Vorrei condividere una riflessione che emerge dall'abstract allegato che si interroga sulla sostenibilità dei programmi d'intervento tempestivo nell'autismo negli USA a fronte delle prevalenze osservate. A pari incidenza teorica, da questo punto di vista l'Italia si avvantaggia della bassa natalità, nonostante una maggior morbilità autistica per l'incrementata sopravvivenza dei grandi prematuri. D'altro canto ci si trova a gestire una prevalenza record di persone adulte sempre più anziane che non furono diagnosticate né precocemente né mai. Visti i tempi, prima che si facciano scelte incongrue di politica socio-sanitaria, forse è il caso di pensarci. L'intervento tempestivo è quello della scuola d'infanzia e dei servizi di neuropsichiatria infantile... Niente di nuovo, ma da ricordare. Stefano Palazzi J Dev Behav Pediatr. 2010 Jul-Aug;31(6):469-76. Can state early intervention programs meet the increased demand of children suspected of having autism spectrum disorders? Wise MD, Little AA, Holliman JB, Wise PH, Wang CJ. Department of Pediatrics, Boston Medical Center, Boston, MA 02118, USA. OBJECTIVE: To determine whether Early Intervention programs have the capacity to accommodate the expected increase in referrals following the American Academy of Pediatrics' 2007 recommendation for universal screening of 18- and 24-month-old children for Autism Spectrum Disorders (ASD). METHOD: We conducted a telephone survey of all state and territory early. Intervention coordinators about the demand for ASD evaluations, services, and program capacity. We used multivariate models to examine state-level factors associated with the capacity to serve children with ASD. RESULTS: Fifty-two of the 57 coordinators (91%) responded to the survey. Most states reported an increase in demand for ASD-related evaluations (65%) and services (58%) since 2007. In addition, 46% reported that their current capacity poses a challenge to meeting the 45-day time limit for creating the Individualized Family Service Plan. Many states reported that they have shortages of ASD-related personnel, including behavioral therapists (89%), speech-language pathologists (82%), and occupational therapists (79%). Among states that reported the number of service hours (n = 34) 44% indicated that children with ASD receive 5 or fewer weekly service hours. Multivariate models showed that states with a higher percentage of African-American and Latino children were more likely to have provider shortages whereas states with higher population densities were more likely to offer a greater number of service hours. CONCLUSION: Many Early Intervention programs may not have the capability to address the expected increase in demand for ASD services. Early Intervention programs will likely need enhanced resources to provide all children with suspected ASD with appropriate evaluations and services. PMID: 20585267 [PubMed - indexed for MEDLINE]