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Autism More Common -- and Treatable -- Than Once Thought

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June 26, 2001 -- The clock is ticking for the many autistic children who could greatly benefit from early treatment.

A British study confirms that the various forms of autism -- now known as pervasive developmental disorders or PDDs -- are much more common than once thought. Moreover, the study finds that most children have mild forms of the disorder. With early treatment, many of these kids could lead relatively normal lives. Without it they face loneliness and institutionalization.

"Our findings are consistent with two other studies, including one by the CDC in America," study leader Eric Fombonne, MD, tells WebMD. " Unless we provide services at an early age, these children will not develop normally. The earlier we intervene, the better the outcome."

Fombonne and colleague Suniti Chakrabarti, MD, of King's College in London, report in this week's Journal of the American Medical Association that PDD is 10 times more common than earlier estimates suggested. By carefully screening 15,500 children aged 2.5-6.5 years, they found that more than six out of every 1,000 children suffer from some form of PDD. This closely matches the findings of a 1998 CDC study conducted in New Jersey.

"It gives me the shivers how common this is, and how many children could benefit from being found and treated early," says Susan L. Hyman, MD, professor of pediatrics at New York's University of Rochester School of Medicine and author of an editorial accompanying the Fombonne report.

Children with PDD suffer from a poorly understood biological problem thought to be caused by a combination of different genes. Problems usually begin soon after birth -- but since PDD children look completely normal, the seriousness of these problems may not be obvious at first. PDD children do not develop normal language skills, and their nonverbal communication is abnormal, too.

"These children don't develop the body language that a child uses to communicate with caregivers," psychologist Janet Kistner, PhD, tells WebMD. "If a kitten comes into child's line of vision, most kids will express delight and look over to their parent to share in that experience. That is the kind of thing children with autism won't do." Kistner is director of clinical psychology training at Florida State University, in Tallahassee.

A surprising finding from the Fombonne and Chakrabarti study is that the vast majority of children with PDD are not retarded; in fact, a large proportion has normal intelligence and just one in four has any degree of retardation. Fombonne suggests that early treatment may offer PDD children a chance for even better mental development.

"The treatments that are available certainly don't cure PDD, but children who have had intensive interventions seem to do better," Patricia M. Rodier, PhD, tells WebMD. "It seems quite important to identify them much earlier." Rodier, co-author of the Hyman editorial, is director of the collaborative program of excellence in autism at the University of Rochester.

"What pediatricians need to do is [make] early diagnosis, because there are things you can do," Hyman stresses. "Parents being worried is the best screening tool we doctors have. If parents say something is not right, that should raise suspicion."

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