July 27, 2007

Program seeks early autism identification

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The American Academy of Pediatrics (AAP) recently mandated that children such as Janey Ramsey, right, and Josh Warren be screened for autism at 18 months, 24 months and 30 months. (photo by Jenny Warren)

Program seeks early autism identification

Autism specialists at the Vanderbilt Kennedy Center (VKC) are launching a multi-pronged program focusing on early identification and intervention for young children with autism.

The program at VKC and TRIAD (Treatment and Research Institute for Autism Spectrum Disorders) integrates research, clinical and training efforts.

A core of Vanderbilt leaders and faculty from diverse training backgrounds — psychology, genetics, neuroscience and special education — are collaborating for the project, according to TRIAD Director Wendy Stone, Ph.D., also a VKC investigator.

“We are doing this because there are more children out there with autism, because more of these children are under 3 years old, and because we are still learning the best ways to treat these young children,” Stone said.

The most current estimates are that one in every 150 children have autism.

The American Academy of Pediatrics (AAP) recently mandated that children receive screening evaluations at 18 months, 24 months and 30 months, but researchers said these mandates are beyond the capacity of resources available for referrals.

“The mandates are ahead of our knowledge and resources so we have to catch up … and the only way to do that is a full court press,” Stone said.

Stone said the comprehensive approach at Vanderbilt includes training both pediatricians and providers, conducting research projects for early identification and starting a clinic for early identification.

Pediatrician training, also known as the Screening Tools and Referral Training — Evaluation and Diagnosis (START ED) program, is unique to Vanderbilt and designed to provide community-based pediatricians with strategies for evaluating young children for autism within their practices.

It is funded by a grant from the TennCare Bureau to the Tennessee Chapter of the American Academy of Pediatrics (TNAAP).

“We are very excited that the TennCare Bureau allowed this unique collaboration between practicing pediatricians, autism specialists at Vanderbilt, and Tennessee's Early Intervention System (TEIS) to address the very real need to provide early and accurate autism diagnosis right in the child's own community,” said TNAAP President Quentin Humberd, M.D., a developmental-behavioral pediatrician at Blanchfield Army Community Hospital in Fort Campbell, Ky.

Five Middle Tennessee pediatricians are participating in the six-month pilot project, which began last weekend with a two-day training workshop.

Pediatricians will now videotape autism assessments from their own practices to gather feedback.

Traditional wait lists for a diagnostic evaluation for autism range from months to years, which can be frustrating for both parents and children.

“We want specialists across the state of Tennessee who can expedite evaluations for kids during this critical time,” said Zachary Warren, Ph.D., director of the VKC/TRIAD Parental Support and Education Program (PSEP).

“This would serve not only families but also our educational systems by really preparing kids and families for more successful entry into school settings.”

Other teaching initiatives include Parent Enhancing Interactions (EI) classes to provide teaching and interaction methods within the context of everyday life, and also early intervention academies and workshops to train community professionals to recognize early signs of autism and implement specialized intervention activities.

STAT training workshops are also conducted several times per year to teach service providers how to use the Screening Tool for Autism in 2-year-olds.

VKC will also offer clinical services assistance for early identification with a PSEP Infant and Toddler Screening Clinic at Vanderbilt Children's Hospital.

Research projects for early identification include longitudinal follow-up studies to identify early behavioral and physiological markers for autism in young children at risk.

Genetic studies will assess families of children with autism to identify genetic markers that can be used to understand causes and develop treatments.

Early intervention research projects will evaluate specific treatment approaches for young children with autism, children at risk for autism, and their families.

The National Institute of Child Health and Human Development (NICHD), Autism Speaks, the Marino Autism Research Institute (MARI), the Simons Foundation, the Tennessee Department of Education, TNAAP, and VKC provide funding for various aspects of this early identification and intervention program.