Early diagnosis and intervention: the Abruzzo experience

Background: Autistic spectrum disorders determine in children that don't receive an appropriate treatment a sequel of consequences that in the most severe cases determine long and expensive institutional interventions. An effective treatment requires: a) early diagnosis that involves general pediatricians and specialized diagnostic centers; b) an adequate functional evaluation; c) an involvement of all subjects working with the child. Most early diagnosed children, properly treated reach an acceptable level of social interaction. Objectives: a) Verify the effect of early screening using CHAT. b) Set up and evaluation of a diagnostic protocol that accounts for the different age and functional level of children. c) Test and evaluate a model of total, continuous and intensive take in charge, involving both the hospital and the families. d) Evaluation of the cost of diagnosis and treatment Methods: This approach was promoted by parents of children with autism, and has been financially supported by the Regione Abruzzo – Assessorato alla Sanita'. The early screening has involved 190 general paediatricians while early rehabilitation intervention has been performed by the Foundation il Cireneo in the centre located in Vasto. Intervention has been performed in natural environments with the goal of improving social interaction and communication skills. Results: During the 3 years of this study we have observed a reduction of the average age at diagnosis from 5 to 3 years. Moreover in order to evaluate the efficacy of intervention we performed a longitudinal phase II study on a group of 48 clients ranging from 5 to 18 years, stratified by age and sex, and have observed a significant improvement in all groups using different evaluation scales. Conclusions: In conclusion we believe that the current model of intervention we have adopted gives an adequate treatment to children with ASD.