Abstract
The evolution of a local fragmented model of services for children with autism in Hong Kong emerged gradually over the past three decades with lack of government funding or support. This had been due to increasing number of children with autism being detected and referred for earlier assessment. With increasing pressure from parents due to long waiting time for assessment and training services and the increasing polarization by mass media there had been a gradual increasing public awareness over the past five years. Though still highly fragmented in the availability of services, there is a growing “business model” available in the community due to increasing need and lack of public funding for support. There is a lack of strategic planning for medical diagnostic and management issues in Hong Kong. Our University of Hong Kong based Autism Research Program was pioneered in 1985 based on the increasing load of autism cases referred for assessment for other developmental problems and diagnosed as Autism in the Duchess of Kent Children’s Hospital. As the first author has been the staff of the University of Hong Kong, this program flourished as a research based program. The benefits of early identification and intervention of autism spectrum disorder (ASD) had been increasingly recognized, and with the increased public awareness and increasing trend of earlier diagnosis, there has been a continuously high demand from parents for earlier assessment and training for children suspected to have ASD. This model had not received extra funding for this integrated program for research, teaching and training in autism. We had to apply for various donations and grants to support the development of this pioneer program. The research output and organization of forums for public education and awareness are reviewed. The latter part of the paper reports the summary of clinical profile of autism cases (N=1441) assessed from 1985 to 2010 June under the University of Hong Kong. As the waiting time for initial developmental assessment for any children in Hong Kong is 12–24 months, we also report our preliminary experience with a newly launched triaging service provision for children suspected to be ASD since 2009, including multi-disciplinary assessment and parallel interim training in our university affiliated child assessment centre in Hong (N=89).
Article PDF
Similar content being viewed by others
References
Wong VC, Hui SL. Brief report: emerging services for children with autism spectrum disorders in Hong Kong (1960-2004). J Autism Dev Disord, 2008, 38: 383–389
Central Registry of Rehabilitation (CRR). [2010-10-11]. http://www. hwfb.gov.hk
Special Assessment Centre, Special Health Service, Department of Health. [2011-01-14]. http://www.parentsassn.org.hk
Fu Hong Society, Hong Kong. [2011-01-14]. http://www.fuhong. org/hdc/
Duchess of Kent Children Hospital. [2010-10-11]. www.dhcas. gov.hk
Wong VC. Professor Virginia Wong Chun Nei. [2010-10-17]. http://www.professorvwong.hk
Social Welfare Department. [2010-10-11]. http://www.swd.gov.hk
Heep Hong Society. [2010-10-11]. http://www.heephong.org
The Spastics Association of Hong Kong. [2010-10-11]. http://www. sahk1963.org.hk
Caritas Rehabilitation Service, Caritas Hospital. [2011-01-14]. http://swsd.citac.edu.hk/
The Child and Adolescent Mental Health Community Support Project, Social Welfare Department, HA. [2011-01-14]. http://www.swd.gov. hk/en/index/site_pubsvc/page_medical/sub_camhcsp/
iCare—Voice and Speech Therapy Centre. [2011-01-14]. http://www. icare.com.hk/en/index.html
Autism Partnership Hong Kong. [2011-01-14]. http://www. autismpartnership. com.hk
iCan, Whole Person Development Institute. [2011-01-14]. http://www. ican.com.hk/index.php
New PAGE Learning & Developmental Consultants. [2011-01-14]. http://www.newpage.hk
Project Aspire. [2010-10-11]. http://www.ied.edu.hk/aspire
The Society for the Welfare of the Autistic Persons. [2010-10-11]. http://www.swap.org.hk/
Autism HK. [2010-10-11]. http://www.autism.hk/
Hong Kong Autism Awareness Alliance. [2011-01-14]. http://www. autism-day.org/
The Parent Association of Autistic Children in Mainstream Ed, PAAC. [2011-01-14]. http://www.paacme.org.hk/paacme.html
The Parent’s Association of Pre-School Handicapped Children. [2011-01-14]. http://www.parentsassn.org.hk
The Salvation Army’s Family Support Service for Persons with Autism. [2011-01-14]. http://www.salvation.org.hk/ssd_web/fsspa/
Intellectually Disabled Education and Advocacy League (IDEAL). [2011-01-14]. http://www.ideal.org.hk
Griffiths R. The Abilities of Young Children. Revised ed. Buckinghamshire: The Text Agency, 1984
Lowe M, Costello AJ. Symbolic Play Test Manual. 2nd ed. Berkshire, England: NFER-Nelson, 1984
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC, 1994
Schopler E, Reichler RJ, Renner BR. The Childhood Autism Rating Scale (CARS) for Diagnostic Screening and Classification in Autism. New York: Irvington, 1986
Lord C, Rutter M, Le Couteur A. Autism Diagnostic Interview- Revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord, 1994, 24: 659–685
Lord C, Rutter M, Goode S, Heemsbergen J, Jordan H, Mawhood L, Schopler E. Autism diagnostic observation schedule: a standardized observation of communicative and social behavior. J Autism Dev Disord, 1989, 19: 185–212
Baren-Cohen S, Wheelwright S, Cox A, Baird G, Charman T, Swettenham J, Drew A, Doehring P. Early identification of autism by the Checklist for Autism in Toddlers (CHAT). J Royal Soc Med, 2000, 93: 521–525
Robbins DL, Fein D, Barton ML, Green JA. The modified checklist of autism in toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. J Autism Dev Dis ord, 2001, 31: 131–144
Wong V, Wong SN. Brainstem auditory evoked potential study in children with autistic disorder. J Autism Dev Disord, 1991, 21: 329–340
Ip P, Wong V, Ho M, Lee J, Wong W. Mercury exposure in children with autistic spectrum disorder: case-control study. J Child Neurol, 2004, 19: 431–434
Lau K. Acupuncture and autism spectrum disorder — an assessor- blinded randomized controlled trial. Dissertation for Master’s Degree. Hong Kong: the University of Hong Kong, 2008
Chan SY, Wong V. DNA diagnosis of FRAXA and FRAXE in Chinese children with neurodevelopmental disorders and fragile X syndrome. Clin Genet, 1998, 53: 179–183
Wong VC, Lam ST. Fragile X positivity in Chinese children with autistic spectrum disorder. Pediatr Neurol, 1992, 8: 272–274
Lam CW, Yeung WL, Ko CH, Poon PM, Tong SF, Chan KY, Lo IF, Chan LY, Hui J, Wong V, Pang CP, Lo YM, Fok TF. Spectrum of mutations in the MECP2 gene in patients with infantile autism and Rett syndrome. J Med Genet, 2000, 37: E41
Khong PL, Lam CW, Ooi CG, Ko CH, Wong VC. Magnetic resonance spectroscopy and analysis of MECP2 in Rett syndrome. Pediatr Neurol, 2002, 26: 205–209
Wong V, Khong PL. Tuberous sclerosis complex: correlation of magnetic resonance imaging (MRI) findings with comorbidities. J Child Neurol, 2006, 21: 99–105
Wong V. Study of the relationship between tuberous sclerosis complex and autistic disorder. J Child Neurol, 2006, 21: 199–204
Wong VC, Hughes S. Autism spectrum disorder in children. Med Prog, 2000, 27: 8–16
Wong V, Hui LH, Lee WC, Leung LS, Ho PK, Lau WL, Fung CW, Chung B. A modified screening tool for autism (Checklist for Autism in Toddlers [CHAT-23]) for Chinese children. Pediatrics, 2004, 114: e166–176
Ng SS, Chow BK, Wong VC. The human secretin gene in children with autistic spectrum disorder: screening for polymorphisms and mutations. J Child Neurol, 2005, 20: 701–704
Feuk L, Kalervo A, Lipsanen-Nyman M, Skaug J, Nakabayashi K, Finucane B, Hartung D, Innes M, Kerem B, Nowaczyk MJ, Rivlin J, Roberts W, Senman L, Summers A, Szatmari P, Wong V, Vincent JB, Zeesman S, Osborne LR, Cardy JO, Kere J, Scherer SW, Hannula-Jouppi K. Absence of a paternally inherited FOXP2 gene in developmental verbal dyspraxia. Am J Hum Genet, 2006, 79: 965–972
Wong VC, Li SY. Rett syndrome: prevalence among Chinese and a comparison of MECP2 mutations of classic Rett syndrome with other neurodevelopmental disorders. J Child Neurol, 2007, 22: 1397–1400
Wong V. Occipital deep white matter hyperintensities in autism spectrum disorder. Pediatr Int, 2007, 49: 513–515
Chan AS, Han WMY, Leung WWM, Leungc C, Wongc VCN, Cheungd MC. Abnormalities in the anterior cingulate cortex associated with attentional and inhibitory control deficits: A neurophysiological study on children with autism spectrum disorders. Res Autism Spect Disord, 2011, 5: 254–266
Rose L, Wong VCN. Possible effect of acupuncture in autism spectrum disorder. Focus Alternative Compl Ther, 2011 16: 46–48
Wong VC, Hui SL. Epidemiological study of autism spectrum disorder in China. J Child Neurol, 2008, 23: 67–72
Wong V. Can acupuncture of the tongue help autism? Autism Asper Digest, 2002, 18-19: 25–29
Chen WX, Wu-Li L, Wong VC. Electroacupuncture for children with autism spectrum disorder: pilot study of 2 cases. J Altern Complement Med, 2008, 14: 1057–1065
Wong VC, Sun JG. Randomized controlled trial of acupuncture versus sham acupuncture in autism spectrum disorder. J Altern Complement Med, 2010, 16: 545–553
Wong VC, Chen WX. Randomized controlled trial of electro-acupuncture for autism spectrum disorder. Altern Med Rev, 2010, 15: 136–146
Cheuk DK, Wong V, Chen WX. Acupuncture for autism spectrum disorders (ASD). Cochrane Database Syst Rev, 2011, 9: CD007849
Wong CL. Acupuncture and Autistic Spectrum Disorder—an assessor- blinded randomized controlled trial. Dissertation for Master’s Degree. Hong Kong: the University of Hong Kong, 2009
Wong VC. Use of complementary and alternative medicine (CAM) in autism spectrum disorder (ASD): comparison of Chinese and western culture (Part A). J Autism Dev Disord, 2009, 39: 454–463
Wong VCN, Chu VL. Autism spectrum disorder and traditional Chinese medicine (acupuncture). In: Garralda E, Raynaud J P, eds. Increasing Awareness of Child and Adolescent Mental Health. Jason Aronson: New York, 2010
Wong VC, Kwan QK. Randomized controlled trial for early intervention for autism: a pilot study of the Autism 1-2-3 Project. J Autism Dev Disord, 2010, 40: 677–688
Wong V. Epilepsy in children with autistic spectrum disorder. J Child Neurol, 1993, 8: 316–322
Wong V. Study of the relationship between tuberous sclerosis complex and autistic disorder. J Child Neurol, 2006, 21: 199–204
Fung KY. Use of dysmorphology for subgroup classification on autism spectrum disorder in Chinese children. Dissertation for Master’s Degree. Hong Kong: the University of Hong Kong, 2010
Wong, PTY. Pilot study for subgroup classification for autism spectrum disorder based on dysmorphology and physical measurements in Chinese children. Dissertation for Master’s Degree. Hong Kong: the University of Hong Kong, 2012
Wong VCN. Autistic disorder in Chinese children. Aust New Zeal J Med, 1991
Wong V, Sun JG, Wong W. Randomized control trial of using tongue acupuncture in children with autistic spectrum disorder. J Neuro Sci, 2001, 187: S329–330
Wong V, Sun JG, Ma QY, Yang E. Double blind randomized placebo- controlled trial using tongue acupuncture in children with autistic spectrum disorder. Eur J Neuro, 2001, 5: A82
Wong V, Leung C, Sze A. A pilot study of traditional herbal medicine (Gingo Biloba and Ginseng) in two children with attention deficit hyperactivity disorder. Eur J Neuro, 2001, 5: A138
Wong V, Sun JG. Research on tongue acupuncture in children with autism. Brain Dev, 2002, 24: 319
Yeung D, Wong V, Sun JG. Effect of tongue acupuncture on brain metabolism in autism using brain positron emission tomography. Brain Dev, 2002, 24: 320
Fung CW, Wong V, Hui SLH. Autistic spectrum disorders in Hong Kong. Brain Dev, 2002, 24: 330–331
Wong V, Lee WC, Leung JLS, et al. Modified checklist for autism in toddlers—third edition (CHAT-3) for Chinese children—Hong Kong Study. Brain Dev, 2002, 24: 331
Wong V, Fung CW, Centers-In-Charge of Heep Hong Society. Autism Research Program in Hong Kong: Collaborative Project of Duchess of Kent Children’s Hospital (Children’s Habilitation Institute) and Heep Hong Society. Brain Dev, 2002, 24: 335
Wong V, Lau KS, Hung CN, Shum T, Ngai CF, Ho SI. Identifying prenatal, perinatal and environmental risk factors for autism spectrum disorder (ASD): a case-control study. J Pediatr Neurobio Neurol Neurogenet, 2006, 26: S168
Wong PTY. Pilot study for subgroup classification for autism spectrum disorder based on dysmorphology and physical measurements in Chinese paediatric and adolescent population. Abstract presented at Asia Pacific Autism Conference, Perth, Australia, 2011
Child Assessment Service, Department of Health, Hong Kong. [2010-10-10]. http://www.dhcas.gov.hk/eindex.html
National Autistic Society, on behalf of the National Initiative for Autism: Screening and Assessment (2003). National Autism Plan for Children, NAS, London, UK. [2010-10-10]. http://www.autism.org.uk/~/media/NAS/Beta%20documents/About%20autism/Autism%20library/Magazines%20articles%20and%20reports/Reports/Other%20reports/National%20Autism%20Plan%20for%20Children%20full%20r eport.ashx
Skuse D, Warrington R, Bishop D, Chowdhury U, Lau J, Mandy W, Place M. The developmental dimensional and diagnostic interview (3Di): a novel computerized assessment for autism spectrum disorders. J Am Acad Child Adolesc Psychiatry, 2004, 43: 548–558
Preece PM, Mott J. Multidisciplinary assessment at a child development centre: do we conform to recommended standards? Child Care Health Dev, 2006, 32: 559–563
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is published with open access at link.springer.com
Rights and permissions
Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
About this article
Cite this article
Wong, V.CN., Fung, CW., Lee, SL. et al. Review of evolution of clinical, training and educational services and research program for autism spectrum disorders in Hong Kong. Sci. China Life Sci. 58, 991–1009 (2015). https://doi.org/10.1007/s11427-012-4294-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11427-012-4294-y