Routine screening can help lead to early diagnosis, which is critical because the earlier educational strategies specific for autism are started, the more effective they seem to be, according to a report sponsored by the U.S. Department of Education and conducted by a committee of autism experts. Over a period of two years, the researchers reviewed several hundred scientific studies on the disease.
"One of our hopes is that by emphasizing the importance of early detection we will increase the number of people who are aware of the issue and are interested in doing screening," committee member Fred R. Volkmar, MD, who is a professor of child psychiatry at Yale University, tells WebMD.
Children with autism often have speech difficulties, problems interacting with other children, and rituals or routines that they repeat over and over. According to the report, up to one in 500 people has autism, which makes the condition more common than childhood cancer or Down syndrome. The symptoms as well as the age of onset vary, but doctors trained in autism can reliably spot the condition in children as young as 2 years old.
Under the Individuals with Disabilities Education Act, public schools must offer educational programs geared specifically for autistic children. But the problem is that there is no standard and some schools are offering programs that are ineffective, Vanee Vines, a spokesperson for the National Research Council, tells WebMD.
The committee reviewed scientific studies on educational strategies for autism in an attempt to determine which ones are the most effective. Although the report doesn't recommend specific educational strategies, it does advise that autistic children receive at least 25 hours of education each week, 12 months a year. Programs that are comprehensive in nature and deal with the physical, speech, socialization, and thought problems that autistic children experience are much more effective than programs that only focus on one of these areas.
Effective programs generally begin as soon as the condition is diagnosed, offer education for the equivalent of a full school day, five days a week for the full year, are taught in 15 to 20 minute segments, and have sufficient amounts of one-to-one interaction between teacher and student, the report notes.
"Plenty of [autistic] individuals, with early intervention ... can really substantially improve," Eric Hollander, MD, director of the Seaver autism research center at Mount Sinai School of Medicine in New York City, tells WebMD. "Many can be mainstreamed into regular classes" and ultimately become independent adults. Hollander was not involved in developing the report.
The Associated Press recently reported that an autistic student, Lee Alderman, graduated as class valedictorian from Cardozo Senior High School in Washington, D.C., this month. "That's not unusual," Hollander says. "Many of these individuals have high IQs, and they often have extraordinary talents in mathematics, computers" and other areas.
Educating an autistic child can be expensive and the report advises that funds be set aside for educational programs so that the parents do not have to pick up the whole tab. Funds should also be earmarked for training teachers and other professionals who work with autistic children and their families, the report says.
A spokesperson for Congressman Dan Burton (R-Ind.) tells WebMD he is not aware of any pending legislation that deals with these issues and that they would probably fall under the Individuals with Disabilities Education Act. This will be reviewed for reauthorization in 2002. Rep. Burton has an autistic grandchild and has been heavily involved in legislation pertaining to autism.