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The extra benefit of caregiver mediated interventions

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This week, a new systematic review published by researchers at Virginia Polytechnic Institute looked at the existing evidence around caregiver (parent) mediated interventions and not child outcome, but family relationships and dynamics. While it isn’t the focus on the intervention, what effect does allowing parents to be involved and empowered on their child’s support on the wider family?  The answer is, it does help, although not all interventions are the same.  Also, a new video tool from collaborators at Washington University and the UC Davis MIND Institute to help parents identify early signs and symptoms in their own children was validated, which is exciting but more work needs to be done.

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The good and evil sides of technology use by autistics

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This year’s Day of Learning included two presentations on the use of technology among people with autism.  As it turns out, technology can be great.  In fact, a new study using Google Glass shows promise in improving socialization.  On the other hand, sometimes technology can have a downside.  People with autism spend more time than typical peers on their iPads, iPhones and other devices.  What could be wrong with that?  Well, problematic internet use is linked to autistic traits and to suicidality.  This link is NOT a clear line and obviously causes of suicide are multifactorial.  However, new data demonstrate that obsessive internet use is not making things better for people with ASD.

 

https://www.ncbi.nlm.nih.gov/pubmed/30934756

https://www.ncbi.nlm.nih.gov/pubmed/30908423

https://www.ncbi.nlm.nih.gov/pubmed/30907929

 

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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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Children are not small adults

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Cathy Lord and her colleagues have been studying a group of people with autism from age 2, all the way through adulthood, at age 19.  Her colleague and first author Vanessa Hus-Bal who is leading the efforts to study adults at a new institute at Rutgers University, talks about the findings and what they mean for people with autism as they get older, and points out the implications on intervention.  Also, the stress response is different in autistic people, but is it different in adolescents and adults, and does it change as people get older?  A social stressor is used to identify how they are different and what it means for treatment.

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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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If you want to know about people with autism, ask them

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There are relatively few studies using self-report findings on standardized measures from people with autism.  Part of the reason for this is because there aren’t that many of these instruments to begin with.   Scientists are working on that.  But this week, a group from the UK took the existing data from smaller studies using the the Ritvo Autism Asperger Diagnostic Scale (which can be found here:  https://www.aspietests.org/raads/) to look at sex differences.  They found subtle differences between males and females on their language and sensorimotor features.  This indicates males and females experience autism slightly differently.   In addition, a different study interviewed people with autism at different ages to ask how symptoms changed over time and found that features of autism peaked in middle adulthood.  However, close family members, friends or caregivers didn’t always see it that way themselves.  This reiterates the need to collect information from multiple people – including people with autism – to provide better services and supports.

https://www.ncbi.nlm.nih.gov/pubmed/29796237

https://www.ncbi.nlm.nih.gov/pubmed/29971654

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Loss of skills in autism partially explained

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Is regression a sudden loss of previously acquired skills or is it the gradual decline in a particular area of function?  Using the right tools, both parents and clinicians can document the gaining and loss of skills in different areas, and they agree on what they see.  However, rather than being a single event, regression is slow, starting at around 12 months and showing continual declines through diagnosis.  Thanks to an NIMH day long symposium on the biological causes of regression, scientists got together to discuss this loss of skills on a biological level.  They think that the decline or loss of skills is due to biological events that disrupt the formation of specific brain circuits at critical times in development.  This can be because neurons stop developing, or maybe the brain goes overboard in shaping and pruning back connections.  If you want to see the amazing full day of presentations that aired in 2016, click here:  https://videocast.nih.gov/Summary.asp?file=19500&bhcp=1.  A link to the Ozonoff study described in the podcast is here:  https://www.ncbi.nlm.nih.gov/pubmed/29524310

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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

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Supporting the support staff, at least a first step

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Paid support staff are critical to helping individuals at all ages with autism.  Unfortunately, they are mostly poorly paid, and exhibit high levels of burnout.  What psychological constructs are most important, and can they be targeted for services to help provide better services for those with ASD?  As it turns out, more important than preventing burnout is building up psychological capital, which helps deal with the effects of burnout.  In addition, a new important feature of autism has been identified: intolerance to uncertainty.  Previously linked to ASD through anxiety, now it is shown to have direct connections to ASD diagnosis and symptomatology.  Is this a new core feature?

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Genes: the beginnings of autism treatment targets

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This week’s podcast focuses on two studies that help illustrate why studying individuals with a specific genetic mutation, or animal models with a particular genetic mutation, are so important.  MSSM researchers focused on individuals with FOXP1 Syndrome, which has a high rate of autism and could be the focus of future treatments.  In the meantime, researchers at UTSW, led by ASF fellow Christine Ochoa Escamilla, identified a particular brain chemical responsible for changes in brain activity following mutations of chromosome 16.  About 1% of people with autism have mutations in this chromosome.  Application of a chemical to counteract this chemical then led to improvements in brain activity, opening up the door to new drug targets that affect some of the more severely affected individuals with ASD.

 

Here are the references:  https://www.ncbi.nlm.nih.gov/pubmed/29088697

https://molecularautism.biomedcentral.com/articles/10.1186/s13229-017-0172-6