Dear Dr. Gomez,
We are writing in response to your recent Med Talk/Health Talk installment on “Autism Spectrum Disorder.” We commend your accurate depiction of autism spectrum disorder (ASD) and the rapid state of autism awareness in the Philippines, which includes a recent push for its acceptance within the neurodiversity community (e.g., Autism Self Advocacy Network [ASAN], n.d.). We also agree with your statement that the country still holds several misconceptions about ASD which may affect treatment choices and outcomes amongst Filipino stakeholders. We appreciate you reaching out to neurodevelopmental pediatrician, Dr. Kathryn Baltazar-Braganza, and parent-turned-advocate, Mrs. Mona Magno-Veluz, current Autism Society Philippines (ASP) national president to further educate the public on ASD.
We appreciate that you selected a format that highlighted common misconceptions, and then allowed your experts to respond with facts surrounding ASD. When you touched upon the issue of diagnosing autism, Dr. Baltazar-Braganza referred to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) and specified core deficits in social communication and repetitive, restrictive behavior, interests, and activities. When you asked about early ASD symptomatology, Dr. Baltazar-Braganza responded with common early indicators such as language delays and a lack of interest in socialization. When probed when it was best to seek out medical advice from specialists, Mrs. Magno-Veluz suggested “trusting the gut,” asking fellow parents, and seriously taking note of developmental milestones and family history.
When you transitioned to the topic of the measles-mumps-rubella (MMR) vaccine and whether it causes ASD, Dr. Baltazar-Braganza highlighted predisposing conditions (i.e., genetics, preterm delivery, high-risk pregnancies) as hypothetical; and stressed that children typically receive an ASD diagnosis right around the same time they are given their first dosage of MMR vaccine (i.e., 18 to 24 months in the Philippines). To aid in her response, we highly encourage you to visit the Association for Science in Autism Treatment website and read the article entitled “Does the MMR vaccine cause autism?” Current scientific evidence contradicts the hypothesis that MMR vaccine, or any combination of vaccines, causes the development of ASD.
Although we deeply agree with Dr. Baltazar-Braganza’s response that minimizing core deficits and co-existing conditions, maximizing adaptive functions, and individualizing treatment to match the needs of every child should be the focal point of treatment, she only mentioned three options to help manage ASD. She specified the following interventions: (1) occupational therapy to work on behaviors, play, and self-help skills; (2) speech therapy to work on communication; and (3) family support to reinforce healthy development.
Certainly, a robust team of professionals working with the family is critical. To that end, we humbly would add that applied behavior analysis (ABA) is the most widely researched and empirically validated treatment for autism in the United States (e.g., US Surgeon General, New York State Department of Health, Maine Administrators of Services for Children with Disabilities, California Department of Education), which thankfully has also gained traction in other parts of the world, including the Philippines. ABA is a critical piece of the treatment roster of ASD services and works phenomenally in unison with occupational therapy and speech therapy.
Best,
Beatriz Querol-Cintron, M.S., BCBA®, LABA
Elizabeth Callahan, M.A., BCBA®
References:
Autism Self Advocacy Network. (n.d.). Position Statements: Changing how people think
about autism – Autism awareness.
https://autisticadvocacy.org/about-asan/position-statements/
