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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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More on why intellectual disability matters.

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There have been more than a few podcasts lately about why intellectual abilities (or disability) are important in understanding ASD. It will probably be a theme in the end of year summary. This week, intellectual ability affects risk of dying from COVID and how anxiety is measured. Some studies show that increasing cognitive ability increases chances of having anxiety, although, because it is not always measured appropriately in those with intellectual disability, this linear relationship may not hold. However, while it is important in anxiety and COVID, it may have less to do with how pain is expressed. Podcast links below:

If you want to register for the December 9thwebinar about the COVID Vaccine:  

https://www.chop.edu/centers-programs/vaccine-update/vaccine-webinar-series

Developmental disorders top the medical conditions that heighten the risk of dying from Covid-19

https://pubmed.ncbi.nlm.nih.gov/33198481/

https://pubmed.ncbi.nlm.nih.gov/33175317/

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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 

 

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Lordy Lordy it’s One in Forty

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This week’s headlines were focused on the new prevalence numbers of 1:40.  They were not calculated using the same method as the 1:59 number, so should not be  compared.  In addition to looking at just prevalence, this survey identified a major problem for families, which is unmet mental health needs.  Those with autism have higher unmet mental health needs than those with  ADHD, anxiety or depression.  Again, there is something unique about an autism diagnosis which poses a challenge to accessing care.  In addition, a new summary paper outlined what needs to be done to better study  regression in autism.  The rate may be higher than you think if a new definition of regression is used.

 

https://www.ncbi.nlm.nih.gov/pubmed/30478241

https://www.ncbi.nlm.nih.gov/pubmed/30475449

 

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What is true for males is not true for females

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This week’s podcast focuses on the Extreme Male Brain Theory of autism, originating from the idea that autism, in part, is a reflection of increased fetal testosterone levels.  Amazingly, fetal testosterone levels are reflected in the length of the 2nd and 4th fingers and can be measured as a reflection of testosterone levels during pregnancy. Research, including those from a recent CDC study, have reinforced that elevated fetal testosterone levels play a role in autism in males, but not females.  Differences in fetal testosterone across gender and diagnosis has also been observed in a study from Drexel University.  What was observed in males is not observed in females.  It doesn’t mean the theory is wrong, it means that what is true for one sex is not always true for the other.

https://www.ncbi.nlm.nih.gov/pubmed/29450837

 

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Autism diagnosis in adulthood

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While still rare, there are cases where an autism diagnosis is not made until adulthood.  Why have these people been missed and what do they need?  How did they go for so long without anyone recognizing that they needed help?  A new study from the lab of Dr. Francesca Happe in the UK investigates the characteristics and features of people who were referred for a diagnosis after 18 years of age.  Hear more about how they managed in this week’s podcast.

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A focus on the siblings of people with ASD

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Two studies recently add to an ever growing literature around undiagnosed siblings of individuals with autism.  While in autism features there is evidence of the “broader autism phenotype” in female siblings, there is no evidence of elevated sensory symptoms in those with a brother or system with autism.  The more we understand about the psychological and psychiatric features of siblings with autism, the more they can be supported to deal not only with their siblings challenges, but with theirs as well.

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Environment or genetics in autism symptomatology? How about both?

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This week I am in Minneapolis at an incredibly important meeting of Medical Examiners to pitch them the importance of collecting brain tissue for Autism BrainNet.  While I was here I noticed a new study on the blogs that is important for families to hear about.  It focused on a known environmental exposure in established genetic groups.  The authors of the study, led by Dr. Sara Webb at University of Washington, showed that an environmental exposure can modify symptoms in genetically susceptible narrow subgroups.  This is the sort of research that will better describe how environmental exposures are affecting autism risk.   Thank you to Dr. Sara Webb for your perspectives and interpretation of the data!

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A year of autism research in under 30 minutes

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What was impactful this year in autism research? This last podcast of 2015 explores the year of the female, highlighting the relatively new exploration into what makes females with ASD different and what they can tell us about everybody with autism and their families.  Some of what is discussed was highlighted in other podcasts, but not all of it.   The summary is organized so that what may initially be interpreted as small, nonsignificant discoveries, are viewed as progress.  Everything from genetics to getting laws passed is included.

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What if it isn’t autism?

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Many times signs and symptoms of autism may be seen prior to 3 years of age, but a diagnosis is not made.  It may not be autism, but what is it?  Studying children at risk for developing ASD but then don’t go on to receive a diagnosis gives researchers a clue.  Dr. Meghan Miller from the University of California at Davis discusses a study that follows up these kids to 9 years of age and finds out what is going on with them.  Do they have autism after all?  Or do they have absolutely no symptoms at all?  Or is there something in between?