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The Science of Screeners for ASD

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Screening for autism is meant to cast a broad net to gather those who show enough features to be included for a full diagnostic evaluation. The most common of these tools is the MCHAT – the Modified Checklist for Autism in Toddlers. An author of the MCHAT, Diana Robins, and a colleague, Andrea Wieckowski and others gathered over 50 studies (English and other languages) in different types of samples (high likelihood and low likelihood) to determine how the MCHAT was doing in terms of finding infants with autism as well as excluding those without autism. It also touched on how well primary care doctors were doing in administering this tool. If you want to see the MCHAT for yourself or take it for your child, there is a FREE website, click here: https://mchatscreen.com

To read the paper, click here: https://pubmed.ncbi.nlm.nih.gov/36804771/

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The true title should be: “A new open source screening tool to help detect autism”

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Many of the existing tools to identify autism cost money or are not specific for ASD, and they are hidden behind paywalls and are hard to obtain. A group of scientists led by Tom Frazer at John Caroll University put together a 39 questionnaire called the Autism Symptoms Dimensions Questionnaire to be filled out by parents of children. It’s free and open source! But that’s just the first step. The media got the intent wrong, yet again.

It should not replace a full diagnosis. Autism is complex, and even those with genetic forms of autism show heterogeneity in symptoms. They each need comprehensive evaluations. But this is a good start. Check it out here!!! It’s open source:

References below:

https://pubmed.ncbi.nlm.nih.gov/36670671/

https://onlinelibrary.wiley.com/doi/epdf/10.1111/dmcn.15497

https://pubmed.ncbi.nlm.nih.gov/36639821/

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Everything you wanted to know, and more, about the revisions to the CDC developmental milestones

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In February, the CDC worked with the American Academy of Pediatrics to update the developmental milestones that parents should use when referencing how their child is developing. These milestones describe what should be accomplished by times as young as 2 months and as old as 5 months. These are helpful to all parents who wonder “shouldn’t my child be walking by now” and “how many words should they be saying”? Pediatricians ask parents about these and parents are expected to know them, so prepare yourselves now. What are milestones? Why change them? What are the changes? Learn more on this week’s #ASFpodcast.

https://www.cdc.gov/ncbddd/actearly/index.html

The article is free:

https://publications.aap.org/pediatrics/article/149/3/e2021052138/184748/Evidence-Informed-Milestones-for-Developmental

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Potential of therapy cats, training for parents, and help for families of diverse backgrounds

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What do cats, the Developmental Check-In and parent training all have in common? They all have the documented potential to help children gain emotional skills, social skills, and receive earlier intervention. A small study shows the potential of a well-tempered cat in easing symptoms of autism. Parent training has been shown time and time again to improve functioning across different domains and a new screening tool based on visual scenarios has been validated in Hispanic populations. Thank you for listening this week!

https://pubmed.ncbi.nlm.nih.gov/33290937/

http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=33303635

https://pubmed.ncbi.nlm.nih.gov/33287762/

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Autistic Black Lives Matter

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Racial and ethnic disparities in autism care is not new, the lower age of diagnosis and lack of care for these families have been reported for years. While they have always been unacceptable, in light of recent events, it’s time to reconsider what scientists should be doing about them. A systematic review identifies what is going on with regards to access to interventions and their efficacy. Another study successfully collaborates Part C Early Intervention providers to reach families of color to improve screening. And finally, researchers not even focused on autism provide a perspective on how far and wide this problem reaches. Autism Science Foundation maintains their commitment to working together with other organizations to eradicate these disparities once and for all.

http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=32238530

https://doi.org/10.1007/s10803-020-04429-z

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The AAP Empowers Pediatricians to Help Kids with ASDs

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Thank you to the American Academy of Pediatrics for publishing an updated guide for their 67,000 members about identification, evaluation and management of children on the autism spectrum.  Pediatricians have a lot of things going on every day and could use a primer, or a condensed guide, on what the basic level of care should be for kids and families affected by ASD.  Here, thanks to Drs. Susan Hyman, Susan Levy and Scott Myers, from the council of the AAP on children with disabilities, they have one.  This podcast will summarize the main points of what the guidance document says.  Please download it and share it by clicking here:  https://pediatrics.aappublications.org/content/pediatrics/early/2019/12/15/peds.2019-3447.full.pdf 

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Keep on Screening for ASD

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This week, a little longer #ASFpodcast on a topic that deserves a little extra attention:  screening for ASD.  Some media click-bait driven headlines have made it seem like screening for autism is a waste of time for parents, doctors and care providers.  That’s FAKE NEWS!   We talk to Whitney Guthrie from CHOP and Diana Robins from Drexel about recent studies that cast doubt on common screening tools, why doctors may not be administering them the same way all the time and how that makes a difference, the importance of screening and data that shows that it does help toddlers with ASD maximize their full potential.

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Yeah, another study about autistic poop

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This week’s podcast includes a summary of the new study, this time in an animal model, looking at microbiome transplantation.  Because this was more of an experimental model, the researchers could be more rigorous in their design and look at things like behavior, brain activity, and specific biological pathways.  While a mouse does not have autism, transplantation of the autism microbiome resulted in autistic-like behaviors.   Second, a hopeful message of the value of participating in research on outcomes – those infants that were tracked prospectively showed improved outcomes later on, suggesting that all of the extra attention they get leads to a reduction in symptoms and an improvement in adaptive behavior.  Even if you do not have a family history of autism – participate in research.  It’s good for your child, and it’s good for other people’s children.

 

https://www.cell.com/cell/fulltext/S0092-8674(19)30502-1 

https://www.ncbi.nlm.nih.gov/pubmed/31032937

 

 

 

 

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How do parents choose different interventions?

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Parents have choices of dozens of different autism interventions, available in private and public settings.  A new study explores factors which influence parents decisions on different interventions, how they are similar to each other and different.  They include cognitive ability of their kids with ASD and economic resources.  Parents in the US may have similarities in how they obtain interventions, but they are also similar in how they identify autism signs in their preschool kids, and these similarities are seen across the world.  In a new study of over 19,000 preschoolers with autism, some similarities are seen in parent reported symptoms of ASD across 24 different countries.  This is pretty remarkable given societal, geographical, and cultural issues.  But it’s not all harmony and unity – there were lots of differences between parents and teachers which can have enormous impact on how autism is diagnosed worldwide.

https://www.ncbi.nlm.nih.gov/pubmed/30990248

https://www.ncbi.nlm.nih.gov/pubmed/30995081

 

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This study is s**t

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You may have heard on the internet that a new “radical” treatment leads to a “50% reduction” in autism symptoms.  This radical treatment is fecal transplants, which is taking the bacteria from the feces from one person and putting them in another person.  This is a still experimental treatment, and while the microbiome should be researched more in regards to its relationship to autism, there might be a less invasive way to alter the microbiome which could stand up to the rigor of a well designed trial.  Also this week, new prevalence data on 4 year olds across multiple years.  Did it change across time, and is it different from 8 year olds, and why is this difference important?

https://www.ncbi.nlm.nih.gov/pubmed/30967657

https://www.ncbi.nlm.nih.gov/pubmed/30973853