Thursday, April 22, 2010

Clinic Notes: The Onset of Autism

Everyone knows by now that the earlier ABA is started for children with autism the better. The problem is there are no biological markers so inferences have to be made from behavior. The categorization of autism into infantile, where the disorder is supposedly present at birth, and regressive, where development is normal until between 2 and 3 has fallen out of favor. According to one study that looked at homemade videos signs of autism were present in children latter diagnosed with regressive autism. As a clinician, I was never satisfied with this study. I think there are cases of regressive autism where signs were missed but I still think most parents are right when they tell me everything was normal until 21/2 years or so. A new study from the Kennedy Krieger Institute finds this "lost" distinctions may be vital as far as prognosis. When children with early onset of symptoms (infantile) were compared to children with later onset (regressive) it was found that children with regressive were more severely impaired and need more services. Of course, the earlier the ABA the better for the early onset children, but apparently no biological or behavioral markers for the children with regressive autism.

Thursday, April 08, 2010

Clinic Notes: Autism and Driving

For most teenagers driver's ed and getting a driver's license is a rite of passage that they can't wait for. However, many kids with high functioning autism and Asperger's find the thought of driving stressful. I have had a number of kids on the spectrum in my clinic that simply had no interest in driving. Others found driver's ed very stressful. Some had no problem learning the necessary skills for driving, but once driver's ed was over they had no interest in taking the test to get their license. Sydney University in Australia has begun a specialized driving program for kids with Asperger's. They also report high anxiety levels because of the coordination of sensory and motor systems that driving involves. So far there are no reports on the success of their program. I am interested because in the kids that we are able to mainstream a lack of public transportation in the rural area where I practice is going to mean driving to a job.

Thursday, April 01, 2010

Clinic Notes: World Autism Awareness Day

World Autism Awareness Day is being celebrated April 2. The Secretary of the United Nations is calling for a "Community of Voices to Promote Greater Awareness." For those of us who work everyday with children with autism and for parents of children with autism it is hard to believe that there is a need for more awareness since it occupies our time 24-7. But there is. Many people just don't understand the battle that is being waged over funding, research, and treatment. I do think there is some good news. Parents of children with autism and professionals who work with children with autism are becoming more aware of what works and what does not work. Of course, there are still intense arguments about causes of autism--especially over vaccinations. But most caregivers are settling into mainstream treatments like ABA, speech, occupational therapy, and when necessary medication. More and more parents who come to our clinic are already acquainted with ABA and other mainstream treatments and have decided that ABA should be the treatment for their child. Funding for ABA and finding qualified experienced ABA professionals is now the challenge, as it is for other mainstream treatments. And the waiting line for diagnosis is still too long.