171 Ashley Ave.
Charleston, SC 29425
843-792-1414
800-424-MUSC
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January 2007
Feature Story
The Autism Queen
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| Jane Charles, MD |
Jane Charles is called the autism queen, though she is more of a soldier fighting on the frontlines than a ruler dictating from on high.
The developmental pediatrician is widely respected as an expert on the screening, diagnosis and management of autism. She is, among other things, director of MUSC's Carolina Autism Resource Evaluation, or CARE Center, one of three statewide that she helped to establish several years ago.
"I worked together with the Autism division, the state agency that provides services to persons with autism, to develop a series of diagnostic clinics to serve three areas of the state - Greenville, Columbia, and Charleston," she explains.
At MUSC's CARE clinic, Dr. Charles and her team see children suspected to have an autism spectrum disorder. "We screen kids who are not developing as they ought to be, who are not walking, talking, learning or behaving in school as they should," she says.
The CARE clinic offers screening, diagnosis, assessment and management by a team composed of a developmental pediatrician, school psychologist and educational specialist.
"This team of physicians and specialists provides evaluations as well as management and education support," says Dr. Charles. The team helps with developing treatment plans and effective learning teaching skills, works closely together to assess the child's needs and skills, and recommends the best possible plan for service and training.
By going on home and school visits, Dr. Charles takes her work with these children a step further.
In particular, she attends Individualized Education Plan meetings for children who are having a lot of problems. "If I'm managing medication for them, that can be a big part of the entire picture. I really like to meet the teachers, see the classrooms, see the kids in school. It's very helpful for me to be able to visualize the child in the school setting."
"You really need a whole team to be involved with these kids to make sure they're getting the right help; that we're all on the same page," explains Dr. Charles, who lectures widely at schools and annual meetings across the state to teachers, school psychologists, speech and occupational therapists, parent support groups and education experts as well as to physicians, nurses, medical students.
Kids with developmental disabilities have complicated learning and behavioral issues, she says, and frequently have medical problems associated with the disability.
Recognizing that much of the difficulty is in physically getting these children into the office for medication, Dr. Charles now intends to travel to them. She will soon open a monthly clinic at North Charleston High for students with severe to profound mental retardation, and another at Burns Elementary for kids with behavioral problems.
Dr. Charles also set up a diagnostic clinic for pediatric residents at MUSC to help teach them how to recognize and screen kids with autism. "They get first-hand experience with children with autism, and it ensures that they can have autism in their differential diagnosis," she explains.
Along with clinical psychologist Dr. Laura Carpenter, PhD, Dr. Charles has also set up a third autism clinic.
"We now have 24 autism diagnostic evaluations per month," she says, "and we're still swamped, with a six-month wait list."
Around the country, many autism programs are equally challenged, some with wait lists as long as two years.
In response to concerns over a growing number of children with autism, Dr. Charles is one of two principal investigators in a study looking at the prevalence of the disorder. Funded by the Centers for Disease Control with a recently renewed, 10-year grant, the scientific study is largely translational, says Dr. Charles.
"It's really a public health project, a surveillance study to inform the public so they can use the information to come up with treatment strategy and intervention," she explains. "To inform the appropriate organizations so they can plan for adequate services. For instance, to help school districts plan teachers, and health care providers plan programs. The results of the study will help these groups predict how much money they'll need for services, to plan for the financial impact."
"We're translating information for the public," says Dr. Charles. "It's research from the bedside to the community."
It's clear that a larger number of kids with autism are being identified, and a larger number are receiving services from the public.
"Current thinking is that it's due to earlier identification and better awareness," she notes. "There's also been change in diagnostic criteria - it's become more relaxed, so it's easier to get a diagnosis."
There is also probably a true increase in the numbers, says Dr. Charles, perhaps related to environmental triggers. The federal government is beginning to fund research to look at the effects of environmental toxins on child development.
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