Autism: Messages of Hope

In honor of April as Autism Awareness Month,” Bradley Hospital is offering messages of hope to families who are facing this devastating condition.

Rowland Barrett, PhD, director of the Center for Autism and Developmental Disabilities at Bradley Hospital is a nationally recognized expert in autism, and 2007 recipient of the Alice Oster award, presented by the Autism Project of Rhode Island in recognition of his exceptional work to improve the lives of children, teens and adults with autism. Barrett addresses key autism-related issues here including early intervention and prevalence rates.

Early intervention can work
“A child’s diagnosis of autism is a very difficult burden for parents to bear, but it’s important to know that there are very effective, very promising treatments available, and that early intervention can make a world of difference,” says Barrett.

The Center for Autism and Developmental Disabilities at Bradley Hospital offers an early intervention program for young children with autism. The Intensive Behavioral Treatment (IBT) Program, a home-based program, focuses on referrals for children under the age of four years. For 20 to 40 hours per week Bradley Hospital staff come to a family’s home, interact with the child on a one-on-one basis, and include family members in the treatment plan. Ideally this weekly regimen can last for up to three years spanning the ages of two to five.

“Early and intensive treatment is an effective way to treat autism spectrum disorders often allowing us the opportunity to begin treating children soon after they are diagnosed with autism, and resulting in substantial gains across the areas of communication, social, and play skills,” says program co-director, Karyn Blane, PsyD.

For example, Blane cites success stories of children who were diagnosed with autism as toddlers, went through the IBT program, and now are functioning well in regular school classrooms.

Research into intervention programs for children with autism spectrum disorder shows that intense education and training using positive reinforcement methodology, coupled with early intervention is a recipe for success. A recent study of autistic children diagnosed and treated at age two, found only 14 percent remained non-verbal by age nine, and between 35 percent and 45 percent could speak fluently.

Experts say children with the neurodevelopmental disorder must be taught what comes naturally to their peers, and while the brain is still pliable enough to absorb the lesson. And because the immature nervous system has a great deal of plasticity, many neuroscientists think early treatment may enrich neural growth.

“Early detection and screening measures can help determine whether or not a child has an autism spectrum disorder at a very early age, so the take-home message to parents is to seek early intervention treatment as soon as a child is diagnosed,” says Barrett.

What the statistics don’t tell us
A recent Centers for Disease Control (CDC) report released in February found that one in 150 of the children who were studied showed behavior that was characteristic of and consistent with a diagnosis of an autism-spectrum disorder.

“In 2004, the CDC partnered with the American Academy of Pediatrics and found autism prevalence rates somewhere in between one in 166 and one in 500, but the media picked up on the higher estimate, which created concern about a so-called autism epidemic. And subsequently, this new CDC study also shows higher prevalence rates than what we thought before,” says Barrett.

While Barrett agrees that the numbers can seem frightening, he cautions that since we never knew what the true prevalence of autism was, it’s hard to classify it as an epidemic. Also, the CDC report does not represent a national sample, and the figures are taken from reviewing medical records, not from face-to-face interviews.

He argues that one of the most-important features of the increase in the autism numbers has been a change in nosology.

“By that I mean specifically broadening the definition of autism to include closely related groups of autistic-like behavior, such as Pervasive Development Disorder and Asperger’s Disorder,” Barrett explains.

He says that because the prevalence of Pervasive Development Disorder (PPD) and Asperger’s Disorder is 300 to 500 percent greater than the narrow definition of classic autism, it makes sense that when the definition of autism was widened to include these disorders, one would expect to see a three to five-fold increase of prevalence rates under the new definition of autism.

“When the definition was broadened to include PDD and Asperger’s, it’s not as if only a few kids who were on the cusp of autism were folded into the group. There are five times as many children with PPD and Asperger’s Disorder than there are with autism,” says Barrett.

Barrett believes that a broadened definition of autism has been a major contributing factor to increased rates in autism; however, closer scrutiny of the condition also has contributed to the higher numbers.

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