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President Obama puts autism at top of his medical to-do list

From Volume 4 Number 12

WASHINGTON DC, USA: Autism tops Barack Obama’s medical to-do list, according to the new American President’s website. Whitehouse.gov launched at 12:01 pm on January 21, 2009, even before the new President had taken his oath of office on the Capitol’s West Front.
    Autism is the only disorder or disease mentioned explicitly in Obama’s 24-point agenda. Heart disease and cancer do not get the call. Neither does diabetes or other chronic diseases. But there are four hefty bullet points addressing autism.

President Obama called for:

1. Increased funding for research, treatment, screenings, public awareness and support services for autism spectrum disorders.

2. “Life-long services” for people with autism spectrum disorders, as children and as adults. Many parents struggle to find and pay for screening and treatments for their children, but there is even less coverage and capacity for adults with autism-based impairments

3. More funding for the 2006 Combating Autism Act, as well as improving state and federal autism programmes.

4. Universal screening for all infants for autism spectrum disorders, as well as re-screening for all 2-year-olds. Children are currently screened only if parents or paediatricians voice a concern, so too many children are not diagnosed until they enter elementary school. The earlier treatment starts, the more effective it is, and a national screening programme would help reduce the number of kids falling through the cracks. It would also be a huge undertaking, at a time when both government and privately insured health care is foundering in the US.
           That second bullet point would be a huge help for families who are struggling to provide care. In a recent survey, 52 per cent of American parents of children with autism said their family finances were drained by treatment and care, compared to 13 per cent of  typical families.
    The 2006 Combating Autism Act promised almost $1 billion over five years for autism research and development, but Congress
 had not appropriated $200 million per year, even before the economy hit the skids. The Obama manifesto gives a major hint that for autism, at least, the hard times cited in the new President’s inaugural address will not mean big cuts in funding.
    Still, universal screening for autism will be a huge challenge. There is no blood test that can be used to diagnose autism, as there is for hereditary diseases like galactosemia and sickle cell anaemia, which are screened for using a heel stick while a newborn is still in the hospital. With autism, parents and doctors instead need to observe a child and look for delays in language and social interaction. The Centers for Disease Control and Prevention recommends that paediatricians screen children during well-baby visits at 9 months, 18 months, and 24 or 30 months. But many doctors do not get around to doing those screenings, and until very recently the recommended tests were not sensitive enough to pick up mild autism spectrum disorders. Early screening for autism is a terrific idea. Making it happen will be a tall order, even for the “can-do” Obama team.

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