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Autism Treatment Network



The Autism Treatment Network (ATN) is the nation’s first network of hospitals and physicians that share the common goal of improving the treatment of individuals with autism by closing the gaps between knowledge and understanding.1 The ATN is currently comprised of 17 sites in North America,2 a monumental increase from the five founding sites that initially comprised the network in 2005.3 The network became a part of Cure Autism Now in 2006, which later completed a merger with Autism Speaks in February 2007.4 The Autism Treatment Network has helped to improve the lives of thousands of children and families with the help of Autism Speaks’ resources and multiple network expansions throughout the years. Like many initiatives spearheaded by autism advocacy groups, the ATN focuses on improving the lives of children and adolescents with autism spectrum disorder (ASD). The network is “working together to develop the most effective approach to medical care for children and adolescents affected by autism.”5 Over the years, the Autism Treatment Network has provided multidisciplinary training to a large number of graduate and medical students,6 has collected useful biological materials from thousands of children with ASD for their registry,6 and utilized that data as a resource for a number of published studies.




Objectives of ATN/AIR-P

The Combating Autism Act was passed by U.S. Congress in 2006 to help create awareness, fund research, and explore treatments for ASD.8 This federal legislation, and the subsequent Combating Autism Reauthorization Act passed in 2011, have allowed the ATN sites to engage in activities as the Autism Intervention Research Network on Physical Health (AIR-P) since receiving two federal grants totaling $24 million.9 Initially, the AIR-P used these funds to conduct studies that focus on weight gain associated with some medications used to treat ASD, sleep problems that often affect individuals on the autism spectrum, and additional research studies related to medical and physical health.9 According to the inaugural edition of AIR-Perspectives,10 the network has three main objectives:

1. To carry out research on evidence-based practices for interventions
2. To develop evidence-based guidelines for clinical care
3. To disseminate toolkits, research findings, and clinical consensus guidelines to pediatricians, other primary care providers, specialty physicians and families


ATN/AIR-P Research

The ATN/AIR-P fund studies that focus on areas related to medical and physical health issues related to ASD. These studies are conducted with data gathered by the ATN/AIR-P network registry, which according to the Summer 2012 issue of AIR-Perspectives includes “over 4,000 children and adolescents with ASD, making it one of the largest databases concerning ASD in younger populations.”11 According to Autism Speaks,6 the ATN provides health care professionals with the latest information about the diagnosis and treatment of autism by:


  • Publishing research in respected medical journals, to ensure their findings reach the widest number of clinicians
  • Reaching thousands of primary care and specialist practitioners through presentations at worldwide conferences
  • Creating and promoting evidence-based guidelines and other tools for autism clinicians
  • Providing multidisciplinary training to medical and graduate level students through a variety of ATN institution-based training programs


The studies result in helping to shape clinical guidelines, develop tool kits, and, ultimately, to provide better care for children.


Accomplishments of ATN/AIR-P

Autism Treatment Network sites have provided services to approximately 27,000 children with ASD in the United States and Canada as of summer 2012.11 The AIR-P has developed a set of medical guidelines to provide reliable and consistent care across the network. An organization known as the National Initiative for Children’s Healthcare Quality (NICHQ) works with the ATN to “guide the development of clinical practice guidelines —systematically developed statements intended to help patient and provider decision making—in two topic areas, and facilitate their widespread adoption and implementation in ATN sites.”12 Through the AIR-P, the ATN has created a partnership with the NICHQ that has resulted in the development of specific “provisional guidelines on constipation, insomnia, and seizures.”13 The AIR-P has also developed clinical guidelines regarding medication choice for behavioral problems common in ASD.11 Specifically, the NICHQ tests algorithms (flow diagrams), which are developed by the ATN, “detailing the benefits and risks of treatment and highlighting effective alternatives based on existing research, or expert consensus where research was lacking.”14 In 2010, the NICHQ worked with the ATN/AIR-P to test algorithms based on feasibility data collected by physicians across ATN sites to develop a formal guideline to be submitted for publication and dissemination.14




The National Initiative for Children’s Healthcare Quality is dedicated its expertise to “pilot testing these guidelines at various ATN sites across the United States….to pave the way for widespread adoption and implementation across the ATN and ensure that quality improvement is applied to improving medical care for physical health issues and conditions related to ASD.”13 The NICHQ has also recently developed after visit summaries for clinicians to use as an outline to explain the diagnosis to the parents, which include “an overview of the diagnosis that was given to the child, contact information for autism resources in the community, and 5 key recommendations for next steps.”15 These collaborative efforts are the embodiment of the ATN’s long-term goal “to provide a place for families to go for high quality, coordinated medical care for children and adolescents with autism and associated conditions.”16


ATN/AIR-P Tool Kits

Over the years, the ATN/AIR-P has released several tool kits designed to educate families on specific aspects of raising a child with autism. The topics of these tool kits include behavioral health treatments, tips for reducing anxiety related to medical visits/blood draws, toilet training, sleep difficulties, visual support, and medication decision aid.17 These tool kits can guide parents to become “effective partners in helping their children to learn skills to replace problems behaviors, increase their positive behaviors and maintain that theme over time, and generalize or transfer positive behaviors from one situation to another as they improve their cognitive, academic, social, and self-help skills.”18 There is even a tool kit designed specifically for dental professionals that includes “a number of behavioral and environmental techniques to help alleviate anxiety and increase cooperation in the dental chair.”19 All of Autism Speaks’ ATN/AIR-P tool kits are available for free public download.


Conclusion

Through multiple collaborations the Autism Treatment Network has developed a robust national registry of children with ASD, clinical guidelines to be implemented across the ATN’s 17 sites, and numerous tool kits designed to advise families and professionals caring for children with ASD. The future goals of the Autism Treatment Network and Autism Intervention Research Network on Physical Health are to continue to increase involvement of parents at ATN sites, transform the ATN into a quality improvement network, and expand clinical research throughout the network.20 Please reference Autism Speaks’ list of ATN providers21 below, if you are interested in contacting the ATN site nearest you:


EASTERN REGION

• Ladders/Mass General Hospital (Boston, MA)
Phone: (781-860-1715)

• Columbia University Medical Center (New York, NY)
Phone: (212) 342-1600

• Kennedy Krieger Institute (Baltimore, MD)
Phone: (443) 923-7644

• University of Pittsburgh Medical Center (Pittsburgh, PA)
Phone: (412) 235-5412
wolfec@upmc.edu

• University of Rochester (Rochester, NY)
Phone: (585) 425-3023
alison_diehl@urmc.rochester.edu

• Children’s Hospital of Philadelphia (Philadelphia, PA)
Phone: (267) 426-3023
ATN-Philadelphia@email.chop.edu

Midwest Region

• Cincinnati Children's Hospital Medical Center (Cincinnati, OH)
Phone: (513) 636-1665
terry.mitchell@cchmc.org

• University of Missouri (Columbia, MO)
Phone: (573) 884-5164
HughesKL@health.missouri.edu

• Nationwide Children's Hospital (Columbus, OH)
Phone: (614) 355-8315
www.nationwidechildrens.org/autism-treatment-network

Southern Region

• Baylor College of Medicine (Houston, TX)
Behavioral Referral Center: 832-822-1900
AutismCenter: 832-822-3704

• Arkansas Children's Hospital / UAMS (Little Rock, AR)
(501) 364-4665
feildhannahc@uams.edu

• Vanderbilt University Medical School (Nashville, TN)
Phone: (877) ASD-VUMC (273-8862)
Autismresources@vanderbilt.edu

Western Region

• Oregon Health & Science University (Portland, OR)
Phone: (503) 494-3331
voltolin@ohsu.edu

• University of Colorado Denver, School of Medicine and Children's Hospital Colorado(Denver, CO)
Phone:720-777-6602

• Children's Hospital of Los Angeles (Los Angeles, CA)
Phone: (323) 361-6102
Canada

• Toronto ATN Site (Holland Bloorview Kids Rehab, Surrey Place Centre, Hospital for Sick Children) (Toronto, ON, Canada)
Phone: (416) 925-5141, ext 2270

• University of Alberta and Glenrose Rehabilitation Hospital (Edmonton, AB, Canada)
Contact person: Barb Traill
Phone: (780) 735-8285
barb.traill@albertahealthservices.ca



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