Tuesday, November 27, 2007

Autism Issue Makes Ripple in Presidential Race As Clinton Promises to Spend $700 Million Per Year

Sen. Hillary Clinton of New York, a front-runner in the race for the Democratic presidential nomination, last week issued a plan to help children and families affected by autism. The plan calls for spending $700 million per year to expand research, identify treatments, expand access to services for children and adults with autism spectrum disorders and provide autism-specific training for teachers.

While some other candidates do address autism in their campaign literature and remarks (read on below), Clinton's proposal is the most detailed of any of the major presidential candidates I could find, and follows her filing a bill in March 2007 with Republican Senator Wayne Allard of Colorado to increase access to support services for Americans with autism. (See "Senators Clinton and Allard Unveil Proposal to Expand Autism Services," in the Autism Bulletin archives.)

You can read a press release about Clinton's plan here. Both the Clinton-Allard bill and this plan—issued during this white-hot period leading up to the Iowa causes and New Hampshire primary in early January—include similar ideas around the same broad themes: expanding access to autism services for people who need them, from children to adults; spending more to understand what happens when someone has autism and why diagnoses are on the rise; generating more consensus around evidence-based effective treatments for autism.

Notably, Clinton calls for providing grants to states to increase programs and services for adults.

What Other Candidates Are Saying About Autism

A number of candidates who serve in Congress have records on autism that relate to the landmark 2006 passage of the Combating Autism Act, which received broad support. In fact, Sen. Christopher Dodd, a Connecticut Democrat, was the co-sponsor of the Senate version of the bill. You can read more about his work on that law here and see more coverage of that landmark law here.

Dodd and other Democratic candidates including John Edwards, the former North Carolina Senator and vice presidential candidate; Sen. Barack Obama, Democrat of Illinois, and New Mexico Gov. Bill Richardson, include their ideas about helping people with autism in their health care reform plans. Some quotes follow:

From the John Edwards campaign blog, Nov. 26:

We need to find the causes so we can help protect our children. The National Institutes of Health have concluded that childhood vaccines are not the cause, but many families are not convinced. As president, I will double funding for autism research, issue an all-hands-on deck challenge and follow the results wherever the science takes us.

We also need to take better care of children affected today. My plan for universal health care, guaranteed coverage of autism care in Medicaid and private insurance, and better investments in special education and home health workers will assist families to support and treat children with autism and help children, and adults, reach their full potential.

We should also invest more in recruiting, training and paying sufficiently teachers, therapists, psychologists and others working in the special education field. It's time to finally get on a path to fully funding special education.

From the Barack Obama campaign's health care plan:

Support Americans with Autism. More than one million Americans have autism, a complex neurobiological condition that has a range of impacts on thinking, feeling, language, and the ability to relate to others. As diagnostic criteria broaden and awareness increases, more cases of autism have been recognized across the country. Barack Obama believes that we can do more to help autistic Americans and their families understand and live with autism. He has been a strong supporter of more than $1 billion in federal funding for autism research on the root causes and treatments, and he believes that we should increase funding for the Individuals with Disabilities Education Act to truly ensure that no child is left behind.

More than anything, autism remains a profound mystery with a broad spectrum of effects on autistic individuals, their families, loved ones, the community, and education and health care systems. Obama believes that the government and our communities should work together to provide a helping hand to autistic individuals and their families.

From Bill Richardson's health care proposal:

First of all I am for strongly increased research on autism. The number of children in this country affected by autism is just staggering. [1 in every 150 children] Comprehensive and universal access to health care is part of the solution. I fought for increased funding in New Mexico for outreach, education, treatment and awareness. This is something that I have been talking about on the campaign trail everyday and it will be a priority in my administration.

From Christopher Dodd's health care plan:

Under the Dodd Plan, every child in America will have guaranteed health insurance equivalent to the health coverage Members of Congress have for their children. All children will have access to preventive health screenings including vision, hearing, autism, and other neurological disorders.

Where Are The Republicans?

I researched the online campaign literature and recent press coverage for Mike Huckabee, the former Arkansas governor; Sen. John McCain of Arizona, Rep. Ron Paul of Texas, and former Massachusetts Gov. Mitt Romney. With the exception of a haircut fundraiser that Huckabee attended for autism in New Hampshire, and a Romney campaign volunteer in Colorado who has done some charity work for autism, I couldn't find a mention of autism anywhere.

That doesn't mean it's not there, so if you know of someone in any of these campaigns, write to me or submit a comment at the end of this post. It could just mean that autism hasn't risen to any level of importance in the Republican race. Health care is present, though. Mitt Romney is running on his bringing health coverage to all in Massachusetts. Ron Paul is a doctor. In the past, Mike Huckabee has been on a mission to make citizens lose weight.

Noted: I couldn't find anything on the websites of two other Democrats, Sen. Joe Biden of Delaware and Rep. Dennis Kucinich of Ohio.

Haircut Footnote

Four candidates have taken up a "$400 haircut challenge" for charity, from the father of an autistic child in New Hampshire. Here's an item from the Autism Society of America's website:

Representative Dennis Kucinich made a campaign stop for autism on November 20. The presidential candidate, a democrat from Ohio, was the third politician to take up New Hampshire hair stylist David Holden on his challenge to get a $400 haircut with all proceeds going to ASA.

Though the challenge was inspired by candidate John Edwards’ high-end haircuts that appeared on campaign statements in April, Holden said the challenge isn’t meant as a dig just an opportunity to help a good cause. Holden is the owner of Hair Biz salon in Concord, and the father of a 12-year-old with autism.

Kucinich is the third to take up the challenge. Representative Tom Tancredo of Colorado and former Arkansas governor Mike Huckabee have also participated.

Also see:

Bush Vetoes Domestic Spending Bill That Includes Autism Research, Education Funds

Saturday, November 24, 2007

Film Review: Three Reasons to See "Autism: The Musical"

Written by Carol Gerwin

If you have a chance to see "Autism: The Musical," the documentary directed by Tricia Regan that chronicles the debut of a Los Angeles theater group for children with autism, you should grab it. Even if it means going by yourself (as I did on Thanksgiving night) because your spouse has to stay home with the kids. Here are three reasons I'm glad I did:

1) The film is a moving and nuanced depiction of the huge range of kids who fall onto the autism spectrum and the challenging reality of their daily lives.

Among the participants who write, plan and produce a full-length musical in five months are Lexi, a 14-year-old with a beautifully sweet singing voice who constantly repeats questions people ask her but has trouble coming up with answers; Henry, an extremely talkative 10-year-old with encyclopedic recall of reptile facts whose awkward behavior puts off peers; and Neal, a nonverbal 12-year-old who sometimes acts out aggressively when feeling anxious.

The movie shows the kids at school, at home, and in chaotic rehearsals that eventually lead to a well-orchestrated and emotional opening night. In one remarkable moment, an often ebullient boy named Wyatt describes his frustration with theater group friends who withdraw from others and then suddenly realizes that he sometimes does the same thing, asking, "Why do I go into my own world?"

2) The movie demonstrates the life-changing impact that having a child with autism has on parents—for better and for worse.

Neal's mother, Elaine, started the theater group she named "The Miracle Project" after discovering that music and movement were effective ways to engage her son. Divorced after several years of Neal's sleepless nights and frequent tantrums, Elaine later finds a new love who embraces her son. During the filming, one couple bickers, one separates and another despairs that they can't afford an expensive legal battle to get appropriate educational services for their child. They all struggle to understand their kids and help them lead fulfilling lives—and they worry intensely about what will happen to them after they themselves die. As Lexi's mother, who has suffered from depression but beams through her tears on opening night, says: "Living with her has had a profound effect on who I've become."

3) The film illustrates both the tremendous potential of kids with autism and the relentless nature of the disorder.

In the end, The Miracle Project's musical really was no miracle at all. No one was cured; no one's life was transformed. (Be sure to stay for the biographical end notes, which drive home the point that the ongoing challenges these kids face certainly will continue.) But the experience had value for everyone involved. These kids showed themselves and their community how much they can accomplish when people take the time to accept them for who they are, celebrate their strengths and devote resources to help them overcome (or at least compensate for) their weaknesses. As the kids sing in the musical's opening song, "Take a chance. Get to know the real me." The real miracle would be for this to happen all the time.

Background notes: "Autism: The Musical" has been showing at film festivals across North America and has picked up two audience awards so far. HBO will show the movie in April and it will be out on DVD after that. (For Autism Bulletin's Boston-area readers, the documentary is playing through Nov. 29 at the Coolidge Corner Theatre in Brookline, Mass. Then it's on to Anchorage, Alaska for a film festival screening December 3. Check the film's website for more updates.)

Carol Gerwin is a Boston-based editor and writer who is married to Autism Bulletin blogger Michael Goldberg.

Tuesday, November 20, 2007

Autism Bulletin Featured on AutismPodcast.org

Usually at Autism Bulletin, there's an effort to share answers and insights for parents of kids with autism spectrum disorders. So it was an interesting experience to be a guest on Michael Boll's Autismpodcast.org to talk about my work on this blog and also about being the parent of a young child on the spectrum.

You can find the recording of the conversation by clicking here.

Michael Boll is a teacher by training and, like many Autism Bulletin readers, he found himself thrust into this role of having to learn all about autism spectrum disorders, what to do about it to help his son and family, all the while carrying on with other parts of his life.

If you are new to Autismpodcast, the website hosts 61 episodes and counting. They include talks with Andy Bondi and Lori Frost, the founders of the Picture Exchange Communication System (PECS), Steven Gutstein, founder of Relational Development Intervention (RDI) and Alex Plank, creator of wrongplanet.net, an online resource for people with Asperger's.

Thursday, November 15, 2007

Additions to Autism Bulletin Resources

Readers who are new to Autism Bulletin can find links to court decisions, research papers, historical and government documents and other websites to help learn more about autism spectrum disorders. I have added links to two papers from the American Academy of Pediatrics that could have an influence on the lives of many children with autism in the United States. The papers are:

* Management of Children With Autism Spectrum Disorders, by Scott Myers, M.D., in the journal Pediatrics, Nov. 2007.

* Identification and Evaluation of Children With Autism Spectrum Disorders, by Chris Plauche´ Johnson, M.D., Scott M. Myers, MD, and the Council on Children With Disabilities. Also in the November 2007 issue of Pediatrics.

Find these and other resources in the Autism Bulletin sidebar, which is the column to the right of articles that appear on this blog.

Also see:

American Pediatricians Make Big Push for Autism Diagnosis, Awareness; Kits for Doctors, Checklists for Parents

Tuesday, November 13, 2007

Bush Vetoes Domestic Spending Bill That Includes Autism Research, Education Funds

President Bush today vetoed a bill that autism advocates say would have increased funding for autism research, data collection on autism diagnosis studies, and provided more awareness and training for professionals working with autistic students. Some autism advocates are calling on Congress to override the president's veto.

The money involved—$1 million at the National Institutes of Health for research, $16.5 million at the Centers for Disease Control for the population studies, and another $37 million for awareness programs—is a relative pittance when compared with the billions of dollars in disagreements you're about to read in the quotes from government leaders that follow. It demonstrates how difficult it can be to get federal funds appropriated for a cause that just a year ago enjoyed wide bipartisan support, when Bush signed the Combating Autism Act into law.

These autism-related items are part of a much larger spending bill that also pertains to education, health and anti-poverty programs.

Partisan Bickering—and the Iraq War

Bush issued a statement saying the domestic spending proposal from Congress, called the Labor, Health and Human Services and Education Conference Report, costs too much and contains too many "earmarks," spending provisions for projects in local Congressional districts. The president's statement said: "This year, the Congress plans to overspend my budget by $22 billion, of which $10 billion is for increases in this bill. Health care, education, job training, and other goals can be achieved without this excessive spending if the Congress sets priorities."

Leaders of the appropriations committees in the House and Senate, both Democrats, sought to point out the relative low cost of the programs designed to make Americans' lives better, compared with the mounting cost of the Iraq war and Bush's tax policies.

Rep. David Obey, D-Wisconsin, chairman of the House budget panel, issued this statement:

“The same President who is asking us to spend another $200 billion on the misguided war in Iraq and is insisting on providing $60 billion in tax cuts next year to folks who make over a million bucks a year, is now pretending to protect the deficit by refusing to provide a $6 billion increase to crucial domestic investments in education, healthcare, medical research and worker protections that will make this country stronger."

Senator Robert Byrd, D-W. Virginia, chairman of the Senate appropriations committee, issued a similar statement, urging the White House to return to negotiating with Congress on the budget.

Autism Society Calls for Veto Override

Since the Bush White House has not developed a reputation for negotiating with Congress, it is not surprising that advocates at the Autism Society of America are urging its membership to contact their representatives in Congress to override the president's veto.

Here's an excerpt from the argument the society is encouraging autism advocates make to their members of Congress urging them to override the president's veto:

This important legislation would provide significant increases for autism research, public awareness, early intervention and education. Specifically, the measure calls for:

* A 3.1 percent increase in research at the National Institutes of Health, a portion of which can be used to expand, intensify and coordinate research into the causes, diagnosis, early detection, prevention, services, supports, intervention and treatment of autism spectrum disorders. This includes $1 million to reinstitute the Inter-Agency Autism Coordinating Committee.

* $16.5 million for the CDC's Disabilities Surveillance and Research Program, which supports data collection, analysis and reporting, so that we can better understand the scope of the autism epidemic.

* $37 million to increase awareness, reduce barriers to screening and diagnosis, promote evidence-based interventions for individuals with autism and train professionals to utilize valid and reliable screening tools to diagnose autism and provide evidence-based interventions for children with autism and other developmental disabilities.

These important increases will ensure that research into improved treatments and interventions can be explored, and that children with autism are diagnosed earlier, can access early intervention services, and are able to receive a quality education.

President Bush's veto seriously endangers our ability to diagnose, treat and serve individuals with autism and their families.

Monday, November 12, 2007

Nominate Your Pick for Autism Advocates of the Year

Autism Bulletin is seeking your nominations for autism advocates of the year. Please submit your suggestions and nominations for people, organizations, no matter where they have done their work, by submitting a comment at the end of this blog post or by e-mailing me at michaelsgoldberg AT yahoo DOT com. Explain who nominee is, what work they have done to advocate for people with autism and why their work made a difference this year.

Nominations are due by December 1. Later in December, I will publish an article highlighting the efforts of these people and organizations.

Also see:

Autism Bulletin's 2006 Advocates of the Year

"Combating Autism Act" Funding Caught in Legislative Wrangling; Bush Veto of Research, Awareness Dollars Possible

Millions of dollars in federal funding for scientific research into autism spectrum disorders and for public awareness campaigns is caught up in an ongoing budget battle between Congress and President George W. Bush, who has threatened to veto the spending bill in which these autism provisions are included.

That's the news in an important legislative update provided by the Autism Society of America, a major autism advocacy group based near Washington D.C. You can read a copy of the update at the society's website by clicking here.

The big picture here is that President Bush has decided, in the last part of his second term, to hold the line on domestic spending programs. A November 6 press release from Rep. David Obey, the Wisconsin Democrat who chairs the House Appropriations Committee, outlines how the Bush Administration and the Democrats in the House view a series of labor, health and education issues. Not surprisingly, the Iraq war plays into the politics of the situation. This is the way the introduction reads on Obey's press release:

WASHINGTON - Even as the President is asking for nearly $200 billion to cover the $10 billion a month we are spending in Iraq (paid for with borrowed money), he is trying to masquerade as fiscally responsible by manufacturing a fight over what we spend in roughly 2 months in Iraq ($22 billion) in investments that will make this a stronger and better country.
At the center of that fight is funding for the Departments of Labor, Health and Education. The conference report considered in the House today provides $150.7 billion, $6.2 billion (4.3%) above 2007 and $9.8 billion above the President’s request (roughly the cost of 1 month in Iraq) for the Departments of Labor, Health and Human Services and Education.
What would that $9.8 billion achieve? Here are some specific examples.

Obey's statement goes on to outline the differences between the White House and the majority in Congress on issues including health care, job training, education, poverty programs and medical research. Obey notes that the House wants to spend more money on all of these programs and Bush wants to cut them, including special education funding under the Individuals with Disabilities Education Act (IDEA).

It is the medical research section that the Autism Society says advocates for people with autism should watch closely. The bill for Labor, Health and Human Services spending "provides $37 million for autism public awareness and early intervention—a $17 million increase over last year, as mandated by the Combating Autism Act of 2006," the Autism Society notes, and adds:

The bill also appropriates $16.5 million for the Centers for Disease Control and Prevention to use toward surveillance and research and $1 million to reinstate the Inter-Agency Autism Coordinating Committee, which would develop a strategic plan for autism research at the National Institutes of Health.

President Bush has vowed to veto the bill because it asks for $9.8 billion more than his budget proposal. Unfortunately, there is not a veto-proof majority in either chamber, so additional negotiations will be needed.

This would be one of those times when it pays to be an engaged citizen. It would be worthwhile to educate yourself about where your House member and Senator stand on this funding bill. Because of Bush's staunch veto threat, it would be especially interesting to go through this effort if you have Republican representation in Congress, because those are the votes in the House and Senate which would be tougher to get if a veto override vote becomes necessary. Let's hope it doesn't.

Also see:

* Bush Signs Combating Autism Act

* More Autism Bulletin stories relating to Congress

Thursday, November 08, 2007

Ohio House Takes Up Autism Health Insurance Bill

The Ohio House of Representatives is considering a bill that would prohibit health insurers from excluding insurance coverage for autism services.

The bill is called H.B. 170, which you can read via the state legislature's website by clicking here. Representatives Jon M. Peterson, a Republican, and Ted Celeste, a Democrat, are co-sponsors of the bill. The bill, introduced in April 2007, does not spell out what kinds of services are covered. According to the legislature's website (which warns that it not to be considered an official record), the bill has been resting with the House insurance committee.

The Associated Press published a story Nov. 8 that summarizes a pattern of activity which advocates for autism services will recognize: a growing awareness that autism services for young children can cost families tens of thousands of dollars a year; health insurance doesn't cover any of it; bipartisan support in the legislature generates a bill to change matters; and a health insurance industry representative oppose the idea. It's a pattern that has played out in several states, including Texas (passed), South Carolina (passed) and Pennsylvania, which as I understand it is still pending. (See past Autism Bulletin articles labeled "health insurance" and an autism insurance map for more background on states around the country.)

In Ohio, the Associated Press lays out two views of the debate by quoting an insurance industry representative, who suggests that autism is another in a list of causes some people would like to see insurers cover; and a provider of autism services, who relays the argument that investing in these services has a long-term return:

Insurance officials are concerned the bill would lead to more mandates based on a disease or health condition.

"Each individual has the belief that their cause is the one that the government needs to find the solution to," said Kelly McGivern, president of the Ohio Association of Health Plans. "We believe employers who buy policies should make the decision."

Continuing treatments, involving such things as speech therapy, a psychologist working on socialization skills and home health aides, aren't covered, said Jacquie Wynn, director of the Center for Autism Spectrum Disorders at Nationwide Children's Hospital.

Autistic children, she said, need 30 hours to 40 hours of intervention a week. Wynn said 30 percent of families who come to the center for treatment leave because they can't afford it.

"There's a cost savings in the reduction of aggressive behavior or the self-care skills they learn," she said. "With short-term, early intervention in their early years, you see the payoff in their lifetime."

Tuesday, November 06, 2007

An Educator Offers Insights into Families of Kids with Autism

Barbara Firestone is asking some good questions: "What does it mean for a person with an autism spectrum disorder to lead a dignified life? How do parents help their children navigate in a world that isn't always sensitive to individuals with differences?"

Firestone, the author of a new book called "Autism Heroes," is also offering some insights, based on her listening to and learning from a group of 38 families about their experiences coping with with growing up, going to school, participating (or not) in the community—essentially a collection of concerns that sounds like many of the things that Autism Bulletin readers are thinking about. Besides dignity, other chapters in the book discuss themes like hope, opportunity and love.

I emphasize "sounds like" because the book from Jessica Kingsley Publishers just came out and I have only read brief excerpts. Barbara Firestone is making an author tour on the east coast starting November 11 in New York City with stops in New Jersey, Massachusetts, Pennsylvania and Virginia (more information at the author's book site).

For parents and families of kids with autism, there are so many books coming out that it is challenging to keep up. So why focus attention on this one? Well, the author herself is intriguing: Firestone is president and CEO of The Help Group, a non-profit organization based near Los Angeles in Sherman Oaks, Calif., which runs six day schools for students with autism. She also serves on the California Legislative Blue Ribbon Commission on Autism which recently came out with an important set of recommendations for improving the state's autism services, education and awareness. (For more coverage, see this article.) Someone who is involved in both educating students with autism—a key component to helping individuals grow and develop—who also takes the time to get involved in an important public policy mission offers parents seeking answers and insights the chance to learn something.

Below is a brief excerpt. Firestone asks some good questions, and hints that in some respects, conditions for people with autism are improving:
What does it mean to lead a dignified life? How do parents help their children navigate in a world that isn't always sensitive to individuals with differences?

Families recount how insensitive, uninformed, and distancing the community can be. When children, who otherwise look normal, have disruptive or unusual behavioral problems in public, strangers can be very unforgiving. Frequently, onlookers attribute the child's behavioral problems to ineffective parenting or to the child being a "bad seed." They often stand to the side rather than help, their faces full of judgment rather than empathy.

Some parents have told me that, although it's difficult for them to admit, they wished at times that if their child had to be disabled, that the disability had taken a more socially acceptable form. Some parents make the decision to fully participate in activities outside the home no matter what the cost; others modify what they will attempt; while others retreat, saying that it's easier to avoid being ostracized. And of late, parents are beginning to tell me that they sense a greater understanding in the community— a more "How can I help?" rather than "What kind of parent are you and what kind of child do you have?"

Thursday, November 01, 2007

American Pediatricians Make Big Push for Autism Diagnosis, Awareness; Kits for Doctors, Checklists for Parents

The American Academy of Pediatrics, the national group for 60,000 primary care children's doctors, this week issued a major announcement to educate its members about the early diagnostic signs for autism spectrum disorders, and urge them to look for those signs during baby checkup visits.

This announcement, made at the Academy's annual national conference on Oct. 29, is important because it sets some baseline expectations for what pediatricians around the country should understand about autism, including the essential importance of early intervention services. The documents make clear to doctors (and parents, grandparents and caregivers) the importance of milestones for early childhood development and communications skills. The Academy advises doctors to look for these signs at every well-child visit, or baby checkups. For parents and advocates of young children with autism, the documents also could help set the stage for minimum expectations for early intervention services.

Read the announcement by clicking here. It is impressive in its scope. It includes links to two research studies published in the November 2007 issue of the journal Pediatrics: "Identification and Evaluation of Children with Autism Spectrum Disorders," explains the history of autism, summarizes research so far into possible causes for it, lays out specific criteria for doctors to diagnose autism and explains how to help parents look for developmental delays. The second report, "Management of Children with Autism Spectrum Disorders," establishes the importance of behavioral and educational interventions, including structured teaching methods such as Applied Behavior Analysis (ABA) and Treatment and Education of Autistic and Related Communication Handicapped Children (TEACHH) delivered in low student-teacher ratios "to allow sufficient amounts of 1-on-1 time" for "at least 25 hours per week, 12 months per year."

The Academy said it published both documents as an update and replacement for materials published in 2001.

Diagnostic Signs for Autism Before 18 Months of Age

"Language delays usually prompt parents to raise concerns to their child's pediatrician—usually around 18 months of age," the Academy notes. "However, there are earlier subtle signs that if detected could lead to earlier diagnosis." The signs include:

* not turning when the parent says the baby's name
* not turning to look when the parent points says, "Look at..." and not pointing themselves to show parents an interesting object or event;
* lack of back and forth babbling;
* smiling late; and
* failure to make eye contact with people.

The doctors' group notes:

"Red Flags" that are absolute indications for immediate evaluation include: no babbling or pointing or other gesture by 12 months; no single words by 16 months; no two-word spontaneous phrases by 24 months; and loss of language or social skills at any age. Early intervention can make a huge difference in the child's prognosis. "Autism doesn't go away, but therapy can help the child cope in regular environments," said Dr. Chris Plauche Johnson, a co-author of the reports. "It helps the children want to learn and communicate."

A Heads Up to Doctors About Parents' Use of Alternative Medical Therapies

In addition to developmental checklists, specific guidelines for doctors and explanations of the medical literature about autism and therapies for it, there's an interesting secondary theme the Academy of Pediatrics is working to convey to its members about parents' interest in alternative medical therapies. The message to doctors goes something like this: There's a great deal of media coverage and growing awareness out there about autism spectrum disorders and lots of information on the Internet. Engage parents in discussions, listen to their concerns. Don't dismiss their interest in alternative therapies, even as you share knowledge about evaluating whether a treatment option has evidence to show it is valuable.

Here's a passage from the Academy's announcement:

Pediatricians who treat children with ASDs should recognize that many of their patients will use nonstandard therapies. The report says it’s important for pediatricians to become knowledgeable about complementary and alternative medicine (CAM) therapies, ask families about current and past CAM use, and provide balanced information and advice about treatment options, including identifying risks or potential harmful effects. They should avoid becoming defensive or dismissing CAM in ways that convey a lack of sensitivity or concern, but they should also help families to understand how to evaluate scientific evidence and recognize unsubstantiated treatments.

“Many parents are interested in CAM treatments such as various vitamin and mineral supplements, chelation therapy, and diet restrictions. It’s important for pediatricians to maintain open communication and continue to work with these families even if there is disagreement about treatment choices, ” said co-author of the reports Scott M. Myers, MD, FAAP. “At the same time, it’s also important to critically evaluate the scientific evidence of effectiveness and risk of harm and convey this information to the families, just as one should for treatment with medication and for non-medical interventions.”

Although use of the gluten-free/casein-free diet for children with ASDs is popular, there is little evidence to support or refute this intervention. More studies are in progress, and it is anticipated that these studies will provide substantially more useful information regarding the efficacy of the gluten-free/casein-free diet.

All of this information is available for sale ($70 for members, $80 otherwise) in a package for pediatricians called "Autism: Caring for Children with Autism Spectrum Disorders: A Resource Toolkit for Clinicians," including "screening and surveillance tools, guideline summary charts, management checklists, developmental checklists, developmental growth charts, early intervention referral forms and tools, sample letters to insurance companies and family handouts."