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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

 

 

 

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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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The sticky subject of cost effectiveness

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In a perfect world, money would not matter.  But in this world, it does, and a dollar spent on one thing in the clinic by families, society and insurance companies means a dollar not spent somewhere else.  Therefore, studies on cost effectiveness need to be conducted to determine how resources may be best used.  In this podcast, Dr. Tracy Yuen of University of Toronto explains two different analyses which looked at 1) universal screening for ASD and 2) use of genomic sequencing to identify novel variants in people with ASD.  Thank you to Dr. Yuen for explaining the process behind this and these intriguing findings.  You’ll have to listen to find out what they are.

 

https://www.ncbi.nlm.nih.gov/pubmed/29651777

 

https://www.ncbi.nlm.nih.gov/pubmed/29644584

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More on that Korea Daily mess. Plus early detection of ASD does improve outcomes.

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This podcast was going to be dedicated to new early detection research which shows what the USPSTF has been looking for – the link between early detection, early intervention, and improved outcomes in a community setting.  Those findings are still included this week, but there is a slight diversion in theme.  The podcast will also include  an explanation of the immune/microbiome study published in Nature and misrepresented  by Korea Daily.  The study is important, however, the media sensationalized the findings and did the research no favors by labeling it a “major cause”.   Learn what the study did and what it actually discovered in this week’s podcast.

 

Here are the references of the studies mentioned in the podcast:

https://www.ncbi.nlm.nih.gov/pubmed/28902840

https://www.ncbi.nlm.nih.gov/pubmed/28905160

https://www.ncbi.nlm.nih.gov/pubmed/27474118

 

 

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Betsy DeVos, autism screening and testosterone – in that order

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This week two studies which examined infants and younger children that will significantly advance understanding of causes and services for people with autism were published.  After a commentary about the confirmation of Betsy DeVos, the study that used a practical methodology to improve autism screening in pediatrics clinic from researchers at Duke University was presented.  After that, some early results from the EARLI study  which examined pregnancies in families where an older sibling was diagnosed was presented.  In this study, Bo Park and her colleagues at Drexel University, Johns Hopkins University, University of California at Davis and Kaiser Permanente show that testosterone levels in pregnancy aren’t related to later autism symptoms unless the older sibling affected is a girl.  These findings can illustrate why girls are less likely to be diagnosed with autism compared to boys.  The study is open access and can be downloaded here, thanks to the journal Molecular Autism:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5282802/pdf/13229_2017_Article_118.pdf

 

13229_2017_118_Fig3_HTML

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The importance if IQ in an autism outcome.

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Cognitive ability, measured by intellectual quotient or IQ, has been thought to predict response to intervention, social abilities, adaptive behavior and long term outcome.  Numerous studies have shown that it can influence what is labeled as a good outcome.  However, two studies this week point out how those across the spectrum in cognitive ability still benefit from early intervention and make friends on the playground.  In both studies, there were factors that were more important for outcome than IQ.  So it may be an important factor in outcome, but not the only factor.

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Old exposures, new diagnoses and more efficient screening for toddlers

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This week, two important studies came out on different topics in autism research.  In the first study, an exposure which has been around for decades, PCB’s, a toxic industrial chemical which has been banned from manufacture or use for the past few decades, was linked to autism.  This dispels the myth that only exposures that have been introduced since the observance in the rise in diagnoses are relevant for study.  First author Kristen Lyall gives her perspective. Here is a website on how to avoid PCBs even though they have been banned.

Second, screening for autism in pediatricians offices has always been challenging.  Patients get 10 minutes at most with their doctor, these doctors have to fit in an hours worth of assessments in this time.  So how can you get them to conduct a screening for autism and add in extra questions?  Kennedy Krieger Institute published on a way that seems to work without sacrificing quality.  Hear more about both on this week’s podcast.