Routine Autism Screening Should Be Done at an Early Age, Experts Say

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June 14, 2001 Search www.feat.org/search/news.asp

GENERAL NEWS

Also: * Parents Sue Province To Get Child Treatment

* Diet Changes May Ease Autism Symptoms: Study

* Apply Research To Autistic Children

* New Books on Autism

Routine Autism Screening Should Be Done at an Early Age, Experts Say

Health: Quick intervention is the key to improving the lives of children

with the disorder, it is found.

[by Martha Groves, LA Times.]

http://www.latimes.com/news/nation/20010614/t000049494.html

Children as young as 2 should be routinely screened for autism, just

as they are for vision and hearing problems, a national committee of experts

recommended Wednesday.

Early diagnosis is crucial because prompt intervention using various

educational programs greatly improves the chances that very young autistic

children will learn to communicate properly and develop appropriate social

skills, according to a report by the National Research Council panel. Autism

is a disease of the brain, which is more malleable at younger ages.

" We need to have coordination of services and intensive intervention

starting very early, " said Lord, a professor of psychiatry at the

University of Chicago who headed the panel. " These efforts should be

systematically planned, tailored to the needs and strengths of individual

children and their families, and regularly evaluated. "

The panel urged that federal, state and local public agencies

coordinate efforts to ensure that children receive services free of charge.

Because of sparse funding and the growth in autism cases, the availability

of services varies drastically from school to school, district to district

and state to state. Many children seeking services end up on long waiting

lists.

" It shouldn't be up to parents to pay for that or have to fight for

that, " Lord said.

Autism is a severe and perplexing developmental disorder in which

children often become isolated from the world around them and develop poor

communication and social skills. Diagnoses within the autism spectrum

include autism, pervasive developmental disorder not otherwise specified,

Asperger's syndrome and childhood disintegrative disorder. These

disabilities differ in severity and the age of onset.

The reported incidence of autism has surged over the last two

decades, the researchers noted in their report. From 1975 to 1985, studies

showed the worldwide rate of autism to be about 4 cases per 10,000 people.

From 1985 to 1995, the numbers tripled to 12 per 10,000. Researchers now

believe that the actual rate is much higher, on the order of 1 in 500 or

even 1 in 250.

As of April, there were 14,777 children with autism enrolled in the

California Department of Developmental Services' 21 regional programs. That

was up more than 280% from the number enrolled in 1987.

In the Los Angeles Unified School District, the number of students

eligible for special education services because of autism has soared to

2,797 from 623 a decade ago.

Whether the reported increases result from improved diagnosis and

greater awareness or from an actual growth in the disorder has yet to be

settled, researchers said.

The notion that children should be screened at a very young age grows

out of the recommendation of another group of psychologists, speech

pathologists and pediatricians. That group recently developed screening

guidelines and is attempting to get the word out to pediatricians, who often

serve as the first line of defense.

" Routinely, we weren't picking up kids [with autism] until about age

3, " said Schmidt-Lackner, an assistant professor at UCLA's

Neuropsychiatric Institute. " Now I'm picking them up as early as a year to

14 months. "

Although much about how to treat autism remains a mystery,

Schmidt-Lackner said, " the one thing we do know is that early intervention,

when the brain is still very plastic and connections can be changed, will

optimize prognosis and outcome. "

The panel recommended that services for young children be offered a

minimum of 25 hours a week year-round, although many autism experts say it

should be more like 30 to 40 hours, if the child can tolerate it. The

recommended education programs would include training in how to conduct

appropriate conversation, read body language and control aggressive

behaviors.

The panel also endorsed a rich ratio of teachers to students and

called for further research to sort out treatments work best.

The report is available on the Web at

http://www.national-academies.org.

* * *

Parents Sue Province To Get Child Treatment

Autistic girl needs care, mother says If untreated, she could end up in a

group home.

[in The Halifax Herald Limited.]

www.herald.ns.ca/cgi-bin/home/displaystory?2001/06/14+204.raw+Metro+200

A family-law lawyer and her husband are suing the province to get the

medical treatment and education they say their autistic daughter needs.

Joyce Dassonville and Yves Trudel of Dartmouth launched a lawsuit June

6 on behalf of six-year-old Dominique Dassonville-Trudel.

" There really was no choice to make, " Ms. Dassonville said. " How can a

mother stand by and watch her child suffer when there is a scientifically

proven treatment that could make a difference in her child's life? "

Named as defendants in her claim are the provincial departments of

Health, Education and Community Services, as well as the IWK Health Centre

in Halifax, the Halifax regional school board and the province's attorney

general.

If successful, Ms. Dassonville said, her suit will ensure that all

autistic children in the province receive the treatment they need.

" If my daughter had cancer, if she broke her leg, if she needed

surgery . . . all of those things are covered by our medicare system, " she

said.

" Treatment for her autism is not, which to me makes no financial sense

whatsoever. "

Autism is a neurological disorder that often leads to impaired social

interaction, speech disorders and repetitive behaviour. Autistic children

often have difficulty expressing themselves, which can lead to violent

behaviour.

Ms. Dassonville said she and her husband first noticed something

wasn't right when Dominique was a toddler.

" When she was very young, she would play with the dirt in the garden

and watch the little specks fall down, " she said. " She'd be plucking hairs

out of the cat, one hair at a time. "

It took more than a year for her to be diagnosed. Then, about a year

ago, they learned of a treatment that might help her.

Known as early intensive behavioural intervention, it's been used in

the U.S. since the 1970s, where studies show about half of autistic children

who undergo treatment achieve normal or near-normal functioning by Grade 1.

" (Dominique) was on a clear path to becoming a completely

dysfunctional adult, " Ms. Dassonville said. " There was simply no question

that I was going to get this therapy for my daughter. "

But their requests for funding were denied by the provincial

government. Ms. Dassonville said the lawsuit seems to be the only way to get

treatment before it's too late.

The therapy is expensive; she estimates it will require two therapists

and cost $60,000 a year for several years.

She believes the Health and Community Services departments should pay

that amount now to avoid paying more later.

" The reason why the province should pay for it is because the

alternative is a totally dysfunctional adult, " she said.

" Untreated autistic children are given up by their families because

they can no longer handle them. A large number of autistic children are put

in group homes at the expense of the government. "

Ms. Dassonville is also suing the Education Department and the school

board, saying their policies do not provide the support that special-needs

children require to learn.

Spokespersons for the defendants declined to comment on the case.

Jo-Lynn Fenton of the Autism/PDD Society of Mainland Nova Scotia

couldn't comment on the case, but she said the level of treatment for

autistic children in Nova Scotia is " far below best-practice standards. "

The Geneva Centre for Autism in Toronto estimates autism affects 10 to

12 in every 10,000 children.

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* * *

Diet Changes May Ease Autism Symptoms: Study

[by Griffiths.]

http://dailynews.yahoo.com/h/nm/20010613/hl/autism_1.html

Reuters Health - A small study conducted by US-based researchers is

providing preliminary scientific support to the idea that changes in diet

can improve symptoms in some people with autism.

Autism is a neurological disorder that impairs thinking, feeling and social

functioning. It typically appears during the first 3 years of life and can

range in severity and symptoms, from mild to devastatingly severe

impairment.

Heredity is thought to play a major role in the disease. Dr. Ted

Kniker has been investigating the theory that poorly degraded food proteins

leak from the gut into the blood, having a drug-like effect that changes

brain activity.

In the first part of his study, reported by Reuters Health in early

May, Kniker, of the San Autistic Treatment Center in Texas, found

that 5 out of 28 children and adults with autism showed improvements in

their symptoms after elimination of dairy products and wheat glutens from

their diets.

In the second part of the study, the researchers eliminated several

other foods, including buckwheat, soy products, tomato, pork and grapes from

the patients' diets. “The improvements were really exciting,” according to

Kniker, who collaborated in this study with colleagues at the Autistic

Treatment Centers of Texas.

“Symptoms changed dramatically in 39.3% of patients during the second

phase of the 3-month intervention period,” he said. Eight out of 28 patients

showed clear improvements, as measured by a variety of quantitative scoring

methods, including the Autistic Treatment Evaluation Checklist.

“Only three patients deteriorated, but we hope that these individuals

will improve in time. In the first part of the study, five patients

deteriorated, but two of these returned to their baseline levels in the last

month of the study, so it could be that the others who deteriorated are

still eating potentially allergenic foods,” he said.

Kniker argues that autism is not usually a defect in brain

development, but is more likely to be a brain dysfunction that is secondary

to extraneous factors, such as dietary factors, immune dysfunctions,

infections or toxins.

“In future studies, we will improve our strategy by identifying all

potentially troublesome foods by blood tests, dietary elimination and

challenge procedures, rather than imposing an arbitrary diet,” Kniker

stated.

Commenting on the study, autism expert Professor Hall from the

London School of Hygiene and Tropical Medicine agreed that “further

carefully conducted randomized trials of this dietary approach to treatment

are worthwhile.”

But he noted that “whether or not treatment is effective does not

necessarily imply that an abnormal response to food is part of the cause of

autism. Any abnormal response to food could be a result of autism.”

Kniker cautioned that standard behaviour management, psychological and

educational approaches to the treatment of autism will still be necessary,

because improvements in cognition and mood can lead to new stresses and

demands on patients.

“As we noted in the previous study, some individuals who showed

improvements in brain function showed deterioration in behaviour, as they

found it hard to deal with these dramatic changes,” he said.

Kniker will present his findings at a meeting in Sicily at the end of

June.

* * *

Apply Research To Autistic Children

[Letter by Winfield.]

http://www.sun-sentinel.com/news/opinion/letters/sfl-pbbr563jun14.story?coll

=s

Dr. 's May 25 column on brain research and the

implications for iel Brazill was interesting. It may even be

unexpectedly promising, for if with " repeated brain scans of kids from 3 to

20, we pieced together `movies' showing how brains grow and change, " then,

with numerous brain scans of children as young as 3 (all presumably normal),

you have half of all the data to embark on a scientific study to find the

answers to autism.

The other half of the data you need -- from autistic children -- would

come easily as thousands, if not tens of thousands, of parents and children

would flock to find the answer to this awful disease. Being told only that

their child has " a neurological " disorder, with no therapy other than

questionable behavior modification therapy, and no cause or what lies in

store for their next child, the troubled parent is understandably

distraught.

A study using brain-scan techniques might result in an understanding

of the disease and possibly lead to medical therapies. Copyright © 2001,

South Florida Sun-Sentinel

* * *

New Books on Autism

[Thanks to the CAN Newsletter.]

Educating Children With Autism

by National Research Council(Editor), et al

Publication date: April 2001

Publisher: National Academy Press

Binding:Hardcover

Subjects: Education; Methods Of Instruction In Special Education; Autism

Breaking Autism's Barriers : A Father's Story

by Bill , Goldband Schunick(Contributor)

Publication date: April 2001

Publisher: Kingsley Pub

Binding:Paperback

Subjects: , ; Mental health; Autism

High Functioning Autism and Asperger Syndrome: A Roadmap

by Andron(Editor), et al

Publication date: April 1, 2001

Publisher: Kingsley Pub

Binding:Paperback

Subjects: Autistic children; Family relationships; Asperger's syndrom

Making a Difference : Behavioral Intervention for Autism

by Maurice, et al

Publication date: May 2001

Publisher: Pro Ed

Binding:Paperback

Subjects: Education

Incorporating Social Goals in the Classrooms: A Guide for Teachers and

Parents with High Functioning Autism and Asperger Syndrome

by A. Moyes

Publication date: May 2001

Publisher: Kingsley Pub

Binding:Paperback

Subjects: Autistic children; Education; Social aspects

* * *

Reader’s Posts

You're not crazy! You don't need therapy, you need a coach! I am a

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Ackerman

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June 28, 2001 from 6:30-8:30PM at Carroll Springs School is our Kick-off

meeting to organize the ASA Chapter in Carroll County, land. Please

come join us to meet and talk with other families. Free child care and

refreshments provided. Contact Jacy Haas at jacyhaas@.... We

will support families in Carroll County, MD; Hanover, Gettysburg,

Littlestown, PA, with children diagnosed with autism spectrum.

******

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