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The ASF Year End Review of Science

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Just three days before 2024, ASF provides a summary of the the highlights of scientific discoveries and how they have translated into tools families can use. They include ways to speed up diagnosis and reduce waitlists, study of the brains in females and clinical recommendations for helping autistic females at birth, evidence of better practices around intervention and supports, and a review of the numbers of people who have a diagnosis. It isn’t comprehensive and if something was missed, our apologies, but the summary is 20 minutes.

You can read the text here: https://autismsciencefoundation.org/2023-year-end-review/

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One in 36 and what it predicts

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The CDC released data from the Autism and Developmental Disabilities Monitoring Network (ADDM) on Thursday. In the past 2 years, the prevalence of autism has increased about 20%. Why? Are there more new cases or is diagnostic practices improving? For 20 years there has been fewer Black and Hispanic kids diagnosed. Is that still the case? Listen to this week’s #ASFpodcast to hear some early thoughts, the CDC will join us for an interview on April 20th:

https://www.cdc.gov/mmwr/volumes/72/ss/ss7202a1.htm

https://www.cdc.gov/ncbddd/autism/data.html

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Parents describe the “best things” about their kids with ASD

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Parents may see challenges in their kids with ASD, but they also know what is great about them and the unique gifts they bring to the world. Now, researchers from Canada have inventoried and categorized these list of great qualities in a large study of children from 3-10 years of age. These “best things” identified and counted across ages should also be used when planning how to transition kids with ASD from EI or preschool into kindergarten. Another study included this week from Curtin University in Australia describes how parents see this process becoming a lot easier.

https://pubmed.ncbi.nlm.nih.gov/33532881/

https://pubmed.ncbi.nlm.nih.gov/33520781/

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Getting kids with autism to eat

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This week’s podcast combines two important post Mother’s Day topics – parents and eating.  Two recent studies have shown the promise of using parent – delivered interventions to help improve food selectivity and food aversions in kids with autism. These two behaviors can be one of the most frustrating and challenging for parents and kids, and can lead to nutritional deficiencies.  These behaviors can range from mild to severe, and previously, only inpatient or outpatient clinic based approaches seemed to have any benefit.  Now it seems that with coaching, encouragement and instruction from trained experts, parents can help their kids eat better foods.

 

https://www.ncbi.nlm.nih.gov/pubmed/31056202 

https://www.ncbi.nlm.nih.gov/pubmed/30101320

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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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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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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

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From cells to anxiety

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Thanks to brain tissue research, scientists now know how cells in the amygdala form, connect, and how this changes with age.  But does that explain behavioral or neurological features in autism?  Last week, Dr. Inna Fishman from SDSU examined connections in and out of the amygdala in children and adolescents in autism, in a different study but the same age range as when cellular changes in the amygdala are seen.  Strikingly, the brain connections to regions outside the amygdala follow a similar pattern at a similar time, which may explain functioning, autism severity and anxiety in adolescents with autism.   Also this week, while autism is a spectrum, it’s on a spectrum with other neurodevelopmental disorders like ADHD.  Just like in autism, there are individuals who are not diagnosed with ADHD until adulthood.  But these adults show signs of autism as children.  This is similar to autism, where symptoms are there but may not manifest until later in life.

 

https://www.ncbi.nlm.nih.gov/pubmed/30274651

https://www.ncbi.nlm.nih.gov/pubmed/30338854

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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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Classroom interventions that work

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Two studies came out recently which used a randomized design to show how interventions can be delivered in the classroom.  They both focused on making sure they were implemented properly and that teachers received the support they needed to help kids in the classroom.  It isn’t just about writing a manual, it’s about making sure teachers know how to deliver it.

https://www.ncbi.nlm.nih.gov/pubmed/29998740

https://www.ncbi.nlm.nih.gov/pubmed/29939056