Autism is a neurological and developmental disorder that usually appears during the first three years of life. The Centers for Disease Control and Prevention (CDC) has reported that about one in 110 eight-year-old children in six communities studied had an autism spectrum disorder, which includes autism, Asperger syndrome, and pervasive developmental disorder. Autism is more prevalent in boys than girls, with four times as many boys affected. Characteristics A child with autism appears to live in his or her own world, showing little social awareness or interest in others. Autistic children focus on a consistent routine and often repeat odd and peculiar behaviors. They tend to avoid eye contact and have problems communicating. Autism can prevent a child from forming relationships with others. This is due partly to an inability to interpret facial expressions or emotions. A child with autism may play alone, refuse to cuddle, resist change, and have delayed speech development. People with autism tend to repeat body movements (such as flapping hands or rocking) and have unusual attachments to objects. However, many people with autism excel consistently at certain mental tasks, such as counting, measuring, art, music, and memory. Cause The cause of autism isn’t known. Research suggests that autism is a genetic condition and that several genes are involved in its development. Studies in autism have found a variety of abnormalities in the brain structure and chemicals in the brain; however, there have been no consistent findings. One theory is that autistic disorder is a behavioral syndrome that includes several distinct conditions. However, parenting behaviors are not a contributing factor to autism, and preventive measures to reduce the incidence or severity of autistic disorders aren’t known at this time. Tests and Screenings Standard guidelines have been developed to help identify autism in children before the age of 24 months. Earlier diagnosis means earlier, more effective treatment for the disorder. The guidelines involve two levels of screening. Level one screening, which should be performed for all children at their well-child checkups during their first two years of life, should check for the following: No babbling, pointing, or gesturing by age 12 months No single words spoken by age 16 months No two-word, spontaneous expressions (non-echolalic, or not merely repeating the sounds of others) by age 24 months Loss of any language or social skills at any age No eye contact at 3 to 4 months The second level of screening should be performed if a child is identified in the first level of screening as developmentally delayed. The second level is a more in-depth diagnosis and evaluation that can differentiate autism from other developmental disorders. It may include neurological evaluation, genetic testing, metabolic testing, electrophysiologic testing (such as CT scan, MRI, PET scan), and psychological testing. Genetic testing is important because there are several genetic syndromes that may cause autism, including Fragile-X, untreated phenylketonuria (PKU), neurofibromatosis, tuberous sclerosis, and Rett syndrome, as well as a variety of chromosome abnormalities. If a genetic disorder is diagnosed, there may be other health problems involved. The chance for autism to occur in a future pregnancy depends on the syndrome found. Treatment Specialized behavioral and educational programs are designed to treat autism. Behavioral therapy is used to teach social, motor, and cognitive (thinking) skills. Behavior modification is also useful in reducing or eliminating maladaptive behaviors. Special education programs focus on developing social, speech, language, self-care, and job skills. Medication is also helpful in treating some symptoms of autism in some children. In addition, mental health professionals can provide parent counseling, social skills training, and individual therapy.