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Fresno Bee

June 20, 2009

Autistic children in the cross hairs of state budget crisis

An explosion of childhood autism and a shrinking state budget could be setting up the central San Joaquin Valley for health-care crisis when those children grow up.

The reason: If young autism patients don't get the help they need, they'll just need more help -- and costlier help -- later in life.

And it looks like thousands of children could fall through the cracks under proposals now on the table in Sacramento, health experts say.

"We're pretty scared right now," said Marion Karian, executive director of Exceptional Parents Unlimited, a Fresno nonprofit that serves children with special needs, including those with autism.

The agency helps 300 families of children with autism or autism-like symptoms in Early Start, the state's early intervention program for infants and toddlers who have developmental delays or at risk of having them.

The Exceptional Parents Unlimited early intervention program loses $200,000 a year that has to be offset by fund-raising, Karian said. Proposed state budget cuts to Early Start would increase that gap, she said.

Across the Valley and statewide, demand for autistic services is growing at epidemic rates, while money to pay for them is declining, agency directors said. The agencies received 3% less in state funds to operate this year.

And they stand to lose more.

Under proposed changes in eligibility and other state budget-tightening policies, as many as one out of five toddlers who need services could be turned away, they said.

The state says that children with the most severe form of autism will continue to receive care, but budget cuts will mean fewer infants and toddlers will be served.

"It's very, very difficult for everybody," said Julia Mullen, the California Department of Developmental Services deputy director of community services and supports division.

A growing problem

Of all the developmental disorders, those labeled as autism are increasing the fastest statewide. No one is sure why -- a combination of genes and environmental factors could be at play -- but the consensus is the upward trend will continue.

"We don't know quite what it is, so we don't know how to stop it. So it just keeps going up and up," said Robert Hendren, professor of psychiatry and executive director of the M.I.N.D. Institute at the University of California at Davis. The institute focuses on autism and related neurodevelopmental disorders.

Statewide the number of autism cases has grown faster than the combined number of cases of mental retardation, epilepsy and cerebral palsy. Autism increased more than 1,100% over two decades, while the number of people with developmental disabilities increased 136%, according to a report made public this year by the California Department of Developmental Services.

In June 2002, nonprofit groups tracked by the state helped 14,279 people with autism. By the end of 2007, the number had grown to 34,656.

State experts expect it to surpass 50,000 by this September and reach 70,000 in June 2012.

The Central Valley Regional Center, a nonprofit agency serving the disabled in Fresno and surrounding counties, saw autism cases increase to 1,041 in July 2007 from 388 in 2002.

And when Exceptional Parents Unlimited, the Fresno non-profit, opened in 1976, "We never saw children with autism in our early intervention program," said Karian, the executive director. "Now we see a lot."

The children often need speech, occupational and physical therapy, as well as intensive behavioral services. The earlier the children get the therapy, the better, Karian said.