Putting MAPS on the MAP: defining the MoveMent forwArd

n important movement has been initiated that holds great promise for the future of autism prevention and recovery. The Medical Academy of Pediatric Special Needs (MAPS) has as its mission to “provide education and long-term support for practitioners, ensuring the quality and consistency of medical care for children with autism and related chronic conditions.” Although much of the focus will be on autism, MAPS will deal with all things pediatric, including allergies, asthma, attention-deficit/hyperactivity disorder, immune dysfunction, and more. Prolific author, researcher, and clinician Daniel A. Rossignol, MD, FAAFP, serves as president, and holistic, board certified pediatrician David Berger, MD, FAAP, serves as vice president. I interviewed Dr. Berger, who has a superb track record of preventing autism and other chronic illnesses in his pediatric population, and I was excited and encouraged by what he told me of MAPS. I first asked Dr. Berger why there was a need for MAPS. Dr. Berger began by telling me why MAPS is unique, exemplifying the need: “This is a program developed by physicians, organized by physicians, and taught by physicians for physicians. Clinicians will need to go through a series of requirements before obtaining the level of Fellowship.” The MAPS curriculum will center on conferences that consist of two levels of training. MAPS will offer several levels of affiliation. Anyone who works with individuals on the autism spectrum can be a member of MAPS and attend MAPS conferences; however, only prescribing practitioners who can implement pharmacological strategies can move to the Candidate and then the Fellow levels of MAPS. The reason for this is that individuals with an autism diagnosis often have underlying conditions—what some people call “comorbid”—that may benefit greatly from some prescription medications. A Candidate is a prescribing practitioner who has completed one conference. To become a Fellow, a Candidate must complete both training conferences, pass a written examination, and complete a mentorship with an existing MAPS Fellow and Mentor; this includes on-site mentoring and longer-term case reviews. Fellows are taught to deliver a systematic, evidence-based standard of care. The great benefit of this to parents is that then there can be a published practitioner resource list, and the parents will know that these clinicians have met all criteria to be a Fellow. MAPS takes accountability to children and families very seriously. A review

board will be established where parents can file a complaint if a MAPS practitioner has gone outside the standard of care or treated a patient poorly. Loss of MAPS Fellowship status is a real consequence. The take-home message is that MAPS is defining standard of care and prioritizes true quality control. Dr. Berger is excited to be a MAPS physician: “By defining standard of care, I’m excited for the parents —a parent will know who should be trustworthy, and doctors can know who is a safe referral from a collegial perspective.” He described a logical and hopeful road forward: “Of course, we see the importance of properly educating and evaluating doctors. Then, by establishing standard of care, we can build databases and do clinical research, data tracking, and compilation in standardized ways. We can then publish what biomedical therapies are doing, further defining standard of care. We can test new treatments. We’ll be able to encourage parents that further treatments are on the horizon—to check back and not to give up. We will publish, and these publications will spread hope and awareness to the general public.” I appreciated the value of comparing medical and behavioral databases in the future because that could potentially show how much biomedical therapies improve core ASD outcomes. Something that I really got out of hearing Dr. Berger talk was that there is much to study. There are so many phenotypic presentations—the different ways that individuals on the spectrum “look” and function—and we need to rationally and in an organized manner tease these issues out. MAPS will do that. In this way, medicine can be tailored to the individual, and we can understand different factors that can go into a consequent autism diagnosis in an effort to prevent possible degradation of health for yet-unaffected children. As MAPS progresses, papers will be published—this is so important. And it is hoped that universities will be more inclined to study this arena and participate in the type of training and investigation that MAPS is doing. It will be a wonderful day when MAPS physicians in academic posts are able to train other doctors. Dr. Berger summed up our talk, outlining three reasons that MAPS offers hope: 1) parents will be able to find qualified, experienced physicians; 2) there will be research for new treatments to help children; and 3) we can stave off autism in siblings as parents consult with MAPS doctors for testing and treatment to prevent the development of autism. The big thing is just knowing that something CAN be done! Dr. Berger’s own practice has beaten the odds of autism, diabetes, asthma, and more. MAPS is not just about autism—it’s about raising healthier kids! www.medmaps.org
Copyright © 2012, Autism International Association, Inc.

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