Autism, disorder that severely impairs development of a person's ability to communicate, interact with other people, and maintain normal contact with the outside world. The disorder was first described in 1943 by American psychiatrist Leo Kanner. One of the most common developmental disabilities, autism affects 2 to 5 out of every 10,000 children and appears before the age of three. It is four to five times more common in males than in females.

Most autistic children are perfectly normal in appearance, but spend their time engaged in puzzling and disturbing behaviors which are markedly different from those of normal children. They may stare into space for hours, throw uncontrollable tantrums, show no interest in people (including their parents) and pursue strange, repetitive activities with no apparent purpose. They have been described as living in a world of their own. Some autistic individuals are remarkably gifted in certain areas such as music or mathematics, as depicted in the film Rain Man.

Causes for Austism.

Scientists once regarded autism as a psychological disorder caused by traumatic experiences that forced a child to retreat into a world of fantasy. Some theorized that parents caused autism by unconsciously rejecting a child, or by failing to bond emotionally. These theories caused enormous guilt in parents and lacked any scientific validity. Scientists today still do not know what causes autism, but they have discredited and rejected theories about a parental cause.

Evidence indicates that autism results from biological abnormalities in brain structure and function. Studies have found that autistic people have abnormally low blood flow to certain parts of the brain and reduced numbers of certain brain cells. These studies suggest that mutations in genes are important in causing autism. Studies of families also support this possibility. For example, families with one autistic child are more likely to have a second autistic child. Other studies have linked some cases of autism with prenatal exposure to the rubella virus (see German Measles) and lack of oxygen during birth.

Another theory sees autism mainly as a problem of cognition. In this view, autism results from an inability to think in ways necessary for normal communication, sharing of experiences, and expression of emotions. Supporters argue that autistic people lack "a theory of the mind"—that is, they do not realize that other people have feelings, beliefs, needs, and an inner life. Without this conception of the minds of others, autistic people cannot predict or interpret the behavior of others and have severe problems in social interaction. Many experts criticize this theory, noting that autism appears at an early age when no children have a conception of the minds of others.

The Numbers

For many years autism occured in about 5 children per 10,000 live births. However, since the early 1990's, the rate of autism has increased enormously throughout the world, so that figures as high as 60 per 10,000 are being reported. The reasons for the increase are being debated, but the most likely cause appears to be the over vaccinations of infants.

Cure

There is no cure for autism. But treatment may reduce symptoms and help people with autism function better. Experts disagree over the effectiveness of different treatments. Many treatments seemed promising when first introduced, but later proved disappointing. Because individuals respond in different ways, no single treatment works for everyone. Treatments include behavior modification, medication, facilitated communication, vitamin and mineral supplements, auditory training, and vision therapy.

Behavior modification involves analyzing the cause of an undesirable behavior, then using rewards and punishments or other approaches to replace the behavior with a more appropriate response. For instance, children who spin or flap their arms because of anxiety about a situation can be taught to say "stop" or point to a symbol for "stop." Parents often collaborate with therapists in providing behavior therapy. Very intensive behavior programs, modeled on the teaching methods of American psychologist O. Ivar Lovaas, have yielded some of the best results. In such programs parents may provide therapy at home seven days a week for several years.

Physicians sometimes prescribe antipsychotic drugs, beta-blockers, anticonvulsants, and other medications to reduce self-abusive behavior, such as head banging and wrist biting. Some individuals with autism benefit from drugs that increase levels of serotonin, a brain chemical. These medications, which include fenfluramine (Pondimin), fluvoxamine (Luvox), and clomipramine (Anafranil), may reduce compulsive behavior and body movements. Other drugs that improve symptoms in some patients include naltrexone (ReVia), which blocks the action of natural opiate-like compounds in the brain, and haloperidol (Haldol), which interferes with the function of the neurotransmitter dopamine.

Facilitated communication is based on the idea that people with autism are unable to communicate because of impaired body coordination. In this technique, a trained professional, or facilitator, supports the person's hand over an alphanumeric keyboard. The person with autism learns to type messages and responses to questions. Critics maintain that the facilitator, rather than the person with autism, is the true source of the messages.

Other treatments for autism include supplements of vitamin B6 and magnesium; auditory training for individuals who are hypersensitive to certain frequencies of sound; and vision training to correct eyesight problems.