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Infant motor issues and later autism diagnosis

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Everyone knows the way to study infants with autism is through thorough testing of younger siblings of those with a diagnosis, who have a 15x greater chance of have a diagnosis themselves.   Through these methods, new ways of identifying and predicting autism  later on have been developed.  On this week’s podcast:   two very influential and recent papers on the study of motor issues in 6 month olds who go on to be diagnosed with autism, and those  who don’t have an autism diagnosis but have signs and symptoms of ASD.  Are motor issues related to an ASD diagnosis or ASD symptoms?  And what about core symptoms of autism like language?   Can early motor behaviors be used to predict who goes on to receive an autism diagnosis or has language problems?  What should parents do?  How should this influence an early intervention plan?  Learn more this week!

 

https://www.ncbi.nlm.nih.gov/pubmed/30628809

https://www.ncbi.nlm.nih.gov/pubmed/30557704

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Genes and Environment, Genes and Environment. Go together like aging and retirement.

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Twins with autism, where either one or both is diagnosed, is crucial to understand the role of genetics and the environment to both autism diagnoses and now, autism traits.  In a study this week, researchers using data from the California Twins Study examined the genetic and environmental influences of brain development in multiple regions and measures.  While estimates of genetic and environmental influences can only be modeled in twins, they can be experimentally tested in animal models.  Researchers at the University of Washington investigate what causes the link between air pollution in humans and autism by studying diesel fuel exhaust in pregnant mice.  Finally, across all of these disparate animal studies – does anything pull them together.  Are these models all one-offs or do they have anything in common?  It turns out disruption in normal brain activity is one thing that they have in common, and something that is at the common core of ASD neurobiology.

 

https://www.ncbi.nlm.nih.gov/pubmed/30659287

https://www.ncbi.nlm.nih.gov/pubmed/30668980

https://www.ncbi.nlm.nih.gov/pubmed/30679017

 

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The latest on complementary and alternative medicines

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Even though many parents of kids with autism and  autistic adults are using cannabis (THC and CBD) and cannabidiols (CBD only), these treatments are technically illegal.  So how are pediatricians discussing these options with their patients when asked?  A few pediatricians from states where it is legal for adults to obtain cannabis containing products weigh in on what they say, how they communicate, and what is ethical to explain in what circumstance.  Also, new findings from an imperfect, but medically supervised, study on stem cell therapies in autism.  Findings are interesting but should be judged with caution.  Links to the articles are below:

https://www.ncbi.nlm.nih.gov/pubmed/30610100

https://www.ncbi.nlm.nih.gov/pubmed/30620122

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Understanding the hard to research

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What do Princess Kate and Amy Schumer have in common, and what does it have to do with autism?  The answer:  Hyperemesis Gravidum.  It’s linked to autism, but not strongly, but it does show more evidence of significant overlap between many neuropsychiatric issues and disorders.

More importantly though, those with low verbal ability and low cognitive function are harder to study than most people with autism.  Two new research studies documented what they had to do to make studies in this population possible, and how this group was different from those with average IQ and some words.  One looked at brain structure, and the other was a treatment for minimally verbal girls with autism.

The HG study:  https://www.ncbi.nlm.nih.gov/pubmed/30594672

The minimally verbal girls study https://www.ncbi.nlm.nih.gov/pubmed/30607780 

The imaging study:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307191/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6307191/

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The 2018 Year in Review: A spectrum within a spectrum

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There were a number of exciting advances in scientific understanding autism in 2018.  These include things that we know to be true, and know to be not true.  Researchers made progress in identifying subgroups of ASD, defining biological markers, and developing  interventions. There were also research that demonstrates that while autism is a spectrum itself, it is also part of a bigger spectrum of neurodevelopmental disorders from anxiety to ADHD to OCD.  Therefore, the approaches to these other conditions may be applicable to ASD. In addition, there may be more similarities than differences in the biological features of these conditions.

This is just a sampling of the exciting research presented on this year’s Year in Review.  You can also read the full summary, complete with references, HERE.

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Nobody puts babies in a corner

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Nobody can dispute that research to better understand autistic adolescents and adults is lacking.  However, scientists continue to make important scientific discoveries in infants and toddlers with autism.  These infants and toddlers eventually become adolescents and adults, so identifying critical periods of brain development that influences behavior, what to say to parents and when, and how to  engage the entire community to better serve infants and toddlers is still needed.  This week is an update on the activities of the Baby Siblings Research Consortium (BSRC), including a paper that ties in activity of different brain regions at 1 year olds, to stereotyped behaviors and insistence on sameness in 2 year olds.  The research of the BSRC is directly applicable to families affected by autism at all ages.

 

https://www.ncbi.nlm.nih.gov/pubmed/30446435

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Lordy Lordy it’s One in Forty

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This week’s headlines were focused on the new prevalence numbers of 1:40.  They were not calculated using the same method as the 1:59 number, so should not be  compared.  In addition to looking at just prevalence, this survey identified a major problem for families, which is unmet mental health needs.  Those with autism have higher unmet mental health needs than those with  ADHD, anxiety or depression.  Again, there is something unique about an autism diagnosis which poses a challenge to accessing care.  In addition, a new summary paper outlined what needs to be done to better study  regression in autism.  The rate may be higher than you think if a new definition of regression is used.

 

https://www.ncbi.nlm.nih.gov/pubmed/30478241

https://www.ncbi.nlm.nih.gov/pubmed/30475449

 

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Scientists know in their gut how the GI symptoms are linked to autism

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People with autism have higher levels of GI problems then people without a diagnosis, and the microbiome is associated with GI function, so is the microbiome linked to autism?  Some studies say yes, but this week studies in China look at non-caucasian people eating different diet.  Do the differences still hold?  Also, while GI  symptoms have been studied in relation to core autism features, they have not yet been linked to psychiatric issues like anxiety, ADHD, and aggression.  Until now.  This week’s podcast features three new studies looking GI issues and the causes of those issues, in kids with autism.

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6204460/

https://www.ncbi.nlm.nih.gov/pubmed/30394313

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6143520/

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The average age of diagnosis depends on where, when, and how you ask

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While autism can be diagnosed reliably by 2 years of age, some people with autism don’t receive a formal diagnosis until much later.  Why not?  Racial and ethnic disparities as well as access to care issues are known factors.  This week, data from Denmark suggested that the diagnostic criteria has played a large role in prevalence in people with autism since 1980.  Many people who have autism may have been missed until they were older.  It suggests that older prevalence estimates were missing a proportion of autistic adolescents and adults.  Take away access and diagnostic barriers to a diagnosis, some kids followed from months of age in the baby siblings research consortium don’t receive a diagnosis at age 2, but do at age 5.  They always had autism, but their symptoms were sub-threshold for a formal diagnosis until age 5.

 

https://www.ncbi.nlm.nih.gov/pubmed/30398592 

https://www.ncbi.nlm.nih.gov/pubmed/30392626