Autism Program at CDRC

Scope of Care

The CDRC Autism Program provides services to children with established or suspected symptoms on the autism spectrum. We provide diagnostic evaluations, treatment and ongoing consultation to the families we serve.

Our program is comprised of an interdisciplinary team of clinical psychologists, developmental pediatricians, speech/language pathologists, occupational therapists, audiologists, physical therapists, and a family consultant who come together to understand the individual differences and needs of each child we meet. Our goal is to provide competent interdisciplinary care for children and their families in a supportive and caring environment, where parents are respected and believed to be their child's best advocate.

Our mission is to improve the quality of life for individuals on the autism spectrum and their families through partnerships with families, professionals, and the autism community.

Services We Provide

Evaluation and Diagnosis. The CDRC Autism Program provides diagnostic evaluations of children suspected of being on the autism spectrum. Evaluation clinics are held three days per week for a total of 36-40 evaluations per month.

Birth through age 5

• children from birth through age five years are seen by a team of professionals for a half-day, either in the morning or the afternoon

School-aged and adults

• school-aged children, adolescents, and adults are seen from three-quarters to a full day, with questions of Asperger's Disorder and high functioning Autistic Disorder as priorities

Structured evaluative tools, informal observations, behavior checklists, and interviews are all used to gather information about the referred child. Records from school and other service providers also provide needed information. We follow the practice parameters as outlined by the American Academy of Pediatric and, as part of the ATN, all patients receive the same evaluation protocol. Those families receiving a diagnosis on the autism spectrum are invited to participate in the ATN Patient Registry.

Follow Along Services

We offer follow along services for individuals who receive a diagnosis on the autism spectrum and their families. These services include:

• Individualized support and referral assistance from our family consultant, with the options of face-to-face meetings, if needed.
• A three-month follow up appointment with one of our developmental pediatricians. This opportunity allows families to make sure all their questions and needs have been addressed to the best of our ability.
• Linking families to local resources through the CaCoon and Community Connections Networks.
• Annual re-evaluations to document progress assist with modifying intervention strategies, and update diagnoses.

Treatment

Treatment is provided to children and families in the following forms:

• The Parent Training Program offers families the opportunity to learn how to increase their child's social and communicative skills through play and routine activities of daily living. The individualized program runs for 12 weeks (2 sessions a week) or for 24 weeks (1 session a week) based on the families needs and availability.
• As part of the ATN, pediatric specialty services are provided to families who have children with medical concerns. These families are referred directly to OHSU/Doernbecher pediatric specialists, such as the gastroenterologist, neurologist, geneticist, and sleep specialist. Each of these professionals have developed an interest and expertise in working with children on the autism spectrum
• Individual sessions with speech language pathologists, occupational therapists, and psychologists, based on the needs of particular children, insurance coverage, and proximity to OHSU.
• Individual sessions with clinical psychologists to address behavioral issues in children with a diagnosis on the autism spectrum, including food refusal and food selectivity, aggressive or self-injurious behavior, and noncompliance..
• Individual sessions with clinical psychologists for children, adolescents, and adults who have or are suspected to have a diagnosis of Asperger's Syndrome or high functioning Autistic Disorder. These sessions are individualized to meeting the individual's needs.

How to make a Referral

Your primary care physician must initiate referral to the Autism Program. As a team, we are strongly committed to the medical home and the involvement of your family doctor or pediatrician in the care of your child. Our staff will be happy to speak with you directly should you have questions about our clinic (please call 503-494-8095 and ask for our intake coordinator, Heather Keel; however, no appointments will be scheduled without input from your primary care physician. In addition, for those children attending public school or EI/ECSE programs, information from the educational team will also be required before appointments can be scheduled.

Resources

Information and support for families of children with autism

Important information for your visit to the Autism Program (PDF) (88Kb)

The Autism Treatment Network

The CDRC Autism Program is proud to be a part of the Autism Treatment Network (ATN). Sponsored by the national advocacy organization Autism Speaks, OHSU and eleven other university-based medical centers across the country are working together to improve the availability, quality, and effectiveness of medical care for individuals with autism and their families. As part of the ATN, the CDRC Autism Program enrolls interested families in a patient registry, which allows for a better understanding of the medical conditions associated with autism. All medical centers within the ATN are committed to improving the quality of treatment options for individuals with autism and their families, with an initial focus on medical treatment.

Autism Programs participating in the ATN recognize that treatment of medical conditions seen in individuals with autism can be improved. In order to do this, the ATN has a long-term goal of evaluating medical treatment of individuals with autism and developing best practice guidelines. Here at OHSU, we have brought together a collection of pediatric specialists in the areas of genetics, metabolism, neurology, gastroenterology, feeding, and sleep. In collaboration with other ATN sites, a comprehensive evaluation and referral protocol has been developed, and research is being conducted in the areas of sleep problems and quality of life (for more information on research opportunities in the Autism Program, click here). For more information about the ATN you can visit our website at www.autismtreatmentnetwork.org.

Research

Director of Autism Research

Robert Steiner, MD

The Autism Program has received funding to conduct clinically-based research in a number of areas important to the autism community.

• Ongoing evaluation of the utility of all of our diagnostic activities, including standardized and informal measurement tools
• Ongoing evaluation of medical conditions associated with autism - how often they occur, symptom presentation, and effective treatment
• Exploration of genetic causes and markers for autism including the relationship between autism and cholesterol metabolism and identifying copy variations in certain genes
• Identifying quality of life issues that are important to individuals with autism spectrum disorders and their families
• Empirically supported treatment for young children with autism spectrum disorders and their families

If interested, current funded research projects being conducted within the Autism Program are listed below.

 

Autism Treatment Network (ATN)

Co PI's: Darryn Sikora, PhD
Robert Steiner, MD

1. Fully funded by Cure Autism Now/Autism Speaks
2. The ATN is designed to support collaboration to improve medical treatment for autism
3. ATN is the nation's first network to focus explicitly on the study and advancement of medical treatment for individuals with autism
4. ATN includes physicians and healthcare practitioners from 12 medical centers that have come together to evaluate the medical conditions present in autism and to provide best practices for their identification and treatment
5. ATN will evolve treatment guidelines that will be made available to physicians, researchers, parents, policy makers and others focused on enhancing the care of individuals with autism

 

 

 

Treatment of Sleep Problems in Children with Autism Spectrum Disorder with Melatonin: Characterizing Endogenous Melatonin Profiles and a Double-blind, Placebo-Controlled Treatment Trial

1. Funded by Autism Speaks
2. Clinical trial of Melatonin in children with an ASD
3. Provides new information regarding the role of sleep problems in behavior phenotype, occurrence and type of sleep problems in ASD

 

The Relationship Between Autism and Cholesterol Synthesis

PI's: Darryn Sikora PhD
Robert Steiner, MD

1. Funded by Collins Medical Trust and Cure Autism Now
2. This project will help determine the extent to which abnormal cholesterol metabolism is related to autism

 

Cholesterol and SLO "Dietary Cholesterol and Defects in Cholesterol Synthesis"

1. NIH R01 grant # HL073981
2. This project determines the effects of altering dietary cholesterol changes (or statins) in SLOS on cholesterol and fatty acid synthetic pathways
3. The Autism Program is involved with this project and has developed additional focus investigating neurocognitive profiles and autism with this population

 

The identification of young children with autism with the Ages and Stages Questionnaires

PI: Robert Nickel, MD

1. Internal funding

If you are interested in finding out more about ongoing research projects or participating in autism-related research at OHSU, you may contact our research coordinator, Dr. Trevor Hall, at 503-494-0333. He will also be able to connect you with the proper study staff.

In addition, a major study on communication problems in autism in children 3-8, funded by the National Institutes of Health, is currently underway at OHSU's Center for Spoken Language Understanding (external link).

More information (external link) is available for parents wishing to participate.

Recent publications/presentations

Sikora, D.M., Pettit-Kekel, K., Merkens, L., Pennfield, J., & Steiner, R.D. (2006). The near universal presence of autism spectrum disorders in children with Smith- Lemli-Opitz syndrome. American Journal of Medical Genetics, 140A(14), 1511- 1518.

Hartley, S.L., Buckendorf, G.R., Haines, K., Hall, T., & Sikora, D. (in press, available online). The Oral and Written Language Scales: Is it useful for older children with autism spectrum disorder? Research in Autism Spectrum Disorders.

Sikora, D.S., Hartley, S.L., McCoy, R., Gerrard-Morris, A., & Dill, K. (in press, available online). Performance of individuals with mental health disorders on the ADOS-G: A question of diagnostic utility. Research in Autism Spectrum Disorders.

Sikora, D.S., Hall, T.A., Hartely, S.L., Gerrard-Morris, A., & Cagle, S. (in press, available online). Does parent report of behavior differ across ADOS-G classifications: Analysis of scores from the CBCL and GARS. Journal of Autism and Developmental Disorders.

Kuhlthau, K. & Hall, T. (May, 2007). Health Related Quality of Life for Children with Autism Spectrum Disorders Enrolled in the Autism Treatment Network. Poster presentation at Pediatric Academic Societies' Annual Meeting, Toronto, Canada

Grant, K.J., Sikora, D.M., Li, S.T., Thomas, J.C (February, 2007). Investigating the Clinical Utility of the Autism Diagnostic Observation Schedule, Generic (ADOS- G) in the diagnosis of Asperger's Disorder. Poster presentation at the Association of Behavioral Analysis (ABA) International Autism Conference "Progress and Challenges in the Behavioral Treatment of Autism", Boston, Massachusetts.

Hall, T. & Sikora, D. (February, 2007). The Relationship Among Scores from the GARS, CBCL and the ADOS-G Classifications of Autism, Autism Spectrum, and Non-Spectrum. Poster presentation at the annual meeting of the International Neuropsychological Society, Portland, OR.

Dill, K., Flachbart, C., Hall, T., & Sikora, D.M. (August, 2007). Establishing Clinical Utility for an Autism Assessment Battery. Oral paper presentation at the annual meeting of the American Psychological Association, San Francisco, CA.

Gerrard-Morris, A., Hall, T. & Sikora, D.M. (February, 2008). Neurocognitive Profiles of Children with Autism Spectrum Disorder. Poster presentation at the annual meeting of the International Neuropsychological Society, Waikoloa, HI.