Resources and Services for Adolescents and Young Adults

Thank you to Sonia Agarwal, smart, efficient and eloquent ASF summer intern for putting together a summary of resources and services and rights for adolescents and young adults with autism, focusing on those who are not intellectually disabled.  They include resources for transitioning into college and support programs at college, with tips and hints along the way.  Sonia has a younger brother with autism and is committed to helping families access the help they need.

The Benefits of Being and Older Father

Advanced paternal age is one of the more replicated risk factors for autism – but maybe not autism as it as seen as a disorder.  Recent studies by Mount Sinai School of Medicine and Kings College of London show in both animal models and in epidemiological studies that advanced age in fathers is associated with the “active but odd” phenotype and PDD NOS.  In people, older (but not “old”) age in fathers led to increased IQ and social aloofness that led to higher academic achievement.  Is this autism?  Or just a subtype of autism where the outcomes are adaptive rather than maladaptive?  There are lots of questions about the nature of autism in these findings.

From Early Detection to Early Intervention

This month, two new important research findings were published from scientists that study the very earliest signs and symptoms of autism.  First, Dr. Suzanne Macari at Yale showed that a type of temperament in toddlers was associated with autism at about 3 years of age.  This may be used in the future to develop specialized interventions very very early on.  Meanwhile, Dr. Jessica Brian’s group in Canada used the very early signs of autism – social orienting – to develop a new intervention called the Social ABC’s which they piloted last year.  Last week, a randomized clinical trial of this intervention showed improvements in social smiling, reactions to parents, and social orienting, suggesting it is a feasible and valid intervention option.  There is now a list of these interventions that have been rigorously tested.  This demonstrates that the early detection of features of autism, like temperament, can be turned into interventions to improve the outcome of toddlers with ASD.

Hip hip hooray for toddler interventions for autism

As always, good news and bad news in autism this week.  First the good news:  an intervention given between 9-14 months of age in children with a high probability of having an autism diagnosis improved autism symptoms at 3 years of age.  Now the bad:  mothers who experience severe childhood abuse are more likely to have a child with an autism diagnosis.  Why?  A new study explains it might have a lot to do with autism traits in the parents.  We would love to hear your thoughts on the results, please provide them in the comment section.

A new clue to autism found in fluid in the brain

Last week, another Baby Siblings Research Consortium Project (BSRC) published an intriguing finding which also has the bonus of being a replication.  Mark Shen, PhD, from the University of North Carolina at Chapel Hill found higher levels of extra axial fluid in the brains of infants who went on to later be diagnosed with autism, and even higher levels in those with severe autism symptoms.  Extra-axial fluid is also called cerebrospinal fluid, the fluid that holds the brain steady in your head.  Other functions of extra-axial fluid and what this means on how it may contribute to autism risk are described in the podcast.  He not only explains the findings, but conveys what families should know about them and how they can help with early identification of ASD.

When can you see autism in the brain?

This week the Infant Brain Imaging Study, or IBIS, published it’s 2nd study on the emergence of changes in the brains of individuals with autism.  While red flags for autism can be seen early, a diagnosis of autism is not typically made until after 24 months of age. Using a baby sibling research design, scientists showed increases in the size of certain areas of the brain between 6-12 months.  This opens up opportunities for even earlier diagnosis of ASD in the future.   Also, a group at Stanford shows the emergence and disappearance of co-morbid symptoms in autism, such as epilepsy, schizophrenia and ADHD, which are dependent on sex and age.  Together, these studies show that autism begins very very early and symptoms and behavioral and biological features change over time.

Betsy DeVos, autism screening and testosterone – in that order

This week two studies which examined infants and younger children that will significantly advance understanding of causes and services for people with autism were published.  After a commentary about the confirmation of Betsy DeVos, the study that used a practical methodology to improve autism screening in pediatrics clinic from researchers at Duke University was presented.  After that, some early results from the EARLI study  which examined pregnancies in families where an older sibling was diagnosed was presented.  In this study, Bo Park and her colleagues at Drexel University, Johns Hopkins University, University of California at Davis and Kaiser Permanente show that testosterone levels in pregnancy aren’t related to later autism symptoms unless the older sibling affected is a girl.  These findings can illustrate why girls are less likely to be diagnosed with autism compared to boys.  The study is open access and can be downloaded here, thanks to the journal Molecular Autism:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5282802/pdf/13229_2017_Article_118.pdf

 

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Why is it so hard to look them in the eye?

There is an ongoing debate about why people with autism avoid eye contact.  There is data to support both, but as this behavior emerges very early, it’s important to look at data from preverbal children to understand the origins of changes in eye contact.  Many scientists also feel that avoiding eye contact snowballs over the lifespan and deprives people with autism from developing social skills.  Infants don’t even know why they avoid eye contact so at the Marcus Autism Center in Atlanta, researchers are using eye tracking technology to answer this question.  The findings have clear implications for early intervention strategies.

A focus on the siblings of people with ASD

Two studies recently add to an ever growing literature around undiagnosed siblings of individuals with autism.  While in autism features there is evidence of the “broader autism phenotype” in female siblings, there is no evidence of elevated sensory symptoms in those with a brother or system with autism.  The more we understand about the psychological and psychiatric features of siblings with autism, the more they can be supported to deal not only with their siblings challenges, but with theirs as well.

Parents are interventionists too

Parent training has a number of important uses in autism.  For toddlers, parents help provide intervention strategies in a number of settings allowing skills to be generalized.  In adolescence, parents can help implement behavioral rules that can manage non-compliant behaviors, aggressive, disruptive or impulsive behaviors.  This week, research investigated the role of parent training plus and ADHD medication for ADHD symptoms in autism and the results are promising.  Finally, a review of the new NIH funding in understanding the causes of autism is reviewed.  You can also read this review at the ASF blogsite.