“…The range of defining and associated features includes reduced eye contact, lack of gesturing, language delays, lack of prosody in speech, inability to interpret emotions from the facial expressions of others, reduced joint attention, impaired attentional shift, hypersensitivity to sensory stimuli, stereotyped hand flapping and upset to change in routine (9,17,53,54,61,66,100,118,182). Additional associated features in some cases include mental retardation, absence of Theory of Mind, seizures, self-injury, anxiety, sleep disturbances, gastrointestinal disturbances and larger head circumference and brain volume at young ages (2,51,52,54,66,74,78,140,153,167,182,187). The importance of genetic factors in the etiology of autism is recognized in the growing literature of twin and family studies that demonstrate up to 60% concordance for autism and 90% concordance for autism spectrum disorders between monozygotic twins, as well as a male : female ratio of approximately 4:1 (13,52,64).…”