Autism in context 2: Assessment, intervention and services in Australia

Abstract

Continuing from part 1, part 2 of the autism spectrum disorders review explores clinical practice and service delivery aspects of autism spectrum disorders including current assessment approaches in Australia, family-centred models of care, and key service structure and delivery issues. Treatments including behavioural interventions, established and emergent medication, and complementary and alternative therapies are discussed. The key role of paediatricians as both individual child and family care providers and advocates, as well as agents of service reform in Australia, is evident. Much still needs to be done.

Practitioner Perceptions of the Assessment and Diagnosis of Autism in Australia

“…There is some evidence that early intensive behavioural intervention provides improved developmental outcomes for some children with autism, including gains in adaptive behaviour, language, and IQ (for review, Reichow, Barton, Boyd, & Hume, 2012). Although the magnitude of gains can vary, and optimal timing, intensity, and duration of intervention are yet to be established (Williams et al, 2014b), guidelines for good practice intervention in Australia outline that intervention should begin as soon as characteristics of ASD are noted and continue for as long as required . There is some evidence to suggest that the timing of intervention may be important, with a number of studies showing that children who received appropriately targeted intervention under the age of 3 years displayed greater developmental gains and reduced core symptom severity compared to children who received the same intervention after the age of three (Goin & Myers, 2004;Landa, Holman, & Garrett-Mayer, 2007;Sheinkopf & Siegel, 2004).…”

Identifying autism early: The Toddlers at Risk of Autism Clinic model

“…temperament, language ability, IQ, imitation and social interaction, motor and adaptive skills), and probably genetic autism subtypes. Several studies have shown that autism symptom severity has little predictive power; ongoing review is therefore an essential part of management …”

“…Research is not clear on the optimal age for early intervention or the best type of intervention . Randomised control trials are challenging in this population in view of the huge variation in individual symptoms, treatment schedules and developmental patterns …”

“…Several studies have shown that autism symptom severity has little predictive power; ongoing review is therefore an essential part of management. 2,16…”

“…28,29 Randomised control trials are challenging in this population in view of the huge variation in individual symptoms, treatment schedules and developmental patterns. 15,16…”