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A brief reflection on the 17th International ESCAP Congress in Geneva, Switzerland.

13/7/2017

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​We were extremely fortunate to attend part of this brilliant conference in Geneva. The overarching theme was transition in a world of change and the content more than met our expectations. 
 
The keynote speakers included Professor Tony Charman from King's College, London and Professor Johannes Hebebrand from Germany.
 
Professor Tony Charman's talk was on tracking the emergence of early autism symptoms in at-risk infants, looking at possibilities for prodromal intervention.  Until recently, most of what we knew about the emergence of autism in infancy relied on retrospective accounts. A new approach, the study of infants at familial risk (younger siblings of autistic children), aims to identify the earliest “pure” manifestations of autism, before subsequent years of atypical development exacerbate, or compensate for, initial atypical development. He explained that there are some studies suggesting that in children from 12 months old, it is possible to detect signs (measured with EEG, ERP, visual fixation and attention) which could be related to ASD development.

He presented data from a prospective longitudinal study (J. Green et al, J Child Psychol Psychiatry 2017) based on using VIPP as a pre-emptive intervention in the prodrome of autism. Specifically, it is a RCT comparing a 12-session parent-mediated social communication intervention delivered in infants at familial risk of autism but not otherwise selected for developmental atypicality, between 9 and 14 months of age (Intervention in the British Autism Study of Infant Siblings-Video Interaction for Promoting Positive Parenting), against no intervention. The results were that very early VIPP for infants at familial risk of developing autism has shown a treatment effect, to reduce the overall severity of autism prodromal symptoms and enhance parent-child dyadic social communication over this period.   

More information about the European project based on siblings of ASD children can be found here www.eurosibs.eu
​
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Professor Johannes Hebebrand presented on pre- and post- natal screening in the context of CAP.  Should we proactively be screening pre and postnatally for mental disorders? He covered the WHO criteria for a screen, the potential biases, the ethical issues around non-invasive prenatal screening, the modified checklist for autism risk in toddlers (M-CHAT-R/F) and highlighted the demand for better integration of CAP services with increased focus on evidence based screening with improved interdisciplinary collaboration with Paediatricians GPs and Gynaecologists.

Other keynote speakers included:
 
* Jörg Fegert (Germany) discussing the Care of traumatized children in youth welfare systems.
* Patrick McGorry (Australia) talking about Transitioning to 21st century mental health care: early intervention for young people with emerging mental disorders.
* Paul Hoff (Switzerland) on Conceptual transitions: what will happen to the concept of mental disorders in the 21st century?
* Patrick Luyten (Belgium/UK) on A radical shift in the treatment of child and adolescent depression: Perhaps the time is ripe?​​* Maria Melchior (France) on Social inequalities in children's mental health – from observation to prevention.
* Dieter Wolke (UK) on Peers and siblings matter for mental health: long term consequences of bullying.

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The symposiums included tracks covering an incredibly broad range of subjects. From presentations on early findings from Professor David Coghill's ADDUCE project to transgenerational effects of childhood adversity, including early detection of personality disorders to the treatment of eating disorders, to the use of neuroimaging and treatment of psychosis to more highly emotionally charged topics relating to the world's response to political crisis in relation to refugees with examples from Syria, Iraq, Serbia & Croatia and a presentation on the child psychiatric care in Nice following the terrorist attack in July 2016. 
There was something in there for absolutely everyone to engage with. We have all learnt a huge amount and come away feeling inspired to collaborate with our colleagues from across the world in future research and clinical practice. 
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We are very much looking forward to the next meeting in Vienna in July 2019.
 


Author: Marina Fabrega Ribera and Rebecca Lancaster
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