Dr. Hanna A. Alonim of MIFNE about treatment of autism in Israel/Palestine

By Milena Rampoldi and Denise Nanni,
ProMosaik. In the following our interview with Dr. Hanna A. Alonim, the founder
and head of the Mifne Center. Hanna is an expert in Infancy Development
Disorders of the Autism Spectrum, head of the School of Therapists at the Bar
Ilan University.  Developed the ESPASI
(Early Signs of Pre-Autism Scale for Infants, 2005) and pioneered the Diagnosis
of Infants Unit at the Sourasky Medical Center in Tel Aviv.  She presents papers at International
conferences all over the world. Dr. Alonim is a member of the Helsinki
Committee at Ziv Medical Center and a member of the International
Classification of Functioning (ICF) Core Set for ASD, The WHO Organization
. We
talked to her about the Mifne Center by asking her questions about ealry
diagnosis of autism. The Mifne Center, is located in Rosh Pinna, Israel, and also
treats children from the Palestinian territories and Gaza.
What are the benefits of an early diagnosis?
Findings from a long-term study (1997-2007) carried out
at the Mifne Center affirm the assumption that symptoms of ASD frequently
appear in the first year of life. The dynamic development of the brain during
the first two years of a baby’s life is critical with regard to the baby’s
ability to assimilate stimuli from the environment, lay down new neural
pathways. Recent clinical and brain science studies, including this study,
provide evidence affirming the influence of early environmental manipulation on
the very early development stages of the brain, when the most accelerated
growth of neurons occurs, creating texture of cells that control the infant’s
sensory-emotional-cognitive regulation, which is critical regarding the ability
to assimilate stimuli.
The exploitation of this window of opportunity through
the use of suitable stimulation may influence the development of neural
connections and may contribute to the possibility of minimizing the severity of
the phenotypic presentation of autism.
The most recent edition of the DSM-5 (2013) recognizes
the possibility of early detection of autism among infants from 12-24 months
and sometimes earlier if the symptoms are severe. This indicates the urgent
need to identify risk for autism in infancy.
The Early Signs of Pre-Autism Screening in Infants
(ESPASI) was based on the results of the study at the Mifne Center, and
includes the following eight observational variables: These include: excessive
passivity; excessive activity; lack of eye contact; lack of reaction; refusal
to eat; aversion to touch; motor development delay; and head circumference
Ongoing research into the efficacy of ESPASI is being conducted in conjunction
with the Tel Aviv Sourasky Medical Center Hospital.
Current Research
Our current study evaluated two groups of infants and
toddlers with autism treated with the Mifne intervention method. Both groups
demonstrated significant improvement in terms of variables related to autism,
including eye contact, expression of needs by means of pointing, pulling hands
or noises, speech or speech-like sounds, comprehension of language, game
behavior, physical contact, and eating. The group of infants between 12-24
months demonstrated significantly greater improvement than the group of
toddlers between 24-36 months, affirming the emphasis on intervention with
infants between the ages of 12-24 months. The findings of this study supports
the research trend emphasizing early diagnosis and treatment for infants with
autism and suggest that early detection of autism can and should, in many cases,
take place around the age of 12 months and be followed by early treatment.
Finally, since diagnosis of the prodrome of autism at this early age is not
clear-cut, but consists of a variable constellation of symptoms, it is
important to bear in mind that focal treatment is ultimately given to the
infant and not to the diagnosis.
83% of the infants treated at the Mifne Center are fully
integrated in mainstream nurseries.                    
How do you reach out to people in order to
raise awareness about autism?
In Israel there is now quite a high level of awareness
about autism. One of our activities is to raise awareness about the possibility
to detect the risk of autism at its very early stages, in order to let parents
know about this window of opportunity. Awareness is raised by the use of the
internet, Facebook, segments on TV and other media outlets. At the same time,
we train pediatricians and therapists to guide parents during the first stages
in order not to miss this crucial time frame. In 2001, The Mifne Center
established a training school for therapists at the Bar Ilan University. This
school trains therapists to work with toddlers and their families in the
Do you cooperate with other institutions or
The Mifne Center is affiliated with the Bar Ilan
University and cooperates with the Tel Aviv Sourasky Medical Center (Ichilov).
When we supervise families and integrate their kids into
mainstream schools, we often work with the educational teams to guide them in
regarding to each child.
We treat families from all over the world including
Palestinian families and professionals from the West Gank and Gaza.
What are the main difficulties that people
with autism have to face?
In the 21st century there is a very high prevalence of
autism, which makes it a well-known phenomenon. It is important to say that the
phenomenon of Asperger’s, which is part of the autism spectrum, is even more
common, and because we live in a world of technology, it has created a measure
of convenience for the Asperger population in the Western world.
However, one of the difficulties of people who are
diagnosed with on the autism spectrum is to understand the environment and be
understood. Autism also has to do with stressful situations which cause people
with Autism to become anxious, for example, background noise or transitions
from language to language, which most people cannot understand.
Do you think that prejudices about autism
still have a strong influence on the social inclusion?
Today quite in a few countries, children with autism are
integrated into regular schools. This has the advantage of giving autistic
children the opportunity to imitate normative behavior, and on the other hand,
gives the opportunity for people to be exposed and get to learn about autism
and not be afraid of it. The result is there is more acceptance of the issue in
most cases. The bottom line is that children with autism in recent years are
not like the severe cases of 20 years ago, and this mainly due to programs that
start treatment at an early age.
Additional information about the Mifne Center, by Dr.
Hanna Alonim.
The Mifne Center, a non-profit organization established
in 1987, is located in Rosh Pinna, Israel. The Center specializes in the
treatment of infants up to age two, diagnosed on the autism spectrum. It is the
first and only such enterprise worldwide, which treats autism in infancy,
encompassing the entire nuclear family, from all over Israel and the world
The Treatment Program focuses on the entire range of the
infant’s developmental components: physical – sensory – motor – emotional –
cognitive aspects through the use of Reciprocal Play Therapy, a method
developed at the Mifne Center to motivate and provide an impetus for the
improvement of the infant’s abilities to engage and communicate with the
environment out of curiosity and pleasure
Family Therapy – Adopting the perception that parents are
actually the main resource of their children and have the ability to promote
their development during the meaningful early infancy stages, the program
encompasses the entire nuclear family. 
The therapeutic approach is holistic and combines medical,
biological-mental, socio-psychological and environmental aspects. Parents are
fully involved and trained regarding the therapeutic processes for their
children in order to sustain and implement them in their daily life
83% of
the infants treated at the Center are fully integrated in mainstream nurseries
The therapeutic staff includes experts from the fields of
medicine, psychology, psychotherapy, family therapy and infant development, who
have been specially trained for work with the Mifne approach
current study 2015 -2017 “Is free exploratory behavior of a novel
environment in pre-walking human infants with ASD and in mice recursive?”
at work in collaboration with the TA University, Prof. Golani
study followed the progress of two groups of infants treated with the Mifne
method. The first group consisted of 39 toddlers aged 2-3 years and the second
group consisted of
45 infants
aged 1-2 years. Durham UK (Alonim et al, 2014
long term Research conducted a retrospective investigation by videos of infants
who were diagnosed on the autism spectrum led to the development of eight
identifying signs for early detection of autism in infants. Israel
(Alonim et al., 2011)
study conducted at the Mifne Center produced significant findings concerning
eating disorders in young children with autism, a disorder typifying this
syndrome which has not yet been officially specified as a diagnostic criterion.
British Academy (Alonim, 2010)
follow-up study conducted at the Mifne Center found that 74.8% of the infants
treated at the Mifne Center in the years 1995-2005, diagnosed with on the
autism spectrum, were functioning within the mainstream education system
(Alonim et al., 2009)
conducted at the Mifne Center by the Schneider hospital points to a significant
statistical improvement in the behavior of the group of children treated at the
Mifne Center between the years 1997-2001. Autism (Apter et al., 2007)
In 2001, the first school for the training of therapists
in the field of autism was established by the Mifne Center in cooperation with
the School of Social Work, the Bar Ilan University. The school trains
therapists to work with toddlers and their families in the community.  The school’s graduates work with children in
the aftercare treatment in the homes of families all over the country
A Center based on the Mifne Method was established in UPK
Basel Switzerland in 2010
Funding for Treatment
The Mifne non-profit Association treats all strata of
population without distinction between families of different religious or
socio-economic means. Funding for Israeli families varies according to criteria
stipulated in the organization’s regulations. 
Mifne is mainly supported by The Mifne Swiss Foundation. Additional
support has been received by The DEAR Foundation, The Rich Foundation, the
Israeli Ministry of Welfare, and Ministry of Immigrant absorption as well as
private funds in Israel and abroad. The Mifne Center is a recognized, certified
public institution for the purpose of contributions