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Cooperation is improving autism treatment

There are effective treatments for people with autism, says Wouter Staal, professor of Autism Spectrum Disorders, in his inaugural lecture on 4 May. However, it is not yet clear which treatment is most effective for which individual.

Like every other species, humans survive because of their ability to adapt. 'This is why humans have a set of characteristics that are always developing,' Staal explains. 'But these characteristics are unevenly distributed over the species, which is necessary to maintain diversity. This variation allows the species to adapt to changing circumstances as rapidly as possible. Some people benefit from this uneven spread, while others do not.

Wouter Staal
Wouter Staal: 'Which treatment method works best for whom?'

Classification criteria

Important characteristics that are needed in order to survive in present-day society are the ability to communicate and cooperate, to filter and integrate large amounts of information, and to be able to handle changing concepts and ideas with flexibility. Staal: ‘By contrast, the classification criteria for an autism spectrum disorder are: difficulties with social communication and interaction, inflexibility, including a dislike of change, repetitive patterns of behaviour, limited interests and few activities.' For a 'hard' diagnosis, these characteristics have to result in limitations in the ability to function; people with 'mild' autistic tendencies can still come a long way in society. 

Continuing brain development

Fortunately, the brain is not static. The autism criteria found in 10 to 20% of autistic children no longer apply by the time they have reached adulthood. Unfortunately, other disorders often take their place, such as ADHD, or anxiety or behavioural disorders. We also know that if the brain is given the right training, it can make new or stronger connections. Given that there is no medication to treat autism, this is good news.'  

Better treatments possible

Although we know that people with an autism spectrum disorder can make good progress so that they experience fewer limitations as a result of their condition, there's still a lot that can be improved in the treatment of autism. Staal: ‘The different treatment centres currently offer one or several methods that do work, but that are still subject to many questions: Which treatment is best for whom, how intensive should the treatment be in terms of duration and frequency, what effect do age and gender have on the treatment, and what is a suitable alternative if a treatment proves ineffective? 

Luckily, the collaboration between these different centres is improving. I see it is an important task to help support that collaboration.' 

Diverse functions

Staal is in well placed to just that. Besides being part-time professor in Leiden, he is also professor of Child Psychiatry at Radboudumc and the associated Karakter treatment centre, researcher at the Donders Institute for Brain, Cognition and Behaviour at Radboud University and board member of the Netherlands Autism Association (NVA) and Balance, the affiliated parent association.

The cost of the ability to adapt

‘People with an autism spectrum disorder pay the price for the ability of the human race to adapt,' Staal states. This is what  motivates him in his efforts to improve treatment methods  and to make it possible for those who suffer from the disorder to function better in everyday life. 

Inaugural lecture by Professor W.G. Staal
Autism spectrum disorders: neurobiology, neurocognition and treatment
4 May 2018

(CH)

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