Recovery and rehabilitation

Recovery and rehabilitation

A wide variety of long-term interventions have been advocated for children with autism. These include applied behavioral analysis, use of pictures for expressive communication (as in the picture exchange communication system), and intensive exercise programs. Therapists working in schools now recognize the holistic learning needs of the child, including personal and emotional growth as well as opportunities to broaden their experiences, regardless of whether measurable developmental progress is made.

Clinical trials

As of early 2004, there were numerous open clinical trials for autism, including:

• drug treatment for autism at the National Institute of Mental Health (NIMH)
• synthetic human secretin in children with autism, sponsored by Repligen Corporation
• improving attention skills of children with autism at the National Institute of Child Health and Human Development (NICHD) in collaboration with the National Institute of Mental Health (NIMH)
• study of fluoxetine in adults with autistic disorder
• a controlled study of olanzapine in children with autism, sponsored by the FDA Office of Orphan Products Development
• randomized study of fluoxetine in children and adolescents with autism, sponsored by the FDA Office of Orphan Products Development and Mount Sinai Medical Center
• valproate response in aggressive autistic adolescents at the NICHD and the NIMH

Prognosis

Among individuals suffering with autism, 75% have a poor outcome and 25% show significant improvement. Acquisition of language before the age of six years old, IQ levels above 50, and having a special skill, such as expertise in computers, predict good outcome. For people with severe autism, independent living and social functioning are unlikely. For those with higher functioning autism, the jobs acquired are often below their education level. The social interactions of most adults with autism are limited or modified.

Special concerns

Most scientists concur that autism has a strong biological basis, with evidence continuing to accumulate for an underlying genetic cause that results in abnormal brain development. Future genetic and brain-imaging studies will undoubtedly contribute to a greater understanding of the disorder's etiology and pathophysiology. The combination of continually evolving methodological and technological advances will, hopefully, bring science closer to the goal of better and earlier intervention in autism.

Resources

BOOKS

Edelson, Stephen M., and Bernard Rimland. Treating Autism: Parent Stories of Hope and Success. San Diego, CA: Autism Research Institute, 2003.

Harris, Sandra L., and Beth A. Glasberg. Siblings of Children With Autism: A Guide for Families (Topics in Autism). Bethesda, MD: Woodbine House, 2003.

Seroussi, Karyn. Unraveling the Mystery of Autism and Pervasive Developmental Disorder: A Mother's Story of Research and Recovery. New York, NY: Broadway, 2002.

PERIODICALS

Baird, G., H. Cass, and V. Slonims. "Diagnosis of Autism." BMJM 327 (August 2003): 448�C493.

Kami��ska, B., et al. "Use of Secretin in the Treatment of Childhood Autism." Med Sci Monit 8 (January 2002): RA22�C26.

Nicolson, R., and P. Szatmari. "Genetic and Neurodevelopmental Influences in Autistic Disorder." Canadian Journal of Psychiatry 8 (September 2003): 526�C537.

Tidmarsh, L., and F. Volkmar. "Diagnosis and Epidemiology of Autism Spectrum Disorders." The Canadian Journal of Psychiatry 8 (September 2003): 517�C525.

Torres, A. "Is Fever Suppression Involved in the Etiology of Autism and Neurodevelopmental Disorders?" BMC Pediatric (September 2003): 3�C9.