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About Sickkids
About SickKids

January 14, 2014

New review will help guide primary-care physicians to better support children with autism

By Erin Collett

A new review published in the Jan. 13 edition of the Canadian Medical Association Journal aims to help physicians provide appropriate medical support, from detection to treatment, for children with autism spectrum disorder (ASD) and their families.

“Community physicians play an essential role in identifying early stages of ASD and ensuring timely diagnosis,” says Dr. Stephen Scherer, co-author of the review, senior scientist and director of The Centre for Applied Genomics at The Hospital for Sick Children (SickKids). “The greatest impact on outcomes will come from careful attention to parents’ concerns, observing early social and communication skills, immediate referral to available intervention services, and timely referrals for specialized assessments and interventions.”

ASD affects more than one per cent of the Canadian population, and a dramatic increase in its recognition is creating huge demands on health-care systems for timely and accurate diagnosis. Earlier diagnosis would alleviate prolonged concerns of many families and advance opportunities for children to benefit from specialized interventions, thereby reducing costs to families and society.

Optimal care depends on a large network of providers, given the breadth of the associated medical issues. Among people with ASD, ten to 25 per cent have an associated medical condition such as a genetic syndrome like Fragile X syndrome, severe anxiety, epilepsy and even gastrointestinal problems. Early detection through improved awareness, family studies or screening programs facilitates early and effective interventions.

The comprehensive, evidence-based review outlines experts’ current understanding of ASD and identifies best practices and resources for primary care and specialized clinics based on randomized controlled trials and other systematic reviews. Developed by a multidisciplinary team of Canadian experts, including specialists in paediatrics, psychiatry, epidemiology, neurology and genetics, it addresses common concerns, like how to detect ASD early, what treatments and interventions are currently available, and how effective they are.

The endowed chairs held by some of the authors receive special acknowledgement since they helped to provide the support necessary to develop this important knowledge translation piece. Lonnie Zwaigenbaum holds the Stollery Children’s Hospital Foundation Chair in Autism. Peter Szatmari holds the Jamie and Patsy Anderson Chair in Child and Youth Mental Health at The Hospital for Sick Children, the Centre for Addiction and Mental Health and the University of Toronto. Eric Fombonne holds the Monique H. Bourgeois Chair for Research on Pervasive Developmental Disorders and a Canada Research Chair in Child Psychiatry Tier I. Susan Bryson holds the Joan and Jack Craig Chair in Autism Research at Dalhousie University. Stephen Scherer holds the GlaxoSmithKline — Canadian Institutes of Health Research Pathfinder Chair in Genome Sciences at the University of Toronto and The Hospital for Sick Children.

Some of the recommendations by the authors are based on their research which has been supported by Autism Speaks Canada, the Canadian Institute for Advanced Research, the Canada Foundation of Innovation, Canadian Institutes for Health Research, Genome Canada, NeuroDevnet, the Ontario Brain Institute, the McLaughlin Centre, the Simon’s Foundation and SickKids Foundation.