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.

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.

A scary halloween story about the media misrepresenting science

How long do you have to study an intervention to see if it works?  Many scientists agree that it isn’t just about what happens in the short run, but if those interventions can be sustained for long periods of time.  In the case of very early interventions, it is now clear that treatment for about a year can change the trajectory of symptoms so those improvements are sustained, maintained or lead to even further improvements for 6 years after the initial intervention has stopped.  This important finding was hidden by the BBC getting the headline wrong and hiding the true value of the research at the end of the story.  This week’s podcast outlines the contribution of parent-implemented intervention and research studying autism even before symptoms emerge in improving trajectories rather than just immediate outcomes.  Happy Halloween!

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.

What came first? Impaired social behaviors or something else that changes social behavior?

This week is a more philosophical, ideological discussion of the origins of social behaviors inspired by review articles written by Mayada Elsabbagh at McGill University and Boaz Barak and Guoping Feng at MIT. The focus of these papers are: when social behaviors emerge, and what brain regions are responsible for their existence. While Dr. Elsabbagh thinks of the question in terms of when behaviors and symptoms emerge in infancy, Drs. Barak and Feng consider the issue by comparing autism to Williams Syndrome. Williams Syndrome is very similar to autism except people with WS are hyper social and empathetic and sometimes gregarious. One tiny change on one area of one gene makes all the difference. This podcast doesn’t settle the question, but hopefully shows you listeners why there is a debate and how it is important for people with autism.

Treatments for social reward in autism: inject it, snort it, or possibly smoke it.

This week saw two new studies on the “love hormone” called oxytocin.  In the first, the IV drip for oxytocin is replaced by a nasal spray.  The results are mild and focused on one type of symptom, but exciting and promising nonetheless.  The second study investigated how oxytocin works in the brain and shows how it interacts with a chemical called anandamide in a region activated by sex, drugs and food.  This may explain why people find social reward pleasurable.  It lays the groundwork for other compounds which may enhance social reward, but more studies are needed.   Finally, a short recap last week’s podcast where High Risk Baby Siblings researchers are finding that the range of possible issues that kids at risk have isn’t focused just on autism symptoms.