Diagnostic and Test Procedures
There are no medical tests to diagnose autism. A diagnosis should be made by an autism specialist after learning the child's complete medical and behavioral history, observing the child's behavior at length, and ruling out other disorders (such as mental retardation, hearing problems, and neurological problems) that may cause some of the same symptoms. It is important to distinguish autism from other disorders because a misdiagnosis may result in inappropriate or ineffective treatment.

Treatment
There is no known cure for autism, but it is treatable. Many people with autism become more responsive as they come to better understand the world, and most scientifically based intervention programs report that some children lose all symptoms of autism. The goals of treatment include:

• Stopping inappropriate behaviors so the child can relate better to others.
• Teaching the child to attend to purposeful activity, which can help the child succeed in educational settings.
• Helping the child learn self-care skills.
• Providing opportunities for the child to socialize with others.
• Improving the child's communication skills.
• Teaching parents how to provide helpful educational and social experiences for their child.

In most cases, treatment is provided in an individualized program that focuses on behavior modification and skills development. Treatment also may involve medication to help control specific symptoms. Usually a team of specialists is involved; the team may include a psychologist, a special education teacher, a speech therapist, a child development specialist and trained aides.

In general, treatment programs tend to be more effective if they build on the child's unique interests; if they engage the child in highly structured activities according to a predictable schedule; and if they provide regular, positive reinforcement for desired behavior. Also, parental involvement in treatment has proven very important to the development of autistic children. It's never too late to begin treatment, but the earlier treatment begins, the better the child's chance of redirecting inappropriate behavior and developing important skills.

Behavioral Therapy
The idea behind behavioral therapy is that people tend to repeat or continue behavior for which they are rewarded. The approach is commonly used to encourage autistic children to practice desired behaviors, such sitting in a chair when asked to do so or making appropriate verbal communications. When the child performs the behavior, the child is given a reward that he or she enjoys, such as a drink of juice or applause. With practice, the child may eventually learn to perform the desired behaviors on his or her own. Over time, the child may be able to "graduate" to more complex tasks.

Structured-behavior modification programs have been used for many years to treat autistic children. Some rely solely on individual work between a therapist and child, use extensive repetition and are very time-intensive, taking up to 40 hours per week. Others are less intensive and involve parents and others in teaching the child. Parents also can learn to apply the principles of behavior modification in everyday life to help their child learn language skills and appropriate behaviors at home.

Developmental Therapy
Developmental therapy focuses on providing structured activities that give children appropriate types of stimulation to help them progress through levels of mental and social development. Activities may include physical exercise, to help the child develop body awareness; art projects, such as painting or stringing beads; social interaction, including modeling by teachers and aides of how to interact effectively; and creative play, such as pretending to be another type of creature or object.

Children who are able may do academic work, too, as part of developmental therapy. It's important that assignments are tailored to the child's level of function and special needs. For instance, autistic children tend to do better with assignments that are broken down into smaller tasks and are highly organized. Special care should be taken to minimize any potential distractions.

School
Under the Individuals with Disabilities Act, schools are required to provide free and appropriate education for children diagnosed with disabilities, including services for preschool children with developmental difficulties such as autism. This may include special services, such as speech therapy, that are not offered to the student body in general. The level of services varies by state (some offer more than required by federal law). Contact the federally funded Parent Training Information Center and Protection and Advocacy Agency in your state for details about services in your area; the federal Department of Education, at 202-205-9058 or 202-205-8824, can refer you to the agency in your state.

All public schools must create and implement an individualized education program, also called an IEP, for each child in a special education program. Developed through a close partnership between school staff and parents, a child's IEP identifies specific educational goals for the child based on the child's unique needs and potential. It also provides a way to assess the child's progress, so that goals can be revised as needed, and new goals can be set as earlier goals are achieved. If your child may be attending public school, talk with the school staff about developing an IEP.

Medication
No medication cures autism, but some drugs may help relieve certain symptoms. Drugs such as fluoxetine, fluvoxamine and sertraline — also used to treat anxiety and depression — may help people with autism feel calmer and less aggressive, and adapt more easily to changes in their environment. These drugs, also called selective serotonin reuptake inhibitors (SSRIs), affect the brain's use of the chemical serotonin. Serotonin affects both mood and behavior. Some researchers think that serotonin imbalances may contribute to autism.

Several other types of drugs may be used to help relieve symptoms of autism, too. Clomipramine, a tricyclic antidepressant that's used to treat obsessive-compulsive disorder, may help reduce obsessive, repetitive behaviors. Haloperidol, also used to treat Tourette syndrome, may help control aggression and self-injury. Autistic children who are hyperactive may benefit from taking drugs such as methylphenidate, commonly used to treat attention-deficit hyperactivity disorder.

Lifestyle Choices
Some children and adults with autism find comfort in structure. They may follow the same route everyday, or the same precise schedule, or always put their clothing on in the same order. Disruptions to such patterns may be very distressing. It's often helpful for caregivers to help them establish and maintain routines that give them a clear sense of order, expectations and meaning.

Adults with autism may need to live in a group home or other supervised living situation where a certain degree of structure is set up for them, and where they get continued training and support to care for themselves and interact with the world. Depending on their abilities, residents may be taught such skills as how to plan, prepare and clean up after meals; how to take public transportation on their own; and how to manage their money. Today, many residential facilities are designed to help autistic people play an active part in their wider community, including holding jobs that are geared to their strengths and interests. In general, they tend to work in jobs that are structured and involve repetition, such as in assembly, manufacturing or some types of office work.

Support
Caring for an autistic child can be very challenging for the child's family. As a parent, you may sometimes feel frustrated, saddened or overwhelmed by the difficulties in communicating or connecting with your child. At times you may mourn that your child may never be able to experience certain aspects of life that you had hoped the child would enjoy. Other relationships in your family may be strained by the intensive attention that your autistic child needs. Your child's outbursts of aggressiveness or other unusual behaviors may be stressful for you and other children in the family, and can be especially difficult to handle in public places, where others may not understand the child's condition.

Support from qualified professionals, such as therapists, and from other families coping with autism may be helpful. Both types of support can help you work through your feelings, get practical advice and find out about the latest treatment options. Connecting with other families that share some of your experiences can be a great source of strength, and can help you not only cope with your situation but also actively encourage your child to reach his or her full potential. The Autism Society of America, at 800-3-AUTISM (800-328-8476) can refer you to support groups and other services in your area.

Most children with autism can be helped significantly by early behavioral intervention. Seeking help immediately can greatly benefit your family. There is hope; most intervention programs reduce symptoms of autism regardless of the child's age or the severity of his or her condition.

Prevention
Although the cause of autism is not known, some cases have been associated with chemical exposure during pregnancy, so it is important to avoid all unnecessary exposure to drugs, chemicals and other potentially toxic substances if you are pregnant. Early diagnosis and treatment of PKU and celiac disease will reduce the risk of a child having autism. Being immunized against rubella prior to pregnancy can prevent rubella-associated autism.

Call Your Doctor If:

• Your infant or child resists cuddling and doesn't respond to his or her environment or to other people as expected.
• By about the age of one year, your child is not pointing to objects, bringing items to you, or engaging in simple interactions, such as "peek-a-boo."
• By the age of 18 months, your child is not using any words or attempting to communicate.
• Your child bangs his or her head, or demonstrates self-injurious behavior or aggression on a regular basis.
• Your child demonstrates unusually repetitive behavior, such as repeatedly opening and closing doors, or turning a toy car upside down and repeatedly spinning its wheels.