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T hey stand like microsoldiers in tight ranks, shoulder-to-shoulder across the top of your brain, each sentry humming its own tune, these millions of tiny processors running your life. Little in Dr. Manuel Casanova's ofce stands in such orderly fashion. Behind him, a bookcase overfows, extra volumes shoehorned in at every odd angle. Tere are books to the right of him, books to the left of him. Every fat surface supports towers of books. He peers between the stacks that tile his desk, looking past the photographs of his four daughters and past his brains. Tey are plastic brains, more talismans than teaching tools, too crude to illustrate the microscopic processors that take up so much real estate in Casanova's thoughts, those minicolumns of neurons snapping away in the folds and ridges of his cerebral cortex. His ofce is in a part of the University of Louisville Health Sciences Center campus that makes a fetish of concrete. Tere is an expanse of hot pavement forming a courtyard fringed by three examples of 1960s brutalist architecture. If you're standing on Preston, facing west, Casanova's ofce is dead ahead, in the tallest building. To your left is Kornhauser Library. And in the building to your right, researcher Estate "Tato" Sokhadze moves amid the warren of small rooms that make up his laboratory. Maureen "Moe" Womack walks into the lab on a Friday afternoon in May trailing three children. Her hair is blond and windstyled, and she clutches a stufed Mickey Mouse dressed in lurid emerald green. It belongs to Augusta, the smallest of the three children fowing around her, a pixie of a girl with sky-blue eyes, luminous skin and a cap of thick brown hair. Sokhadze stands to greet them, his voice rising an octave and growing louder, taking on the musical tone adults use with children. "So how are you?" he says to Augusta, who is wearing two ribbons on her shirt. "Is this a prize you got at school?" Augusta afrms this in the tiniest voice. "Congratulations!" he says. "So it was after school? It was a competition?" She nods. "Very good!" he says. "It looks very nice!" She is here to take part in an experiment, one of more than 120 youngsters to visit Dr. Tato — that's what everyone calls him — for a treatment that is showing promise to an intractable problem. In this treatment, Sokhadze and Casanova are a team. Casanova has the theory; Sokhadze waves the magic wand. Together, they hope to change the lives, at least to some degree, of children with autism. Augusta, diagnosed with autism at age four, is one of those children. Tere has been a sharp and rapid increase in the number of autism diagnoses in the last decade. In 2002, one in 150 children in the United States was labeled with some form of the developmental disorder. By 2011-'12, the most recent years for which data is available, the rate increased nearly threefold to one in 50 school-age children, according to the U.S. Centers for Disease Control and Prevention. Just what those numbers say is less clear; it's difcult to untangle how much of the increase refects better diagnosis and how much of it reveals actual rising incidence, but it's a good bet that the numbers will continue to increase at least a little longer as people become more aware of autism's symptoms, which include fawed social interactions and severe communication problems. absence of interest in other children. "It totally was weird," Moe says. "When I look back on it now, she did all kinds of strange things, and I just got used to it." Autism can make for a Dali-esque world where life's simple verities take unaccustomed shapes and slide out of focus. Toddlers won't cuddle. Youngsters won't gaze into their mothers' eyes. Children lapse into a personal world, unaware of everyone else. Tere are three hallmarks of autism, says Scott Tomcheck, co-clinical director of the U of L Autism Center, and they are interlinked, starting with communication difculties. Tis is more than a speech defcit. Children robbed of speech by reasons other than autism will point and use gestures to get what they want. "Children with autism don't develop those alternative means of communication," Tomcheck says; they simply do not communicate. Te second sign involves a lack of social skills at the most fundamental level — something called "joint attention." "Tis is the triangle of interaction between a child and another person and some kind of object or event," Tomcheck says. In joint attention, the six- Autism can make for a Dali-esque world where life's simple verities take unaccustomed shapes and slide out of focus. Toddlers won't cuddle. Youngsters won't gaze into their mothers' eyes. Children lapse into a personal world, unaware of everyone else. Sokhadze leads Augusta back to a narrow room dominated by an overstufed easy chair. He fts her with a swim cap and begins attaching electrodes to her fngers, hands and ankle, preparing to record heart rate, muscle tension and skin conductance — a measure of arousal. Tis is Augusta's eighth treatment, and she seems at ease, pouring herself into the chair like a girl without a spine, resting her head on the chair's overstufed arm and yawning several times. Sokhadze talks to her as he works. Augusta yawns some more. It took awhile for Moe and Rob Womack to realize their daughter was diferent from other kids. Moe puzzles at all the signs they missed: Augusta's reluctance to speak, her month-old infant looks at his bottle, and then looks up at Mom, then at his bottle, then up at Mom. Or the infant looks up at an airplane, then looks at Dad, then looks at the plane again. It's as if the baby recognizes that we're all in this together. A child with autism doesn't create these momentary triads. Te fnal major sign of autism is a pattern of repetitive, rote play or restricted interest. Instead of playing with a toy truck by running it along the foor, says Tomcheck, "these kids may be more excited about turning the car over and watching the wheels spin." Augusta didn't talk until she was four. "Tere were times she would say something, or it sounded like she would say something, 8.13 LOUISVILLE MAGAZINE 57