Friday, October 05, 2007

Australian system spots autism in toddlers

Hmmmm... probably useful but much care about misdiagnosis would be warranted

CHILDREN as young as 14 months of age can be reliably diagnosed with autism, according to an Adelaide psychologist who has devised a tool to help experts detect the telltale signs of the lifelong disability. Robyn Young, head of the Early Intervention Research Program at Flinders University, said the assessment tool could even be used to identify risk in children as young as 12 months. Until now, there have not been widely available systems for accurately assessing autism because there are no biological markers or tests. People with the disorder have impaired social interaction, communication and imagination, and often engage in repetitive patterns of behaviour.

Associate Professor Young's system - called Autism Detection in Early Childhood - is the first method to assess 16 behaviours linked to the core brain deficits driving autism. "I had two little ones, 12 and 14 months, this week," Professor Young said. Using ADEC, she found the older child had been misdiagnosed as autistic, while the younger was very likely to have the disorder.

According to Professor Young's colleague, psychologist Carrie Partington, very young children with autism spectrum disorders frequently displayed three types of behaviours: they didn't recognise their name, they didn't imitate adult facial expressions and they didn't switch their gaze. "Most kids will look around the room to share their experience of, say, a new toy," she said. The inability to do that, "gaze switching", is a predictor of ASD.

The exact causes of autism remain unknown. One in every 160 children has the disorder or related conditions such as Asperger's syndrome, according to recent findings from the Australian Advisory Board on Autism Spectrum Disorders. Using Centrelink data, the board found that 10,625 children aged six to 12 had an ASD. It also found most Australian youngsters were not diagnosed until they were two or three. That meant children missed out on early interventions known to improve their functioning, Mrs Partington said. "Age at diagnosis is an important predictor of how well children will do," she said. "If we can get them early, we can make a lot more significant changes."

The type of intervention is also critical. Comparative international research has consistently indicated that the only effective evidence-based approaches are based on behaviour modification. Such programs cost $40,000 to $60,000 a year for each child because they require 14 to 40 hours a week of one-on-one work. To overcome the cost barrier, Professor Young in 2003 established the EIRP, a research body aimed at making home-based therapy possible by providing information, training and services to parents or caregivers.

The EIRP has an eight- to 10-month waiting list for the program, which is free. It consists of a two-week clinic-based program for each autistic child and their parents, during which parents are trained to provide the therapy, and follow-up support for 18 months. In a forthcoming report on the first 87 of 150 children and their families, Professor Young's team claim their approach works as well as conventional behavioural modification programs.


Early intervention important for autistic childrten

In a converted church 10 minutes from Brisbane's CBD, the dedicated staff of a centre for young children with autism have been making little miracles. After a two-year intensive program of speech therapy, occupational therapy and tailored teaching, the first dozen graduates of the AEIOU Centre at Moorooka in Brisbane's south included two boys who no longer fitted the criteria for autism and nine children who were now in mainstream schooling.

One of them is six-year-old Riley Foulis, whose family moved from Melbourne to Brisbane in 2005 so he could attend AEIOU. His mother, Lynda, yesterday cried with pride as she recounted her son's journey from a toddler who would not speak, wasn't toilet-trained and had no self-help skills to the "quirky" young boy who was named student of the month at his mainstream school this year. "He's talking, he's self-sufficient, he answers back and he's cheeky," said Ms Foulis, who now works at AEIOU. "We are so proud. It's so amazing and overwhelming. He still has speech therapy; sometimes he might have a bit of trouble understanding long instructions but generally he's your average six-year-old. "If he hadn't had the full-time early intervention, we don't think he would be were he is today."

The federal Government yesterday announced a $190million package that includes subsidies for approved centres offering intensive early intervention of up to $20,000 a child over two years. The package will cover up to 1200 children nationwide. AEIOU founder and chief executive James Morton said the package was "ground breaking" and praised the inclusion of Medicare items for early diagnosis. "Some parents face a two-year wait to get a diagnosis," Dr Morton said. "A child with autism has specific learning deficits but they've also got specific learning skills, those early learning years is your greatest opportunity to overcome them."

The federal funding package would enable AEIOU to meet its goal of having 120 full-time places for children in the early intervention program by 2009. Early intervention increased the chances of children with autism becoming independent, he said.

Dr Morton was motivated to establish a full-time early intervention program after being frustrated by the lack of resources following the diagnosis of his son, Andrew, with autism: "By the time we got this all set up, Andy had already moved on to school stage, so he really got very little out of the program."



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

Trans fats:

For one summary of the weak science behind the "trans-fat" hysteria, see here. Trans fats have only a temporary effect on blood chemistry and the evidence of lasting harm from them is dubious. By taking extreme groups in trans fats intake, some weak association with coronary heart disease has at times been shown in some sub-populations but extreme group studies are inherently at risk of confounding with other factors and are intrinsically of little interest to the average person.


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