Wednesday, May 02, 2007

Experts Unveil New Framework for Identifying Developmental Delays, Possible Signs of Autism, In Very Young Children

A working group of experts in autism spectrum disorders and child development has published a simple framework designed to help parents and pediatricians identify very young children who may present with developmental delays that indicate autism or other developmental disabilities and benefit from early intervention services.

The experts produced the four-point framework in a report for the Centers for Disease Control and the Interdisciplinary Council on Developmental and Learning Disorders (ICDL), a non-profit organization founded by the creators of the DIR/Floortime model for behavioral intervention. A statement from the report says the framework "is based on current understanding of health developmental patterns and is designed to detect all possible deviations from those patterns. It uses risk indicators designed to detect a lack of mastery of age-expected emotional, social and cognitive milestones during a child's first two years of life."

The four points ask whether a child can do the following:

* Be calm and focus on sights and sounds by 2 months of age

* Initiate and sustain warm, joyful interactions with caregivers by 4 months of age

* Exchange emotional and social gestures (using different sounds), reaching, exchanging, back-and-forth smiling, looking, and searching by 8 to 9 months of age

* Engage in shared social problem-solving and playing, including taking a caregiver's hand to find a toy or favorite food; playing with a toy and a caregiver together with lots of back-and-forth exchanges of sounds; and social gestures such as smiles, looks, and pointing by 12 to 16 months of age.

This new framework "casts a wider net than current common practice in an effort to identify all children at risk of developmental disabilities," according to a statement put out by CDC and ICDL. You can find the text of the statement, in a PDF file issued April 23, by going to this website. A 10-page report on the frameworks, dated December 2006, is available here. The proponents said in the press release that they were announcing the new framework in April to coincide with autism awareness month. Both are hosted by ICDL, the non-profit organization that presents the DIR/Floortime model of behavior intervention and relationship building established by Stanley Greenspan and Serena Wieder.

The group that developed this framework included Greenspan and others, among them: Jose Cordero, former director of the CDC's National Center on Birth Defects and Developmental Disabilities; T. Berry Brazelton, founder of the Child Development Unit at Children's Hospital Boston; and Margaret L. Bauman of Massachusetts General Hospital.

The effort to develop this evaluation framework overlap with some other efforts by researchers at places like the M.I.N.D. Institute at the University of California at Davis, to look for ways to diagnose children with autism by their first birthday -- on the theory that the earlier intervention services can start, the better the potential outcomes for these kids later in their development. This research project was the subject of a "60 Minutes" segment earlier this year. Read more about that here.