Ask the Expert: About autism

Matt is an angel-faced 4-year-old. He rocks back and forth on the floor, rearranging the same toy cars over and over. He does not answer when his mother calls him, nor does he look her in the face. When she hugs him, he remains rigid in her arms. He seems to care only for a set of old keys, which he carries with him everywhere, even to bed.

Matt has autism. And he is far from alone. Estimates vary, but studies indicate that some form of autism may affect as many as one out of every 88 children.

Research on autism frequently makes headlines. Here is what parents need to know.

What is autism?

Autism is really a catch-all term that describes a wide spectrum of developmental disorders, some mild, some severe. These disorders appear by age 3 and affect how the brain develops social and communication skills.

What causes autism?

Experts are not entirely sure, but they do know this: It is not “bad parenting,” as was thought in the past. “Genes appear to play a major role,” says Shanna Kralovic, DO, a developmental behavioral pediatrician with University Hospitals Rainbow Babies & Children’s Hospital. “Families with one autistic child have up to an 18 percent chance of having a second child with autism. And when it comes to gender, boys are up to four times more likely to have autism than girls.”

Environmental factors or certain medical problems – including viruses or digestive ailments – may also contribute to autism.

Despite rumors, research clearly indicates that there is no link between any vaccines – including the measles-mumps-rubella (MMR) vaccine – and autism. “In fact, in early 2010, the Lancet article that first suggested this link was retracted by the journal after flaws in the study’s research methods were revealed,” Dr. Kralovic says. “There is no scientific evidence, therefore, that vaccines cause autism.”

What are the symptoms?

Autism’s hallmark is three types of symptoms: delayed communication ability, difficulty with social interaction and repetitive behaviors. Talk with your pediatrician immediately if your child:

  • Cannot speak single words by 16 months
  • Repeats or echoes memorized phrases
  • Does not play “pretend” games
  • Avoids eye contact and cuddling
  • Does not point at objects
  • Is withdrawn and does not interact with peers
  • Repeats body movements over and over
  • Gets stuck on a single idea, object or task
  • Is intensely concerned with routines and sameness
How is autism treated?

There is no cure, but early diagnosis and treatment are vital to helping children function to the best of their abilities. “Effective programs often combine behavior, speech and occupational therapies with medication,” Dr. Kralovic says. “In addition, family counseling can help parents navigate the challenges of raising an autistic child.”

Our autism educational sessions will build your understanding of autism, options for treatment and intervention and more. To learn more, visit, call 216-286-5500 or email

kralovic-shannaShanna Kralovic, DO
Developmental Behavioral Pediatrics and Psychology, UH Rainbow Babies & Children’s Hospital
Professor, Case Western Reserve University School of Medicine

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