1. Section Editor(s): Woods, Jennifer

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The Cowden Preautism Observation Inventory

Cowden, J., Springfield, IL: Charles C. Thomas, 2011, 206 pages, $43.95, ISBN: 9780398086435.


Written by Jo E. Cowden, PhD, an exceptionally well-qualified professor and practitioner in the field of pediatric motor development, the Cowden Preautism Observation Inventory: With Effective Intervention Activities For Sensory Motor Stimulation and Joint Attention will benefit parents and practitioners alike. Using data from a 1998 survey, the Centers for Disease Control and Prevention issued a 2012 U.S. prevalence rate of 1 in 88 children. With a nearly doubled incidence rate since the Centers for Disease Control and Prevention first began tracking autism in 1992, the neuroscience nurse will likely encounter several patients and their families dealing with the disorder and is uniquely positioned to facilitate intervention, provide education, and make appropriate referrals.


Autism is commonly diagnosed between the ages of 2 and 3. In this volume, likely the first book to address a new category of knowledge designated preautism, Dr. Cowden discusses numerous preautistic behaviors occurring from birth to 1 year old. With early identification of symptoms, early intervention can lessen the disease severity.


For those not familiar with the term "preautism," Dr. Cowden defines it as "a condition in infants who indicate/show an extreme detachment, unresponsiveness, and lack of concern or interest in other young children or family" (p. xi). One clinical feature exhibited is extreme head growth in circumference in the first year of life. The Cowden Preautism Observation Inventory has been developed for parents who are concerned regarding deficits in their child in the first year of life.


Addressing the pressing question "Why does my child have autism?", Dr. Cowden reviews genetic and environmental factors, including medications. The proposed relationship of the MMR vaccine to autism, which has generated a great deal of controversy, is also discussed in detail.


Providing detailed assessment tables, with age benchmarks, the Cowden Preautism Observation Inventory aids in establishing an objective evaluation of the child less than 1 year old. Offering a hopeful outlook, the book discusses brain plasticity and the fact the brain is not "hard wired" and can positively adapt with targeted interventions. Dr. Cowden makes the case that the brain can change structure and function based on what it senses and perceives.


Delayed motor responses seen in infants with preautism and characteristic findings such as crawling and rolling differences are discussed in detail. Stereotypical behaviors and impaired socialization seen in preautism are also reviewed. An entire chapter is devoted to sensory systems.


The text addresses a 14-point intervention strategy, including increase or decrease of muscle tone to facilitate effective movement, inhibition of primitive reflexes, stimulation of automatic equilibrium reactions, and psychophysiological response to stress, to name a few. A tool is provided to evaluate effectiveness of the designated interventions. A full chapter is appropriately dedicated to sensory-motor curriculum activities, as is a chapter for activities for reflex integration and decreasing muscle tone. Dr. Cowden is a strong proponent of therapeutic horseback riding and discusses this modality in detail.


In summary, this book is of great value to parents who are concerned that their child may be experiencing an autism spectrum illness and offers effective interventions to optimize neurological functioning. The provider caring for affected children and their families will be aided in crucial early diagnosis and evaluation of interventions by Dr. Cowden's research.


Reviewed by Marie Lasater, MSN RN CCRN CNRN, Residential Care Nurse, Pathways Behavioral Health Care, Rolla, MO.