YAI Autism Community

Erica Pitman, LMSW

Today’s post is by Erica Pitman, LMSW, social worker at the YAI Autism Center.

Impacts of Autism Diminished through a Specific Early Intervention Approach

A recent study conducted at the University of California and other sites around the country and funded by a grant from the National Institute of Mental Health (NIMH), indicates that early intervention for children diagnosed with autism improved their I.Q. scores and levels of functioning.

To families who have children with autism, this news may not seem altogether groundbreaking. Families of children with autism and other disabilities have been fighting for early intervention services for many years, asserting the needs of their children to their local district administrators, pediatricians, educators and therapists.  Parents are often their children’s best advocates.

What is newsworthy about this story is the effectiveness of a specific treatment modality that has not yet been buttressed by a large-scale research study. The model tested was The Early Start Denver Model (ESDM), created by Dr. Sally Rogers of the University of California-Davis M.I.N.D. Institute and Dr. Geraldine Dawson of Autism Speaks. The study looked at this form of intervention for children between 18 and 30 months old over a two-year period. This study compared the Denver Model against more traditional therapies, such as Applied Behavior Analysis—currently, the most common form of treatment for children with autism, and that which is the most outcome-oriented, based upon existing research.

The ESDM was shown to improve general intelligence skills, increasing I.Q. scores by up to 18 points, patterns of communication and social interaction. This was achieved by training parents to interact and teach their children in a very specific way. The therapy took place predominantly in the home by the parents, and through skills that are transferred from the parents to their children. Thus, parents can more easily carry over therapeutic concepts into daily interactions with their children, increasing the likelihood of generalization and impact. This study marks the first controlled study of a specific intervention modality for children suspected of having autism who are younger than 2 ½ years old.

The study was reported by CNN on November 30, 2009 and included several comments from Dr. Fred Volkmar of the Yale Child Study Center who praised the study as “well done” and “important.” Dr. Volkmar is also a member of the YAI Autism Center’s Advisory Council. While the results of the study are exciting and provide new information for many families, this information brings with it questions, feelings of uncertainty and naturally, some underlying levels of anxiety. While parents have turned to ABA for their children’s therapy, the Denver Model suggests that a blending of the principles of ABA, or a similar community intervention, with a more relationship-based approach yields more significant effects in terms of I.Q., language and social interactivity. This is the ultimate trifecta of autism symptomology for many families.

It is important to consider the implications of this news. Will families now seek out the Denver Model over traditional ABA hours? Will government-funded services prefer this approach due to its efficiency—delivering improved outcomes in fewer hours?

Dr. Charles Cartwright, Director of the YAI Autism Center, sees big potential for the ESDM to work in tandem with other therapies. “The Denver Model is a short-term intervention for very young children and involves the entire family in the therapeutic process,” he said. “It can lead into ABA or other therapies that can continue throughout a person’s life.”

We want to hear your thoughts! Comment or post questions in the form below. Learn more about The Early Start Denver Model here and studies conducted by U.C. Davis here.

Jeff Stimpson

Today’s post is by Jeff Stimpson, author of the books Alex: The Fathering of a Preemie and Alex the Boy: Episodes From a Family’s Life With Autism.

A panel has concluded that there’s still no proof that special diets help or don’t help kids with autism, or that food allergies or sensitivities or gut problems cause autism. The panel, chaired by a Harvard doctor, included 28 experts in 12 scientific disciplines; it evaluated scientific evidence regarding gastrointestinal disorders in all forms of autism.

One pivotal question remains: Did the panel examine pretzels?

For that’s what we’re trying this week to kick Alex of: Utz Dark, original golden thins, even minis. He’s been munching them for years, leaving almost as many on the floor as he got to his mouth – often with a splattery crash of an upsetting bowl, a crash I’ll hear for the rest of my life – and, as with Elmo, the time has come for the heave-ho from Alex’s life.

Yes, we’ve heard all the talk about wheat and salt and all the other stuff that’s supposed to hinder those with autism, but we stuck with pretzels all these years for the same reason we’ve stuck with Elmo and allowed Alex to wear deliberately mismatched socks and only khakis: Because we’re working on other stuff with him, things like better sleep and losing baby teeth and, soon, eating at the table. When parenting a child with autism, you pick your battles.

So the news of this panel was heartening, at least to us. They noted that many parents and medical professionals have reported improvements in autistic behaviors after dietary treatments, but stipulated that these observations aren’t based on controlled, scientific studies.

One of the panel’s strongest statements was that “gastrointestinal woes” often worsen autism-related behaviors. Signs of gut disorders (I prefer to call them woes, but that’s next year’s battle) may include frequent clearing of the throat or swallowing; sobbing for no reason; sighing, whining, or groaning (what do you know: most of the people I’ve ever worked for have gut disorders!); grimacing or wincing, or gritting teeth (see previous note); constantly applying pressure to the abdomen by leaning against furniture or pressing with hands; self-injurious or aggressive behavior; and bad sleep, among others.

The panel recommends that if a child with autism is on any kind of restricted diet —due to dietary treatment, food sensitivities, or food aversions — the child should be evaluated by a nutritionist.

We’ll do that. Note to Elmo: How about a show on gastrointestinal woes?


On Friday, YAI Autism Community reported that the Centers for Disease Control and Prevention had released the results of a study that found that 1 percent of 8-year-olds in the United States have autism. The study has created quite a stir in the media, as well as in the healthcare and education communities. The policy implications of this study will no doubt be unfolding for years to come. For now, the CDC has released a transcript of a press conference with Dr. Catherine Rice, the lead author of the study. The transcript is unedited and there are definite errors (“springing” instead of “screening”), but it’s an informative and interesting conversation. Best yet, there’s an MP3 version of the talk, so you can hear Dr. Rice speak in her own words.

In its coverage of the study, the Wall Street Journal interviewed Dr. Philip H. Levy, the YAI Network’s CEO and President, on the increased rates in autism. If you don’t subscribe to the WSJ, you can read the article for the next five days or so before access is limited to subscribers only. Dr. Levy brings up an interesting point in the article: In a drastic turn about from autism theories of previous decades (and research into most developmental disabilities), studies suggest a correlation between older fathers and increased rates of autism.

Let us know what you think!

According to a Centers for Disease Control and Prevention study released today, at least one in 110 children have an autism spectrum disorder. Boys are around five times more likely to have the disorder than girls, the agency reported. This ups the previous estimate of one in 150 children. Read CBS’s coverage of the study or download the full report here (PDF).

As this is posted, YAI Network autism experts are being interviewed by major media outlets on this important news story. We will post links to the news stories on YAI Autism Community as they become available. Don’t forget to add us to your Google Reader or other RSS feed to stay up-to-date.

Jeff and Alex

Today’s post is by Jeff Stimpson, author of the books Alex: The Fathering of a Preemie and Alex the Boy: Episodes From a Family’s Life With Autism.

The Catholic Review of the Archdiocese of Baltimore has run an interesting story on how the church is beginning to deal with parishioner families living with autism. (I tried to show the story to Alex, but he just kept running to the TV to watch “Elmo” and line up his plastic animals.)

This story relates how a Maryland family eventually had to splinter at Sunday services and at Mass when their little boy Donald would, rather than commune with his God, “ball himself up in a pew” or “bark like a dog.” “Throughout Mass, Donald held a video game controller, even in the line for the Holy Eucharist,” the story says, adding the mom’s entry for Understatement of the Year: “Some parishioners … were surprised.”

I bet. Alex has been, well, Alex in venues as varied as movies, parties and hotels: bolting, obsessively flipping light switches, yanking every door handle until he found one unlocked. Once he ran into a Marriott lobby in his underwear. Once he recited the alphabet at full voice in the middle of Shrek 3. Some people understand; most don’t. As recently as last weekend he screeched and bolted at a family party – “recently” being a key word here, as Alex is pushing five feet tall now and even has Matt Dillon-like line of fine brown fuzz along his upper lip. People look differently at a young man behaving like this than they do at a little boy.

The Catholic Church around Baltimore has embraced and accommodated Donald’s family in worshipping separately, though the parents claim that autism still breaks up the family at one of the moments when it most wants to be together. The Church also aims to form a committee to look at autism among its families, and high time.

In a story that made headlines coast to coast a few years ago, a Midwestern church out-and-out booted a teen with autism for disrupting services. One got the clear impression that it was the rule in religion then, rather than the exception. One big shame of the situation is that places of worship had little choice: All people are entitled to worship in their individual, conventional peace, undistracted by dogs or Elmo or Jack Nicholson snoring in the back row like in The Witches of Eastwick.

All I can say is that we’ve found tools to help Alex through such moments: chocolate, saltines, a favorite toy, tons of whispered patience. Now he’ll sit through a movie or a circus. We still leave him home for some formal get-togethers, however, telling ourselves that he just wouldn’t be comfortable anyway. And no way I’d bring him to a wedding or a funeral yet. Maybe someday we’ll find the tools to get through things like that. Maybe one of those tools will be prayer.

Stevie Wonder

This UN-designated day is a great day for coalition building among people with all different types of disabilities–one in ten people working together can make for some serious changes that affect most people with disabilities! And today, the UN is honoring Stevie Wonder, one of the most famous and beloved Americans with a disability. Congratulations Stevie! Read more here.