January 15, 1999

New program established to help children with autism

New program established to help children with autism

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Wendy Sonte, Ph.D., here with six-year-old Daniel Mirtes, is the director of the Treatment and Research Institute for Autism Spectrum Disorders. (Photo by Donna Jones Bailey)

Vanderbilt Children's Hospital has established a new program designed to improve the lives of children with autism and their families through a wide range of services, training for parents, teachers and service providers, and research.

The program, offered through the Child Development Center, is called TRIAD, which stands for Treatment and Research Institute for Autism Spectrum Disorders.

"These children demonstrate a combination of different characteristics that make them a challenge to teach and a challenge to parent," said Wendy L. Stone, Ph.D., associate professor of Pediatrics and director of TRIAD.

"Very few specialized services exist in the community. The community's need for a program like this is great."

Autism is a developmental disability that typically appears during the first three years of life. The neurological disorder affects about one in 1,000 individuals, who have difficulty forming social relationships, impaired understanding and use of language, and restricted patterns of activities and interests.

Because symptoms and characteristics of autism can be present in different combinations and with varying degrees of severity, autism is considered a spectrum disorder.

TRIAD offers a wide range of services directly to children and families, including individual family consultation, behavior management training, social skills training and early intervention training for parents of children with autism.

Because the characteristics and symptoms of autism also affect the child's education, TRIAD also provides consultation to school personnel with concerns about individual students with autism or general classroom issues related to autism. TRIAD's work with schools includes district-wide teacher training for selected teams of individuals who, in turn, can train others in the school system.

TRIAD also conducts workshops for parents and professionals on a variety topics. For example, a recent workshop focused on how to create a "visual schedule" to help parents and children with autism move more smoothly through their day.

"Understanding and using language can be very difficult for these children, so creating a schedule with visual clues can be very helpful," Stone said.

In addition to Stone, TRIAD's staff currently includes psychologist Lisa Ruble, Ph.D., assistant professor of Pediatrics; Dr. Susan G. McGrew, assistant clinical professor of Pediatrics; and secretary Brenda Sparks.

Diagnosis of autism can be tricky because there is no medical test, Stone said. Instead, the diagnosis is based on observation of a child's behavior and often doesn't occur until a child is 3 or 4 years old.

Research is demonstrating that earlier diagnosis of autism and early intervention often results in better outcomes because the development of certain brain pathways may be more malleable at younger ages, Stone said.

She has developed and is pilot testing a screening tool to identify autism in toddlers. The test involves play, interaction and communication, coupled with close observation of the child's response.

"It takes 20 minutes to administer," Stone said. "It involves direct interaction with the child and is designed specifically for children between 24 and 35 months old so we can catch children early. So far, the screening has been very effective in identifying which 2-year-olds will receive a diagnosis of autism from a psychologist and which will not."

Other research being conducted by TRIAD members includes a partnership with the Vanderbilt Bill Wilkerson Center for Speech and Communication Sciences that is examining the reaction of children with autism to various auditory stimuli. Stone is also collaborating with Craig H. Kennedy, Ph.D., associate professor of Special Education, comparing three different treatments. The study will compare treatment with SSRI drugs like Prozac, behavioral interventions alone and a combination of the drugs and behavioral management.