DEAR DOCTOR K:

I've read that early treatment of autism can make a big difference. But what are the early signs of autism?

DEAR READER:

You're right -- my colleagues who are experts in autism say that early recognition and treatment really can help.

Autism (also called autism spectrum disorder, or ASD) is a developmental disorder of the brain. Kids and adults with autism have problems communicating and interacting socially. They also may have unusual behavior patterns, interests and activities. Symptoms range from mild to severe. Autism symptoms are usually apparent by the time a child is 2 or 3 years old.

What should you look out for? Children with autism may not show signs of it during their first year. Those who do may not hit typical developmental milestones on schedule. For example, they may not smile at the sound of their mother's voice, point out objects to catch someone's attention or maintain eye contact. And they may respond negatively to being touched or cuddled.

Behaviors become more apparent in toddlers and young children. For example:

-- Disordered play. A toddler with autism usually prefers to play alone and is unlikely to engage in make-believe play. He or she may spend hours repeatedly laying out objects in lines or concentrating on one object or topic. Any attempt to divert the child can provoke an emotional outburst.

-- Disordered speech. A child with autism may not speak much or may remain silent. When the child does speak, the words may echo someone else's words. Speech patterns may be unusual.

-- Repetitive behaviors. A child with autism may repeat the same phrase or a particular motion. He or she may sit and rock back and forth, lick objects repeatedly, become fascinated by objects like the swinging pendulum of a grandfather clock, or certain lights, or the flame on a gas burner.

-- Abnormal behaviors. Children with autism may develop obsessive routines. They may become intensely preoccupied with something. They may become hyperactive, aggressive, destructive or impulsive, or intentionally injure themselves.

-- Absence of expressiveness, lack of joy. Children with autism express few emotions other than anger with much frequency. They don't appear to be joyful even when they are doing something they are clearly interested in -- not even if they are given something they love, like a coveted toy. They often don't show affection to members of their family.

If you observe any of these behaviors, contact your child's pediatrician. Symptoms can improve with intense treatment. Treatment should include some combination of education, behavioral management, medication, speech and language therapy, social skills and life-skills training.

You can learn more about autism in "The Autism Revolution," a new book by my Harvard Medical School colleague Dr. Martha Herbert. (You can learn more about this book at AskDoctorK.com).

Exciting new research links certain genes to autism. Factors in the environment (possibly infections or toxins) also may be involved. Research may be getting us closer to understanding what causes this terrible disorder, and how to prevent and treat it.

(Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.)

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