[Good practice guidelines for the treatment of autistic spectrum disorders]. / Guia de buena practica para el tratamiento de los trastornos del espectro autista.

INTRODUCTION: Due to the inexistence of an aetiology-based intervention for autistic spectrum disorders (ASD) families and professionals are exposed to diverse and sometimes conflictive recommendations when they have to decide the most adequate alternative for treatment. AIM: To elaborate treatment guidelines agreed by consensus at the ASD Study Group of the (National) Institute of Health Carlos III. DEVELOPMENT: Information about treatment of ASD was searched and gathered through available evidence based medical (EBM) databases. The data generated was complemented with practice parameters published elsewhere, reports from prestigious international institutions, focus oriented searches in PubMed and, finally, the opinion and experience of a multidisciplinary Study Group with extensive experience in treating ASD in Spain. Most popular treatment methods were reviewed as well as the common elements to be considered in successful support programs. CONCLUSION: No simple treatment algorithm can be produced at this time, and the level of available evidence based recommendations are in the weaker degrees of EBM classifications. Nevertheless, there is widespread agreement to stress that education, with special incidence in the development of communication and social competence, with the addition of community support are the main means of treatment. They can be complemented, depending on individual needs, with medication, behavioural approaches and cognitive-behavioural therapy for associated psychological problems in persons with higher cognitive level. Support to families and community empowerment are essential elements for the quality of life of persons with ASD.

Investigación epidemiológica en el autismo: una visión integradora / Epidemiological research in autism: an integrative view

Introducción. Sesenta años después de las primeras descripciones del Autismo, todavía hoy siguen vigentes aquellos criterios diagnósticos basados en la observación clínica. El Instituto de Salud Carlos III creó hace dos años el Grupo de Estudio en los Trastornos del Espectro Autista (GETEA), con la intención de evaluar el estado de la investigación de los TEA en España, estableciendo lazos estrechos de colaboración con las asociaciones y creando una forma de trabajar más coordinada y cercana a la realidad que viven diariamente las familias. Objetivo y desarrollo. El objetivo de la revisión es el actualizar ciertos conocimientos sobre la distribución de los determinantes de los TEA, es decir, sobre la epidemiología de estos trastornos, y a su vez despertar una mayor inquietud entre los profesionales que están más estrechamente relacionados con el estudio de los trastornos generalizados del desarrollo. Las nuevas herramientas diagnósticas permiten alcanzar un grado mayor de certeza en el complicado proceso de evaluación de un caso con síntomas de autismo; sin embargo, dada la efectividad de la atención temprana y su influencia en el pronóstico, es imprescindible la implantación de programas poblacionales de cribado de los TEA, utilizando para ello cuestionarios del tipo Modified Check List for Autism in Toddlers (M-CHAT), seguido de varios niveles diagnósticos, de modo que permitan reducir los falsos positivos y aumentar los verdaderos positivos (AU)

Introduction. Sixty years after the first descriptions of Autism, the same diagnostic criteria based on clinical observation used then are still valid today. Two years ago, the Instituto de Salud Carlos III set up the Grupo de Estudio en los Trastornos del Espectro Autista (Autism Spectrum Disorders Study Group) with the aim of evaluating the current state of research in autism spectrum disorders (ASD) in Spain. This group established collaborative links with different associations and set up a way of working that was more coordinated and closer to the real day-to-day situation experienced by the families involved. Aims and development. The aim of this review is to update certain areas of knowledge concerning the distribution of the factors that determine ASD, that is to say, about the epidemiology of these disorders. At the same time, it intends to arouse a greater degree of interest among professionals who are more directly involved in the study of pervasive developmental disorders. The latest diagnostic tools offer a higher degree of certainty in the complicated process of evaluating a case with symptoms of autism. Nevertheless, given the effectiveness of early attention and how it affects the prognosis, population-based ASD screening programmes must be implemented. These would have to include the use of Modified Check List for Autism in Toddlers (M-CHAT)-type questionnaires, followed by several levels of diagnosis, in order to reduce the number of false positives while at the same time increasing the true positives (AU)