Missouri team aims for early autism diagnosis

Saturday, March 12, 2011 | 6:00 a.m. CST

JOPLIN — Before January, Brett and Melissa Smith could not stay in Joplin for an evaluation of Braylon, their 20-month-old son. They would have had to wait a year and travel to Columbia, St. Louis, Kansas City or farther.

But Braylon was evaluated for autism on Jan. 21 in Joplin — a month after being referred by his pediatrician.

After a diagnosis by a newly formed Autism Diagnostic Team, Braylon quickly started receiving treatment from a therapist trained by the Ozark Center for Autism.

"In just a few days, we've seen so much progress. It's a blessing," Dianna Smith, Braylon's grandmother, said.

That's the goal for Dian Doody, the Joplin pediatrician who organized Joplin's new diagnostic team and arranged for specialized training for team members, in collaboration with the University of Kansas Center for Child Health and Development.

The team began work in January and already has seen six youngsters, she said.

"Parents were having to take their kids a long way and having to wait at least nine months even to get in," Doody said. "That's a long time to wait for kids who need treatment and for families who are worried about them."

Melissa Smith said she and her husband received a preliminary diagnosis immediately after the screening and were told Braylon met the criteria for autism.

"My stomach dropped," said Melissa. "But I also felt hopeful and supported. I felt like we would have a plan and get the information and resources we needed."

The ability to get the diagnosis within a month of being referred by her pediatrician also was important to Melissa.

"This is a critical window for his learning, so time is of the essence. Within the first two days, we were already hearing new sounds and seeing increased eye contact."

Scott McClure, a therapist trained by Ozark Center, agrees that early diagnosis and intervention are critical.

His work with Braylon includes a lot of specialized play aimed at improving eye contact, communication and motor skills.

"It's exciting; he's moving along really quickly," McClure said, as Braylon turned somersaults on the living room floor.

Before, Melissa Smith said the 20-month-old wasn't making eye contact, wasn't progressing in his speech and didn't recognize or respond to family members.

"He didn't respond to his name; it was like we were speaking another language," she said. "For a while, I was looking for other ways to justify his behavior. He'd had chronic ear infections since birth, and I thought there might be a hearing problem."

Braylon is the youngest child diagnosed so far, but children learn quickly at a young age, Doody said.

The screening, which lasts about four hours, brings together specialists to focus on all elements of a potential autism diagnosis. They test and observe the child, meet with the parents and review information from teachers and others who know the child on a personal level.

Team members meet with parents after the screening and give parents recommendations based on the evaluation, whether or not it leads to an autism diagnosis.

"I was excited to have the attention of all those professionals for four hours to talk about every piece of Braylon's development," Melissa Smith said.

She said her anxiety about the process had been lessened by the team's parent educator, a registered nurse who has a child with special needs.

"She's there for you from the start, and through the whole process. It's someone you can call whenever you have a question," she said.

Paula Baker, Freeman Health Systems' chief clinical officer and the administrator for all autism programming, praised the members of the diagnostic teams assembled by Doody for their willingness to take on the additional training. Doody proposed developing a local team after completing a fellowship in autism at the KU Medical Center.

"They've used a team approach for years," Doody said.

Team members started training at KU last June, sometimes locally and sometimes via a "tele-medicine" hookup. The team involves pediatricians trained in diagnosis of developmental disorders; psychologists; speech pathologists; a behavioral analyst trained in autism disorders; and a parent educator.

"It's a team that brings all the disciplines to the table, rather than sending a parent and child to a lot of different places," Doody said.

Of the youngsters seen so far, half have been determined to meet the criteria for autism. That's the same rate as found in other diagnostic centers, Baker said.

A diagnosis opens the possibility of treatment at the local center or at another location. The final report is comprehensive, Doody said, and can be used by other physicians in treatment, or by schools in developing an education plan for the child.

"Some will result in recommendations for other programs, or for medical or psychological treatment," Doody said.

Melissa Smith said she believes the comprehensive nature of the diagnosis also removed any potential roadblocks for getting treatment for her son, who is eligible for behavioral and speech therapy. She said she was able to arrange treatment through Missouri's First Steps program, though it would have been covered by her insurance as a result of a new state law that went into effect in January.

Baker said she expects the team will attract parents and children from a broad region, adding: "We'll help them where they are."

For officials of the center, the diagnostic team was part of a natural progression.

"Until there's a cure, the best we can give a family is early diagnosis and treatment," she said.

Like what you see here? Become a member.

Show Me the Errors (What's this?)

Report corrections or additions here. Leave comments below here.

You must be logged in to participate in the Show Me the Errors contest.


Leave a comment

Speak up and join the conversation! Make sure to follow the guidelines outlined below and register with our site. You must be logged in to comment. (Our full comment policy is here.)

  • Don't use obscene, profane or vulgar language.
  • Don't use language that makes personal attacks on fellow commenters or discriminates based on race, religion, gender or ethnicity.
  • Use your real first and last name when registering on the website. It will be published with every comment. (Read why we ask for that here.)
  • Don’t solicit or promote businesses.

We are not able to monitor every comment that comes through. If you see something objectionable, please click the "Report comment" link.

You must be logged in to comment.

Forget your password?

Don't have an account? Register here.