Public subsidy urged for autism treatment
As the father of an autistic child, Dino Trakakis knows only too well the challenges faced by parents of such children - and the difference the right sort of treatment can make.
As the director of the Autism Recovery Network, Trakakis says he's also aware that not enough affected children are getting the right sort of treatment, while the number of newly diagnosed cases has soared sevenfold in 15 years.
The concern group has called for more treatment options to be made available to autistic children whose parents cannot afford expensive methods - one of which, Trakakis says, has cured his son of the reputedly incurable condition.
According to the latest government statistics, 1,452 children under the age of 12 were newly diagnosed with autism last year. This was a big jump from the 1,023 cases in 2008 and 887 in 2007. In 1995 the figure was 198.
Doctors say the increase could be a result of greater parental awareness, but the network says that, whatever the reason, more government resources should be devoted to the problem to avoid the children growing up to be a burden on society.
Government-subsidised organisations that teach autistic children to express themselves mainly use a system called treatment and education of autistic and related communication-handicapped children (TEACCH), but it might not be the best for them, Trakakis said.
He said a full-time, more costly treatment, applied behavioural analysis (ABA), popular in the West for two decades, was more effective.
While children learn with visual aids like picture cards about once a week in TEACCH, with ABA they get intensive one-on-one training from a teacher for at least 40 hours a week.
Trakakis said of 200 children who sought help from the network, which offers ABA, a quarter fully recovered and half improved significantly.
But ABA sessions cost HK$15,000 to HK$35,000 a month, and he urged the government to consider subsidising such services so that less well-off families could afford them.
'It is a good investment. Although ABA is expensive in the short term, it can turn autistic children into functioning members of society,' he said.
Dr Catherine Lam Chi-chin, a Department of Health consultant paediatrician and head of the Child Assessment Service, said cost was only one of the reasons why government-subsidised organisations did not adopt ABA as the sole treatment.
Autistic children needed tailor-made care, she said, and there was not a single most effective treatment.
'Government-subsidised NGOs are using a mixture of treatments, for example TEACCH, ABA, speech therapy and social cognition,' she said.
Lam said the sharp increase in autistic children in recent years was due to more parents becoming aware of the condition and taking their children for checkups. The defining criteria for autism had also widened in recent years, meaning that previously borderline cases would now be regarded as autistic, she said, 'but it is not like a pandemic outbreak'.
Rachel Poon Mak Sui-man, a senior clinical psychologist at Kwai Chung Hospital, said some studies suggested ABA's efficacy was similar to that of other types of therapy.
Poon said local health authorities provided an array of support services for autistic children of different intelligence levels. There were kindergartens and primary schools that catered to special education needs, and nurses also gave one-on-one advice for those who were in mainstream schools.
'It is impossible to cure autism once and for all, but we can give as much help as we can,' she said.
Trakakis, on the other hand, said it was a 'misconception' that autism was incurable. He said his son Alex, eight, was proof that autistic children could live as happily and healthily as normal kids.
A top scorer in the primary soccer league, Alex was not afraid to meet strangers. His father said the child was a top student at Kowloon Junior School, a mainstream primary school run by the English Schools Foundation.
When Alex was first diagnosed with severe autism, it was an entirely different story.
'He was basically like a vegetable. He drooled all the time and did not talk. He did not like to have eye contact with people and was constantly having diarrhoea,' Trakakis said.
Doctors at the Duchess of Kent Children's Hospital in Sandy Bay said Alex's mental age lagged one year behind his real age, the father recalled.
Desperate to get his son treated as soon as possible, Trakakis was disappointed to find he needed to wait for six to 12 months before being offered a place in a government-subsidised child development centre.
It was then that Trakakis founded the network with a group of parents to try to offer ABA at a lower price.
Alex learned to talk a year after he underwent ABA treatment. When he went to the Duchess of Kent hospital for a regular assessment at the age of five, doctors found that his mental age had caught up with his real age.
'Doctors said there was no need for him to have follow-up checkups. His autistic symptoms had all disappeared,' Alex's mother, Peggy Trakakis, said.
About a dozen international medical professionals are speaking at an autism conference in Hong Kong tomorrow and Sunday.
Number of new cases of autism in 1995: 198
Newly diagnosed cases in 2009: 1,452
Here are some characteristics many autistic patients share:
Lack of eye contact
Flat or high-pitched intonation
Hyper- or hyposensitivity to sound or light
Source: Department of Health