[DS-Autism] New Guidelines Promise Earlier Identification of Autism

[Guest guest]

April 23, 2007

New Guidelines Promise Earlier Identification of Autism

CDC/ICDL Working Group Releases New Report during Autism Awareness Month

Washington, D.C., April 23, 2007 (ICDL) – Leading experts on child

development today presented a new framework for identifying children at risk of

Autism

Spectrum Disorders (ASD) and other developmental challenges, saying that

current guidelines fail to identify many children who need and would benefit

from early intervention.

The framework is contained in a report by a special working group formed by

the Centers for Disease Control (CDC) and the Interdisciplinary Council on

Developmental Learning Disorders (ICDL), co-chaired by Dr. José Cordero,

former

Director of the CDC’s National Center on Birth Defects and Developmental

Disabilities and currently Dean of the School of Public Health of the

University

of Puerto Rico, and Dr. Stanley Greenspan, chair of the ICDL.

The framework presents newly formulated indicators to identify at-risk

children in the first and second years of life, components for a comprehensive

evaluation of infants and children determined to be at risk, and essential

elements of a successful early intervention program for ASD and other

developmental disorders.

The authors say the new rubric casts a wider net than current common

practice in an effort to identify all children at risk of developmental

disabilities.

“Children identified with developmental or behavioral disabilities earlier

have a better chance of reaching their full potential,†said Dr. Cordero.

“We

believe this framework improves our ability to identify infants, young

children, and families at risk and to organize truly comprehensive,

developmentally-based intervention efforts.â€

The CDC-ICDL framework is based on current understanding of healthy

developmental patterns and is designed to detect all possible deviations from

those

patterns. It uses risk indicators designed to detect a lack of mastery of

age-expected emotional, social, and cognitive milestones during a child’s

first 2

years of life. These include the inability to:

* Be calm and focus on sights and sounds by 2 months of age

* Initiate and sustain warm, joyful interactions with caregivers by 4

months of age

* Exchange emotional and social gestures (using different sounds),

reaching, exchanging, back-and-forth smiling, looking, and searching by 8-9

months of age

* Engage in shared social problem-solving and playing, including

taking a caregiver’s hand to find a toy or favorite food; playing with a toy

and

caregiver together with lots of back-and-forth exchanges of sounds; and social

gestures such as smiles, looks, and pointing by 12-16 months of age.

Early identification and preventive intervention for ASD and other

developmental disorders have been long-standing goals, yet until now there has

been no

widely accepted framework for determining which infants and young children

are at risk and the best ways to intervene. The new framework is intended to

fill that gap to help more infants and young children overcome early

challenges and acquire the foundations for healthy emotional, social, and

intellectual

development.

The CDC-ICDL report, which is being released during Autism Awareness Month,

comes at a time when concern about autism and other developmental disorders

is growing. A recent CDC study showed that an estimated 1 in 150 children in

the United States has autism, a rate much higher than previously thought.

Moreover, nearly 17% of U.S. children present a wide range of developmental

challenges, including autism and other learning disabilities, that require

early

identification and preventive interventions. However, less than 50% of these

children are identified as having a problem before starting school.

In presenting the new framework, the CDC-ICDL Working Group Report cautions

against evaluations that are limited to specific behaviors or diagnostic

criteria. During infancy and early childhood, all children who do not

demonstrate

mastery of the newly formulated healthy development milestones should

receive early diagnostic evaluation and early intervention, the report says.

A comprehensive evaluation must include assessment of social, emotional,

cognitive, language, motor, and sensory functioning; parental and family

patterns of interaction; and availability of community support, says the

report. It

recommends that intervention programs focus on infant-parent relationships,

family functioning, and overall social-emotional, cognitive, motor, and

sensory functioning. The report concludes that narrowly focused intervention

programs that target specific behaviors or symptoms may increase risk in

infancy

and early childhood.

“This report is important to the future of children and families all over

the country,†said Dr. T. Berry Brazelton, founder of the Child Development

Unit at Children’s Hospital Boston and the Touchpoints Center and member of

the

CDC-ICDL Working Group. “Without it, many adults would be thrust on our

society with untreated autism that might have been effectively treated had

intervention been started early in their childhood. We know that the earlier in

childhood --or even in infancy-- treatment begins, the more likely people

affected by autism can adapt to society and the workplace.â€

Brazelton added, “With the frightening rise in the incidence of autism, we

are facing a costly epidemic. The ICDL has been working to identify these

babies early and to introduce therapeutic intervention as early as possible.

This

therapy works to increase the process of social and neurological org

anization that help these children learn to function, to help parents

understand

their role with them, and to assist the children themselves to reach out for

the

world they would otherwise shut out. This report is like a lifesaver thrown

into a drowning society. We should all be grateful.â€

Dr. Greenspan also announced that the CDC-ICDL Working Group will

periodically review early detection and intervention programs and the degree to

which

they are consistent with these new principles. “Early identification and

intervention programs that occur early in life can have long-term effects and

should receive the same rigorous long-term scrutiny as any pharmacological

intervention does,†he said.

Work group members included: Co-Chairs - José F. Cordero, M.D., M.P.H.

(former Director, National Center on Birth Defects and Developmental

Disabilities –

CDC) and Stanley I. Greenspan, M.D. (Chair, Interdisciplinary Council on

Developmental and Learning Disorders). Members - Margaret L. Bauman, M.D.

(Massachusetts General Hospital), T. Berry Brazelton, M.D. (Harvard Medical

School), Geraldine Dawson, Ph.D. (University of Washington), Barbara Dunbar,

Ph.D.

(Georgia State University), C. Mundy, Ph.D. (University of Miami), Ruth

Perou, Ph.D. (National Center on Birth Defects and Developmental Disabilities

– CDC), G. , Ph.D. (University of Miami), Stuart G. Shanker,

D.Phil. (York University, Toronto, Canada), and Ruth E. K. Stein, M.D.

(Children’

s Hospital at Montefiore).

The Interdisciplinary Council on Developmental and Learning Disorders (ICDL)

is a non-profit organization dedicated to improving the prevention,

assessment, diagnosis, and treatment of emotional and developmental disorders

in

infancy and childhood by promoting dialogue and integrating knowledge from

different disciplines.

For the complete report and more information, please visit _www.icdl.com_

(http://m1e.net/c?42343594-nobHArqoU23Pw2418974-g7KDfbP2f (DOT) bf.) or contact

Cecilia Breinbauer, M.D., M.P.H. at _cbreinbauer@..._

(mailto:cbreinbauer@...)

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