Alaine Reschke-Hernandez

Changing the focus

Reschke-Hernandez focuses on treating the unique needs of each individual. “Music therapy is a very systematic application of music interventions that are individualized,” she says, “and they work on non-music goals. We work on communications skills, social skills, academics, motor skills if need be, all based on individualized assessment and on-going assessment.” Because autism is a relatively new disorder — the first paper was written in 1943 — it is not fully understood. According to Buie and Kilo, this has resulted in some diagnoses and treatments that are less than ideal. Buie says it’s because so many physicians and caregivers have been quick to blame treatable problems on autism.

“We need autism caregivers to separate the behavior from the diagnosis,” he says.
While there is no known single cause for autism, Buie believes too much focus is being placed on finding causes rather than on treating the conditions. We want families to look at children and think in terms of medical problems,” he says. “We must change the focus and treat the underlying problem. For instance, it’s very common for autistic kids to have sleep disorders. Too many practitioners say, ‘He’s autistic, so he doesn’t sleep well.’ That’s not an answer.”

To help caregivers find the answers, the Division of Developmental Disabilities at the Missouri Department of Mental Health and the Thompson Foundation for Autism developed Autism Spectrum Disorders: Missouri Best Practice Guidelines for Screening, Diagnosis, and Assessment. Kilo served on the project leadership team during the document’s development. Kilo says the guidelines were written as a consensus document with input from therapists, educators and parents to help Missouri health and education professionals and families of persons with ASD make informed decisions regarding identification, diagnosis and assessment of the disorders.

“In order to make accurate diagnoses and get children with autism into the right services,” Kilo says, “we have to have a consistent way to approach this population: to screen them in pediatric offices, to refer them to subspecialists, make accurate diagnoses and then initiate the correct set of interventions.” Kilo says the guidelines will help with what Buie described as changing the focus.

“We wanted to say (to physicians) that when working with this population of kids, you can’t just treat ’em and street ’em,” Kilo says. “You can’t just say, ‘Hey, I think you’ve got autism. See you later. No, you don’t need to see me again.’ And then send the family out into the street. The family would be absolutely overwhelmed and devastated. And the guidelines will help families know what to expect.”

“It’s a good explanation for families,” Buie says of the guidelines. “It’s a wonderful thing for the state of Missouri to set these standards. Other states will follow.”

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