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Everything you wanted to know, and more, about the revisions to the CDC developmental milestones

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In February, the CDC worked with the American Academy of Pediatrics to update the developmental milestones that parents should use when referencing how their child is developing. These milestones describe what should be accomplished by times as young as 2 months and as old as 5 months. These are helpful to all parents who wonder “shouldn’t my child be walking by now” and “how many words should they be saying”? Pediatricians ask parents about these and parents are expected to know them, so prepare yourselves now. What are milestones? Why change them? What are the changes? Learn more on this week’s #ASFpodcast.

https://www.cdc.gov/ncbddd/actearly/index.html

The article is free:

https://publications.aap.org/pediatrics/article/149/3/e2021052138/184748/Evidence-Informed-Milestones-for-Developmental

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Tooth brushing: It’s not for sissies

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Parents or caregivers of children with ASD sometimes have a lot of difficulty helping their child brush their teeth. Parents and caregivers of children not on the spectrum have difficulty helping their child brush their teeth. By working with families on an individual level, coaching, encouraging and breaking down each of the steps of tooth brushing into something manageable, a group of Medicaid-eligible parents helped their children learn these skills on some level by the end of the study. Incredibly, 93% of parents who are trying to do it all with less, stayed in the program and felt more confident about their abilities. This study also used a randomized clinical trial design which compared the training and coaching with just those who got some toothbrushes and toothpastes in the mail. In this week’s #ASFpodcast, you get to hear from the leaders and the therapists who helped these families, what they did, and what worked. Join me with Dr. Eric Butter, Kelly Birmingham and Dr. Rachel Fenning to hear more about this study.

https://pubmed.ncbi.nlm.nih.gov/35211746/

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A 2022 Day of Learning Quickie

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This year’s Day of Learning was a huge success, with topics ranging from biological sex differences to mobile technologies all the way to the importance and documented value of leisure activities in people on the spectrum. the speakers included a discussion of the IACC, sex differences, the value of prevalence data, mobile technologies, leisure activities, and a recognition of two advocates who made or make a difference in families: Samantha Els and Suzanne Wright. Listen to this week’s podcast for a quickie, but don’t let it prevent you from watching the longer videos, a link to which can be found below

www.babynavigator.com

www.autismnavigator.com

Day of Learning
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Can animals be autistic?

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The answer is obviously “no”, however, animal models are necessary to help understand brain circuitry and improve interventions and supports for not just core symptoms but associated issues like anxiety, OCD, seizures and GI issues. Scientists view behaviors consistent with an ASD diagnosis differently, and this has created some problems in interpretation of animal model data. This week’s #ASFpodcast will break down a recent paper in Genes, Brain and Behavior which addresses inconsistencies in the literature and makes recommendations on how researchers should shift how they think about how they can replicate features of ASD in a model system.

https://pubmed.ncbi.nlm.nih.gov/35285132/

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Environmental factors as both causes and interventions?

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Environmental exposures, including toxic chemicals, can contribute to the causes of ASD. But how do other environmental factors, like behavioral supports, work in the brain to improve behaviors associated with ASD? For this, you need a broad interpretation of the term “environmental” and an animal model so you can see the mechanism involved. Studies show while environmental factors can contribute, they can also provide modifications in cellular and molecular function which support learning and improved developmental trajectory. Finally, on a different topic, are autistic adults more likely to be involved in a crime compared to other groups? No, they are not, but there are factors which affect the risk of being involved with the criminal justice system, at least in the UK. Read more in the studies below.

https://pubmed.ncbi.nlm.nih.gov/34972219/

https://pubmed.ncbi.nlm.nih.gov/35259351/

https://pubmed.ncbi.nlm.nih.gov/35261275/

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New ways to solve old problems

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This week’s podcast focuses on innovative methodologies to understand how to reach black families, understand why and when autistic people prefer not to look at faces and how interventions can improve conversation and social communication. They use culturally and racially matched mentors, old home video tapes (keep taking those!) and machine learning to look not just at novel methods but novel ways of studying a particular outcome.

https://pubmed.ncbi.nlm.nih.gov/35232271/

https://pubmed.ncbi.nlm.nih.gov/35228613/

https://pubmed.ncbi.nlm.nih.gov/35229983/

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Is Autism Inflammation Nation?

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Several studies have linked the immune system to autism, but how are they connected? Two new studies this week illustrate differences in immune function in those with a diagnosis compared to those without, and also find differences in the blood of of pregnant mothers who go on to have an autistic child. Women who go on to have autistic girls show higher levels and more inflammatory markers than mothers who go on to have boys, the finding of elevated IL1 is now a finding that has been replicated across countries. However, it’s too early to tell if this information can be used to help with a diagnosis and it’s probably not specific to autism. But the message is the same as it was before: getting sick during pregnancy is not great. Get vaccinated! Stay away from sick people and wash your hands.

https://pubmed.ncbi.nlm.nih.gov/35110990/

https://pubmed.ncbi.nlm.nih.gov/34987169/

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Watershed moments in development

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Autism diagnosis at 3 years of age isn’t something that happens suddenly. It evolves, there are deficits seen early on and markers that are evident prior to 3 years. Some of them are cascading events – with problems in one area like motor function, other behaviors like reaching, grasping, and learning about the environment and interactions with other people are stunted. Sometimes, these cascading moments lead to a loss of language. Early intervention can turn these early deficits around so that communication, learning and daily functioning are continually supported and instead of one trajectory, another can be reached. This podcast highlights studies that demonstrate that with data, and with theory. But it is never boiled down to one thing, despite early studies that screen time use is linked with an ASD diagnosis.

https://pubmed.ncbi.nlm.nih.gov/35098539/

https://pubmed.ncbi.nlm.nih.gov/35099540/

https://srcd.onlinelibrary.wiley.com/doi/abs/10.1111/cdep.12439

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What I like about you.

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This week is a “brick-a-brack”: of topics. They include: 1. how COVID-19 is especially dangerous for people with neurodevelopmental disorders; 2. how certain genes associated with neurodevelopmental disorders can affect other body functions other than the brain (like the digestive system and kidney function and metabolism); and finally, 3. why parents think their autistic children are so great. No overall theme, just information we hope you can use.

https://www.ijidonline.com/action/showPdf?pii=S1201-9712%2822%2900048-0

https://link.springer.com/content/pdf/10.1007/s10803-021-05405-x.pdf

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2788262

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Parents! Parents! Parents!

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Parents are now used as intervention partners through a design called parent-mediated intervention. It started to be studied before the pandemic but has now become a necessity. Does it work? Should it always work for everything? How long should the intervention last and how often? These are all questions of interest, and while research is still early, parents can be amazing partners in intervention especially below age 5. The provide opportunities for learning and communication, and they can utilize more hours during the day at home than traditional in-clinic services can. Of course not every family is the same and may not have the same abilities to learn the intervention, and in the future more of these contextual factors need to be studied. But for now, three cheers for parents helping their kids!

https://pubmed.ncbi.nlm.nih.gov/34867556/

https://pubmed.ncbi.nlm.nih.gov/35037520/

https://pubmed.ncbi.nlm.nih.gov/35040001/