children with autism are often abandoned by specialist services

System 'failing autistic adults'

Adults with autism can become socially isolated

Thousands of people with autism in England are failing to get the diagnosis and specialist help they need, the National Audit Office says.

Most local authorities do not know how many adults with autism live in the area and provide no specific services.
Yet better support in areas such as housing and employment could save the taxpayer millions of pounds in the long run, a report concluded.
The government is due to publish its first autism strategy later this year.
People with autism struggle to communicate socially and have trouble understanding facial expressions and tone of voice and recognising emotions.
Around half of those with autism also have a learning disability, but for those who do not - those with high functioning autism, such as Asperger Syndrome - accessing support for housing, further education and employment can be particularly hard, the NAO said.
Three-quarters of local authorities have no commissioning plan in place for specialist autism services and 65% struggle to find appropriate housing.
The report also found that children with autism are often abandoned by specialist services when they turn 18, due to a lack of adult services or a proper transition plan.
Diagnosis
An average GP is thought to see two adults with undiagnosed high-functioning autism every six months.
But the vast majority say they need better training to identify and manage patients better.
And although there are education programmes now in place, there is still a lack of expertise at job centres, with only 200 of 500 disability advisors trained to help people with autism, the NAO said.

The hope is that this report will lead to a step change in how we meet the needs of this invisible group in our society Professor Simon Baron-Cohen

If local authorities identified just 4% of people with high-functioning autism, and offered them specialist support with living independently or getting a job, the cost would be cancelled out by savings in other areas, the NAO calculated.
Diagnosis and support for 8% of that population would actually save £67m a year, it added.
Mark Davies, NAO director of health value for money studies, said there would be people in their 40s and 50s who had never been diagnosed with the condition.
"We would like people to look at our report and the modelling we have done because we think there is a good case for having more specialist support."
Care services minister Phil Hope said the first ever autism strategy would be published at the end of 2009 and a study was being done to work out exactly how many adults have autism in England.
"Our commitment to do this will have the force of law - in the first ever Autism Bill going through parliament."

AUTISM IN ENGLAND An estimated 400,000 adults have autism Half of those do not have a learning disability Only 15% are in full-time employment

Geoffrey Maddrell, chairman of Research Autism, agreed there was an "appalling" lack of joined up and accessible provision for adults with autism.
"With the correct employment support and mentoring, many of these adults can sustain long-term education and career paths in various sectors.
"But at present this is not happening in many places."
Mark Lever, chief executive at the National Autistic Society, said the government could not ignore the "huge cost savings and benefits", identified by the NAO.
"Neither the government, people with autism nor the taxpayer are getting value for money from existing autism services and support, leaving those affected by the condition feeling isolated, ignored and often at breaking point."
Professor Simon Baron-Cohen, an expert in autism at the University of Cambridge, said even when people were diagnosed they were often left "isolated, unemployed, lonely, and at risk of developing potentially preventable secondary depression".
"The hope is that this report will lead to a step change in how we meet the needs of this invisible group in our society."

Families share 'autistic traits'

'Autistic' brain changes may be seen in the relatives of those with autism

Relatives of people with autism may display autistic brain differences and behaviours despite not having the condition themselves, a study shows. New Scientist says the work could make it easier to spot families at risk of having an autistic child.
It could also help in the quest to find genetic and environmental triggers for the condition, experts hope.
Autism is a disorder that makes it hard for the individual to relate socially and emotionally to others.
'Autistic traits'
It affects about five in 10,000 people, predominantly boys and men, and is often also associated with learning disabilities.
The New Scientist piece reported on work presented at the annual meeting of the Society of Neuroscience that took place in Washington DC this month.
Dr Eric Peterson, from the University of Colorado in Denver, spoke about his work comparing the brain scans of 40 parents with autistic children with those of 40 matched parents whose children did not have autism.
The parents of autistic children shared several differences in brain structure with their offspring, including an unexpected increase in the size of brain areas linked to movement planning and imitation - the motor cortex and basal ganglia.
However, a neighbouring brain area called the somatosensory cortex was smaller than average.
This region is important for understanding social information such as facial expressions - a skill autistic people often lack.
Brain changes
The cerebellum, which is important for co-ordinating movement, and a frontal region thought to play a key role in understanding the intentions of others were also smaller than average.
Another US study, led by Brendon Nacewicz from the University of Wisconsin-Madison Medical School, showed that the amygdala, a brain region involved in processing emotions, was shrunken in both autistic children and their brothers.

It is telling us that genes, as they run through families, are affecting brain function and structure not just in the person with autism but also in their first degree relatives Professor Simon Baron-Cohen of the Autism Research Centre, Cambridge

The brothers also avoided eye contact - a common feature of autism - just as strongly as their affected siblings, even though they did not have autism themselves.
Other researchers have been attempting to identify genes predisposing people to autism, which are thought to be as many as 20.
Professor Simon Baron-Cohen, director of the Autism Research Centre in Cambridge, in the UK, said: "First-degree relatives - parents or siblings of those with autism - may have some but not all of those genes, which would explain why they do not have autism but do show some milder manifestations.
"We have known for years that family members of people with autism may share some traits.
"However, the finding that there are differences in brain structure in parents of children with autism compared to parents of children without autism is new.
"It is telling us that these genes, as they run through families, are affecting brain function and structure not just in the person with autism but also in their first degree relatives."
He said it was too early to use these brain changes to spot people who might be at risk of autism, but he added: "I'm sure that will come."

Fear centre 'shrinks' in autism

Fear centre 'shrinks' in autism

Autism impairs social interaction, communication, and imagination

A part of the brain associated with emotional learning and fear shrinks in people with autism, research suggests. Teenagers and young men with autism in the study who had the most severe social impairment were found to have smaller than normal amygdalae.
The researchers from the University of Wisconsin suggested the amygdalae may shrink due to chronic stress caused by social fear in childhood.
The study was published in the Archives of General Psychiatry.
Of 54 male participants aged eight to 25 years who took part in the study, 23 had autism and five had Asperger syndrome.

We now need to discover if this neural difference is observed at the earliest point in development, and what causes this atypical development professor Simon Baron-Cohen

The size of the amygdalae, two almond-shaped groups of neurons located deep within the brain, was measured by MRI scans.
Individuals were also asked to complete tasks associated with social interaction such as eye tracking and recognising emotional facial expressions.
Men with autism who had small amygdalae were slowest to distinguish emotional from neutral expressions and showed the least fixation of eye regions.
The same individuals were the most socially impaired in early childhood.
The researchers also found a link with age suggesting that amygdala volume decreases from childhood into early adulthood in autistic people with the most severe social impairment.
Hyperactivity
Study leader Dr Richard Davidson said the findings pointed towards a model of autism where the brain first reacts to stress brought on by fear of people by becoming hyperactive, which eventually leads to cell death and shrinkage.
Children with autism who have the least difficulty with social interaction would have slower amygdala shrinkage than those who struggled the most.
He said the findings could account for more than half the differences in social impairment in people with autism.
An earlier study published by Dr Davidson reported that unaffected siblings of people with autism share some of the same differences in amygdala volume and the way they look at faces and process information about emotions.
He said: "Together, these results provide the first evidence linking objective measures of social impairment and amygdala structure and related brain function in autism.
"Finding many of the same differences, albeit more moderate, in well siblings helps to confirm that autism is likely the most severe expression of a broad spectrum of genetically-influenced characteristics."
Professor Simon Baron-Cohen, director of the Autism Research Centre in Cambridge, said: "This paper provides important evidence that size of the amygdala is associated with autism severity and social skill.
"We now need to discover if this neural difference is observed at the earliest point in development, and what causes this atypical development."

autism adult

System 'failing autistic adults'

Emma Wilkinson Health reporter, BBC News

Adults with autism can become socially isolated

Thousands of people with autism in England are failing to get the diagnosis and specialist help they need, the National Audit Office says.

Most local authorities do not know how many adults with autism live in the area and provide no specific services.
Yet better support in areas such as housing and employment could save the taxpayer millions of pounds in the long run, a report concluded.
The government is due to publish its first autism strategy later this year.
People with autism struggle to communicate socially and have trouble understanding facial expressions and tone of voice and recognising emotions.
Around half of those with autism also have a learning disability, but for those who do not - those with high functioning autism, such as Asperger Syndrome - accessing support for housing, further education and employment can be particularly hard, the NAO said.
Three-quarters of local authorities have no commissioning plan in place for specialist autism services and 65% struggle to find appropriate housing.
The report also found that children with autism are often abandoned by specialist services when they turn 18, due to a lack of adult services or a proper transition plan.
Diagnosis
An average GP is thought to see two adults with undiagnosed high-functioning autism every six months.
But the vast majority say they need better training to identify and manage patients better.
And although there are education programmes now in place, there is still a lack of expertise at job centres, with only 200 of 500 disability advisors trained to help people with autism, the NAO said.

The hope is that this report will lead to a step change in how we meet the needs of this invisible group in our society Professor Simon Baron-Cohen

If local authorities identified just 4% of people with high-functioning autism, and offered them specialist support with living independently or getting a job, the cost would be cancelled out by savings in other areas, the NAO calculated.
Diagnosis and support for 8% of that population would actually save £67m a year, it added.
Mark Davies, NAO director of health value for money studies, said there would be people in their 40s and 50s who had never been diagnosed with the condition.
"We would like people to look at our report and the modelling we have done because we think there is a good case for having more specialist support."
Care services minister Phil Hope said the first ever autism strategy would be published at the end of 2009 and a study was being done to work out exactly how many adults have autism in England.
"Our commitment to do this will have the force of law - in the first ever Autism Bill going through parliament."

AUTISM IN ENGLAND An estimated 400,000 adults have autism Half of those do not have a learning disability Only 15% are in full-time employment

Geoffrey Maddrell, chairman of Research Autism, agreed there was an "appalling" lack of joined up and accessible provision for adults with autism.
"With the correct employment support and mentoring, many of these adults can sustain long-term education and career paths in various sectors.
"But at present this is not happening in many places."
Mark Lever, chief executive at the National Autistic Society, said the government could not ignore the "huge cost savings and benefits", identified by the NAO.
"Neither the government, people with autism nor the taxpayer are getting value for money from existing autism services and support, leaving those affected by the condition feeling isolated, ignored and often at breaking point."
Professor Simon Baron-Cohen, an expert in autism at the University of Cambridge, said even when people were diagnosed they were often left "isolated, unemployed, lonely, and at risk of developing potentially preventable secondary depression".
"The hope is that this report will lead to a step change in how we meet the needs of this invisible group in our society."

poaching has put some rhino populations at risk of extinction.

Across Africa as a whole, rhinos have been on the increase

A rise in poaching has put some rhino populations at risk of extinction.
The wildlife trade organisation Traffic has documented a five-fold increase in the volume of rhino horn entering the illegal market between 2000 and 2005.
The populations most affected are in western and central Africa and Nepal, with one sub-species in Cameroon believed extinct already.
However, overall, rhinos are doing well with Africa-wide numbers increasing by about 6% every year.
The Traffic report was released at the Convention on International Trade in Endangered Species (CITES) summit in The Hague.
"We are seeing an increase in the quantity of horn which is leaving the continent," said Simon Milledge, Traffic's deputy director for eastern and southern Africa.
"The main market remains in east and southeast Asia, as well as in the Middle East. It's a concern."
Poached to extinction
In the middle of the 1800s, there were probably more than a million black and white rhinos on the plains of Africa.
Rapacious hunting by European settlers brought numbers down spectacularly, and at one point the southern white was thought extinct.
Protective measures brought a reversal for both species, and in southern and eastern Africa, the revival continues, with countries such as Namibia and South Africa having found a new use for their rhinos as a tourist attraction.

Making conservation pay

Across the continent, there are now more than 14,000 white and nearly 4,000 black rhinos. Live animals can legally change hands for between $20,000 and $50,000 (£10-25,000), far more money than an illegally traded horn can bring.
The Traffic report names Cameroon, Democratic Republic of Congo and Zimbabwe as countries where protective measures have broken down.
An expedition in Cameroon last year found that the one remaining tiny population of the northern black rhino sub-species Diceros bicornis longipes had probably been poached to extinction.
DRC is home to the last four northern white rhinos (Ceratotherium simum cottoni) in existence.
Hunting profits
Asian rhinos, meanwhile, show a mixed picture.
Indian populations are rising; but in Nepal, recent conflict has brought heavy poaching. And there are other problems in Indonesia.
"The Sumatran and Javan rhinos are very vulnerable," noted Simon Milledge.
"The greatest threat is habitat loss and the fragmentation of habitat; the threat of the horn trade is there, but it's mainly habitat issues for those two species."

Many of Nepal's large animals have been poached No peace dividend for wildlife

CITES voted through a resolution aimed at enhancing rhino protection through greater monitoring of both the animals and the horn trade, better co-operation between African range states, and an assessment of horn stockpiles.
A Kenyan amendment that stockpiles should be destroyed was defeated.
Earlier, another Kenyan proposal, to stop the annual export of five black rhino hunting trophies by Namibia and a further five by South Africa, was defeated. The exports had been approved at a previous CITES meeting, and South Africa says that its quota brings in nearly $1m per year which can be spent on conservation.
Traffic is a joint programme of the conservation group WWF and the IUCN, which is famous for drawing up the Red Lists that document the status of the planet's flora and fauna.

chinese tiger use

End of the tiger tale?

By Richard Black Environment correspondent, BBC News website, The Hague

Chinese tiger farms house more big cats than remain in the wild

To Valmik Thapar, it is a matter of principle, of human dignity, and distortion of the traditional relationship between mankind and nature.
"To me it is disgusting," he thunders. "It's not civil to have tiger farms; it's not part of anyone's dream."
The target of Mr Thapar's ire is the prospect of China re-opening its domestic trade in tiger products.
The trade has been banned for 14 years, and using material from wild tigers would remain prohibited.
Instead, traditional medicine ingredients such as bone would be sourced from animals kept in farms.

If there wasn't a ban on the tiger trade, I assure you there wouldn't be one single tiger left in India today Valmik Thapar, Conservationist

There are thought to be at least five tiger farms in China, housing about 5,000 animals, the majority born and bred in captivity.
Astonishingly, that is more tigers than remain in the wild.
Animal welfare and conservation groups are virtually united in their opposition.
Re-opening a domestic market would boost poaching for that market, they believe, and would also lead to an increase in international trade, which would remain illegal under the Convention on International Trade in Endangered Species (CITES).
A prominent conservationist who has spent 30 years observing India's tigers, Valmik Thapar is under no illusions as to what this would mean for the remaining wild populations, based largely in India.
"If there wasn't a ban on the tiger trade, I assure you there wouldn't be one single tiger left in India today," he told a reception at this year's CITES meeting in The Hague.
But there was a wider message. Tigers are wild creatures; that is how we used to treat them and respect them, and putting them behind bars, denuding them of their instincts and their traditional behaviours, has no place in a world which claims to be civilised.
Closed doors
Tiger farms sprang up in China in the 1980s, when the market was still thriving.
Bans on national and international trade stemmed the lucrative stream of material flowing out of the farm gates. Some turned to tourism for income.
An information document which China is presenting at this CITES meeting, entitled The Current Situation of Tiger Breeding and the Facing Difficulties (sic) of the Guilin Xiongsen Tigers and Bears Mountainvillage, laments the financial difficulties which one farm is facing.

The tiger could easily earn its keep and buy its way out of extinction, if we allow it to do so Barun Mitra, Liberty Institute, Delhi

"We need 50,000,000 RMB ($6,500,000) to run the zoo, and yet, the income from tourism was just 15,000,000 RMB ($2,000,000).
"Without a fresh financial support, the 1,000 tigers would be starving. Then, it would become meaningless to talk about protections of these animals."
The farm owners display compassion too for the people who come to their door seeking medical help.
"Patients of rheumatism could be often seen to come to us for tiger bones, but we could give them nothing even when they get down on their knees pleading because it is not allowed."
The tiger farmers receive a sympathetic hearing from some NGOs which believe that conservation strategies work best when the conservation targets acquire some financial value.
"When trade is outlawed, only outlaws trade," says Barun Mitra of the Liberty Institute in Delhi.
Mr Mitra's thesis is that money should be made from tigers in a number of ways, from ecotourism to trading in tiger parts.

Xiongsen bear and tiger village Enlarge Image

The demand for crocodile skin used, he says, to be met by poaching. Nowadays the supply chain starts in crocodile farms, which provide the same material at a fraction of the cost.
As a result, crocodile numbers in the wild have risen; and he believes exactly the same thing could happen with tigers.
"The tiger could easily earn its keep and buy its way out of extinction, if we allow it to do so," Mr Mitra concludes.
Some observers point to a big distinction between farming and ranching, which is what may have saved crocodiles.
The CITES definition of ranching entails regularly gathering eggs from the wild to ensure genetic diversity of the captive breeding stock, while leaving enough behind to ensure the wild population continues - all done under licence.
And Sue Lieberman of WWF International believes captive tigers will do nothing for their wild relatives.
"It costs a lot to keep a tiger in captivity, and next to nothing to kill them in the wild," she says.
"In any case, legitimate traditional medicine doesn't need tiger parts. And those who use tiger bone prefer bones from wild animals."
Farming for conservation
During debates, Wang Weisheng, from the Wildlife Management Division of China's forestry department, said the domestic trade would not be re-opened unless that trade would assist in conservation.

Farmed tigers lose their hunters skills, opponents say

A resolution passed here by consensus - ie, with China's endorsement - says that captive populations should be reduced "to a level supportive only of conserving wildlife".
But what does that mean? How many might be needed to support conservation?
"That might depend from region to region, on the habitat - it might be two in one place and 10 in the next," said India's delegate Rajesh Gopal from the National Tiger Conservation Authority.

China has done a great deal in 14 years, in terms of education, enforcement, and banning tiger products from traditional medicine Sue Lieberman, WWF International

"We don't really need any captive tigers," he added.
But Mr Weisheng suggested sales of tiger products to hospitals could raise money which could then be ploughed back into conservation - a very different definition which could, potentially, result in an increased captive stock.
In the shops?
Next month China is hosting a meeting at which scientists, economists, NGOs and policymakers will thrash through the various aspects of this issue.
A decision to approve the trade would bring outcry from neighbouring countries, western governments, and activists.
"China has done a great deal in 14 years, in terms of education, enforcement, and banning tiger products from traditional medicine," comments Dr Lieberman.
"So why they would want to risk all that now, just to give a bit of profit to a few rich businessmen, I don't know."
But some of those businessmen are apparently making a profit from tiger parts already.
Earlier this year, undercover reporters from the UK's ITN visited Guilin tiger farm and found that tiger meat was being sold illegally. The origin of the meat was validated by an independent laboratory in China.
John Sellar, senior enforcement officer with CITES, told delegates that the US Fish and Wildlife Service has now endorsed the Chinese laboratory's findings. That has been communicated to the Chinese government, he said.
If China decides it is not worth the effort and brings the tiger farming era to a close, one thorny issue will be what to do with the 5,000 tigers already in captivity.
They lack the instincts needed to survive in the wild. And coming from a small gene pool, they have little to offer the existing wild population.
But that will be a single problem requiring a single solution. For Valmik Thapar, a much larger problem looms if farms are not closed and the tiger trade banned forever - the final extinction of this magnificent predator.
"History will never forgive one human being or one collective of human beings if we take any other decision," he says.

bush meat supermarket

'Barcodes' tackle bush meat trade

Bush meat is a key part of the diet for many in central Africa

Researchers have developed a new tool in the fight against the illegal hunting and trading of wild animals.

"We can use a small sequence of DNA as a species identifier in the same way as a barcode," says George Amato of the American Museum of Natural History.
The technique can accurately identify an animal species, even once it has processed and turned into meat or other products.
The illegal trade in bush meat has grown dramatically over recent years.
Hunting for income or subsistence is traditional in Asia, South and Central America and West and Central Africa.
There is also increasing international demand for meat and other products from "exotic" wild animals.
The trade is difficult to monitor but estimated to be worth billions of dollars a year.
Knowing the species can help trace where an animal is from, and therefore help determine whether the hunting and killing was illegal.
Along with traditional techniques like education, it could help control the trade.
Health concerns
"All sorts of species are hunted, from snails up to elephants," says Noelle Kumpell from the Zoological Society of London.

Scientists hope to use the technique to identify goods sold in markets

She manages conservation programmes which include the monitoring of the bush meat trade in west and central Africa.
"Conservationists are particularly worried about the impact on the more vulnerable species, which are the larger, more slowly reproducing species such as great apes, or elephants."
As well as causing problems for conservation there are health concerns over eating species like apes which are closely related to us, as there is a risk of transmitting diseases.
To develop the DNA barcode, scientists had to find a region of DNA that is varied enough to distinguish between species, and resilient enough that it can be found in leather, bone, or dried meat.
Database
They are now building a database of the wild species so that products can be checked and compared.
"The whole point of this new development was to make a useful new tool for monitoring the trade at point of origin, whether it's in the field, in markets, at airports, and all along the chain of where these wildlife products might travel," Mr Amato told BBC Science in Action.
"The notion is that we'll be able to, very shortly, identify the barcode from the product locally, which could be right in a market. Then we will access the database over the internet, and get that information back, at point of origin."

carehome cons

Charities warn of care home costs

Like most western countries, the UK has an ageing population

Charities say families with elderly relatives in local authority care homes in England are struggling to meet demands for top-up fees.

Age Concern and Help the Aged say councils are paying about £60 a week less than it takes to provide services, forcing families to meet the shortfall.
Care Services Minister Phil Hope told the BBC the situation was "distressing" and "shouldn't be happening".
But the Local Government Association said Westminster must increase funding.
'No limitless pot'
Age Concern and Help the Aged said some relatives were being asked to contribute several hundred pounds a month in top-up care fees.
"As local authority budgets come under tighter pressure, it's definitely something we anticipate getting worse unless government ministers get together with local authority leaders and thrash something out here," spokesman Patrick South told the BBC.
One relative, Jean Cutts, told the BBC about her struggle to pay nearly £300 a month for her 97-year-old mother's council-run home.
"It's hit us critically," she said. "Whatever money comes into the bank is drained out every month."

We have to radically change our system of care for the future Care Services Minister Phil Hope

The National Care Association, which represents care homes, said they were being asked to provide a far greater range of services because people with complex medical needs who would previously have been cared for in hospital were now looked after in the community.
And David Rogers, from the Local Government Association, said that this wider remit, combined with an ageing population, presented a huge challenge for councils who did not have a "limitless pot of money".
'National care service'
Mr Hope said half a billion pounds extra had been allocated to fund care and it was "up to local authorities to make sure that they meet the assessed care needs that an individual has".
However, he did acknowledge that "we have to radically change our system of care for the future".
To do this, he said, the government was proposing a national care service "where everybody no matter what their income will get some help with their care and support".
The top-up fees row comes as Health Secretary Andy Burnham is set to speak about the healthcare "timebomb" facing Britain's ageing population.
In a speech on Friday, he will say that the current system is "creaking at the seams and can't cope", and will call on public and health professionals to give their opinions on how it should be reformed.
The Department of Health has launched a public consultation exercise - the Big Care Debate - to get people's views on how care and support should be funded and provided in the future.
Care Services Minister Phil Hope said: "Local councils make decisions to best meet the needs of people living in their area.
"To help them do this, we have increased investment in local council services by 39% cent since 1997 and this will rise to 45% by 2010-11.
"We have also put £520 million into making services more tailored to individuals needs.
"More of us are living longer - life expectancy is going up and advances in medical science mean that people with a disability are living longer.
"This is worth celebrating but does mean we need to radically change the way care is provided and paid for.
"We need a system that is fair, simple and affordable for everyone and gives excellent care wherever we live and whatever our needs."