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3 The  number  of  children  with “full  spec- trum,” or profound autism had increased by 273 percent – from 2,778 in 1987 to 10,360 in 1998  –  more  than  tripling  in  one  decade, according to a 1999 report from California’s State Department of Developmental Services. While  the  article  Increase  in  Autism  Baffles Experts,  published  in  the  October  18, 2002 issue of The New York Times, caught some by surprise, it confirmed the suspicions of many parents and therapists. What was even more baffling is that sci- entists could not attribute the rise to any one specific cause such as genetics, birth injuries, immunization,  more  accurate  diagnosis,  in- creased  awareness,  population  migration  or environmental factors. Whereas tradition- ally it had been estimated that 4 or 5 children  out  of  10,000  might  develop autism,  it  appears  that  10  children  in every 10,000 are seriously autistic. IDENTIFYING THE DISORDER Autism, first described by doctors in 1943, is a complex developmental disorder that can severely impair children’s social interactions, reasoning skills and ability to communicate. Autism was once thought to be a disease of upper-middle-class dysfunctional families. The myth of the “refrigerator mother” – a parent who failed to attach to the child – persisted until  the  late  1960s,  when  research  began uncovering the neurological roots of the dis- order. Autism  is  a  brain  disorder  that  typically affects a person’s ability to communicate, form relationships with others and respond appro- priately to the environment.  Recently, scien- tists  have  also  identified  some  patterns  of brain  abnormalities  that  may  reveal  an  or- ganic, biological basis for the disease. Some  people  with  autism  are  relatively high functioning, their speech and intelligence intact. Others are mentally retarded, mute or with  serious  language  delays.  For  some,  au- In-utero exposure to rubella, thalidomide, or  any  birth  defect  causing  substances  in- creases the chance that autism will develop. Although studies  failed to provide conclusive answers as to what occurs or why, they did tell us a great deal about when. In cases of thalidomide-induced  autism,  the  critical  pe- riod seems to have occurred as early as 20 – 24 days after conception, before many women even know they are pregnant. The study con- cluded that many cases of autism, if not all, are initiated very early in gestation, implicat- ing damage to the brain stem as a possible cause. Other  scientists  hypothesize  that  there may be environmental triggers, as yet undis- covered,  which  may “switch  on”  previously dormant,  faulty  genes.  This  theory  may  ex- plain  why  many  children  first  exhibit  symp- toms  of  autism  between  18  months  and  3 years of age. This later onset of autism, often coinciding  with  the  period  of  time  in  which children are first vaccinated, have led many parents to attribute the disorder to the measles virus  or  MMR  vaccine  given  in  early  child- hood. Studies indicate that although autism is not purely genetic, the spectrum of symptoms may run in families. At present, there is no cure for autism, nor do children outgrow it, but they do have the capacity to learn and develop new skills. Those Leah Schlager PUTTING PIECES TOGETHER: UNDERSTANDING AUTISM tism  makes  them  seem  closed  off  and  shut down. Others seem locked into repetitive be- haviors and rigid patterns of thinking. Autism has sometimes been called “mind blindness,” an attempt to describe how diffi- cult it is for children with autism to be able to imagine,  or  “see,”  what’s  going  on  in  the minds of others, an essential task for forming social  relationships.  Many  children  with  au- tism don’t know, anticipate or react to what others  are  thinking. This  makes  the  world  a confusing,  unreadable,  unpredictable  place and  contributes  to  the  child’s  isolation.   As one mother put it, “It’s as though someone broke  into  my  home,  stole  my  child’s  mind and left his helpless body.” HOW, WHY, WHEN? Autism has long been thought to have a purely  genetic  basis,  however,  studies  with identical twins confirm that although the dis- order has a heritable component, other influ- ences play a role as well. Studies of identical twins  have  shown  that  when  one  twin  has been diagnosed with autism, the second twin has only a 60 percent chance of sharing the diagnosis, (not 100 percent as had been pre- supposed), and a 86 percent chance of having some autistic symptoms.