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Psychiatric decompensation and autism: Two words you never want to hear together

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A series of three scientific articles explore the link between the onset of psychiatric symptoms in adolescence in people with Phelan McDermid Syndrome, or PMS.  PMS is caused by a mutation in the SHANK3 gene, leading to a wide range of medical, behavioral and intellectual challenges, as well as autism spectrum disorder.  Scientists used a broad literature review as well as the PMS patient registry to better describe what was going on, and a group at Duke compiled a case series of girls affected that were responsive to treatment.  While so far this decompensation as a result of onset of psychiatric illness has only been documented in PMS, families across the spectrum should be aware so they can seek immediate help for their child if they see similar symptoms.

https://www.ncbi.nlm.nih.gov/pubmed/32050889

https://www.ncbi.nlm.nih.gov/pubmed/31879555

https://www.ncbi.nlm.nih.gov/pubmed/32015180

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“ASADHD” – where does ASD and ADHD join together, and go their separate ways?

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One the surface, symptoms of ADHD and ASD may seem very similar.  However, they come from very different places.  The genetic and behavioral makeup may be on the same spectrum across the two disorders, but they are actually farther apart than you might think.  Dr. Meghan Miller from UC Davis MIND Institute who studies both ADHD and ASD and people with ADHD and ASD explains what those differences and similarities are, how to make the right diagnosis, and what’s on the horizon for treatments for ADHD in people with ASD.

 

https://www.ncbi.nlm.nih.gov/pubmed/31974800

https://www.ncbi.nlm.nih.gov/pubmed/30535156

https://www.ncbi.nlm.nih.gov/pubmed/30658861

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This one’s for the girls

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In this week’s podcast, I semi-plagiarize from a recent summary of sex differences in ASD, written by Drs. Meng-Chuan Lai and Peter Szatmari from the University of Toronto.  They delve into why more males are diagnosed with females, and differences in the presentation of those features of ASD that differ between males and females.  These include camouflaging, differences in language style, differences based on behaviors determined by sex, and associated features like anxiety and internalizing behaviors.  Thank you to the authors for putting together the information in a way that makes sense.

https://www.ncbi.nlm.nih.gov/pubmed/31815760

https://www.ncbi.nlm.nih.gov/pubmed/30962869

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CBT and ADDM – two acronyms in the autism news

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Two studies missed last year (sorry) but are of importance to the autism community include a modified version of Cognitive Behavioral Therapy to treat anxiety, which was adapted and updated for people with ASD.  It also works better than traditional CBT, which is good news for  the 80% of people with ASD that also suffer from anxiety.  Also, in recognition of MLK day today, the CDC released information last year that shows that 1/4 of those that they counted in their prevalence numbers were missed by schools or other health care providers.  Unfortunately, those who were black or hispanic were more likely to be those that were missed but still met criteria.  This just shows that educators have to do better in helping those with ASD from all racial and ethnic backgrounds.

https://www.ncbi.nlm.nih.gov/pubmed/31868321

https://www.ncbi.nlm.nih.gov/pubmed/31755906

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#thisisanautismmentalhealthcrisis

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Mental health disorders are a serious problem across the lifespan in people with autism.  This has been shown by over 2 decades of research and further proven by a new meta analysis and a systematic review of the last 25 years of data.  What is the result of these mental health disorder co-morbidities?  Many times, these mental health disorders trigger a crisis situation: the police are called, someone goes to the hospital, may end up hospitalized, and family members are traumatized.  This week’s podcast summarizes the evidence and provides recommendations from scientists to help those with autism and possibly prevent crises from occurring.

https://www.ncbi.nlm.nih.gov/pubmed/31447415 

https://www.ncbi.nlm.nih.gov/pubmed/31652032

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The Pros of Prozac and the Placebo Effect

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Two of the largest randomized control trials of Prozac as an intervention for restrictive and repetitive behaviors were published recently.  They both coincidentally found no effect on the core features of autism, nor clinician rated improvement.  What they did find is a big placebo effect.  That is the behaviors of the participants changed even if they thought they might be getting the medication, but were actually getting an empty pill.  This is a big problem in research in studying medications across mental health.  So why is Prozac so popular?  And when it comes to some features of autism, is the placebo effect so bad?

https://www.ncbi.nlm.nih.gov/pubmed/31638682 

https://www.ncbi.nlm.nih.gov/pubmed/31267292

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Where superior ability crosses disability in ASD

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A study conducted by researchers at Yale this week revealed that while people with autism have disabilities in reading individual emotions, they have an unexpected amazing ability to understand and apply social rules to groups of people.  They understand social phenomena much better than those without. So how can this be?  Also, a new groundbreaking study shows scientists that there are changes in brain activity that are observed way before a diagnosis, which can change early detection and early intervention of ASD.

http://www.pnas.org/cgi/pmidlookup?view=long&pmid=31501348

https://www.ncbi.nlm.nih.gov/pubmed/31519897

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How to get and keep a job – from those that know

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There are many different factors that go into successful employment for people with and without autism.  As part of the ASF policy brief on employment, the US, Australia and Sweden held meetings with autistic adults, family members and employers and asked “what are the issues in your words”?  Then they were mapped onto areas of functioning, not ability or disability.  One thing that stands out is “matching interests and skills to job requirements”.  This is important, but a complicated issue.  This week’s podcast reviews what autistic people say, how it maps onto functioning and why we need to be careful about taking a one – sided approach to autism.

https://www.ncbi.nlm.nih.gov/pubmed/31276308

https://www.ncbi.nlm.nih.gov/pubmed/31177369

 

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Happy Pride all!

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This week’s podcast is dedicated to the “T” in LGBTQ –  trans.  Several studies over the past few years have linked higher rates of gender variance in people with autism and higher rates of autism traits in those who are trans.  Why?  Are they biologically or psychologically linked or both?  This is important for understanding, not treatment or intervention.  This week’s podcast celebrates trans people who are also autistic.

https://www.ncbi.nlm.nih.gov/pubmed/30547258

https://www.ncbi.nlm.nih.gov/pubmed/29752630

https://www.ncbi.nlm.nih.gov/pubmed/30920347

https://www.ncbi.nlm.nih.gov/pubmed/23864402

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Getting Autistic People to Work

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This week’s podcast is dedicated to the recently released INSAR – supported employment policy brief.  This was a 2 year project by ASF, Stony Brook, University, Karolinska Institute in Sweden and Curtin University in Australia to provide a cross-cultural perspective on getting autistic people who want to work, employed, and stay employed.  Thank you to all the participants in the surveys, community meetings, and GoldNFish for putting together a document that is not just informative, but fun to read.

 

Click to access 2018-insar_policy_brief.pdf

Work and study