The incidence of reexposure to lead poisoning in 17 children with pervasive developmental disorders (PDD), including autism, compared to a randomly selected group of 30 children without PDD who were treated for plumbism over the same six year period, was evaluated by a retrospective chart review at the lead treatment program, Children’s Hospital, Harvard Medical School, Massachusetts Poison Control System, Boston, MA. Despite close monitoring, inspection and lead hazard reduction or alternative housing, 75% of children with PDD were reexposed to lead compared to 23% without PDD. Those with PDD were older at diagnosis (46 vs 30 months) and had a longer period of elevated lead (39 vs 14 months) during management. 
COMMENT. Children with developmental delays and PDD are at increased risk of lead poisoning beyond 3 years of age. Children with PDD and other behavior disorders should be tested for lead at regular intervals beyond 4 years of age. More importantly, primary preventive measures designed to abate lead from the environment before lead intoxication occurs may be the only successful method of management.