Naomi Swiezy, clinical director at the Christian Sarkine Autism Treatment Center in Indianapolis, says autism treatments today address symptoms, not causes. No one knows its cause.
As clinical director at an IU School of Medicine autism treatment center, Naomi Swiezy is, by nature, a goal-oriented health-care practitioner. A researcher as well as a behavioral psychologist, her focus is on research-based, empirically supported approaches to treating the pervasive developmental disorder. She uses the term treat advisedly. Like any expert in the field, she can only speculate on what causes the range of behavioral, social and intellectual impairments known as Autism Spectrum Disorders. Genetic predisposition triggered by unknown environmental factors is the prevailing wisdom. Cure isnt a part of the vocabulary. Its not about curing the autism, Swiezy said during an interview at the Christian Sarkine Autism Treatment Center at Riley Hospital for Children in Indianapolis. We dont believe thats a possibility. Autism is, in fact, a relatively new and little-understood condition, she said.
While autism appeared in the literature in 1943, Swiezy explained, the American Psychiatry Association didnt even define the Autistic Disorder diagnosis until 1980, with the publication of the third edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-III). At that point, thats really when autism came to be officially defined as a disorder, she said. Aspergers Disorder and Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS) werent diagnostically recognized as Autism Spectrum Disorders until the DSM-IV came out in 1994, a mere 15 years ago. Although all of this was being talked about in the 1940s, Swiezy said, it wasnt really until much later that there was a recognition.
"No one can say for certain what happens physiologically in the brains of those with autism."
I was getting trained in the 1980s, and there was much less understanding than we even have today, she said. I could see how positively the children were reacting to interventions, and the opportunity to teach other people that there really is hope for these children was really an outstanding opportunity. When Dr. Christopher McDougle, a 1986 IU medical school grad-turned-professor of psychiatry at Yale, came back to teach at his alma mater in 1997 and established an autism clinic, Swiezy saw another opportunity. She contacted McDougle, who shared her vision of a multidisciplinary approach to treating autism, and she joined his clinic in 1998, adding a behavioral component to the treatment regimen. McDougle ascended to the position of chairman of the Department of Psychiatry in 2000. The clinic transformed into the Christian Sarkine Autism Treatment Center and moved to Riley in 2002. Named after the autistic grandson of U.S. Rep. Dan Burton, R-Indianapolis, the Sarkine Center is one of the three largest facilities of its kind in the United States. The move to Riley and an accompanying expansion of services was underwritten by $1.8 million in federal funds that Burton secured. The centers Mission Statement declares: Services are provided to individuals across the autism spectrum, including individuals of all ages, language abilities, and overall developmental levels. The general goal is to help children and adults with Autism Spectrum Disorders to achieve their potential and to participate as fully as possible in family, school, and community life.
The Sarkine Center is affiliated with the IU School of Medicine and is located in the Riley Hospital for Children. The sprawling Riley Outpatient Center, which opened in 2000, was designed around the facade of the old Riley Hospital, which opened in 1924.
"The American Psychiatry Association didnt even define the Autistic Disorder diagnosis until 1980."
Sibling studies show genetic predisposition is a factor. But there are pairs of identical twins in which one has autism, and one does not. What experts pretty much agree is that there are multiple hits and multiple possibilities that impact on the brain, she said, environmental pollution among them. But then theres too much variability among the children who have autism to be able to really say specifically this is the cause.
"ABA is a scientific approach for treating behavior disorders, including but not limited to autism."
We do a lot of parent training, she said. The focus really is on providing tools that the families can use when they leave here. Parents can help the children generalize the skills they learn in therapy, so Sarkine therapists teach them necessary skills. The process includes modeling appropriate intervention techniques for the parents, shadowing them as they learn and eventually fading from the scene. We give them homework, Swiezy said. Educators have been another target group. A 2004 CDC grant facilitated a program called Hands in Autism that seeks to develop a training model for caregivers, such as teachers. Educational teams will come here in the summer and spend a week with us and work hands-on with kids, she said. In 2006, the Hands program began collaborating with Indianapolis Public Schools (IPS) to develop a classroom program for autistic students. IPS provided a classroom and interested teachers, and Sarkine therapists taught them intervention techniques. The program started in 2006, Swiezy said. And now that the teachers have been trained and shadowed, Were at a point of very much fading.
Originally posted here:
Treating a little-understood condition