisoning.

If it is confirmed that your child suffers from autism, her treatment may include several different types of therapy such as:

• Behavior therapy, which can help your child to learn new ways of acting when she is with others, and can help her learn to control behaviors that are causing problems.
• Educational therapy, in a very structured school setting, which can help your child to communicate better and to learn social skills.
• Medical therapy with certain types of medicines, including haloperidol and antidepressants, which has helped many children to function better.

Call your doctor if...

Your child is withdrawn and has problems communicating or interacting with others. This is especially important if your child has never learned to speak, or her speech was delayed. Also call your doctor if you notice that your child always wants to play alone, or that she cannot play happily with other children with the usual eye contact, "give-and-take" sharing and pretending that are normally seen among children at play.

Last updated December 17, 1996
Johns Hopkins University
Used with the permission of the copyright owner. All rights reserved.

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