NEWS: Pediatrics publishes two significant reports on evaluation, diagnosis and treatment of gastrointestinal disorders in individuals diagnosed with ASD

Note: This is cross-posted from the Practitioner Issues in Behavior Analysis Special Interest Group (PIBA-SIG) blog.

One particular note of interest for those in Oregon is that the Acknowledgements of the consensus report states that, 

"The meeting and consensus report were sponsored by the Autism Forum. The forum's goal in this initiative is to establish best practices for the care of co-occurring medical conditions that may affect the developmental outcome of persons with ASDs. Autism Forum programs are developed under the guidance of the Northwest Autism Foundation and in association with, and support of, the Autism Research Institute, Autism Society of America, and Easter Seals Oregon."

On January 4, 2010 Pediatrics, the official journal of the American Academy of Pediatrics, published online two articles related to the evaluation, diagnosis and treatment of gastrointestinal disorders in individuals with autism spectrum disorders.

Both articles are currently available in free full-text at the Pediatrics website,and professionals working with the ASD population may find them of value for their own education and in their roles in serving individuals with ASD.

The first is a consensus report based on the review of current available evidence by an expert panel (composition of the panel, evaluative process and resulting twenty-three statements described in the full report). Because evidence-based recommendation was not achievable at this time, this consensus report was produced, with a footnote included that,

"The guidance in this article is not intended to advocate for an exclusive course of treatment or to represent a standard of medical care. Individual circumstances will determine variations that may be appropriate."

Buie T, et al "Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report" Pediatrics 2010; 125: S1-S18.

DOI: 10.1542/peds.2009-1878C

http://pediatrics.aappublications.org/cgi/reprint/125/Supplement_1/S1

ABSTRACT:

Autism spectrum disorders (ASDs) are common and clinically heterogeneous neurodevelopmental disorders. Gastrointestinal disorders and associated symptoms are commonly reported in individuals with ASDs, but key issues such as the prevalence and best treatment of these conditions are incompletely understood. A central difficulty in recognizing and characterizing gastrointestinal dysfunction with ASDs is the communication difficulties experienced by many affected individuals. A multidisciplinary panel reviewed the medical literature with the aim of generating evidence-based recommendations for diagnostic evaluation and management of gastrointestinal problems in this patient population. The panel concluded that evidence-based recommendations are not yet available. The consensus expert opinion of the panel was that individuals with ASDs deserve the same thoroughness and standard of care in the diagnostic workup and treatment of gastrointestinal concerns as should occur for patients without ASDs. Care providers should be aware that problem behavior in patients with ASDs may be the primary or sole symptom of the underlying medical condition, including some gastrointestinal disorders. For these patients, integration of behavioral and medical care may be most beneficial. Priorities for future research are identified to advance our understanding and management of gastrointestinal disorders in persons with ASDs.Pediatrics 2010;125:S1–S18

The second,

Buie T, et al "Recommendations for evaluation and treatment of common gastrointestinal problems in children with ASDs" Pediatrics 2010; 125: S19-S29.

DOI: 10.1542/peds.2009-1878D

http://pediatrics.aappublications.org/cgi/reprint/125/Supplement_1/S19

includes differential diagnostic and treatment guidelines which make reference to the consensus report.

ABSTRACT:

Children with autism spectrum disorders (ASDs) can benefit from adaptation of general pediatric guidelines for the diagnostic evaluation of abdominal pain, chronic constipation, and gastroesophageal reflux disease. These guidelines help health care providers determine when gastrointestinal symptoms are self-limited and when evaluation beyond a thorough medical history and physical examination should be considered. Children with ASDs who have gastrointestinal disorders may present with behavioral manifestations. Diagnostic and treatment recommendations for the general pediatric population are useful to consider until the development of evidence-based guidelines specifically for patients with ASDs. Pediatrics 2010;125:S19–S29

As a sidebar to the newsstories on the Pediatrics articles, it was noted in one news report that there is a current well-designed and controlled study at the University of Rochester that is anticipated to provide useful information on the effects of the gluten-free/casein-free diet on children with ASD, and that Autism Speaks will be issuing its own recommendations on treatment, including diet, within the year via its Autism Treatment Network.

For further reading/references:

Source: NEWS: Pediatrics publishes two significant reports on evaluation, diagnosis and treatment of gastrointestinal disorders in individuals diagnosed with ASD

Thursday, January 7, 2010

Practitioner Issues in Behavior Analysis SIG blog

Pediatrics Gastrointestinal Consensus Statement & Recommendations Provide First Step Toward Needed Guidelines for Children with Autism

Autism Speaks

No Proof Yet That Special Diets Ease Autism

Experts say that, for now, parents should work with their child's doctors
By E.J. Mundell
HealthDay Reporter, BusinessWeek

NIMH study NCT00090428, Diet and Behavior in Young Children With Autism.

Autism Speaks Autism Treatment Network

Pediatrics - Official Journal of the American Academy of Pediatrics

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ANNOUNCE: National Autism Center releases National Report from the National Standards Project

The National Autism Center, in Randolph, MA, "dedicated to serving children and adolescents with Autism Spectrum Disorders (ASD) by providing reliable information, promoting best practices, and offering comprehensive resources for families, practitioners, and communities.", has just issued its National Standards Project National Report.

There are three available options for download:

• National Standards Project Overview (pdf)
  (This two-page document provides a summary of the National Standards Project.)
  

• Findings & Conclusions of the National Standards Project (pdf)
  (This is a pdf of the 53-page Findings and Conclusions Report, which includes the
  results of the National Standards Project.)
  
  
• National Standards Full Report (pdf)
  (This is a pdf of the full 160-page National Standards Report.)
  

Some notes about the report and intent,

"...The findings of the National Standards Project include the identification of:

11 “Established” Treatments: treatments that produce beneficial outcomes and are known to be effective for individuals on the autism spectrum. The overwhelming majority of these interventions were developed in the behavioral literature (e.g., applied behavior analysis, behavioral psychology, and positive behavior support).

22 “Emerging” Treatments: treatments that have some evidence of effectiveness, but not enough for us to be confident that they are truly effective.

5 “Unestablished” Treatments: treatments for which there is no sound evidence of effectiveness. There is no way to rule out the possibility these treatments are ineffective or harmful.

The National Standards Report encourages parents, educators, and service providers to use this information about treatment effectiveness as they make decisions about which treatments to select. It also strongly advises decision makers to consider other factors in addition to treatment effectiveness, including the judgment and data-based clinical recommendations of qualified professional(s), the values and preferences of the individual with ASD and those who care for him/her, and the capacity of their local schools and/or treatment programs to deliver the treatment correctly.

The project identified significant limitations of current autism treatment research. The National Autism Center is hopeful that the results of the project will encourage the research community to concentrate its efforts and conduct more research in areas that have not been studied adequately. In addition, research on all treatments should be extended to appropriate age groups, treatment targets, and diagnostic populations. "

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UPDATE: Thursday, December 3, 2009
ANNOUNCE: National Autism Center releases new educators' manual on evidence-based practice for ASD in schools

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Disclaimer
The Oregon Association for Behavior Analysis (OR-ABA) posts items only as a service to OR-ABA members and other interested persons. OR-ABA reserves the right to edit items submittedfor content, length, and style. OR-ABA will post only those event announcements that appear to be consistent with OR-ABA's statement of purpose, relevant laws, regulations, and ethical principles. OR-ABA's decision in this regard is final. These announcements should not construed as advertisements or endorsements of the products, services, or events described. OR-ABA cannot accept paid advertising on these pages. Announcements of commercial events or events with strong commercial tie-ins will be carefully evaluated for suitability. OR-ABA makes no representation of the accuracy of the events announcements, the quality of the events described, or suitability of any event or its intended use.
Please visit our website to find out more about OR-ABA, our activities, monthly meetings and speakers.