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Audio Autism experts call for more targeted interventions

Jennifer Macey

The latest editorial of the Medical Journal of Australia, autism experts argue that autism should be considered as an umbrella term for a collection of behavioural disorders. They argue that there could be multiple causes for autism but they haven't been identified yet and that could lead to better targeted intervention programs.


TIM PALMER: Leading autism researchers in Australia say evidence suggesting the trigger for the condition may not lie in one gene, or in one environmental cause but in multiple potential causes demands a new approach to the syndrome.

They argue that more research is needed to identify all the causes and start treating autism as a grouping of multiple disorders.

They believe that may lead to better and more varied targeted intervention programs, rather than a 'one size fits all' approach.

Jennifer Macey reports.

JENNIFER MACEY: While people with autism may share the same behavioural traits, no two individuals are the same.

TONY ATTWOOD: Some have significant language problems. Others, it can be the intensity of their emotions - that tendency to catastrophise and anxiety and so on, or explosive emotions.

Maybe that's the priority.

JENNIFER MACEY: Professor Tony Attwood is a leading expert in autism spectrum disorders.

TONY ATTWOOD: For others, it's making friends and socialising. Others have an unusual learning profile and some may have intellectual disability, and that will need to be targeted.

We also have a sensory sensitivity - for those who have it, it's excruciating, because ordinary sounds are unbearably intense - but also movement disturbance that may inhibit handwriting skills to putting your brain into gear with your mouth to talk.

So each person needs a very detailed assessment, multi-disciplinary assessment, and then specific programs as to what we think - and the person - is their priority.

JENNIFER MACEY: Now autism experts are debating whether autism should be treated as not simply one condition, but multiple disorders with multiple causes.

Professor Andrew Whitehouse is the head of autism research from the Telethon Institute for Child Health Research at the University of Western Australia.

ANDREW WHITEHOUSE: What we are saying is that we actually think there a multiple different areas in the brain that may cause autism, and what we need to do is really home in on those different areas.

JENNIFER MACEY: What are the potential different causes?

ANDREW WHITEHOUSE: Well, we know that autism is a strongly heritable disorder, which means that the genetic factors play a very large role.

But the fact remains that we can't find any single genetic variant that accounts for a large amount of cases of autism, so what we actually think is that there is a very strong interplay between the genetic profile of an individual and also the environment.

And the way that these interact actually may play a large role in autism.

JENNIFER MACEY: He says currently there's still a tendency for a 'one size fits all' approach to therapy.

ANDREW WHITEHOUSE: Very exciting thing that what we do know is that certain interventions can change the way that our brain functions and once we identify those different areas, we can actually home in on that.

JENNIFER MACEY: Professor Tony Attwood agrees that this is a useful approach.

TONY ATWOOD: Well it means that you've got a common behavioural description, but many pathways that will lead to that description, from neurology, biology, psychology and circumstances may lead to that particular pattern.

So I think the concept of the 'autisms' is a very good one and eventually, we will subdivide it into different groups according to the causes and different future.

JENNIFER MACEY: A school for autistic children that is trying to tailor intervention to individual students is Giant Steps in Sydney, which has 75 autistic students.

The teachers and therapists work together in a classroom. The child is not withdrawn from class to do speech or occupational therapy as happens in mainstream schools.

Trish Karedis is the director of the kindergarten to year six middle school at Giant Steps.

TRISH KAREDIS: We've got some students that wouldn't necessarily be able to attend to a lesson for more than five minutes, wouldn't be able to sit in a chair.

So their kind of programs are far more physically engaging, whereas another class may look a little bit more like a typical classroom, where they're sitting at desks and they're focussing on the interwrite board and they're doing that for 15 minutes and then they're off and doing a group lesson.

So each of the classes are treated according to the needs of the student.

TIM PALMER: Jennifer Macey with that report.