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Departments to receive grant to identify children with ASD 

Autism spectrum disorder (ASD) has gained much national media attention in recent months, with reporters delving into the misunderstood condition affecting children and adults throughout the country. One of the most basi,c and as of yet unanswered, questions is how many people in the United States live with ASD and its various manifestations.
 
MUSC Department of Pediatrics—Division of Genetics and Developmental Pediatrics, and Department of Biostatistics, Bioinformatics and Epidemiology—are one of 10 state sites selected to receive a grant from the Centers for Disease Control and Prevention (CDC). The $350,000 grant was awarded to developmental pediatrician Jane Charles, M.D., and Joyce Nicholas, Ph.D., epidemiologist, to continue identifying the number of children with autism spectrum disorder (ASD) and other developmental disabilities in South Carolina. 
 
A total of $3.5 million was distributed to sites in Alabama, Arizona, Colorado, Florida, Maryland, Missouri, Illinois, North Carolina, Pennsylvania, South Carolina and Wisconsin. All sites are a part of the Autism and Developmental Disabilities Monitoring Network (ADDM) that will provide comparable, population-based estimates of the number of children who have ASD and related disorders in different sites through time. The grant award began in June and will continue for four years. 
 
“One of the interesting things about the analysis of this condition is that there are no good studies out there on how many children have autism,” Charles said. “One of the things that MUSC is doing about this is to work with the Centers for Disease Control (CDC) to do a prevalence study in South Carolina.”
 
“These grants are a significant part of CDC’s effort to learn more about autism in the United States. It will help us determine whether the number of children with ASD is increasing, decreasing, or staying the same,” said Jose F. Cordero, M.D., assistant surgeon general and director of CDC’s National Center on Birth Defects and Developmental Disabilities. “This is important if we hope to understand the impact of autism on families and communities.”
 
ASDs are lifelong neurodevelopment disorders characterized by repetitive behaviors and social and communication problems. Individuals with ASD have impairments in social, communicative, and behavior development, often accompanied by abnormalities in cognitive functioning, learning, attention and sensory processing. Many people with ASD also have unusual ways of learning, paying attention, or reacting to different sensations. ASD begins during childhood and lasts through a person’s life.
 
Of children referred to MUSC clinics for suspected autism, 66 percent are diagnosed with ASD, and of those children there are three major categories:
  • Asperger Syndrome: The child is high functioning with normal cognitive abilities but has profound social deficits and odd or repetitive behaviors.
  • Autistic: The child has deficits in language and social interactions, and displays odd or repetitive behaviors.
  • Pervasive Developmental Disorder-Not Otherwise Specified: This describes children who don’t fit into the two previous categories or who don’t meet full criteria for diagnosis.
ASDs are considered developmental conditions of public health concern by the CDC due to the increasing numbers of children receiving services for these conditions. In response to this concern, the CDC established the ADDM Network to track the prevalence and characteristics of ASD in multiple areas of the United States. This network is a multiple-source, population-based, active surveillance system reviewing developmental records at educational and health sources using a standardized case algorithm to identify ASD cases.
 
In 2000, Charles and Nicholas were awarded a large grant to become one of the original states to participate in this collaborative project with the CDC. In addition to Charles and Nicholas, current MUSC project personnel include psychologist Laura Carpenter, Ph.D., program coordinator Lydia King, education and outreach coordinator Walter Jenner, and abstractors Amy Burrell and John Redant.
 
“Our South Carolina surveillance region includes 21 contiguous counties in the Coastal and Pee Dee regions,” Nicholas said. “Surveillance sites within this region include 41 school districts and 21 South Carolina Department of Disabilities and Special Needs Boards in 23 counties, as well as clinics at MUSC and USC. We have tracked three study groups to date (children aged 8 years in 2000, 2002, and 2004) and received a new grant to continue the project for the study years 2006 and 2008. Results from these five study years will permit us to examine changes in prevalence, service needs and service delivery over time. In addition to ASD, the South Carolina project has tracked mental retardation since 2002.”
 
MUSC clinics dedicated to the diagnosis of ASD conduct four brand new evaluations a week where a patient sees a physician and a psychologist. The child receives a complete medical and psychological work-up, and if diagnosed, begins follow-up visits with the pediatrician in addition to treatment.
   

Friday, Oct. 13, 2006
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