- Classification Tool May Better Describe Autism-Related Disorders, Help
                            Evaluate Treatments -

    PHILADELPHIA, July 5 /PRNewswire/ -- A new classification tool may allow
healthcare professionals treating children with autism and autism-related
disorders to more systematically sort out the combination of traits in the
condition, and to better predict how children may improve over time. If the
model holds up to further study, it may also allow researchers to gauge the
effectiveness of different autism treatments.
    Developmental pediatrician James Coplan, M.D., reports on a study of 91
children he saw between 1997 and 2002 at the Regional Autism Center of The
Children's Hospital of Philadelphia. Most patients were pre-schoolers or of
elementary school age, and predominantly boys. The study appears in the July
2005 issue of Pediatrics.
    The children in the study had autistic spectrum disorders (ASD), a group
of neurodevelopmental disorders of impaired social communication. Those
disorders include classic autism, pervasive developmental disorder and
Asperger's syndrome. Dr. Coplan studied the relationship among three
variables: the severity of the disorder (called atypicality), general
intelligence (measured as IQ or developmental quotient) and time.
    "These disorders are dynamic and change over time," says Dr. Coplan.
"Although they are traditionally classified into mutually exclusive diagnostic
boxes, they tend to blend into each other, and this model provides a way to
look continuously at ASD, as the symptoms occur and develop along the autistic
spectrum, and as the symptoms change over time."
    Some children have severe autistic symptoms but high intelligence; others
have mild symptoms and mental retardation, or combinations in between, he
added. In explaining the model to parents, he sometimes draws an analogy to
weight and height. Just as each individual can have a different combination of
weight and stature, someone can have an individual combination of intelligence
and degree of autism.
    One central finding of the study, said Dr. Coplan, is that children in the
normal range of intelligence (an IQ of 70 or above) show significant
improvement in their ASD symptoms over time. "We can offer the hopeful message
to parents that many children with ASD will improve as part of the natural
course of the condition," he said. This finding reinforced impressions by Dr.
Coplan and many previous researchers about clinical outcomes for children with
ASD.
    Dr. Coplan cautions that although the model has predictive value for
clinical outcomes when looking at average outcomes for groups of children, it
will not necessarily predict a course for each individual patient. Rather it
would provide a "roadmap" on which to plot a child's progress over time.
    The model still must be confirmed in larger studies of populations of
children with ASD, not just in a sample from one clinic, according to Dr.
Coplan.
    If larger studies validate the model, he adds, it may become a benchmark
to help researchers evaluate the effectiveness of particular ASD treatments.
"Many currently popular therapies may be capitalizing on the natural history
of ASD, and claiming such improvement on their own behalf," he writes in the
paper. If patients improved more than would be anticipated from the model's
outline of the natural course of ASD alone, that might provide evidence for a
treatment's success.
    Additionally, the model might shed light into causes of ASD, as yet
unknown. Children with ASD from different causes may follow different
developmental paths," says Dr. Coplan, and studying those patterns may help
researchers to better identify causes for the diseases.
    Dr. Coplan has since left Children's Hospital to establish a private
practice, Neurodevelopmental Pediatrics of the Main Line, in Rosemont, Pa. Dr.
Coplan's co-author was Abbas F. Jawad, Ph.D., of the Division of Biostatistics
and Epidemiology of The Children's Hospital of Philadelphia, and the
University of Pennsylvania School of Medicine. The Regional Autism Center at
Children's Hospital houses a large interdisciplinary program for the diagnosis
and treatment of children with ASD.
    About The Children's Hospital of Philadelphia: The Children's Hospital of
Philadelphia was founded in 1855 as the nation's first pediatric hospital.
Through its long-standing commitment to providing exceptional patient care,
training new generations of pediatric healthcare professionals and pioneering
major research initiatives, Children's Hospital has fostered many discoveries
that have benefited children worldwide. Its pediatric research program is
among the largest in the country, ranking second in National Institutes of
Health funding. In addition, its unique family-centered care and public
service programs have brought the 430-bed hospital recognition as a leading
advocate for children and adolescents. For more information, visit
http://www.chop.edu.

     Contact: John Ascenzi
              Phone: (267) 426-6055
              Ascenzi@email.chop.edu

SOURCE  The Children's Hospital of Philadelphia