Autism is a complex, life-long developmental disability that was first described by Dr. Leo Kanner of Johns Hopkins Hospital in 1943.

At about the same time, a German scientist, Dr. Hans Asperger, described a milder form of the disorder which later became known as Asperger syndrome. Today, the disorders described by Kanner and Asperger are considered the worst and mildest forms, respectively, of at least five conditions which are collectively referred to as autism spectrum disorders (ASD) or pervasive developmental disorders.

Autism spectrum disorders affect approximately one in 500 individuals. They occur throughout the world among all races, nationalities and social classes, but males are affected three to four times more often than females.

In these disorders, the brain malfunctions in areas of social interaction and communication skills such that those affected have varying degrees of impairment in communication skills and social interactions, and exhibit restricted, repetitive and stereotyped patterns of behavior.

Among autistics, language is slow to develop, if it develops at all. It usually includes peculiar speech patterns like echolalia (parroting words) and the use of words outside of normally accepted meanings. Autistics also often talk incessantly.

Typically, autistics have their "own world" as in the case of your nephew. They avoid eye contact, are withdrawn, do not play with other children, resist being picked up, appear indifferent, and tend to "look through" people. They hardly interact, they prefer to be alone and they laugh and giggle inappropriately.

Autistics manifest inconsistent and sometimes bizarre behavior towards sensory stimuli. They appear to be deaf at times, but at other times get extremely distressed by everyday noises such as a dog’s bark. They likewise manifest repetitive body movements and stereotypic motor behavior such as rocking or hand flicking. They are usually gentle, naive and reserved although some may be hyperactive and violent.

Autism spectrum disorders can be diagnosed by one year of age or younger, but often, the symptoms become markedly noticeable only between one and a half and three years of age. When there are indications that a child could be autistic, a developmental pediatrician should be consulted immediately because studies have shown that the earlier the needed interventions are instituted, the more effective they become.

Possible indications that a child has an autism spectrum disorder include developmental delays such as failure to: point or make meaningful gestures at one year of age, speak a word at 16 months, or respond to name. Other indicators include losing previously acquired language or developmental skill, poor eye contact, excessive attachment to a particular toy or object or inability to play with toys.

Autistic individuals look normal physically. They are very healthy looking and do not look retarded; but in reality, most have some degree of mental retardation and only 10 to 20 percent possess average or above-average intelligence.

The cause of autism spectrum disorders is unknown, but they are definitely not caused by factors in the psychological environment of the child nor to bad parenting. Current evidence suggests that, among autistics, there is a host of chemical and physical abnormalities that impinge on the brain system making it react to stimuli differently. It is possible that a complex combination of genetic factors may play a role in the development of these diseases.

Autism spectrum disorders occur in varying degrees – mild to very severe. Mildly affected individuals may exhibit only slight delays in language. They are able to handle social interactions well – establish eye contact, show affection, smile, laugh, and display a variety of other emotions. Some autistics are able to live and work independently, earn college degrees and raise a family. But most will not be able to totally overcome their functional impairments.

Autism spectrum disorders cannot be cured, but all autistics can improve significantly with proper education and training. Where should you bring your nephew for the special education and training that he needs? I think the person who can give you the best advice on this is your nephew’s pediatrician.