The conference aimed to take stock of current understanding of autism's causes and the range of therapeutic and rehabilitative possibilities available. It was directed primarily at professionals working in research, clinical practice, and the treatment of autistic children—physicians, psychologists, educators, and neuromotor therapists.
This meant the presentations covered highly technical ground, not always accessible to someone like me, who possesses only a general understanding of autism. Yet over two days of sessions, I was able to follow and extract the key themes that speakers emphasized.
The Genetic Origins of the Disorder
The genetics presentation was the most difficult to track. What is now certain is that autism is not caused by inadequate maternal behavior. The speaker presented research demonstrating the genetic basis of the condition.
In recent years, research has made swift progress toward identifying the gene or genes responsible for autism.
Early Diagnosis
There is clear evidence that prognosis improves significantly when therapy and rehabilitation begin early. Children with autism rarely reach a child psychiatry service before age two or three, yet clinical histories show that autistic symptoms are already evident by eighteen months—signs that parents notice but that pediatricians often fail to take seriously. The conference gave considerable weight to this problem: the poor cooperation of pediatricians, who should be willing to use the screening tools that specialized institutes recommend, tools that are essential for early diagnosis.
Multidisciplinary Approaches
No cure with proven efficacy exists. Given that autism presents many characteristics that vary from person to person, no single technique is sufficient on its own. Instead, treatment must draw on all relevant expertise.
Family Support Networks
In addressing the autistic child's particular needs—from early diagnosis through school integration—we must recognize that this child and his or her family have needs that belong to ordinary life in a social context. We cannot expect every environment to be custom-designed, but it should be accessible in its fundamentals. This requires public awareness and a breaking down of prejudice (fears about the autistic child). The task is to create socially welcoming environments based on an understanding of the problem, and to strengthen the social support networks families need: places where they can go and find at least human solidarity.
The Gap Between Research and Practice
To build services that respond to actual needs, we must close the gap between research and practice. If practitioners in the field do not stay current with the latest knowledge about autism, we cannot expect their work to change.
Conclusions
Much remains to be discovered, and much work lies ahead. Yet given the progress made over the past two decades, it is reasonable to expect further advances and discoveries in years to come.
One observation struck me during the conference: aside from the IRCCS center at La Nostra Famiglia in Ostuni, all the speakers worked in institutions in northern Italy—universities, public health systems, research centers. The president of ANGSA in Puglia attended and felt compelled to point out the stark differences in how autism is addressed across regions. He spoke of the need for competent, motivated personnel and noted that too often work focuses only on immediate crises, without any long-term plans.
Laura Nardini, 2005
