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The 2018 Year in Review: A spectrum within a spectrum

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There were a number of exciting advances in scientific understanding autism in 2018.  These include things that we know to be true, and know to be not true.  Researchers made progress in identifying subgroups of ASD, defining biological markers, and developing  interventions. There were also research that demonstrates that while autism is a spectrum itself, it is also part of a bigger spectrum of neurodevelopmental disorders from anxiety to ADHD to OCD.  Therefore, the approaches to these other conditions may be applicable to ASD. In addition, there may be more similarities than differences in the biological features of these conditions.

This is just a sampling of the exciting research presented on this year’s Year in Review.  You can also read the full summary, complete with references, HERE.

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The average age of diagnosis depends on where, when, and how you ask

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While autism can be diagnosed reliably by 2 years of age, some people with autism don’t receive a formal diagnosis until much later.  Why not?  Racial and ethnic disparities as well as access to care issues are known factors.  This week, data from Denmark suggested that the diagnostic criteria has played a large role in prevalence in people with autism since 1980.  Many people who have autism may have been missed until they were older.  It suggests that older prevalence estimates were missing a proportion of autistic adolescents and adults.  Take away access and diagnostic barriers to a diagnosis, some kids followed from months of age in the baby siblings research consortium don’t receive a diagnosis at age 2, but do at age 5.  They always had autism, but their symptoms were sub-threshold for a formal diagnosis until age 5.

 

https://www.ncbi.nlm.nih.gov/pubmed/30398592 

https://www.ncbi.nlm.nih.gov/pubmed/30392626

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Through the years

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Rarely can individuals with autism be studied more than once – but a new study tracks how cognitive and adaptive behavior changes over time.  What researchers in the British Autism of Infant Siblings, or BASIS found, was that family history of autism meant as much to cognitive and adaptive behavior than an actual autism diagnosis.  This calls for close monitoring of siblings of those with autism, regardless of whether or not they had a diagnosis.  Also, investigating psychiatric issues in children may underestimate their prevalence because many psychiatric issues do not emerge until the teenage years, so Kaiser Permanente looked at medical and health records of those with autism at 14-25 years to see what other issues they were facing, and the findings are both sobering yet maybe a little comforting.

Please watch the UN WAAD event here:

https://www.youtube.com/watch?v=Tyhm7p8Gr2A&t=7943s 

The two studies mentioned in the podcast are:

https://www.ncbi.nlm.nih.gov/pubmed/29616486

https://www.ncbi.nlm.nih.gov/pubmed/29610415 

 

 

 

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What is the can do vs. the will do of autism?

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Often overlooked in intervention studies, it is becoming increasingly clearer that adaptive behavior, the “will do” vs. the “can do” of functioning, should receive more focus.  In people with autism and high IQ, cognitive ability, the “can do” is higher than adaptive behavior, the “will do”.  Why?  The key in new research from the National Institutes of Health may be social abilities.  Another study this week from Children’s Hospital of Philadelphia in adult  with high IQ demonstrates that social motivation may be the key to improving social skills and socialization in people with ASD.

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Hip hip hooray for toddler interventions for autism

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As always, good news and bad news in autism this week.  First the good news:  an intervention given between 9-14 months of age in children with a high probability of having an autism diagnosis improved autism symptoms at 3 years of age.  Now the bad:  mothers who experience severe childhood abuse are more likely to have a child with an autism diagnosis.  Why?  A new study explains it might have a lot to do with autism traits in the parents.  We would love to hear your thoughts on the results, please provide them in the comment section.

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Parents are interventionists too

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Parent training has a number of important uses in autism.  For toddlers, parents help provide intervention strategies in a number of settings allowing skills to be generalized.  In adolescence, parents can help implement behavioral rules that can manage non-compliant behaviors, aggressive, disruptive or impulsive behaviors.  This week, research investigated the role of parent training plus and ADHD medication for ADHD symptoms in autism and the results are promising.  Finally, a review of the new NIH funding in understanding the causes of autism is reviewed.  You can also read this review at the ASF blogsite.