Children with autism deserve effective intervention

Some young children diagnosed with autism can look forward to substantial improvement in the condition but may not get access to effective therapy because of the unfunded costs involved, according to editorial comment in the current edition of the Medical Journal of Australia.

Traditionally seen as a severe, life long disability affecting communication, learning and social skills, autism affects one in 1,000 children.

Behavioural therapy teaches the child by reinforcing adaptive behaviours and reducing maladaptive ones. It targets specific deficits in autism — imitation, attention, motivation, compliance and initiation of interaction. Only positive reinforcement is used to teach the children.

"There is now definite evidence that behavioural intervention improves communication, learning and social skills in young children with autism, said Dr Jennifer Couper, head of the Endocrinology and Diabetes Centre at the Women's and Children's Hospital in Adelaide.

"A 1987 US study showed apparent recovery, persisting into adolescence, of nine out of 19 young children who received an intensive home-based behavioural intervention. Subsequent and recent studies have supported these results," she said.

In one of these studies, after three to four years of intensive therapy, about half the preschool children with autism acquired near-normal functioning in language, performance IQ and adaptability.Ninety two per cent of intervention children acquired some language. Control children who received special education showed no gains in IQ or adaptability.

Several preschool programs in the USA and the UK report comparable success to home-based behavioural programs.

Despite the reported success of the therapy, most young children with autism in Australia do not receive intensive behavioural intervention programs because they are not recommended by many health professionals and because of their prohibitive cost for families. Only WA has achieved partial government funding for these programs. Many children with autism in Australia instead receive interventions, which lack evidence for their efficacy.

"If early behavioural intervention means about half of the children with autism no longer need special education and other costly interventions, government funding of such programs would provide economic returns in the long term," said Drs Couper and Sampson, both parents of children with autism.

The Medical Journal of Australia is a publication of the Australian Medical Association

CONTACT: Dr Jennifer Couper, 08 8161 7000 (pager 4127)

Judith Tokley, AMA, 0408 824 306