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News new families can use, thank you to the BSRC

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This week an important study was released that provides information that parents can use – particularly parents with a child with autism and another on the way or who is an infant.  This of course comes from the Baby Siblings Research Consortium and makes particular observations about families with 2 or more affected children vs 1 affected child.  They have different rates of autism outcomes and trajectories of behaviors that parents and doctors should be aware of.  In addition a new meta analysis of vitamin supplementation shows that while moderate doses of vitamins may not be harmful, they may not also be helpful.  In other words, talk to your doctor about a nutritional plan and assessment, and save your money for things that are known to work.

https://www.ncbi.nlm.nih.gov/pubmed/31589284

https://www.ncbi.nlm.nih.gov/pubmed/31586029

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Do the rules apply in school?

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This week is focused on what happens in schools, including classification, service receipt and new interventions.  How an educational classification translates to a clinical diagnosis, how and what factors are important in receiving services, what teachers think about repetitive behaviors and finally, a new intervention that can be delivered by therapists in school or mental health settings.  They all have real-life consequences for kids who are receiving services in school.

 

https://www.ncbi.nlm.nih.gov/pubmed/30892948

https://www.ncbi.nlm.nih.gov/pubmed/30848681

https://www.ncbi.nlm.nih.gov/pubmed/30889547

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2727134

 

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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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Super siblings!

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This podcast is dedicated to siblings of people with autism who are typically developing.  They play an important and beneficial role in development of socialization of those with ASD.  But sadly, they also have issues of their own, such as a high rate of issues like anxiety and depression.  Those siblings may be genetic carries of a specific mutation and not have an autism diagnosis, but have increased risk for schizophrenia and cognitive disability.  Finally, just because they are considered “typically developing” doesn’t mean they don’t have challenges with adaptive behavior.  However, they have a very special relationship with their brothers and sisters, and the world needs these strong advocates for the community.

 

https://www.ncbi.nlm.nih.gov/pubmed/30280363

https://www.ncbi.nlm.nih.gov/pubmed/30248583

https://onlinelibrary.wiley.com/doi/full/10.1111/jcpp.12985

Click to access s41436-018-0266-3.pdf

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Quality vs. Quantity in an autism diagnosis

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In the fight to ensure everyone with autism is detected and diagnosed as early as possible, community providers are sometimes pushed to the limit in what they can do.  They have a huge caseload and there are long waitlists.  So how accurate are autism diagnoses given by these providers with little time and little resources for training?  As it turns out, they are just okay.  Approximately 23% of those diagnosed by community providers were not diagnosed using standardized and validated autism tools.  How can we weigh this potential over and mis-diagnosis with the potential for missing individuals with autism and depriving them of interventions and services?  That’s a topic for another discussion.  However, one question on the cause of autism was addressed and a theory debunked:  autism is not caused by caesarean section deliveries altering the microbiome, and then leading to ASD.  The microbiome may be involved, but not because of method of delivery and use of antibiotic medications.

https://www.ncbi.nlm.nih.gov/pubmed/30270970

https://www.ncbi.nlm.nih.gov/pubmed/30273187

 

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What is autism? It’s changing.

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This week, the Autism and Developmental Disabilities Network, or ADDM, was used to look at the changes across time in co-occuring conditions in people with autism, like ADHD, depression, anxiety, language delay and other developmental delay.  They found the frequency of 8 year olds with autism with these co occurring conditions is increasing.  So is the percent of people with autism with intellectual disability.  The data continues to show that in many people, what was autism 20 years ago, is not the same autism seen today.  While depression and anxiety have already been established as co occurring issues, things like hoarding are just starting to be examined.   These results suggest that co-occurring conditions may be one of the features of autism that can separate people into different groups, to improve intervention and treatment opportunities.

https://www.ncbi.nlm.nih.gov/pubmed/30227350

https://www.ncbi.nlm.nih.gov/pubmed/30178724

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Autism diagnosed in school age, and does early intervention make a difference?

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Thanks to a Facebook follower, this week’s podcast highlights a new systematic review on Early Intense Behavioral Intervention. This systematic review, however, is not different from one published 5 years ago, because the nature of early interventions have changed so much that they no longer fit into the same criteria. While the rankings are disappointing, the findings do not reflect the ways in which newer interventions are being selected, delivered and studied. Also, we always hear about early diagnosis helping with early intervention. But what about kids who are not diagnosed until they reach school age? They have a different profile of ASD and may be a different subgroup of autism altogether.

https://www.ncbi.nlm.nih.gov/pubmed/29742275

https://www.ncbi.nlm.nih.gov/pubmed/29852752

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A sampling of science from the International Meeting of Autism Research

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In case you didn’t have time to jump on a plane and fly to the Netherlands last week for the International Society of Autism Research meeting, this week’s podcast is a short summary of just a few of the presentations.  There was more of an emphasis on what has been called “real life” research questions like employment, quality of life, and relationships.  As a result, some of the more basic science questions around autism are now being presented at other meetings.  This is a shame.   This podcast follows some of those basic science questions to the now translational opportunities that were presented at the meeting.  It also highlights some newer findings that will provide help to people at all ages who need supports and services.

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Through the years

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Rarely can individuals with autism be studied more than once – but a new study tracks how cognitive and adaptive behavior changes over time.  What researchers in the British Autism of Infant Siblings, or BASIS found, was that family history of autism meant as much to cognitive and adaptive behavior than an actual autism diagnosis.  This calls for close monitoring of siblings of those with autism, regardless of whether or not they had a diagnosis.  Also, investigating psychiatric issues in children may underestimate their prevalence because many psychiatric issues do not emerge until the teenage years, so Kaiser Permanente looked at medical and health records of those with autism at 14-25 years to see what other issues they were facing, and the findings are both sobering yet maybe a little comforting.

Please watch the UN WAAD event here:

https://www.youtube.com/watch?v=Tyhm7p8Gr2A&t=7943s 

The two studies mentioned in the podcast are:

https://www.ncbi.nlm.nih.gov/pubmed/29616486

https://www.ncbi.nlm.nih.gov/pubmed/29610415 

 

 

 

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An ode to rats as animal models for autism

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This week, the lab of Dr. Jill Silverman at UC Davis published a study that showed the most similar types of social communication deficits in an animal model.  Her group, led by Elizabeth Berg, used a rat model, rather than a mouse, because rats exhibit both receptive and expressive communication.  Through a collaboration within the UC Davis MIND Institute and Mount Sinai School of Medicine, she tested an animal model of autism that shows a lack of expression of SHANK3.  SHANK3 mutations are seen in those with Phelan-McDermid Syndrome as well as in 1% of people with autism.  This new study opens up new ways to understand autism symptoms in an animal model, and moves autism research using animals forward significantly.   The references mentioned in the podcast are:

 

https://www.ncbi.nlm.nih.gov/pubmed/29377611

https://www.ncbi.nlm.nih.gov/pubmed/29126394

https://www.ncbi.nlm.nih.gov/pubmed/27189882