Charting a course for autism spectrum disorders

Autism spectrum disorders (ASDs) are neurodevelopmental disorders that are characterized by two core symptoms of impairment namely: 1) social interaction and communication and 2) restricted, repetitive behaviors (APA 2013; DSM 5 2013)

The usual referral begins when a child cannot talk or has difficulty in communicating. These communication challenges can range from being non-verbal to responding inappropriately in conversations, to not understanding non-verbal cues, or having difficulty building friendships appropriate to his age.

In addition, individuals with ASD may be overly dependent on routines (i.e. taking exactly the same route to school, liking just one color or shade of color or even insisting on a particular type of clothing wear).

They are also highly sensitive to changes in their environment (i.e. very fearful of certain sounds or showing a dislike for certain colors), or intensely focused on inappropriate items (i.e. wheels of a car, a box of toothpaste, a piece of string, etc.).

The symptoms and characteristics of ASD can then be present in a wide variety of combinations from mild to severe. Therefore, there is no “standard” type or typical child with autism although they often share some of these characteristics described above.

The following are possible early signs of ASD (adapted from First Signs & and Autism Speaks**):

• Impairment in social interaction and communication
• Lack of appropriate eye gaze
• No big smiles or other warm, joyful expression by six months or thereafter
• Lack of sharing interest or enjoyment
• Lack of response to name
• No back-and-forth sharing of sounds, smiles or other facial expressions by nine months
• Lack of showing gestures such as hand pointing, showing, reaching or waving by 12 months
• Lack of coordination of non-verbal communication
• No babbling by 12 months
• Unusual prosody (little variation in pitch, odd intonation, irregular rhythm, unusual voice quality)
• Restricted Repetitive Behavior
• Repetitive movements with objects
• Repetitive movements or posturing of body, arms, hands or fingers.

Studies have shown that the estimated prevalence for ASD has been rising constantly over recent years, reaching 1 in 68 persons in the United States. However, there are no clear comparative studies in our local setting.

The Center for Autism and Developmental Medicine of St. Luke’s Global City has been envisioned to be a resource and research center to advance the best science of clinical care for individuals with autism and their families. Its clinical services include evidence-based evaluations, Comprehensive and holistic management and capacity-building consultations with medical and allied medical professionals, educational facilities and communities.

Initial plans for research cover a wide range of clinical and basic science projects, from child finding and gene charting to access of existing community services. The primary focus of research is to provide a local registry of identified individuals and their families, create a system of accredited resources for intervention and develop a community-based program that is anchored on strong parental training and support. Secondary plans include participation in international studies that will allow for a comparison of successful approaches geared towards achieving meaningful outcomes.

The Center for Autism and Development Medicine will showcase programs in phases like:

1. The Diagnosis and the Initial Steps program using standardized instruments (ADOS, ADI-R) for confirmation and includes a parent training guided early intervention program.
2. The Active Find Research will be developing a national online survey to establish prevalence.
3. The Section for Future Planning is a transition program for adolescents and young adults where programs and placement are finally addressed after they “age out” of school.
4. A Circle of Support will be a team of volunteers from different sectors who are willing to share their time in focus group discussion, transition planning and clinical administrative work.
5. The “A Hub” is a safe haven envisioned for adolescents and young adults with an Autism Spectrum Disorder who simply want to enjoy a social network of “friends” in an atmosphere of acceptance.

The Center for Autism and Developmental Medicine of St. Luke’s – Global city endeavors to inculcate autism advocacy, autism-friendly health care and leave a legacy of continuing autism education and capacity building knowledge so that Filipino families are empowered during their most challenging but amazing journey with their children who have ASD