This week President George W. Bush signed the Combating Autism Act paving the way for increased efforts to seek out causes and improve education about the condition which affects 1 million Americans.

Early in December the US House of Representatives passed this important act, as the Senate had done earlier. Now the final hurdle has been overcome as President Bush has put his signature to it.

The Combating Autism Act should see a long overdue increase in efforts to tackle autism, the incidence of which has increased tenfold over the last few decades. The act mainly focuses on increased research into the causes of the condition and better education, rather than providing therapies, however. Parents of autistic children will be further frustrated by the focus on future generations rather than efforts to help their already sick children. That said, the act will be considered good news by almost everyone.

Over 5 years The Combating Autism Act specifically authorizes:

• $90 million for surveillance of and research on autism and other developmental disabilities by the Centers for Disease Control and Prevention.
• $210 million for federal and state autism information, education, early detection and intervention programs.
• $635 million for expanding, intensifying and coordinating autism research at the National Institutes of Health.

Put into context, these new funds should translate to roughly a doubling of the scope and intensity of ongoing research and education.

Autism spectrum disorders are currently the most prevalent set of serious developmental disorders in America, and the developed world as a whole. They are likely to stay that way for the foreseeable future as diagnoses continue to soar, despite the concensus that perhaps half of all pediatricians continue to miss telltale signs of autism spectrum disorders. More than 1 in 200 are believed afflicted in the US, and since the condition affects boys more than girls, that means as many as 1 in 100 young boys can be expected to show some signs of autistic problems early in life.

There is still much debate about whether the huge increase in the number of reported cases is the result of better awareness and therefore diagnosis, or that there is a genuine increase in the proportion of people with autistic disorders. Many have noted the correlation between the increases in autism and the increasing presence of chemicals and other environmental pollutants that babies and children are exposed to. It is now generally accepted that autistic spectrum disorders are likely to result from an interplay between genetic susceptibilities and exposures to environmental triggers such as heavy metals, chemical pollutants, and the barrage of vaccinations that children receive early in life.

With the frightening realization that detectable levels of a multitude of toxins from pesticides and plasticizers, to heavy metals and other industrial chemicals, are present in the bodies of everyone in the western world, is it any wonder that developmental disorders such as autism are on the rise? Many of these ubiquitous chemicals are known neurotoxins and children are readily exposed to a cocktail of them from a multitude of sources, from their mothers breast milk, to the toys they play with and the vaccinations they receive.

We recently reported on an initiative by the Autism Society of America (ASA) designed to increase awareness of the important role environmental triggers play in the development of autistic disorders. The initiative includes a special edition of their Autism Advocate magazine as well as a web based campaign. It seems the campaign is perfectly timed and could help influence how research funds are allocated under the Combating Autism Act. There has often been a focus on genetics research, so it is important that research into environmental triggers receives the attention it deserves to come to a better understanding of autism spectrum disorders.

With a total of over $700m set to be invested in research over the next five years under the Combating Autism Act, we can be more confident than ever that answers are around the corner.

The $210m earmarked for federal and state autism information, education, early detection and intervention programs should help make a difference before research leads to more effective treatments. As already mentioned, a vast number of pediatricians still fail to spot the telltale signs of autism spectrum disorders in the crucial toddler years when existing therapies are known to be most effective. Any effort to increase education about how to recognize these devastating conditions is therefore a welcome step in the right direction.

With all this extra money set to be spent on autism research and education initiatives there is much to rejoice about but many will wonder why the Combating Autism Act doesn't do more to "combat" autism for those already affected. Surely more could have been done to provide autistic toddlers with the treatments that are currently available during the period in their young lives when these therapies are most effective?

Estimates suggest that around only 10 percent of autistic toddlers receive the intensive treatment that the National Academy of Sciences and others have recommended. This intensive treatment typically consists of 25 or more hours a week of one-on-one behavioural therapies. What's more, health insurance companies in the US do not cover such treatments using the excuse that they are experimental and unproven. In the UK meanwhile, the state funded National Health Service (NHS) does no better at providing these services to autistic children. Back in the US some state and local council programs help a few kids but hardly any are given the funding that would be required to help all the autistic children that need it.

So, there is much to cheer in the Combating Autism Act and we should thank the US government for acknowledging the enormous problem presented by autism, both for individuals and their families affected by the condition, and for society as a whole. Perhaps this will encourage governments of other developed nations who are under funding autism research, education and care, to follow suit. There is still more that can be done however, so let's hope that those in need of treatment and care now will have access to them as soon as possible.

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