On the 25th September 2001, Dr Gillian Baird, one of the country's leading experts on autism spoke for over an hour and a half giving an overview of her current research and also answering questions from the audience. A review of her talk is included here. This covers many of the points raised. The event was also recorded and is now available to listen to in RealAudio format. In order to listen to the talk, you must have RealPlayer installed on your computer. You can follow the instructions on the BBC Radio 4 website on how to download the free version of the player from RealNetworks. The recording is broken down into sections varying from a few seconds to around 10 minutes. Each section covers a topic or a question. Just click on the title or topic that interests you to start listening.
Read the review of the evening
In recent years the team have done a lot of research into early diagnosis and developed the Checklist for Autism in Toddlers (CHAT) to be used by health visitors at the 18 month check-up. They are currently looking at prevalence rates (the numbers of children being diagnosed), whether different forms of intervention have different outcomes, and medications used for other conditions that can occur with autism such as phobias or hyperactivity. Dr. Baird's team is also involved in the international studies into genetics and autism. It is thought that there are probably 4 or 5 genes involved in autism, and researchers have found two promising sites for further research.
Dr. Baird praised the work of the outreach teachers from Linden Bridge and Freemantles Schools. Diana Ennis, the Linden Bridge outreach teacher, was at the meeting and explained the help she gives to families and mainstream schools (see previous issue of Surrey News). Dr. Baird also had great praise for the Little Group nursery in Epsom, which she described as absolutely superb.
Feeding and sleeping
Sleep problems are more difficult as they can disrupt the whole family's life and may occasionally persist into the teenage years if not tackled. Both eating and sleeping are problems which can affect all children although they are more difficult to deal with in autistic children because autism means that our children find it harder to learn and therefore to change their behaviour using standard behavioural programmes. The medication Melatonin can help to get children to sleep, and there is now a slow-release Melatonin which may help with those children who wake after a few hours.
Asperger Syndrome and language Somebody asked about the overlap between language problems and Asperger Syndrome (AS). Dr. Baird explained that 'Asperger Syndrome' has become a shorthand way of describing someone who is high-functioning (in terms of being intelligent), has language skills which they like to use but has social impairments, special interest and may be clumsy.
The official diagnostic manuals classify people with AS as having normal language and behaviour until at least the age of 3, which rules out a lot of children who had early language delay etc. By the teenage years there are few significant differences in outcomes between those AS children who had normal speech at 3 and those who didn't; what matters is the difference in overall ability, language level and severity of autism.
Almost everyone with an autistic spectrum disorder will have problems with language - when to say things, what the meaning is, appropriate conversation, and within the spectrum there is a huge range of language difficulties. The professionals are still grappling with the most meaningful way of describing children. Dr. Baird sees some where the language difficulty is the more severe problem although they also have social impairments, and they are often diagnosed with Semantic Pragmatic Language Disorder. Dr. Lorna Wing has encouraged the use of the term 'autistic spectrum disorder', although the drawback of this is that it applies to so many children that it does not convey an individual description of the child.
A question was asked about different therapies. Dr. Baird explained that Applied Behavioural Analysis (ABA) programmes involve working intensively with the child on particular behaviours by rewarding so that they are repeated. Son-Rise/Options is another intensive programme but it is child led. The therapists follow the child's interests and imitate what the child does. Higashi is yet another programme, which involves group teaching. Dr. Baird feels that all the programmes can help if a child enjoys them and they are done frequently, but each has advantages and disadvantages. Ideally a mix of all approaches is used. There have been difficulties when children who have just been using Son-Rise try to integrate into schools, as it is necessary for the children to be able to conform to requests and the child-led approach does not prepare them for that.
Dr. Baird currently has a waiting list of 2 years, although when a new colleague joins her in January that should reduce to 'only' one year. We are very grateful to her for coming to talk to us.
Listen to RealAudio recording
Review is © 2001 Sara Truman. Our thanks to Dr Gillian Baird for giving permission for the recordings to be made available
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