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The good and evil sides of technology use by autistics

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This year’s Day of Learning included two presentations on the use of technology among people with autism.  As it turns out, technology can be great.  In fact, a new study using Google Glass shows promise in improving socialization.  On the other hand, sometimes technology can have a downside.  People with autism spend more time than typical peers on their iPads, iPhones and other devices.  What could be wrong with that?  Well, problematic internet use is linked to autistic traits and to suicidality.  This link is NOT a clear line and obviously causes of suicide are multifactorial.  However, new data demonstrate that obsessive internet use is not making things better for people with ASD.

 

https://www.ncbi.nlm.nih.gov/pubmed/30934756

https://www.ncbi.nlm.nih.gov/pubmed/30908423

https://www.ncbi.nlm.nih.gov/pubmed/30907929

 

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Do the rules apply in school?

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This week is focused on what happens in schools, including classification, service receipt and new interventions.  How an educational classification translates to a clinical diagnosis, how and what factors are important in receiving services, what teachers think about repetitive behaviors and finally, a new intervention that can be delivered by therapists in school or mental health settings.  They all have real-life consequences for kids who are receiving services in school.

 

https://www.ncbi.nlm.nih.gov/pubmed/30892948

https://www.ncbi.nlm.nih.gov/pubmed/30848681

https://www.ncbi.nlm.nih.gov/pubmed/30889547

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2727134

 

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DSM5 – where are we now?

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Don’t be fooled, not all the studies on this week’s podcast focus on the DSM5.  But the first one, a review of a meta analysis and review of the dozens of publications that have emerged in the past 5 years around the DSM5 leads us off.  There are some people that weren’t captured by either DSM5 or Social Communication Disorder that need a diagnosis, and that should be the focus of future research.  A new topic of diagnosis is also explored by a large collaboration is addressed:  diagnosis in cousins.  They do show a higher probability of an autism diagnosis, but not as high as first degree siblings.  Finally, a new tool called JAKE in monitoring  treatment effectiveness is presented.  This could be used not just in the clinic but at home.  It includes monitoring of biological and behavioral features, and might be the next big thing in outcomes for treatment studies.

 

https://www.ncbi.nlm.nih.gov/pubmed/30852784

https://www.ncbi.nlm.nih.gov/pubmed/30851399

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402449/

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What does and does not change the probability of an autism diagnosis

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Once again, this week another study  came out dismissing the link between vaccines and autism.  Add this one to the list, but this is one of the largest and takes into account genetic and non-genetic risk factors.  It continues to discredit the vaccine-autism link.  However, in other science, more evidence that prenatal folic acid supplementation, something women should be doing anyway, does reduce the probability of having a second child with autism.  So take your folic acid – either by prescription or over the counter.  As Martha Stewart says, it’s a good thing to do.

https://www.ncbi.nlm.nih.gov/pubmed/30831578

https://www.ncbi.nlm.nih.gov/pubmed/30810722

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An update on females with autism, on the double

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Females with autism are different than males with autism in a lot of ways.  This week, researchers used twins to examine the differences between males and females with autism in their brain structure and how it’s associated with autism traits, not a diagnosis.  To do this, researchers in Sweden turned to twins.  As it turns out, females have more of a diversity of differences in brain changes compared to boys, supporting the female protective effect.  But how to females with autism feel?  As them!  A group in the UK interviewed over 20 women on the spectrum or their parents to find out what concerns them most and what they find most challenging.

Both articles cited this week are open access:

https://link.springer.com/article/10.1007%2Fs10803-019-03906-4     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6373677/

 

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A topic for discussion on President’s Day: violence and victimization

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Happy President’s Day!  This week’s podcast is focuses on a topic that has been on the mind of families affected by autism:  autism and violence and victimization.  The studies reinforce 1) the lack of an association between autism and criminality, 2) the association of an autism diagnosis with being the victim of abuse.  This includes self report data, database analyses and assessment of people who cannot report their abuse.  This sobering podcast was posted today because gun violence is an issue at the forefront of this president’s administration.  While this podcast is not focused on gun violence, hopefully this data will reduce the misconceptions and stereotypes around autism and violence.

 

https://www.ncbi.nlm.nih.gov/pubmed/30655190

https://www.ncbi.nlm.nih.gov/pubmed/28593599

https://www.ncbi.nlm.nih.gov/pubmed/28545754

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Autism spectrum disorders underneath a bigger umbrella: more data from the brain

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There is demonstrated genetic overlap between many neurodevelopment disorders including  ASD, ADHD, and schizophrenia, and now there is data showing similarities in the structure and size of the brains in people with autism and those with ADHD.  These differences depend on how severe social difficulties are, but the similarities are seen with ASD and ADHD, but not OCD.   In addition, this week there are new depressing results from the Interactive Autism Network on unemployment and females with ASD.  The results may not surprise you, but they will upset you.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361977/

https://www.ncbi.nlm.nih.gov/pubmed/30729799

 

 

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Infant motor issues and later autism diagnosis

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Everyone knows the way to study infants with autism is through thorough testing of younger siblings of those with a diagnosis, who have a 15x greater chance of have a diagnosis themselves.   Through these methods, new ways of identifying and predicting autism  later on have been developed.  On this week’s podcast:   two very influential and recent papers on the study of motor issues in 6 month olds who go on to be diagnosed with autism, and those  who don’t have an autism diagnosis but have signs and symptoms of ASD.  Are motor issues related to an ASD diagnosis or ASD symptoms?  And what about core symptoms of autism like language?   Can early motor behaviors be used to predict who goes on to receive an autism diagnosis or has language problems?  What should parents do?  How should this influence an early intervention plan?  Learn more this week!

 

https://www.ncbi.nlm.nih.gov/pubmed/30628809

https://www.ncbi.nlm.nih.gov/pubmed/30557704

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Genes and Environment, Genes and Environment. Go together like aging and retirement.

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Twins with autism, where either one or both is diagnosed, is crucial to understand the role of genetics and the environment to both autism diagnoses and now, autism traits.  In a study this week, researchers using data from the California Twins Study examined the genetic and environmental influences of brain development in multiple regions and measures.  While estimates of genetic and environmental influences can only be modeled in twins, they can be experimentally tested in animal models.  Researchers at the University of Washington investigate what causes the link between air pollution in humans and autism by studying diesel fuel exhaust in pregnant mice.  Finally, across all of these disparate animal studies – does anything pull them together.  Are these models all one-offs or do they have anything in common?  It turns out disruption in normal brain activity is one thing that they have in common, and something that is at the common core of ASD neurobiology.

 

https://www.ncbi.nlm.nih.gov/pubmed/30659287

https://www.ncbi.nlm.nih.gov/pubmed/30668980

https://www.ncbi.nlm.nih.gov/pubmed/30679017

 

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The latest on complementary and alternative medicines

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Even though many parents of kids with autism and  autistic adults are using cannabis (THC and CBD) and cannabidiols (CBD only), these treatments are technically illegal.  So how are pediatricians discussing these options with their patients when asked?  A few pediatricians from states where it is legal for adults to obtain cannabis containing products weigh in on what they say, how they communicate, and what is ethical to explain in what circumstance.  Also, new findings from an imperfect, but medically supervised, study on stem cell therapies in autism.  Findings are interesting but should be judged with caution.  Links to the articles are below:

https://www.ncbi.nlm.nih.gov/pubmed/30610100

https://www.ncbi.nlm.nih.gov/pubmed/30620122