Autism is a brain disorder that affects a person's ability to communicate and interact socially. Autism and related disorders usually appear before age 3 and persist throughout life, though many children show some improvement as they get older, especially with treatment.

Some people with autism are mildly affected, and are able to go to school, live independently, hold down a job and have families of their own. Others are severely affected by autism, and may need constant lifetime care. Most people with autism fall somewhere between these two extremes.

Autism is one type of developmental disability in the category of "autism spectrum disorders" (ASDs). Related ASDs are Asperger's syndrome, Rett's syndrome and pervasive developmental disabilities.

Autism is four times more likely to occur in boys than it is in girls.

The Centers for Disease Control reports that autism and ASDs occur in between two and six out of every 1,000 children. More children than ever before are being diagnosed with autism and ASDs. There is much debate about whether this increase is because of better diagnosis of these problems, or whether there are environmental or other factors causing the increase.

The cause of autism is unknown; scientists are studying genetic, metabolic and environmental causes. It is generally believed that autism results from abnormal brain structure or function; it is certainly not caused by poor parenting.

Autistic children and adults have problems interacting socially with others. Their communication skills - both verbal and nonverbal - are limited; they have difficulty expressing their needs and feelings.

About 40 percent of autistic children do not talk at all. Many autistic children will repeat the words or phrases they hear instead of replying to them.

People with autism may exhibit repetitive behaviors, such as rocking back and forth or spinning objects. Some develop obsessive interests in specific subjects.

Autistic children may have difficulty making eye contact, may seem deaf and seem to prefer to be alone. Most are resistant to change and require a consistent environment and routine. They may react unusually strongly to certain sounds, smells and touch.

Parents are usually the first to notice signs of autism in their children, often as early as 18 months of age. However, a formal diagnosis may not be made for years after this. This is unfortunate, since this means a missed opportunity for early intervention and treatment.

Parents and caregivers should watch for these milestones of normal development, according to the American Academy of Neurology:

• babbling by 12 months,

• gesturing (pointing, waving bye-bye) by 12 months,

• saying single words by 16 months,

• spontaneously saying two-word phrases by 24 months (not just imitating others).

The failure to meet any of these milestones - or the loss of language or social skills at any time - is a red flag.

What should you do if you suspect your child has autism? First, see your child's pediatrician or health care provider. Share your observations and concerns. Any child with developmental delays should have a formal hearing test done by an audiologist; some may need a blood test for lead. There are several screening tests for autism that most health care providers can perform. If a screening test indicates a possible autism diagnosis, a more formal evaluation by an experienced child development specialist is warranted.

It was once believed that there is no treatment for autism, but now it is known that early intervention and education can be very helpful.

Speech and language therapy can help children with autism learn to communicate, either verbally or with sign language, typing or pointing to pictures on a board. Behavioral intervention, which involves an intensive structured teaching of skills, has proven effectiveness, especially if started as early as possible.

Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send ideas to kbbrown@eastoregonian.com. You can find more local health news and information in the Health section at www.dailyastorian.info

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