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When it comes to intervention, earlier is better

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This week, we talk to Whitney Guthrie from Children’s Hospital of Philadelphia who spent the last 6 years conducting the gold-standard randomized control trial that demonstrates intervention for social communication skills at 18 months shows greater effects than intervention starting at 27 months. If you wanted evidence that earlier is better, here it is! Interventions and supports are important at any age, but the critical window of development between 18-27 months is particularly important for long term development.

https://pubmed.ncbi.nlm.nih.gov/36922406/

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Can we solve the pandemic problems around diagnosis and intervention?

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This week’s #ASFpodcast highlights a few articles from the Journal of Autism and Developmental Disorders this week which examined the tolerability and efficacy of online diagnostic procedures and interventions, from the perspective of both parents and clinicians. They seem to work about the same, although there were some caveats. For many reasons, online and telehealth options are here to stay, and more needs to be done to improve their accuracy, acceptability, feasibility and effectiveness. These early studies are promising though, and lead the way to even more improvements to help make them a viable option for families in the future.

https://link.springer.com/article/10.1007/s10803-022-05435-z

https://link.springer.com/article/10.1007/s10803-022-05576-1

https://link.springer.com/article/10.1007/s10803-022-05554-7

https://link.springer.com/article/10.1007/s10803-022-05580-5https://link.springer.com/article/10.1007/s10803-022-05607-x

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The meaningful impact of clinical trials

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Clinical trials in autism are so incredibly important to families and adults, but sometimes hard to understand. Why? How can it help me or my family? What do I need to do? What do all of these terms mean? For researchers: it’s hard to get families to participate in my study. What can I do to improve the appeal? Caroline Averius and Zachary Williams explain in this podcast about a newly launched two new guidebooks designed to help explain clinical trials, why they are important and what needs to be shared with the community to ensure transparency.

Want to read them? Links below:

https://tinyurl.com/AutismTrialsGuidebook

https://tinyurl.com/AutismTrialsExplainer

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Psychedelics and Symptoms

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More and more, psychiatrists are looking to psychedelic medication to help individuals who are resistant to other types of therapies. These include seizures, PTSD and depression. But can they help individuals with autism or ease autism-related problems or improve cognition? Two new studies on cannabis and one on ketamine are summarized in this week’s ASFpodcast. Promising, interesting, but not definitive. It’s a short podcast this week.

https://pubmed.ncbi.nlm.nih.gov/36085294/

https://pubmed.ncbi.nlm.nih.gov/35617670/

https://www.sciencedirect.com/science/article/pii/S2666247722000549?via%3Dihub

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Parents! Parents! Parents!

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Parents are now used as intervention partners through a design called parent-mediated intervention. It started to be studied before the pandemic but has now become a necessity. Does it work? Should it always work for everything? How long should the intervention last and how often? These are all questions of interest, and while research is still early, parents can be amazing partners in intervention especially below age 5. The provide opportunities for learning and communication, and they can utilize more hours during the day at home than traditional in-clinic services can. Of course not every family is the same and may not have the same abilities to learn the intervention, and in the future more of these contextual factors need to be studied. But for now, three cheers for parents helping their kids!

https://pubmed.ncbi.nlm.nih.gov/34867556/

https://pubmed.ncbi.nlm.nih.gov/35037520/

https://pubmed.ncbi.nlm.nih.gov/35040001/

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All about ABA

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The practice of ABA, or applied behavioral analysis, can be easily misunderstood. Rather than a single procedure, ABA is a variety of techniques that can be applied to different situations to improve communication, reduce aggression, and improve the quality of life of people on the spectrum. Why is it getting a bad reputation? Is the ABA of today the same as it was in the 1960’s? And what benefits does the techniques and principles of ABA confer to those on the spectrum? Listen to today’s #ASFpodcast which also includes footage from Melanie Pellecchia’s Day of Learning presentation.

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Here’s what you won’t hear about that new JAMA study on Twitter

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A couple of weeks ago, a group in Australia published a study that investigated the efficacy of a “preemptive” intervention. That is, what happens if you provide support to parents to improve social communication, interaction and skills in infants before a diagnosis can be made? The results have a lot of meaningful implications of what interventions are possible at this age, how they can be delivered, and what it means to NOT receive an autism diagnosis but still show challenges. But the Twitter hive didn’t perceive it that way. This week I explain what the study did and didn’t do, and how it can help people across the spectrum.

Open access here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8453361/

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From being high to being aggressive

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There are many many potential factors that influence a diagnosis of ASD that have been underexplored, and recreational drugs are one of them. Of course it would never explain all the cases of ASD, not one singular thing does, but does cannabis consumption during pregnancy lead to an increased probability of having a child with ASD? As it turns out, yes, a small increase, meaning it isn’t the only thing causing ASD but: JUST SAY NO if you are pregnant. On the other end of the spectrum is aggression, a completely horrible feature of some people with ASD. About 30% of people who are aggressive and have an ASD diagnosis are not responsive to any medications or therapies, which is horrifying. Researchers in Canada and Brazil have studied the brains of this group, with what is called “refractory aggression” to try to get to the mechanism.

https://pubmed.ncbi.nlm.nih.gov/32778828/

https://pubmed.ncbi.nlm.nih.gov/32762791/

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Autistic Adults Advise and Advance Research

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Have you ever heard of an initiative called “Autistic Adults and other Stakeholders Engaged Together”? If you have, you know their goal is to ensure that autistic perspectives are included in future scientific research. They recently published an article that summarized the research that autistic people feel is critical, and what is missing, and what needs to be done. They concluded most of the research done so far is applicable to males without intellectual disability. That needs to change. Speaking of adults, how many adults are autistic? Is it 5 million? Maybe, maybe not, but it is still unclear even after a recent publication. Listen to hear more.

To learn more about AASET click here

https://www.ncbi.nlm.nih.gov/pubmed/32390461

https://link.springer.com/content/pdf/10.1007/s10803-020-04494-4.pdf

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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