ABSTRACT
Autism is a profound developmental disorder that affects approximately 1 in 1,000 children. It is biologically based (Gillberg & Coleman, 1992); epilepsy is common in autism, more boys than girls are affected, and three fourths of those with autism are also mentally retarded. At present, however, there is no blood or chromosome test for autism-the diagnosis is behavioral and made on the basis of impairments in socialization, communication, and imagination in the presence of a restricted repertoire of interests (American Psychiatric Association, 1987). The manifestation of these problems varies with age and ability, giving rise to the so-called autistic spectrum or continuum (Wing, 1988). Thus, an autistic toddler may show his or her social problem in aloof behavior, for example, by not taking toys to show Mother or by not going to Father even when hurt or upset. The toddler may show his or her imagination impairment through a striking lack of make-believe play: Instead of pretending to clean or crash a toy car, the child may spend hours spinning the wheels with fixed concentration. The communication impairment in such a child is profound; not only is he or she mute, but unlike a deaf or languageimpaired child, he or she does not use gesture or facial expression to convey thoughts and feelings. The same three impairments (known as Wing's triad) remain in evidence as the child grows, although the presentation may change. An able adult with autism may be overfriendly rather than aloof, for example, greeting strangers with a kiss. Though now too old to be expected to play pretend games, the same imagination problems are evident in his or her inability to follow the plots of soap operas and in a preference for learning lists of train times over reading books with fictional contents. Communication impairment persists in able adults with autism in the face of apparently good language (grammar and phonology). Despite a perhaps enormous and erudite vocabulary, conversation is impossibly stilted, pedantic, and overformal: Humor, irony, and figurative language all remain a mystery.
