Neurology

Treating the fundamental basis of autism spectrum disorders: A ray of hope

A host of autism spectrum disorders seem to share the same fundamental basis: Cells in the brain have problems making the right number of stable connections with each other—the “synapses” between neurons. Contrary to previous thinking, recent laboratory research on a related disorder, Rett syndrome, indicates that those cells may actually be able to recover, and a drug can help the wobbly synapses to mature and can actually reverse symptoms.

Boston Children’s clinicians are working to follow up on those leads by testing the drug in children with Rett syndrome. This study represents the first trial of a drug treatment seeking to modify the underlying cause of a disorder with autistic symptoms. Physicians and researchers hope that trials like this will give them clues about how to help not only children with Rett syndrome, but patients with a whole host of other neurological disorders, too.

Keeping headache care close to home

Headaches are a common childhood problem that cause parents a lot of worry and lead to tough questions: When does your child need an imaging test? When should he be referred to a neurologist? Since a patient may receive headache care from his pediatrician or with a neurologist, coordinating care can be a challenge. Our team at Boston Children’s wants to make sure that children get the right care, in the right place, at the right time.

In 2009, a group led by Scott Pomeroy, MD, Boston Children’s neurologist-in-chief, and Richard Antonelli, MD, medical director for integrated care, sat down with primary care providers from Harvard Vanguard Medical Associates to develop specific ways to help primary care providers and Boston Children’s neurologists work together to care for our patients.

A major goal of the program is for our neurologists to provide support to primary care providers so that when it’s appropriate, patients can receive headache care from their primary doctors. This approach should also make Boston Children’s Neurology wait times shorter and lower medical costs for families.  

We hope to expand this collaborative care model to other referrers in the near future. In the meantime, it informs what we do with all of our patients: We know how important it is to work closely with our patients’ primary care doctors.