A child is born. And amidst the general rejoicing the parents wonder why he does not coo and gurgle when they play with him, why he resists attempts at cuddling, why he doesn't respond to overtures of affection Later as the child grows up and is sent to school, the parents notice more worrying characteristics:

• He is either quiet or emits noisy screams.

• He is withdrawn and is unresponsive to affection or touching.

• He is obsessive about keeping sameness in his environment, and resists change violently.

• He cannot differentiate between animate and inanimate objects and shows attachment to the latter.

• He is overactive, with repetitive movements.

• He looks bright and intelligent but he never looks you in the eye.

These are all signs of autism, a mysterious and provocative condition that was first described by Kanner in 1943. Four or five children out of a 100 are affected by autism. Boys are affected 4 times more than girls.

It is conjectured that autism develops because of an organic defect in the brain, caused by a birth condition or epilepsy. 33% of autistic children never learn to talk. About 30 % are mentally retarded to some extent, but some are very able in certain areas and are called autistic savants (remember Rain Man, the movie, where Dustin Hoffman gave a brilliant performance as an autistic savant?)

Autistic children are unable to make contact with the outside world and don't communicate normally, which is why psychiatrists refer to them as an empty fortress. They try to arrange the environment on their own terms so as to exclude intervention from other people, stimuli, events and variety. These children need special education with backup and assessment from skilled professionals. Some children become socially competent, as they grow older, while others need special care and sheltered jobs as adults.

Autism is not yet properly diagnosed in India. It is often confused with deafness or sometimes even schizophrenia. One characteristic of autistic children is that they never look into your eyes. For a loving parent trying to nurture a child who does not know or even care to know who his or her parents are, autism can be bewildering and crushing. Like in everything else, the family needs emotional help. In many cities parents of autistic children have banded together to form support groups so that they can learn and cope with such children. Many support groups also have doctors advising them.

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