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| |    What Is Autism? by Robert Needlman, M.D., F.A.A.P. reviewed by Robert Needlman, M.D., F.A.A.P. Not many years ago, autism was considered a hopeless diagnosis. It called to mind the image of a child cut off from all social contact, rocking hour after hour or staring at his hands. Many professionals believed that autism was caused by cold, unemotional mothering, a belief that only added to the parents' shame, confusion, and grief. Fortunately, things have changed. We now know that autism is due to abnormal development of the brain, not abnormal parenting, and that it's symptoms improve greatly with treatment. With early and intensive interventions, many children with autism can learn to communicate and function independently to some degree. Main features of autism Children with autism have problems in three main areas: communication, relationships, and behavior. Although healthy children sometimes have difficulties in one or another of these areas of development (for example, talking later than usual, or showing repetitive behaviors), it is the overall pattern or problems that constitutes autism. Here are some examples: Communication. Children with autism may not babble at the expected time (around 6 to 12 months), and often are late to say words. If they do speak, they tend to repeat words meaninglessly and have great difficulty carrying on a back-and-forth conversation. They often invent terms, point to things they want, and show limited interest in responding to questions. They also have problems with non-verbal communication. These children don't use eye contact to show that they are listening, or point to things to show that they find them interesting. Relationships. Infants with autism may not cuddle normally or reach out to be picked up; some are upset by tickle games such as "sooo big" that most babies find delightful. Children with autism often ignore peers. Or they might interact in unwanted ways because they can't read the social cues that mean "I'm ready to play now" or "leave me alone." They may walk past familiar adults as if they were not there, or rush over for a hug to someone they have never seen before. Many are affectionate with their parents, but often in odd ways. One child, for example, may insist on fondling his mother's ears. Another child backs into his mother when he wants a hug. Behaviors. Children with autism often become fascinated by one or two behaviors which they repeat time and time again. One child lines up toy cars in the same order, or perpetually flicks the lights off and on. Another child puts a tape into the VCR and takes it out again, for hours at a time. Any attempt to change the routine brings on an overwhelming tantrum. Spinning objects often seem to hold a special fascination. Children with autism often spin their own bodies, flap or twist their hands, or rock back and forth repetitively. They often react unexpectedly to sounds, odors, or touch. For example, many love the feeling of being held tightly, but hate being touched lightly. The range of autistic problems Experts recognize that there is a spectrum of autistic disorders, ranging from mild to very severe. Children with milder forms may use words correctly, but struggle with the finer points of social language use (for example, the intonation of their speech is wrong; they may articulate words exceptionally clearly, sounding like little professors, and they often find it very hard to make pleasant, light conversation). Other children may think of them as "strange," a very painful condition for any child. At the more severe end, autism that occurs along with mental retardation, hearing problems, or persistent seizures can be especially disabling. Other articles in this section look more closely at how autism is diagnosed, the different varieties of autism, and the treatments that can help children and families cope with these disorders.
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