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Can we solve the pandemic problems around diagnosis and intervention?

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This week’s #ASFpodcast highlights a few articles from the Journal of Autism and Developmental Disorders this week which examined the tolerability and efficacy of online diagnostic procedures and interventions, from the perspective of both parents and clinicians. They seem to work about the same, although there were some caveats. For many reasons, online and telehealth options are here to stay, and more needs to be done to improve their accuracy, acceptability, feasibility and effectiveness. These early studies are promising though, and lead the way to even more improvements to help make them a viable option for families in the future.

https://link.springer.com/article/10.1007/s10803-022-05435-z

https://link.springer.com/article/10.1007/s10803-022-05576-1

https://link.springer.com/article/10.1007/s10803-022-05554-7

https://link.springer.com/article/10.1007/s10803-022-05580-5https://link.springer.com/article/10.1007/s10803-022-05607-x

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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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Managing autism practice from a distance: it’s called ECHO

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Extension for Community Healthcare Outcomes (ECHO) pairs specialist centers with community providers to help them manage cases and empower them with knowledge to help their patients locally. It is done over the computer, which is especially relevant today. The goal is to help clinicians and physicians manage patients when local expertise is not available. Micah Mazurek of University of Virginia recently published a randomized study about the efficacy of this program, and is a special guest on the podcast to explain what it is and how it can be used to help doctors help each other and their families.

https://jamanetwork.com/journals/jamapediatrics/article-abstract/2762007

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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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SLEEP: it’s what’s important for autism

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Sleep disturbances affect up to 80% of people with autism, and as it turns out, these sleep problems translate to daytime problems like probability of hospitalization, severity of symptoms and even employment.  This week’s podcast focuses on three new studies that examine the relationship between sleep problems and function in people with autism across the spectrum, and provides new insights on how to study sleep.  Dr. Ashura Buckley from the NIH will be speaking about sleep in autism at the Day of Learning on April 11th – if you have’t registered yet, there is still time:  https://www.eventbrite.com/e/2018-autism-science-foundation-ted-style-autism-science-conference-registration-39878706284

Articles used in this podcast:

https://www.ncbi.nlm.nih.gov/pubmed/29500758

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5660229/

https://www.ncbi.nlm.nih.gov/pubmed/29455555

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A different type of autism?

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Last week, investigators with the Autism Treatment Network published a long awaited study on the differences between the DSM IV and DSM5.    Other studies had relied on information on old pieces of paper to judge whether or not someone who met criteria under DSM IV would be now diagnosed with DSM5 criteria.  This study, on the other hand, used in person evaluations of over 400 individuals with autism.  PI from the Missouri site and lead author of a new study, Dr. Micah Mazurek was gracious enough to provide a summary of the findings in the podcast.  A quick preview:  they showed differences in the diagnosis in the group previously known as PDD-NOS.  Is this a new type of autism?  Their symptoms were less severe and they had normal IQ ability – do they have a subtype of autism or a new form of ADHD?  This study isn’t the first to suggest using different categories of symptoms of autism like DSM IV did, and indicates that the new criteria of the DSM  5 are more specific.  In addition, a 2 minute summary of all the great presentations at the Autism Society of America is given.  Totally insufficient to describe everything that went on, but it’s a start.