Cuba had the honor to host the first international conference regarding autism and inclusion in 2013. Island’s extraordinary efforts to understand, recognize and manage the condition in it’s early stages highlight the prestige and excellence of Cuba’s autism management. Cuban physicians represent global subject-matter-experts in the field of autism spectrum disorder (ASD). Cuba strives to find the best possible solutions for individuals suffering from ASD through the development of specialized ASD centers that focus on ASD treatment and inclusion of families within the society – of course, absolutely cost-free.
ASD represents a complex condition requiring multidisciplinary approach – a burden for profit- based healthcare systems. The fact that the management of ASD has been assessed as costly best illustrates the difficulties of western systems to properly address the issue of growing incidence of ASD. Waiting lists, inefficiency, high prices are the characteristics of profit-based healthcare systems that often result in inadequate management of those requiring prompt and intensive treatment. Cuba has developed a sustainable program for the management of individuals suffering from ASD focused on meeting the needs of each child.
Cuba offers a carefully tailored program for individuals suffering from autism spectrum disorder (ASD). The main goal of this program is to improve the child’s learning capabilities and reduce the symptoms of ASD. Overall, the program aims to boost the development capacity of each child with ASD. As a result, a visible improvement is seen in the child’s physical and mental abilities, due to the specific nature of the program design that is specifically tailored to meet the needs of each child individually. The program offers a peaceful and comfortable treatment environment and expert medical attention, which is very relevant for achieving the favorable treatment outcome. The facility is equipped with services and amenities such as cable TV, internet, pool, sauna, gym, pharmacy, and laundry services.
The program duration is 38 days. During this period, a set of activities is performed that may be divided into two main stages – evaluation and treatment. A detailed description of each phase is given below.
Stage 1 – Evaluation
During the evaluation phase, the information regarding the ASD nature of each child is obtained through consultation with specialists, laboratory and clinical investigations, as well as specific assessments necessary for evaluation and staging of the disease.
The initial steps in the evaluation phase include consultations with the team of experienced specialists in order to plan and tailor the comprehensive treatment and rehabilitation program for each child. This includes assessments performed by pediatricians, neuro-pediatricians, child psychologists, genetics specialists, logophobia specialists as well as otorhinolaryngologists. Furthermore, detailed laboratory investigations are required for disease evaluation and assessments. Biochemistry panel includes measurements of urea, creatinine, serology investigations, urine metabolic testing, complete blood count, sedimentation rate, blood glucose level, including but not limited to liver function tests.
Following initial testing, complex assessments are performed in order to get the clear picture regarding disease nature and severity. The assessments are performed by highly experienced subject-matter-experts and include logopedic evaluation, neuropsychologic assessment, Brunet-Lezine scale evaluation, as well as psychotherapy assessment and evaluation. Additionally, during the assessment period imaging studies may be performed such as brain MRI, evoked potential studies, EEG etc.
Once all the information has been gathered and a treatment plan has been tailored, the findings and possible management options are discussed with the family. The duration of this phase is dependable on the nature of the underlying disease as well as the child’s abilities to adapt to the new environment. Approximately, it takes no longer than 10 days in order to complete the evaluation and tailor the specific treatment.
Stage 2 – ASD Management
ASD represents a complex disorder requiring multidisciplinary and individual treatment approach for each child. This program offers multiple treatment modalities including equine therapy, sensorial stimulation techniques, occupational therapy, language therapy, ozone treatment as well as trans-cranial electric stimulation, which has been proven useful in hyperkinetic patients. Treatment is conducted by highly experienced experts with the constant involvement of parents.
The focus is on speech therapy that lasts for 20 days and involves both therapists and parents. This treatment modality lasts approximately 20 days and is conducted each day excluding Sundays and public holidays. Depending on the child’s ability to accept the treatment approach, initial sessions may last from 20 minutes to one hour. Protocol for conducting the therapy is tailored based on the individual characteristics of each child. It is strongly advised for the child to continue this treatment approach at home, once the language therapy is finished since this will ensure the long-
lasting results in the future.
Occupational therapy will last approximately 30 days where the intensive treatment will aim to reduce neurological, mental and physical barriers of each child with ASD. This program allows a child to develop and maintain self-care activities, increases the overall productivity and enables a child to participate in leisure activities. The intensive treatment protocol is comprised of two treatment sessions during the day (in the morning and in the afternoon) approximately lasting for an hour or longer. The responsiveness of a child is stimulated by various methods including images projection, object identification, interactive and didactic games, palpation exercises as well as equine therapy.
At the end of each treatment, a detailed report is issued to parents with all of the activities performed at the site including detailed expert recommendations for further treatment and rehabilitation.