Saturday, February 27, 2010

Clinic Notes: Autism's Earliest Symptoms and ABA

At the Childrens Treatment Center ( I see 40+ kids a week. Most of these children have autism and are helped by ABA. Naturally, with autism being epidemic, I have been looking for signs of autism in my grandchildren from birth on. Studies have found that if intensive ABA is started early enough the symptoms and the diagnosis of autism may disappear and I want to be ready. Normally developing infants show some signs of autism at times--staring at objects--not responsive to stimuli--avoiding eye contact--etc. The question is when in the infant's development are these signs clinically significant. A recent study from the MIND Institute finds that symptoms like eye contact--smiling and communicative babbling are not present at 6 months, but develop gradually and only become observable during the latter part of the first year of life in infants. Furthermore, these behaviors appear they decline slowly, not suddenly in infants with autism. So watch your infant from 6 to 12 months and be prepared to start ABA if you notice these declines.

Wednesday, February 24, 2010

Clinic Notes: Children with Developmental Disabilities and God

According to a recent Schafer Report, Bob Marshall, a legislator in Virginia, said in a press conference that disabled children are God's punishment because mom's had prior abortions. The press conference was a group of 20 or so clergy who were opposed to state funding for Planned Parenthood who provides abortions. Well, I see 40 plus kids in my clinic each week and their parents are struggling with the stress of raising a child with special needs and the last thing they need is to hear is that it's God's punishment. I guess I'm going against God for providing ABA and behavior management for these families. It will be interesting to see what fellow Republican Sarah Palin says about this. And by the way Mr. Marshall, none of the moms of disabled children who come to my clinic had an abortion.

Wednesday, February 17, 2010

Clinic Notes: Mandatory Insurance Coverage for ABA for Autism

The Virginia Senate Passed a bill requiring insurance companies to pay for ABA, the most effective treatment for autism. The lobbyist for the health insurance company fought hard, but lost. Other opponents argued that the mandated coverage would result in higher coverage, perhaps even forcing some employers to drop insurance coverage for their employees. Autism Speaks said that mandated coverage would increase the cost by $10 to $25 per year. Tennessee, the sate where I live and practice, passed the Autism Equity Act several years ago which said that if insurance companies cover other neurological disorders then they must pay for autism. Parents have told me that when they have called the insurance companies to remind them of this they say their home office is not in Tennessee so they do not have to comply with the bill. Also ERISA, or employee funded insurance companies are exempt. If mandatory insurance coverage for ABA becomes law in Virginia I hope families fare better than Tennessee.

Friday, February 12, 2010

Clinic Notes: Autism and Wakefield

Lancet has formally retracted Dr. Wakefield's paper that purportedly found a link between autism and the MMR vaccine. His "finding" made so much sense. Mercury is toxic to the nervous system and autism is usually diagnosed between the second and third year shortly after the MMR vaccine is given to children. But it was a flawed study and better-done research has found no link. Many parents are still convinced though and yelling cover up by government and the pharmaceutical industry. Recently, it was time for my grandchildren to get their MMR vaccines. I'll admit that I cringed. I know that's it's very difficult for a parent who has a normally developing child to see them regressing after the MMR vaccine. It is not a causal link, but so emotional and hard for parents to put aside. But it is time to move on and look for the real cause of autism.

Tuesday, February 02, 2010

Clinic Notes: Successful Treatment of Autism Depends on Parental Involvement

Many studies have shown that early diagnosis and intensive therapy is the key to the successful treatment of autism. Multiple therapies including Applied Behavior Analysis (ABA), speech therapy, occupational therapy, and medication are essential. Parents must not only find a way to pay for these services, but get their children to therapy, which is usually weekly. (Unfortunately, money, or the lack of it, determines what services, if any, a child with autism will receive.) Only a small percentage of parents can afford, or find qualified therapists who will see their child more than once a week. Autism is epidemic and money speaks. Lovaas recommends 40 hours of ABA a week, but who can afford that or find a therapist who will give a single child an entire workweek. So the majority of the therapy--ABA, speech, ot, etc falls to the parent. It's a burden--but one that pays off in the long run.