One in 110 American children are considered to fall somewhere along the autism spectrum, according to the latest report released by the Centers for Disease Control and Prevention. The new figure, which was released in October 2009, is drawn from the most comprehensive set of data yet on the developmental health of 8-year-olds.

 
The new Medical Autism Clinic, directed by Myrian Peralta-Carcelen (left) and coordinated by nurse Vicki Farley (right), will enable physicians to address feeding, sensory, motor, sleep, gastrointestinal and nutritional problems in a comprehensive, coordinated plan.
The number reflects a significant increase from the federal government’s previous estimate of one in 150 children with an autism spectrum disorder (ASD) —  a neurobiological disorder that manifests as behaviors and developmental problems. Experts are at a loss to explain if the change is due to improved awareness and diagnosis of the disorders or if the rise reflects a true increase in ASD risk.

Nonetheless, parents persist in their search for answers when it comes to providing proper medical care for their children.

The opening of UAB’s new Medical Autism Clinic in affiliation with Children’s Hospital hopes to give parents of children diagnosed with an ASD a roadmap to navigate their medical problems.

The clinic has specialists in genetics, nutrition, occupational therapy, speech therapy, rehabilitation, sleep disorders and audiology in one location to expedite the evaluation of some of the medical problems seen in children with ASDs.

“In particular, we’re interested in addressing the feeding, sensory, motor, sleep, gastrointestinal and nutritional problems,” says Myriam Peralta-Carcelen, M.D., professor of pediatrics and director of the clinic. “Having this in a clinic setting enables us to address these issues and others in a more comprehensive and coordinated way.”

The Medical Autism Clinic is one of a few in the state and the only one in the Greater Birmingham area. It began with the efforts of a team of doctors that wanted to provide better medical care in a timely fashion — a feat not always possible in many autism clinics across the country.

“I’ve visited many autism clinics, and one of the complaints we heard from many places is that they have to wait a year to be seen and another year to get a complete report,” Peralta says. “It’s a very comprehensive and very detailed report, but it’s still time lost. I know it can be very frustrating. Parents can be doing things in the interim that can dramatically help their children.”

Once patients are referred to the clinic by their pediatrician, the parents or caregiver is contacted for preliminary screening and evaluation and they are asked to complete an intake questionnaire. A clinic appointment is scheduled after the questionnaire is received.

At the appointment, patients are seen and evaluated by Peralta, a behavior and development specialist. They also could see geneticist Edward Lose, M.D., if they have not had a previous evaluation by a geneticist. In addition, they might see Drew Davis, M.D., a rehabilitation physician, or other appropriate specialists. Parents then leave the clinic with appropriate recommendations for continuing care, educational materials and follow-up appointments as needed.

“We really hope to make the whole experience as comfortable as possible for the parents,” says Vicki Farley, nurse coordinator of the clinic. “We don’t want them to have an occupational therapy appointment today and a speech appointment in two weeks. We’re putting it all together in one visit to make it easier so when parents walk out of the door they have in their hands some recommendations and a plan of action. We want them to leave with some answers, or at the very least some direction, and help them plug into the resources available in the community.”

Funded by Protective Life, UAB
The Medical Autism Clinic, funded by a Patient Clinical Care Initiative Grant from Protective Life and UAB, is a separate entity from the Civitan-Sparks Clinics, which provides evaluation and diagnostic services for developmental and behavioral disorders.

“Sparks Autism Clinic concentrates mostly on the academic and psychological testing and administering diagnosis,” says Peralta, who began the Sparks Autism Clinic in 2001 with the help of a Health Services Foundation grant. “The goal of this new Medical Autism Clinic is to provide evaluations beyond the diagnosis and help parents with the associated medical co-morbidity in ASD.”

Farley and Peralta say it’s often the health problems that frustrate parents more than the behavioral problems.

“The kids don’t complain much, and it may be that they have a gastrointestinal problem or a sleep problem that is contributing to their behavioral issues,” Peralta says. “You can’t really address the behavior problems unless you fix the underlying medical problem. Sometimes parents just say, ‘Oh, they’re acting bad,’ but it really could be a stomach ache that’s fueling the behavior. We hope to answer some of those questions for parents.”

Two separate visits may be required to complete the assessment. Visit www.chsys.org/MAC for more information or call 939-5275 for questions regarding eligibility or to schedule an appointment.