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 community.
Do you cooperate with other institutions or schools?
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.
•        A 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.
•        A 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 of45infants aged 1-2 years. Durham UK (Alonim et al, 2014 .(
•        A 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 Pediatrics(Alonim et al., 2011).
•        A 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).
•        A 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).
•        Research 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.