A reflection on the state of autism
As the country marks April 2 as World Autism Awareness Day, and April as National Autism Awareness Month, Yale Child Study Center Director Fred Volkmar reflects on some major advances, and discusses some of the challenges still facing autism diagnosis, treatment, and research.
The good news is that with earlier diagnosis and interventions, children are doing better — more are becoming self-sufficient, independent adults and going to college. That said, not everyone gets better — even with early diagnosis. We need to understand more about what predicts/correlates with treatment response and do a better job of matching children to the treatments that are right for them.
Unfortunately, treatment research is some of the most difficult to do — partly because funding is poor. And for older individuals (adolescents and adults) funding is vanishing, even though we know there is a tremendous need. For younger children, there has been more activity and funding, and a number of evidence-based treatments are available.
Here at Yale, we recently demonstrated specific brain changes in children getting a form of treatment called pivotal response training for a period of some months. Work like this is also taking place at other research centers as well, and may help us clarify issues of treatment response and mechanisms.
In my experience, even when people do well they have some residual vulnerabilities. It is unusual to meet an adult with a history of autism and for me not to, more or less, immediately recognize it. That said, other problems arise given the somewhat loose nature with which the term is used — particularly when you get into the move from autistic disorder (strictly defined) to Autism spectrum (more common but poorly defined).