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Clinical Crossroads
April 4, 2001

An 8-Year-Old Boy With Autism

Author Affiliations

Author Affiliation: Dr Rapin is Professor of Neurology and Pediatrics, Attending Neurologist and Child Neurologist, Albert Einstein College of Medicine, Bronx, NY.


Clinical Crossroads at Beth Israel Deaconess Medical Center is produced and edited by Tom Delbanco, MD, Richard A. Parker, MD, and Risa B. Burns, MD; Erin E. Hartman, MS, is managing editor.
Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.

JAMA. 2001;285(13):1749-1757. doi:10.1001/jama.285.13.1749

DR PARKER: Austin is an 8-year-old boy diagnosed as having autism at age 2½ years. He has improved substantially in cognition and speech but still struggles with social interactions. This is his first year in a public school with his peers, and his parents wonder what the future holds. They live in a suburb of Boston, and Austin's medical care is covered by managed care insurance.

Austin weighed 8 lb 10 oz at birth, after a normal pregnancy and delivery. He appeared alert and normal in all respects. The parents noted normal early development, but at 12 months Austin began to box his ears at loud noises and cry for no apparent reason. Friends and family told the parents not to worry. At 18 months, Austin spoke only a few words (eg, "Mama, Daddy, juice"), yet these few words soon disappeared from his speech. The pediatrician reassured the concerned parents and advised them not to compare Austin with his older sibling.