Autism: early identification and management in family practice

Autism is a chronic, nonprogressive developmental disability with a unique triad of abnormalities in socialization, communication and behavior. Most, but not all, children with autism have some degree of mental retardation, and many develop epilepsy. No single biomedical etiology has been found, but a significant number of medical disorders occur in association with autism. The medical evaluation is directed toward finding underlying or associated neurologic, metabolic, genetic or infectious diseases. Psychoeducational and behavioral therapies are the most successful approaches to the treatment of autism. Community-based and structured programs that emphasize socialization, communication and family training are the most effective. Medical management focuses on treatment of underlying or associated diseases. Pharmacotherapy is sometimes beneficial, but no drug acts specifically on this complex of symptoms. Family physicians can provide early identification, continuing medical care and support to the child and the family.