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Which came first, ASD or sleep problems?

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People with autism have lots of problems, and sleep is one of them. This week’s podcast explores when these problems begin, which brain areas are involved, and how autism contributes to, or suffers from, lack of sleep. Does sleep make ASD worse or are ASD symptoms causing a sleep problems? It’s not a one way street, and the neurons that go to the wrong places at the wrong times which cause ASD, may also be contributing to lack of good sleep. References below:

https://pubmed.ncbi.nlm.nih.gov/33207724/

https://pubmed.ncbi.nlm.nih.gov/33184732/

https://pubmed.ncbi.nlm.nih.gov/32375538/

https://pubmed.ncbi.nlm.nih.gov/32140983/

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Psychiatric decompensation and autism: Two words you never want to hear together

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A series of three scientific articles explore the link between the onset of psychiatric symptoms in adolescence in people with Phelan McDermid Syndrome, or PMS.  PMS is caused by a mutation in the SHANK3 gene, leading to a wide range of medical, behavioral and intellectual challenges, as well as autism spectrum disorder.  Scientists used a broad literature review as well as the PMS patient registry to better describe what was going on, and a group at Duke compiled a case series of girls affected that were responsive to treatment.  While so far this decompensation as a result of onset of psychiatric illness has only been documented in PMS, families across the spectrum should be aware so they can seek immediate help for their child if they see similar symptoms.

https://www.ncbi.nlm.nih.gov/pubmed/32050889

https://www.ncbi.nlm.nih.gov/pubmed/31879555

https://www.ncbi.nlm.nih.gov/pubmed/32015180

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Environmental factors: the forgotten stepchild of autism spectrum disorders

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When people hear the word “heritability” in mathematical estimates, they automatically think “just genetics”.  That isn’t true, and this week epidemiologist Brian Lee from Drexel talks us through his SpectrumNews viewpoint about what heritability actually is and why there is room for environment.  Also this week, twin studies, which have traditionally used the word heritability to distinguish genetic vs. environmental interactions, are studied in a new light.  This one shows that severity and differences of autism across the spectrum in identical twins are caused by environmental differences – not just genetics.

https://www.ncbi.nlm.nih.gov/pubmed/31853901

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Autism: Difference or Dysfunction?

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The question of whether or not autism is a difference or a true dysfunction in brain development has been debated for years.  A new study from Canada demonstrates that within an autism diagnosis, there is less of a difference in symptoms in the last 5 years than there was 30 years ago.  This raises a lot of questions about what autism researchers have been studying lately.  It also reinvigorates the discussion of whether the heterogeneity issue in autism has become such an issue that those with a true dysfunction are not getting the services they need, because of an interpretation that autism is just a difference.  The podcast includes thoughts of the community voiced on social media as well as opinions of the ASF scientific advisory board.

Article is open access here:  https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2747847