The neurology of autism: many unanswered questions

Autism is a behaviorally defined developmental disorder of the brain almost always presenting in infancy or the preschool years. Its symptoms persist life-long, although partial compensation is possible through targeted special education that addresses children's deficits in sociability, verbal and non-verbal communication, and atypical range of interests, activities, and cognitive skills. Although a majority of autistic individuals are mentally deficient, IQ is not a defining feature and verbal autistic persons of normal intelligence are increasingly being identified, referred to as Asperger syndrome. Meager neuropathologic data have disclosed subtle prenatal cellular limbic and cerebellar abnormalities. Autism is associated with a variety of defined genetic and acquired conditions, with multifactorial genetic traits, alone or interacting with environmental events, presumably responsible for most unexplained cases. Autistic regression is frequent and poorly understood and may be associated with clinical or subclinical epilepsy. Unravelling the neurobiologic basis of a disorder that may affect 1-2 in 1000 children will require a concerted multidisciplinary attack.