Quite a while.... well, I need to open a "window in time" in time , mainly when in MICHIGAN, as, while in Porto Alegre the priorities are my patients, and Nina.

Today I would like to introduce a bit of my astonishment whenever I am confronted with my main passion, number 1, at the office: a kid with PDD - pervasive developmental disorder. Since the beggining (back to 78, at HEPAC, Churchill Hospital, Oxford, England) I always get the impression, not only the parents and relatives, but also myself in the medical field as well as a person, that we NEED to look for cues that not always are obvious on whatever the child wants to tell us. The non verbal, the subtleness of the information puts us in a situation that frequently takes us to the edge!

We are trained to have a certain amount of signs/symptoms that gives us a guide to fulfill a diagnosis. But in this situation there is not only the diagnosis, there is the spectrum! An to understand this spectrum means not only follow the triplet where autistic spectrum disorders is based upon, but to follow and to understand what are the levels of penetrativeness of the spreading throughout the 3 main areas, verbal and non verbal communication, social interaction and repetitive behavior. It's a neurodevelopmental disorder. It is multi factorial in its etiology.

This means, dependent not only on inhibition/facilitation mechanisms in the brain; but on the amount of input/representation as well as level of penetrativeness on genetic background.