Here are some questions we received on our Network and the answers given by our "experts".

It is a disease affecting psychological and mental development: some children (4-5/10,000) has difficulties in realizing what is happening around them, but also in understanding sensorial information. These troubles prevent them from appropriate social relationships and behaviour and good communication.

The seriousness and the level of autistic troubles remarkably change according to the patients, but we can generally notice:

• remarkable difficulties in the development of language: it is slowly organized, often missing and it can show particular features, such as new words (neologisms) or expressions without any common meaning. Autistic patients often use metaphors; short sentences are pronounced in a monotonous and feeble voice;
• autistic patients are unable to understand social relationships. They avoid direct visual contact (they do not look in the eye), but they carefully observe everything happening around them, looking stealthily. They seem to have no interest for people or objects they get in touch with, nor for leisure activities of their mates or members of their family. We notice apparent inability to understand other people’s feelings, but they actually live in a state of tension, anxiety or anguish;
• incoherent sensorial reactions: autistic children sometimes seem to be deaf (and they are considered as affected by this handicap), or they react with crises of anguish even to familiar noises (vacuum cleaner, etc.); a barking dog often causes terror. By contrast, sometimes it seems as if they do not feel pain, heat or cold; annoying stimuli are not significant;
• intellectual abilities are variable: children may show good intellectual abilities in some fields or in specific tasks (drawing, music, calculating, memorizing facts or numbers) and, at the same time, show remarkable mental retard in intelligence tests. Because of these differences, autism is enigmatical and it may cheat observers;
• personal interests are remarkably reduced: autistic patients show limited spontaneous activities and very few interests; their resistance is, at any rate, very short. Their initiative is limited to repeated and forced movements and affected expressions; they obsessively program their movements when they repeat a specific course, dress, arrange objects. If the routine breaks they react with anguish.

This problem is not easy to solve, but we must take into account that, unfortunately, x-fragile, down epileptic and mental inadequate patients are considered as autistic, but these cases should be definitely separated. All these syndromes must be distinguished because they have completely different clinical, psychodinamic and psycho-evolutive features.

In autistic autism in the hiperkinetic and symbiosis psychosis we cannot remark any neurologic deficiency.

Among all techniques of rehabilitation, FC plays a foundamental role: it allows us to "give words back" to autistic patients, who can acquire, in this way, a means of expressing themselves. Even the australian psychologyst Rosemary Crosseley, the inventress of this method, remarked that FC is not a therapy, but a way to re-establish communication. This supports several observations that emphasize the importance, for autistic children, of a therapy which allows them to socialize.

The etiopathogenesis of this disease affecting psychological and mental development is much debated because some specialists think it is a genetic disease, others remark that it shows cerebral malformations (limbic lobe, frontal cortex, encephalic trunk), some emphasize alteration of neurotransmitters (lately: endorphins). Then some researches prefer thinking it is a psychological trouble, mainly caused by emotional problems in the first relations with their mother.

More global reflections consider that autism is a disorder which starts precociously, when biological system (the brain: e.g. the development of frontal cortex is accomplished between the 18^th and the 24^th month) and psychological and mental processes are both coming to maturity. Consequently, autism may be a complex disease, (it is psychological, neurological and biological) in which errors or delays in biological development interfere with the psychological and mental one. As a result, the first relationships are alterated and cause "short circuits" or "vicious circles" which can hardly be overcome, unless we use a therapy aimed at reorganizing the first phases of the formation of ego.

This is one of the embarassing and annoying questions which are often asked to the specialist by relatives or people we occasionally meet. As a dilemma, this problem is not only unsoluble, but it cannot be faced. Too many items and consequences should be analysed, but, on the other hand, the question is not asked by the patients, who would wonder: "What do I have to do about my autism?". This is the question, so the real problem is: "What can we do for these children?"

This question made us say in a recent meeting: "I have a dream! Making autistic children come out of their black hole, so that they can find the light shining over us all which unites us in a universal perspective, beyond any disablement and handicap".

Our expectations, related to the application of the E.I.T. (Emotional Integrated Therapy), remark that a therapy is not enough to solve the problem, though it is essential in order to recover psychic functions and to start rehabilitation. This is not different from what happens in any other psychotherapy, but also in any psycho-pharmacological intervention. Social introduction and the possibility to bear the impact of relationship with other people always affect the results firstly.

This therapy leads to:

• solve a symptome called free emotionality combined to crises of anguish or terror;
• control problematical attitudes such as shouting, stereotyped and forced movements, uneasiness, aggressiveness;
• good participation in role activities with mates, who involve and accept an autistic child, despite his "oddities";
• good level of communication (even if the oral one is not completely recovered);
• involvement in activities which allow the children to approach to games, but also to attend Church services, to join in social life and in activities in Sunday schools;
• easier introduction into school, where not only individual, but also role educational activities can be organized;
• suitable arrangement of rehabilitation activities, such as Facilitated Communication, Hippotherapy and others, in which progress are quicker, clearer and more lasting;
• important recovery of their possibility of relationship so that parents (and necessarily their father, too) can start arranging activities which involve all family members;
• better initiative in children’s ability of socializing;
• progressively recover the possibility to join in trips, holiday programmes, camping, visiting relatives, leisure activities in special centres and in holiday resorts.

These opportunities offer autistic children a wide range of social activities, which really lead them to improvement, rehabilitation and possible global re-integration.

When a child shows his relationship problem to his mother (he does not look in the eye, he stays in the same place for a long time, he is not attracted by toys, he does not take part in his brothers and friends’activities the development of language is delayed, he shows inadequate reactions to stimuli) he must be visited by a specialist, in order to have a precocious diagnosis and to carry out a therapy as soon as possible. This is also useful to confirm the diagnosis and to identify mental functions which are related to symptomes.

The main problem is language; a precocious and specific therapy allows us to obtain the bases to start logopedia in order to make rehabilitation easier (see Facilitated Communication and Hippotherapy) and encourage introduction into school.

These procedures are considered as self-stimulating or self-erotic activities. Even though this interpretation cannot be confirmed, we can say that repeated movements are a request to maintain "objects" in a specific place. Autistic patients are anguished by all "modifications", so repetition is the same as maintaining an object. As a result, it is reassuring because it allows them to acqire a certain degree of self-consciousness.

She surely does not, but autism is an extremely complex problem that must be faced, no matter how it is observed. Consequently, the specialist must control it regularly as he carries out the therapy, and lead activities to encourage education and rehabilitation.

We must make a distinction between affections and emotions. Autistic patients are particularly emotional (they show free emotionality, they are unable to contain emotions); anxiety, anguish frustrations and terror are typical of them.

Autistic children’s problems concern affective area (values): we can notice lack of reciprocity and of gratefulness; then they are unable to realize other people’s expectations and take them into account.

Playing has a therapeutical function if it is used for a specific purpose, but autistic patients, as all children, have the right to use or not leisure activity to obtain self-satisfaction, freedom of initiative and the most useful "source" to acquire the ability of socializing.

The answer is "yes", but we should not only focus on education; we should aim at functional recovery, appropriate behaviour and social integration, which can be obtained thanks to integrating therapy

The aim of this therapy is to help autistic children acquire the necessary bases to be introduced in compulsory school efficaciously and with profit. Parents must play an active role in this programme with the therapist and the teachers, discuss about progress and successes, accept suggestions. They must involve all family members to carry out a socialization programme, which is at the basis of a real integration.

The numbers we report on this subject vary from 4-5/10,000 to 20/10,000.

According to an interesting data, which at present has still to be examined, the incidence among people taking thalidomide (the medecine pregnant women took in the 60s to cure nausea,which caused several defomities) is 5%. This index is thirty times higher than among women who did not take that medecine.

Nowadays the biological basis of autism has not been proved yet; in addition we must take into account that four autistic children out of five are male. Autism has the same incidence all over the world, regardless of race, nationality and social class.

We have no proofs of the genetic origins of autism, even though recent studies remark the presence of focuses: these are responsible for slight alterations in the structure of encephalic trunk.

These are actually different forms of autism, the autistic one and the hiperkinetic which forms, with symbiosic syndrome, a specific trilogy. It may explain why the disorder of psychological and mental development can start in different moments, more or less subsequent, of children’s evolution.

Several concomitant facts modify psychologic and pathologic course of autism, but it is always possible to obtain excellent results for what concerns social integration, emotional development, control of emotions and of problematic attitudes.