There is no cure for autism, but there are enabling treatments that improve symptoms and increase the quality of life of patients and families. On the occasion of World Autism Awareness Day which occurs on April 2nd, the Bambino Gesù Pediatric Hospital – which treats around 500 patients every year in the Center for Autism Spectrum Disorder – reaffirms the need for effective therapeutic and sustainable interventions at the same time, both for families and for the national health system, such as Cooperative Parent-Mediated Therapy (TMGC). Over 150 are the ASL operators trained by specialists of the Holy See Hospital on this specific therapy in the last two years, despite the difficulties associated with the pandemic. The streaming event organized by Bambino Gesù in collaboration with ANGSA (National Association of Parents of Autistic Subjects) Lazio and Gruppo Asperger Lazio is dedicated to “Autism beyond the medical gaze”. The event will take place in the afternoon of April 2nd with experiences and testimonies of families and patients with autism. In the morning, at the Nobili Auditorium of the S. Paolo site, a scientific conference is scheduled: “From research to clinical practice and the organization of services”.
COOPERATIVE PARENTAL MEDIATED THERAPY
According to the Istituto Superiore di Sanità in Italy, autism spectrum disorders affect 1 out of every 77 children and about 500,000 families. Patients generally have difficulties in mutual social interactions and communication. Parental Mediated Cooperative Therapy (TMGC) is a parent coaching technique that helps parents to relate as effectively as possible with their child. The course lasts 6 months: it starts once a week with a meeting of about 2 hours and ends with a monthly meeting. Parents learn to implement interactive behaviours that favour the development of social and communicative skills in the child, as well as increasing the parents’ sense of self-efficacy and reducing their stress.
“A 2020 Bambino Gesù randomized trial of Cooperative Parent-Mediated Therapy developed by our team”, says Dr. Giovanni Valeri, head of the Center for Autistic Spectrum Disorder – highlighted positive results on the improvement of socio-communicative skills in preschool-age children with autism. A recent meta-analysis on parent-mediated interventions identified 30 randomized trials of this type worldwide, and our study is unique among EU countries”.
COLLABORATION WITH THE TERRITORY
In the process of taking charge of the patient with autism problems, the relationship with the territorial structures of the ASL and the psychologists and therapists who will follow the child after the diagnosis is fundamental. “Today there is a lot of debate about therapies for autism – adds Valeri – because not only their effectiveness is at stake, but also their sustainability on the part of families who often bear heavy burdens when the public service fails to satisfy the request for support”.
“The training of family members on the model of Mediated Therapy with Cooperative Parents – explains Valeri – provides for 6-8 hours with the specialists each month. The intervention of an ASL therapist with an individual patient, on the other hand, is quantified between 15 and 20 hours a week, therefore between 60 and 80 a month”. The socio-communicative strategies mediated by the parents do not replace the therapist’s intervention, but “can provide immediately after the diagnosis until other local resources are activated and, in any case, reduce the intensity of the individual intervention with the patient”.
Together with the training of family members, the Holy See Hospital has promoted, in the last two years, training courses on the TMGC model in various Italian ASLs. Over 150 operators trained in Lazio, Sardinia and Emilia-Romagna, while similar initiatives are planned in Tuscany and Campania. “The hope – says the head of the Center for Autistic Spectrum Disorders – is that in turn trained operators will be able to take care of the training of other operators and families, with a beneficial cascade effect”.
It is intuitive, among other things, that by reducing the operators’ commitment with a single patient thanks to the training of parents, the territorial structures will be able to take care of more patients with autism spectrum disorder and respond to an ever growing request of intervention.
AN EXPORTABLE MODEL
The combination of effectiveness and sustainability makes the Cooperative Parenting Mediated Therapy model adaptable to other contexts in the world as well. Since 2014, Bambino Gesù has been using it in a collaborative project with the hospital of Karak, in Jordan, aimed at the treatment of neurological and neurodevelopment disorders. The World Health Organization has adopted it as a pilot project within the global health reform program it is carrying out in Jordan, believing that the Italian inclusive model fully corresponds to the model for taking charge of age-related evolutionary neuropsychic disorders advocated by OMS. Furthermore, the TMGC model of Bambino Gesù was recently the subject of an online training course for operators of a rehabilitation center for developmental disabilities and autism in Mexico City, as part of a project financed by the Italian Bishops’ Conference and promoted by the ReTe Institute (Research and therapy in the developmental age), of which prof. Stefano Vicari, Head of Neuropsychiatry of Childhood and Adolescence of Bambino Gesù.