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  • Stramski Center

An Autism Awareness Month Update

This article was originally published in L.A. Parent, and can be found here:

April is Autism Awareness Month, so we checked in with Gary Feldman, M.D., medical director of the Stramski Children’s Developmental Center at Miller Children’s & Women’s Hospital Long Beach, for an update on research, diagnosis and treatment.

What’s going on in the field of autism research now that makes you feel most optimistic?

Probably two categories. One is the increasing evidence that shows us that early intervention can have a strong influence on outcome. The other one is the possibility of making earlier diagnoses, primarily through genetics and genetic studies. And coming out of that is the possibility of what we call targeted medication treatments.

Tell me more about targeted treatments. How do these work?

When you have genes that are giving bad signals that ultimately cause changes in the brain that would result in autism, if you can redirect or block that process, then the effect of that process may be aborted or reduced or minimized. If you can identify what the process is, you can intervene on a molecular level through medications.

It’s still experimental. It’s promising, and a lot of trials are being done on different medications. It’s definitely going to happen in the future.

Have we changed anything about how autism is diagnosed?

Right now, it’s still an observational diagnosis. The mechanisms of making those diagnoses are improving slightly in terms of the tools that are available: direct assessments, direct observations of the child, specific rating scales, etc. But a lot of it is based on parental report or based on the observations of an examiner and how the examiner interprets what they see.

There are some more tangible things on the horizon. If you look at the brain anatomy of the child with autism or the child at risk for autism, they tend to have larger brains and more cerebrospinal fluid – the fluid that surrounds the brain. Moving forward, we may be able to scan the brain and look for certain features that might aid earlier diagnosis.

The other category is the genetics. By looking at RNA or looking at genetic material you can build a profile that can be predictive for autism. There’s research going on to develop these profiles.

What advice do you have for a parent whose child has just been diagnosed with autism? 

A diagnosis is a shock. Allow yourself to go through the grieving process, but then move on. Get access to good information. The more informed you are, the more knowledgeable you are about the condition, the better position you are in to ask the right questions for your child and to advocate effectively for your child. Put your emphasis initially on well-tested treatments, which at this time means speech therapy, behavioral therapies, occupational therapy.

People mustn’t be afraid of the diagnosis. It’s not a terminal illness. It’s a lifelong condition, but you can definitely do something about it. And it doesn’t mean that your child is not going to amount to anything. Is there a cure? At this point, no. Can we do something about it? Definitely. And in the future, with earlier diagnoses and specially targeted treatment, can it change the outcome even further? Yes, I’m very confident. Your child will invariably end up better than you think.


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