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The Pros of Prozac and the Placebo Effect

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Two of the largest randomized control trials of Prozac as an intervention for restrictive and repetitive behaviors were published recently.  They both coincidentally found no effect on the core features of autism, nor clinician rated improvement.  What they did find is a big placebo effect.  That is the behaviors of the participants changed even if they thought they might be getting the medication, but were actually getting an empty pill.  This is a big problem in research in studying medications across mental health.  So why is Prozac so popular?  And when it comes to some features of autism, is the placebo effect so bad?

https://www.ncbi.nlm.nih.gov/pubmed/31638682 

https://www.ncbi.nlm.nih.gov/pubmed/31267292

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News new families can use, thank you to the BSRC

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This week an important study was released that provides information that parents can use – particularly parents with a child with autism and another on the way or who is an infant.  This of course comes from the Baby Siblings Research Consortium and makes particular observations about families with 2 or more affected children vs 1 affected child.  They have different rates of autism outcomes and trajectories of behaviors that parents and doctors should be aware of.  In addition a new meta analysis of vitamin supplementation shows that while moderate doses of vitamins may not be harmful, they may not also be helpful.  In other words, talk to your doctor about a nutritional plan and assessment, and save your money for things that are known to work.

https://www.ncbi.nlm.nih.gov/pubmed/31589284

https://www.ncbi.nlm.nih.gov/pubmed/31586029

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The extra benefit of caregiver mediated interventions

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This week, a new systematic review published by researchers at Virginia Polytechnic Institute looked at the existing evidence around caregiver (parent) mediated interventions and not child outcome, but family relationships and dynamics. While it isn’t the focus on the intervention, what effect does allowing parents to be involved and empowered on their child’s support on the wider family?  The answer is, it does help, although not all interventions are the same.  Also, a new video tool from collaborators at Washington University and the UC Davis MIND Institute to help parents identify early signs and symptoms in their own children was validated, which is exciting but more work needs to be done.

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INSAR with a T, for “technology”

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Lots of news outlets have great summaries of things that were presented at the International Society for Autism Research. However, one area was relatively missed:  technology.    This week’s podcast summarizes advances in technology for people with autism, how they are being used, what they could be used for and how they will improve services and help for those on the spectrum.  They range from ways to aid diagnosis, to better understanding of features and symptoms in different settings, to improved intervention.

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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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Just listen to Nancy Reagan: say NO to MDMA

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This week’s podcast begins with a comment on the debate over ABA, helpful or harmful?  But the big news this week is an analysis of very early, but very published data, on the use of MDMA, or “ecstasy” or “Molly” in people with autism.  Called an “empathogen”, MDMA can elicit feelings of warmth, love and need to cuddle.  However, it has a dark side. MDMA is a neurotoxin.  It kills serotonergic brain cells.  There is no known safe dose.  Researchers studied and found weak evidence that it reduces social anxiety in people with autism.  Social anxiety isn’t a core symptom of autism and thank you to Larry Scahill at Emory University to provided an expert description of each.  While we will not comment on every negative study out there, this one is worth noting.  When someone offers you MDMA, JUST SAY NO.

https://www.ncbi.nlm.nih.gov/pubmed/30196397

 

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Can IGF-1 treat autism symptoms? A clinical trial aims to find out

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A full transcript of this podcast episode can be read on the ASF blog here.

Researchers at Mount Sinai led by Alex Kolevzon are running a clinical trial of the compound insulin-like growth factor 1 (IGF-1) for children with idiopathic autism. Dr. Kolevzon’s team previously demonstrated the safety and feasibility of IGF-1 in treating Phelan-McDermid syndrome, a single-gene form of autism. Particularly, the IGF-1 treatment improved symptoms of social impairment and repetitive behaviors, which are core symptoms of autism. Expanding their investigation into idiopathic autism, the researchers are working hard to make sure families can comfortably and knowledgeably participate in the clinical trial. Mahir Rahman spoke with Dr. Kolevzon about the study and where it hopes to go. Interested in joining the study? Go here to learn more.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326443/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450831/

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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

 

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Clinical trials talk with Tom Frazier from Autism Speaks

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This week, a special surprise:  a conversation with Dr. Thomas Frazier, Chief Science Officer of Autism Speaks, on what is needed for better clinical trials for drug treatments for ASD, and what they are going to be doing to help move the science along.  Of course, the conversation hit on other topics, like disclosure of a diagnosis, sex differences, and some of the newest more exciting findings in autism research.

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The ASF Day of Learning mini-recap

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Did you miss the ASF Day of Learning in NYC but want to hear some teasers before they are available online?  Listen to this week’s podcast, and you’ll hear the 12 minute talks distilled to 2 minutes, leaving out a lot of details and eliminating the video part but giving you a quick recap of each.  Topics this year included:  1) What have we learned this last year?  2) Are Boys and Girls with Autism Different? 3) Does diet make a difference in autism?  4) Is medical marijuana a treatment option? 5) Why won’t my child sleep and 6) How can we improve adult outcomes in people with autism?  ASF also announced 8 new pre and post-doctoral fellowships on Wednesday, filling out an already amazingly active autism awareness month.   Stay tuned for the complete presentations to appear on the ASF homepage.