[NVIC] AAP Urges Early Autism Diagnosis, Then Drugs Often Used

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AAP Urges Early Autism Diagnosis, Then Drugs Often Used

by Barbara Loe Fisher

America's pediatricians, who cannot explain to American parents why so many

of their young, highly vaccinated children are developing autism and other

developmental disabilities, announced this week at a conference in San

Francisco that it is time for doctors to get serious about diagnosing

autism early and often.

http://www.time.com/time/health/article/0,85

99,1677611,00.html?xid=feed--healthsci

This push for " early diagnosis " before age two is coupled with a push for

" early intervention. " Currently that intervention involves doctors

prescribing psychiatric drugs for 80 percent of the children diagnosed with

autism or Asperger disorder according to a report released at the same

conference.

http://www.medscape.com/viewarticle/565002

Although few parents would argue that it is important to recognize when a

child is regressing physically, mentally and emotionally into autism, many

parents are more interested in addressing the biological root causes for

the kinds of brain and immune system dysfunction that their autistic

children are exhibiting, rather than giving their children psychotropic

drugs that only suppress the symptoms. Many parents, like Goldenberg

in the early 1990's and McCarthy a decade later, have found that

eliminating gluten and casein from their child's diet and employing other

alternative therapies to repair healthy immune function, can effectively

address vaccine-related biological causes for autism and greatly improve

their children's health.

However, currently mainstream American pediatricians are overwhelmingly

attempting to deal with the autism explosion by drugging children. Tobias

Gerhard, PhD, assistant professor at the Rutgers University Institute for

Health, Health Care Policy, and Aging Research acknowledged that the

prevalence of Autism Spectrum Disorders increased 10-fold in the last

decade and presented an analysis of medical care surveys reflecting two

million health visits involving autism or Asperger disorder. He found that

children were overwhelmingly male and white and that disruptive behavioral

disorders were involved with 3 of every 10 cases.

The surveys revealed that about 80% of children diagnosed with Autism

Spectrum Disorder are treated with at least one psychiatic drug; 30% are

given antipsychotic drugs, 40% antidepressants, 40% stimulants and about

30% some other drug, including mood stabilizers and anticonvulsants. Some

children are prescribed several medications. " As with many psychiatric

conditions in children, we really know very little [about] how these drugs

actually work and how they should be used in practice, " Dr. Gerhard said.

In Canada, where there is a nationalized health care system and long

waiting lines for a doctor's appointment, there is a warning by Canadian

pediatricians that early screening and treatment for autism is easier said

than done. The former president of the Canadian Pediatric Society, Emmet

Francoeur, points out that increased screening would involve an increase in

the number of evaluation teams and treatment services, all of which is time

consuming and expensive. He says " Unfortunately, unlike a broken bone or

pneumonia, where you can take an x-ray and come up with a diagnosis, it

takes multiple observers looking at multiple aspects of a child's

development to diagnose autism. "

http://www.theglobeandmail.com/servlet/

story/RTGAM.20071030.wautism30/BNStory/specialSci enceandHealth/home

As hard as it is for pediatricians to figure out how they are going to

identify and treat lots of highly vaccinated autistic children, it is much

harder for parents searching for answers for why their once healthy

children developed autism and how to help them heal. The diagnostic

screening tests, the visits to different doctors specializing in different

parts of the body and the drug and behavioral therapies that may or may not

work, can bankrupt the average middle class family.

One day, the educational and health care costs associated with the biggest

epidemic our nation has ever experienced - the chronic disease and

disability epidemic - may bankrupt our nation. It is a chronic illness

epidemic that makes the polio epidemic of the 1950's look small by

comparison. We are all paying a very high price for the failure of

pediatricians, drug companies and government health officials to act

responsibly in the 1980's when parents of DPT vaccine injured children

pleaded with them to conduct methodologically sound scientific studies to

investigate the biological mechanisms and genetic factors involved in

vaccine-induced regression and neuroimmune dysfunction.

http://www.time.com/time/health/article/0,8599,1677611,00.html?xid=feed-yaho

o-healthsci

Finding - and Fighting - Autism Early

TIME Magazine

October 30, 2007

by Wallis

From the earliest months, a healthy baby engages in an astonishing range of

social behaviors. Most will begin smiling back at a loved one in the first

four months of life. Most will follow a parent's gaze with their own eyes

by eight months. Most will also study a caregiver's facial expressions and

mimic exhibits of fear, surprise or delight with their own tiny features.

They will babble a conversation back and forth by nine months, respond to

their names by 10 months, and begin to point to a desired toy or treat by

around a year.

But some babies won't do these things, and a pattern of such deficits can

be an early sign of autism. Despite these and many other early tip-offs,

autism spectrum disorders (ASD) are rarely diagnosed before age 3. More

subtle forms, such as Asperger's Syndrome, may not be recognized until the

child begins school.

The American Academy of Pediatrics (AAP) would like to change this. At its

annual meeting, held in San Francisco on Monday, the AAP released two

reports: one aimed at helping pediatricians recognize autism spectrum

disorders - in all their varieties - by age 2 and the other at providing

guidance for early intervention. At the same time the AAP formally

recommended that all pediatricians routinely screen for autism at ages 18

months and 2 years and announced it was making a new " toolkit " of

diagnostic information available to all its members - for about $70.

The announcements came in response to a growing consensus that autism can

be picked up very early in life and that early intervention holds the best

promise for helping affected children. It is also an admission that,

despite an explosion of news on autism in recent years, pediatricians are

not currently doing an optimal job of identifying the spectrum of

conditions now believed to affect as many as 1 in 150 children. A 2004

survey of primary care pediatricians found, for instance, that only 8% were

routinely screening for autism, even though 44% said they saw at least 10

kids with autism in their practice.

The AAP had already recommended routine screening for autism in 2006, but

the new recommendations are more specific and backed by more information

for practitioners. Two screenings are needed - one at 18 months and one at

24 months, explains Dr. Meyers, who authored one of the reports,

because about a quarter of children with ASD appear to develop normally at

first and then regress - losing early language and social behavior -

sometime between 15 and 24 months.

Meyers, a neurodevelopmental pediatrician with Geisinger Health System in

Danville, Pa., wrote the AAP's new survey of research on managing the care

of children with autism. His report supports intensive behavioral and

speech therapy - at least 25 hours a week - beginning as early as possible.

But, he concedes, there's a lack of rigorous, randomized research on what

interventions work best. The report encourages pediatricians not to condemn

parents who turn to alternative therapies, but to help guide them toward

the safest and best researched approaches. " Don't just dismiss it out of

hand, " says Meyers, " It's important to keep communication open and respect

the fact that parents are going to be looking of answers. "

http://www.medscape.com/viewarticle/565002 (requires registration but it is

free)

Physicians Rely on Psychiatric Drugs to Treat Autism Spectrum Disorders

Medscape

October 29, 2007

by Brice

(San Francisco) - An observational study of physician prescription patterns

indicates that 80% of children diagnosed with autism or Asperger disorder

are treated with at least 1 psychiatric drug.

Results presented here at the American Academy of Pediatrics 2007 National

Conference and Exhibition reflect the medical community's initial

therapeutic response to the growing prevalence of autism spectrum disorders

(ASD) including autism and the generally less debilitating Asperger

disorder. An estimated 1 child in 150 in the United States and United

Kingdom is affected by ASD, according to Tobias Gerhard, PhD, assistant

professor at the Rutgers University Institute for Health, Health Care

Policy, and Aging Research.

The degree of impairment associated with both conditions is highly

variable. Their etiologies are unknown, though the prevalence of ASD has

increased 10-fold in the last decade, Dr. Gerhard said.

Treatment typically includes behavioral, educational, and pharmacologic

components. A lack of understanding about the characteristic use of

medications to treatment ASD led Dr. Gerhard to sift through data from the

National Ambulatory Medical Care Survey and the National Hospital

Ambulatory Medical Care Survey for answers. In combination, he said, they

reflect the experience of 2 million visits involving autism or Asperger

disorder annually.

Data from 2002 to 2005 revealed variations, though no statistically

significant differences, in the demographics of autism and Asperger

disorder patients. The average age of an autism patient was 9.7 years,

compared with 11.1 years for an Asperger patient. Patients were

overwhelmingly male and white. The presence of psychiatric comorbidities

for autism and Asperger disorder were 36% and 44.4%, respectively.

Disruptive behavioral disorders were involved with 3 of every 10 cases for

each condition, Gerhard said.

About 80% of children diagnosed with ASD were treated with at least 1

psychiatric drug. About 30% of patients were prescribed antipsychotic

drugs, 40% antidepressants, 40% stimulants, and about 30% some other class

of drug including mood stabilizers and anticonvulsants. Some patients are

treated with several medications.

Physicians tended to prescribe psychoactive drugs more often for Asperger

disorder than autism (89% vs 64%). Differences in the treatment pattern

were especially evident for the prescription of stimulants. About 57% of

Asperger patients were prescribed stimulants compared with 20% of Autism

patients.

However, these results apply to the prescription pattern before US Food and

Drug Administration approval of the antipsychotic drug risperidone in 2006.

Session moderator W. Rutherford, MD, professor of epidemiology at

the University of California, San Francisco, told Medscape Pediatrics that

the data suggest an evolution toward a de facto standard for treating ASD.

" If you are looking to see what your colleagues are doing, there is a

tendency to treat a large portion of these patients with psychotropic

drugs, " he said in an interview.

The findings suggest to Dr. Gerhard that more research is needed to

determine whether the drug prescription pattern reflects the clinical

efficacy of the agents or an effort to placate parents who demand

aggressive treatment.

" As with many psychiatric conditions in children, we really know very

little [about] how these drugs actually work and how they should be used in

practice, " Dr. Gerhard said. " This is really a first step in research that

should ultimately motivate more research. "

American Academy of Pediatrics 2007 National Conference and Exhibition.

Presented October 28, 2007.

www.theglobeandmail.com/servlet/story/RTGAM.20071030.wautism30/BNStory/speci

alScienceandHealth/home

Autism groups support earlier screening

Globe & Mail

October 30, 2007

by Unnati Gandhi

:

Canadian autism groups are putting their weight behind an American call for

universal screening for the disorder, but pediatricians here are wary of

the realistic benefits of doing so.

The split comes as the American Academy of Pediatrics at its annual meeting

in San Francisco yesterday made its strongest push to date to screen every

child twice for autism by the age of 2, warning of symptoms such as failure

to babble at nine months and one-year-olds who don't point to toys.

The advice is meant to help both parents and doctors spot the disorder

sooner. And while there is no cure, experts say that early therapy can

lessen its severity.

" Absolutely, we need a screening procedure in place, " said Margaret

Spoelstra, executive director of Autism Ontario, adding there is currently

no standard screening practice in place in Canada. " To screen means that

we're simply casting the net more widely in order to determine who might

have autism out there. For us, it's better to have some false positives

than to miss kids. "

But too many false positives is precisely where the problem lies in

practice, according to a leading Montreal pediatrician, because that would

overload a system that is already strained.

Going from a screening to therapy requires a multidisciplinary team of

specialists who can properly diagnose the disorder, said Emmett Francoeur,

director of the child development program at the Montreal Children's

Hospital and former president of the Canadian Paediatric Society.

But the waiting list for such an evaluation is as long as a year in some

parts of Canada.

" We know that the earlier you diagnose them, the better the outcome. That

we're pretty sure of, " he said last night. " Unfortunately, unlike a broken

bone or pneumonia, where you can take an X-ray and come up with a

diagnosis, it takes multiple observers looking at multiple aspects of a

child's development to diagnose autism. "

So, he said, if screening were to be increased, that would mean an increase

in the number of evaluation teams and the amount of services for treatment

- all of which are not currently feasible.

" Should all of this be done? I think so, if you're talking about the moral

aspects of trying to help every possible child who has autism, " Dr.

Francoeur said. " Can it be done? It's a really tough question because the

governments have to decide where to put all their money. "

As for screening, Dr. Francoeur stressed that there are several methods

that are used, but only a few are accurate enough to warrant widespread

promotion.

The two American Academy of Pediatrics reports, which will appear in the

November issue of the journal Pediatrics, list numerous warning signs, such

as a four-month-old not smiling at the sound of mom or dad's voice, or the

loss of language or social skills at any age.

The academy's renewed effort reflects growing awareness since its first

autism guidelines in 2001. A 2006 policy statement urged autism screening

for all children at their regular doctor visits at 18 months and 24 months.

The authors caution that not all children who display a few of these

symptoms are autistic and they said parents shouldn't overreact to quirky

behaviour.

The new reports say children with suspected autism should start treatment

even before a formal diagnosis. They also warn parents about the special

diets and alternative treatments endorsed by celebrities, saying there's no

proof that those work.

With a report from Associated Press

************************************************************

National Vaccine Information Center

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founder.

Learn more about vaccines, diseases and how to protect your informed

consent rights at www.nvic.org

--------------------------------------------------------

Sheri Nakken, former R.N., MA, Hahnemannian Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

Vaccines - http://www.wellwithin1.com/vaccine.htm Email classes start in

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