Susan E. Folstein, M.D., an expert on the genetics of autism and its effects on psychological functioning, is pleased to fill that gap. The prominent researcher and clinician recently joined the Miller School faculty and opened the University of Miami Autism Clinic to provide psychiatric services to children and adults on the autism spectrum who have concurrent psychiatric symptoms or disorders.

"It's complimentary to CARD,'' said Dr. Folstein, whose appointment as professor of psychiatry and behavioral sciences is pending. "There are lots of services for autistic children that are provided by the schools, or by agencies like CARD, but there are not many psychiatric services. In fact, I don't know any for the psychiatry of autism even though people with autism have a lot of psychiatric disorders. A lot of kids have aggression for a lot of reasons. Almost all have anxiety of various types."

In addition to treating adults and children, Dr. Folstein can perform diagnostic evaluations for parents who suspect or have been told their child is autistic, and need a qualified diagnosis to initiate services. When appropriate, she will also facilitate a clinical genetic evaluation.

"All children with the diagnosis of autism should have a genetic workup because 10 to 15 percent of the time you find some specific genetic condition that is associated with autism and could have implications for the rest of the family,'' Dr. Folstein said. "Fragile X is the most common example. Families like to know whether they carry it or not.''

A 1970 graduate of Cornell Medical College, Dr. Folstein began her illustrious career training under luminaries in both child psychiatry and medical genetics. In conjunction with Great Britain's Michael Rutter, M.D., whose pioneering work helped establish child psychiatry as a medical specialty, she conducted the first systematic study of twins, one or both of whom had autism, while in England as a research fellow. Published in 1977, their paper demonstrated for the first time that autism had a genetic cause.

"At the time, there was no direct evidence for a genetic cause but people were starting to notice it ran in families, so I tried to find all the twin pairs in England where one or both had autism,'' Dr. Folstein said. "I interviewed the parents, examined the affected children and showed quite clearly that there was a genetic component. It is probably the biggest and most important cause.''

After returning to the U.S., Folstein began her genetics training at The John Hopkins University School of Medicine under the late Victor McKusick, M.D., a founder of medical genetics who helped make the discipline a central part of medicine.

"I've been very fortunate in my teachers,'' she noted.

Dr. Folstein, who spent more than 20 years at Hopkins and a decade at Tufts University School of Medicine, is obviously an excellent mentor herself. The first woman elevated to professor of psychiatry at Hopkins, she founded the Division of Psychiatric Genetics there, and helped several fellow faculty members launch research careers on the genetics of psychiatric disorders, including autism.

She also was instrumental in establishing the Autism Genetics Cooperative, the forerunner to the Autism Genome Project, a worldwide consortium of clinicians and scientists dedicated to identifying the genetic factors underlying autism. She and Margaret Pericak-Vance, Ph.D., director of the John P. Hussman Institute for Human Genomics, collaborated on that and other projects, and Dr. Folstein looks forward to conducting new research at the Hussman Institute, where she is a member and holds a dual appointment as professor of genetics.

"Today, most of the research is to find genes in 85 percent of the cases where we have no known cause for autism,'' Dr. Folstein said. "We know it's genetic but don't know which genes are responsible.''

To make an appointment, or for more information on the autism psychiatry clinic, please call 305-301-8436.