The behavior of children with autism may improve during a fever, according to a first-of-kind study.
Researchers hypothesize that fever may restore nerve cell communications in regions of the autistic brain. The restoration may help children improve socialization skills during a fever.
The study was based on 30 autistic children between ages 2 and 18 who were observed during and after a fever of at least 100.4 degrees Fahrenheit. More than 80 percent of the children showed some improvement in behavior during a fever and 30 percent showed significant improvement, researchers said. Behavior changes included longer concentration span, increased amount of talking and improved eye contact.
The study was written by Craig J. Newschaffer, Ph.D., professor and chair of the Department of Epidemiology and Biostatistics at Drexel University, and Laura K. Curran, Ph.D., an epidemiology doctoral degree graduate who Newschaffer advised before he joined Drexel from Johns Hopkins University.
“Any leads that suggest new biologic mechanisms that could be acted on through treatment are welcomed,” Newschaffer said.
Study data suggest that behavior changes may not solely be the byproduct of sickness and, consequently, could be the byproduct of a biologic response to fever. More research, however, is needed to prove fever-specific effects, researchers say.
Autism can limit social interactions and disable verbal and nonverbal communication. About 1.5 million Americans have some form of autism, according to the Autism Society of America. The cause of autism is unknown.
Monday, December 10, 2007
Researchers create first-ever genetic animal model of autism
Washington, Dec 9 :
US researchers have created what might be an accurate model of autism not associated with a broader neuropsychiatric syndrome, which includes conditions like - Fragile X, the most common cause of inherited mental impairment, and Rett Syndrome, a childhood neurodevelopmental disorder characterized by normal early development followed by slowed brain and head growth, seizures, and mental retardation.
Autism is a neuropsychiatric disorder characterized by repetitive behaviours and by impairment in social interactions and communication skills.
The animal -model finding was based on a study, led by Thomas Sudhof, M.D., professor and chairman of neuroscience at UT Southwestern, which might help researchers better understand abnormal brain function in autistic humans, which could help them identify and improve treatment strategies.
"Prior to this study we knew next to nothing about the mechanisms of autism in the brain," said Craig M. Powell, M.D., Ph.D., assistant professor of neurology and psychiatry at the University of Texas Southwesters Medical Centre at Dallas and a co-researcher in the study.
"With this research, we can study changes in the brain that lead to autistic behaviours and symptoms, which may help us understand more about progression and treatment of the disorder," Powell added.
The research team replaced the normal mouse neurologin-3 gene with a mutated neuroligin-3 gene associated with autism in humans.
By doing so, the researchers were able to create a gene in the mice that was similar to the human autism disease gene.
While the result amounted to a very small change in their genetic makeup, it perfectly mimicked the same small change occurring in some patients with human autism.
Dr. Powell studied the genetically altered mice and found that, when examined in behavioural tests that might reflect key signs of autism, they showed decreased social interaction with other mice; other traits, such as anxiety, coordination and pain sensitivity, were unaffected.
Powell said that these social interaction deficits were hallmark features of human autism. In addition, the mice showed enhanced spatial learning abilities, which might resemble the enhanced cognitive abilities in autistic savants, people who have a severe developmental or mental handicap as well as extraordinary mental abilities.
"These findings could be especially helpful in identifying novel treatment approaches. We already know that inhibitory chemical synaptic transmission from one neuron to the next is increased in this mouse model. Now we can test drugs that decrease this effect directly in the mice and ask whether this reverses their social interaction deficits," Powell said.
The research was presented at the American College of Neuropsychopharmacology annual meeting.
US researchers have created what might be an accurate model of autism not associated with a broader neuropsychiatric syndrome, which includes conditions like - Fragile X, the most common cause of inherited mental impairment, and Rett Syndrome, a childhood neurodevelopmental disorder characterized by normal early development followed by slowed brain and head growth, seizures, and mental retardation.
Autism is a neuropsychiatric disorder characterized by repetitive behaviours and by impairment in social interactions and communication skills.
The animal -model finding was based on a study, led by Thomas Sudhof, M.D., professor and chairman of neuroscience at UT Southwestern, which might help researchers better understand abnormal brain function in autistic humans, which could help them identify and improve treatment strategies.
"Prior to this study we knew next to nothing about the mechanisms of autism in the brain," said Craig M. Powell, M.D., Ph.D., assistant professor of neurology and psychiatry at the University of Texas Southwesters Medical Centre at Dallas and a co-researcher in the study.
"With this research, we can study changes in the brain that lead to autistic behaviours and symptoms, which may help us understand more about progression and treatment of the disorder," Powell added.
The research team replaced the normal mouse neurologin-3 gene with a mutated neuroligin-3 gene associated with autism in humans.
By doing so, the researchers were able to create a gene in the mice that was similar to the human autism disease gene.
While the result amounted to a very small change in their genetic makeup, it perfectly mimicked the same small change occurring in some patients with human autism.
Dr. Powell studied the genetically altered mice and found that, when examined in behavioural tests that might reflect key signs of autism, they showed decreased social interaction with other mice; other traits, such as anxiety, coordination and pain sensitivity, were unaffected.
Powell said that these social interaction deficits were hallmark features of human autism. In addition, the mice showed enhanced spatial learning abilities, which might resemble the enhanced cognitive abilities in autistic savants, people who have a severe developmental or mental handicap as well as extraordinary mental abilities.
"These findings could be especially helpful in identifying novel treatment approaches. We already know that inhibitory chemical synaptic transmission from one neuron to the next is increased in this mouse model. Now we can test drugs that decrease this effect directly in the mice and ask whether this reverses their social interaction deficits," Powell said.
The research was presented at the American College of Neuropsychopharmacology annual meeting.
Thursday, November 1, 2007
Doctors group calls for universal autism screening
All U.S. children should be formally screened for autism twice by the age of 2, the nation's top pediatrician group recommended on Monday.
The new guidelines issued by the American Academy of Pediatrics focus on early intervention, which can improve a child's chances for effective treatment.
"If you recognize it earlier, you get them into treatment earlier," said Dr. Scott Myers, a pediatrician who specializes in neurodevelopment and who helped write two clinical reports designed to help pediatricians identify and manage autism.
"Kids who start (treatment) earlier do better in the long run," Myers said in a telephone interview.
The guidelines for the first time call for universal screening of babies at the regular 18- and 24-month check-ups, regardless of whether there are warning signs. They will be published in the journal Pediatrics and on the group's Web site at http://www.aap.org.
No one knows what causes autism, a complex developmental disorder that includes problems with social interaction and communication.
Symptoms range from mild awkwardness to severe disability and mental retardation. The U.S. Centers for Disease Control and Prevention estimates that about one in every 150 U.S. children has autism or an autism spectrum disorder, such as Asperger's syndrome.
Delays in communication often are an early warning sign.
The guidelines urge pediatricians to watch for subtle signs, such as a lack of babbling, late smiling and failure to make eye contact. Picking up on these cues could lead to earlier diagnosis and treatment.
"Young children and infants between 9 and 12 months should turn and respond when their name is called," said Myers, of Janet Weis Children's Hospital/Geisinger Medical Center in Danville, Pennsylvania.
"If you say look at something across the room and you point, they ought to follow that with their eyes," he said.
Warnings signs needing immediate evaluation include: no babbling or pointing or other gestures by 12 months, no single words by 16 months, no two-word phrases by 24 months and regression or loss of language or social skills at any age.
If autism is suspected, the guidelines urge parents not to wait for a specialist to confirm the diagnosis before seeking treatment for the specific symptoms.
"You can begin with therapy geared toward the impairments that are there," Myers said.
The reports also review educational therapies and advises that children be engaged in intensive intervention of at least 25 hours per week, 12 months a year, with a low student-to-teacher ratio. Parents should be included in this treatment.
Pediatricians treating patients with autism should make themselves aware of various alternative therapies and to help parents make treatment decisions based on scientific evidence.
But the report suggests doctors should maintain open communication, even when families are pursuing unproven alternative treatments.
While the guidelines stress early intervention, Myers said many children benefit from therapy even if their autism was not detected until later.
"In the milder forms, it may not be possible to diagnose early," Myers said. "It is not hopeless by any means if it is diagnosed later but there does seem to be an advantage to getting intervention going as early as we can."
The new guidelines issued by the American Academy of Pediatrics focus on early intervention, which can improve a child's chances for effective treatment.
"If you recognize it earlier, you get them into treatment earlier," said Dr. Scott Myers, a pediatrician who specializes in neurodevelopment and who helped write two clinical reports designed to help pediatricians identify and manage autism.
"Kids who start (treatment) earlier do better in the long run," Myers said in a telephone interview.
The guidelines for the first time call for universal screening of babies at the regular 18- and 24-month check-ups, regardless of whether there are warning signs. They will be published in the journal Pediatrics and on the group's Web site at http://www.aap.org.
No one knows what causes autism, a complex developmental disorder that includes problems with social interaction and communication.
Symptoms range from mild awkwardness to severe disability and mental retardation. The U.S. Centers for Disease Control and Prevention estimates that about one in every 150 U.S. children has autism or an autism spectrum disorder, such as Asperger's syndrome.
Delays in communication often are an early warning sign.
The guidelines urge pediatricians to watch for subtle signs, such as a lack of babbling, late smiling and failure to make eye contact. Picking up on these cues could lead to earlier diagnosis and treatment.
"Young children and infants between 9 and 12 months should turn and respond when their name is called," said Myers, of Janet Weis Children's Hospital/Geisinger Medical Center in Danville, Pennsylvania.
"If you say look at something across the room and you point, they ought to follow that with their eyes," he said.
Warnings signs needing immediate evaluation include: no babbling or pointing or other gestures by 12 months, no single words by 16 months, no two-word phrases by 24 months and regression or loss of language or social skills at any age.
If autism is suspected, the guidelines urge parents not to wait for a specialist to confirm the diagnosis before seeking treatment for the specific symptoms.
"You can begin with therapy geared toward the impairments that are there," Myers said.
The reports also review educational therapies and advises that children be engaged in intensive intervention of at least 25 hours per week, 12 months a year, with a low student-to-teacher ratio. Parents should be included in this treatment.
Pediatricians treating patients with autism should make themselves aware of various alternative therapies and to help parents make treatment decisions based on scientific evidence.
But the report suggests doctors should maintain open communication, even when families are pursuing unproven alternative treatments.
While the guidelines stress early intervention, Myers said many children benefit from therapy even if their autism was not detected until later.
"In the milder forms, it may not be possible to diagnose early," Myers said. "It is not hopeless by any means if it is diagnosed later but there does seem to be an advantage to getting intervention going as early as we can."
Friday, September 21, 2007
Breaking The Silence
(CBS) Over the last few years, statistics have shown a significant and startling rise in the number of children diagnosed with autism.
But there has also been what some are calling an unexpected breakthrough in the disorder.
It has happened quietly, with just a handful of children - but it could have profound implications for nearly half a million children in the U.S. alone.
They are kids with autism - kids many presume are mentally retarded, or locked in their own world, unable to communicate or even to think for themselves. That was the prevailing view of autism. Until now.
Correspondent Vicki Mabrey takes a look at the remarkable people who are breaking the silence of autism - a silence that led one couple on a desperate search for a cure. This report originally aired in January.
For Hollywood producer Jon Shestack and his wife, Portia Iversen, their son Dov appeared to be developing normally.
Then, at around 18 months, he lost the few words he had learned to speak, stopped answering to his name and disappeared into the frightening world of autism.
“I felt helpless to help him. And yet, every minute, every day, I saw him getting further and further out of my grasp and there was no expert out there to stop it,” says Portia.
Jon and Portia were told their son had the most severe form of autism, and would never speak again. Doctors said there was nothing the couple could do for him except give him constant care and get on with their lives.
Now 10, the only sounds Dov makes are unintelligible. His behavior is filled with uncontrollable movements called “stimming,” or self-stimulation.
The parents were told there was no cure. And they discovered there were very few scientists even doing autism research. So they formed a research foundation called Cure Autism Now, or CAN, which is now the largest private supporter of autism research in the country.
Their biggest breakthrough came from a 14-year-old boy their foundation brought over from India - a boy who seemed very much like their own son, but with some dramatic differences.
Tito Mukhopadhyay is challenging every assumption about autism, turning the world of Portia and Jon, and thousands of other parents like them, upside down.
Like Dov, he's severely autistic. He, too, is almost mute and has little control over his body.
But unlike Dov, and thousands of other autistic children, Tito is doing what doctors and researchers once thought impossible: He has learned to write eloquently and independently about what it’s like to be trapped in an autistic body.
“I was able to ask Tito things I always wanted to ask my own son, Dov,” says Portia. “Why do you flap? Why do you rock? Why can’t you look me in the eyes? You know, and Tito could answer all those questions.”
What does Tito think is the biggest misperception that people have of autism? "That they don't have any understanding," writes Tito.
Scientists say they’ve never seen anyone like Tito before. By definition, people with severe autism have trouble with language – a notion that Tito shatters every time he puts pen to paper.
Dr. Mike Merzenich has been studying Tito for more than a year. A neuroscientist at the University of California at San Francisco, he says he believes Tito is not only authentic, but also miraculous. “There can be little question in the writing and typing behaviors of Tito that he’s providing the answers, and that the answers are coming from his brain."
If Tito is a miracle of autism, the miracle worker is his mother Soma, who gave up a career in chemistry to devote her life to teaching her son - even though doctors in India said he would never be able to learn.
“At first, they told us he was mentally retarded because he wasn’t doing anything. He wasn’t doing what a 3-year-old child should do. He did not respond. He did not do anything,” says Soma, who was simply told to keep him busy.
As a young child, she noticed he was staring at calendars, so she started teaching him numbers and letters. When he wouldn’t hold a pencil, she used a rubber band to tie one to his finger and taught him to draw lines, and eventually to write.
If her method looks simple, parents of other severely autistic children will tell you that at one time or another, they, too, tried to get their child to type or communicate - with no success.
But Soma's method requires tenacity. For the past 11 years, this tireless taskmaster has spent every waking moment talking and teaching, constantly prodding, to keep Tito stimulated, and his mind on track.
Her determination, and her assumptions about Tito, may have made all the difference. She never doubted that he could learn. So she fed him a healthy diet of knowledge – from Shakespeare to geometry to music.
Tito says that if his mother hadn’t pushed him, he would have been a “vegetable.” Merzenich agrees.
Though Tito seems to have escaped that fate through his writing, he remains severely autistic. He can’t pick up the pad and pencil to write without his mother’s constant prodding and urging. But when Tito does write, it is with astonishing insight, especially for a boy just 14 years old.
He's written hundreds of poems, including one that 60 Minutes II watched him write from beginning to end: “I have fancied a little dream and the world is left unseen… with the light of your eyes… through the darkness of the night … I have held that little dream … beyond my world beyond all scenes.”
“Tito is a beautiful example of the possible," says Merzenich. "Here we have a boy that largely through the empirical interaction of this boy with his mother, a way has been found into his ability, into his spirit.”
Is Tito just one in a million?
"I think there could be thousands, maybe tens of thousands of Titos out there," says Merzenich.
Scientists will soon find out if that's true. For the past year, Soma’s been testing her methods on a small group of children at the Carousel School in Los Angeles. Among her students is Jon and Portia's son, Dov.
Like Tito, these 9- and 10-year-olds are severely autistic. Few can speak. Until recently, teachers had no idea if anything was actually getting through.
But in the space of a year, kids who were being taught on a kindergarten level are now being taught math, social studies and science like fourth graders.
“I had honestly never seen anything like this in my life,” says teacher Karen Spratt, who admits she was skeptical when Soma first came to the school.
“Soma really did everything that I was told not to do as a teacher. For instance, she talked constantly. In my training, it was that you give basic directions and wait for a response, and not to verbalize too much because it could be distracting.
” Instead of being distracting, Soma’s “Rapid Prompting Method,” as she calls it, seems to keep the children’s attention focused long enough for them to communicate. She ignores their erratic movements and wandering eyes, and focuses instead on the mind locked inside.
Soma is sure that her method works. And she offers some astonishing proof. Dov was one of her first students – since it was his parents, Portia and Jon, whose foundation brought Soma to the United States.
His parents were astonished at his progress: From a boy who six weeks earlier couldn’t even tie his shoes suddenly came full sentences, complex thoughts and words spelled correctly.
“The best way I could put this is it seemed like I was seeing the kid that had disappeared seven years before. Suddenly it wasn’t just the one word or gesture I was able to get. It was whole sentences. And ideas,” says Portia.
“I was like a kid in a candy shop. I didn’t know where to start. You know? What’s your favorite color? What do you want to be when you grow up? I mean, you know, all the things you ask your child over the years. Every day, there was a whole new set of things I was finding out.”
They learned that Dov is interested in religion and history and is a surprisingly good mathematician.
60 Minutes II asked Dov how he had learned so much when no one had formally taught him. He told us that all those years when people thought he was lost in his own world, he was actually listening to everything around him.
Although Soma’s method has not yet been studied scientifically, Merzenich is one of many researchers who think it should be taken seriously: “I think it’s almost certain that this method can be used with many, many autistic children, and the initial indication from the studies in Los Angeles is that it might apply even to the substantial majority of these children.”
But one thing is certain. The ability to communicate has had a profound effect on Dov's life. He's happier now - and you don't have to be a scientist to understand why. “I can tell others my feelings,” writes Dov.
After this report aired in January, Cure Autism Now received thousands of letters from families asking Soma to work with their children. Since then, she's worked individually with some 70 kids with autism. The results, parents tell us, have been remarkable. Soma and Portia are now finishing a manual that will teach others how to use the Rapid Prompting Method.
But there has also been what some are calling an unexpected breakthrough in the disorder.
It has happened quietly, with just a handful of children - but it could have profound implications for nearly half a million children in the U.S. alone.
They are kids with autism - kids many presume are mentally retarded, or locked in their own world, unable to communicate or even to think for themselves. That was the prevailing view of autism. Until now.
Correspondent Vicki Mabrey takes a look at the remarkable people who are breaking the silence of autism - a silence that led one couple on a desperate search for a cure. This report originally aired in January.
For Hollywood producer Jon Shestack and his wife, Portia Iversen, their son Dov appeared to be developing normally.
Then, at around 18 months, he lost the few words he had learned to speak, stopped answering to his name and disappeared into the frightening world of autism.
“I felt helpless to help him. And yet, every minute, every day, I saw him getting further and further out of my grasp and there was no expert out there to stop it,” says Portia.
Jon and Portia were told their son had the most severe form of autism, and would never speak again. Doctors said there was nothing the couple could do for him except give him constant care and get on with their lives.
Now 10, the only sounds Dov makes are unintelligible. His behavior is filled with uncontrollable movements called “stimming,” or self-stimulation.
The parents were told there was no cure. And they discovered there were very few scientists even doing autism research. So they formed a research foundation called Cure Autism Now, or CAN, which is now the largest private supporter of autism research in the country.
Their biggest breakthrough came from a 14-year-old boy their foundation brought over from India - a boy who seemed very much like their own son, but with some dramatic differences.
Tito Mukhopadhyay is challenging every assumption about autism, turning the world of Portia and Jon, and thousands of other parents like them, upside down.
Like Dov, he's severely autistic. He, too, is almost mute and has little control over his body.
But unlike Dov, and thousands of other autistic children, Tito is doing what doctors and researchers once thought impossible: He has learned to write eloquently and independently about what it’s like to be trapped in an autistic body.
“I was able to ask Tito things I always wanted to ask my own son, Dov,” says Portia. “Why do you flap? Why do you rock? Why can’t you look me in the eyes? You know, and Tito could answer all those questions.”
What does Tito think is the biggest misperception that people have of autism? "That they don't have any understanding," writes Tito.
Scientists say they’ve never seen anyone like Tito before. By definition, people with severe autism have trouble with language – a notion that Tito shatters every time he puts pen to paper.
Dr. Mike Merzenich has been studying Tito for more than a year. A neuroscientist at the University of California at San Francisco, he says he believes Tito is not only authentic, but also miraculous. “There can be little question in the writing and typing behaviors of Tito that he’s providing the answers, and that the answers are coming from his brain."
If Tito is a miracle of autism, the miracle worker is his mother Soma, who gave up a career in chemistry to devote her life to teaching her son - even though doctors in India said he would never be able to learn.
“At first, they told us he was mentally retarded because he wasn’t doing anything. He wasn’t doing what a 3-year-old child should do. He did not respond. He did not do anything,” says Soma, who was simply told to keep him busy.
As a young child, she noticed he was staring at calendars, so she started teaching him numbers and letters. When he wouldn’t hold a pencil, she used a rubber band to tie one to his finger and taught him to draw lines, and eventually to write.
If her method looks simple, parents of other severely autistic children will tell you that at one time or another, they, too, tried to get their child to type or communicate - with no success.
But Soma's method requires tenacity. For the past 11 years, this tireless taskmaster has spent every waking moment talking and teaching, constantly prodding, to keep Tito stimulated, and his mind on track.
Her determination, and her assumptions about Tito, may have made all the difference. She never doubted that he could learn. So she fed him a healthy diet of knowledge – from Shakespeare to geometry to music.
Tito says that if his mother hadn’t pushed him, he would have been a “vegetable.” Merzenich agrees.
Though Tito seems to have escaped that fate through his writing, he remains severely autistic. He can’t pick up the pad and pencil to write without his mother’s constant prodding and urging. But when Tito does write, it is with astonishing insight, especially for a boy just 14 years old.
He's written hundreds of poems, including one that 60 Minutes II watched him write from beginning to end: “I have fancied a little dream and the world is left unseen… with the light of your eyes… through the darkness of the night … I have held that little dream … beyond my world beyond all scenes.”
“Tito is a beautiful example of the possible," says Merzenich. "Here we have a boy that largely through the empirical interaction of this boy with his mother, a way has been found into his ability, into his spirit.”
Is Tito just one in a million?
"I think there could be thousands, maybe tens of thousands of Titos out there," says Merzenich.
Scientists will soon find out if that's true. For the past year, Soma’s been testing her methods on a small group of children at the Carousel School in Los Angeles. Among her students is Jon and Portia's son, Dov.
Like Tito, these 9- and 10-year-olds are severely autistic. Few can speak. Until recently, teachers had no idea if anything was actually getting through.
But in the space of a year, kids who were being taught on a kindergarten level are now being taught math, social studies and science like fourth graders.
“I had honestly never seen anything like this in my life,” says teacher Karen Spratt, who admits she was skeptical when Soma first came to the school.
“Soma really did everything that I was told not to do as a teacher. For instance, she talked constantly. In my training, it was that you give basic directions and wait for a response, and not to verbalize too much because it could be distracting.
” Instead of being distracting, Soma’s “Rapid Prompting Method,” as she calls it, seems to keep the children’s attention focused long enough for them to communicate. She ignores their erratic movements and wandering eyes, and focuses instead on the mind locked inside.
Soma is sure that her method works. And she offers some astonishing proof. Dov was one of her first students – since it was his parents, Portia and Jon, whose foundation brought Soma to the United States.
His parents were astonished at his progress: From a boy who six weeks earlier couldn’t even tie his shoes suddenly came full sentences, complex thoughts and words spelled correctly.
“The best way I could put this is it seemed like I was seeing the kid that had disappeared seven years before. Suddenly it wasn’t just the one word or gesture I was able to get. It was whole sentences. And ideas,” says Portia.
“I was like a kid in a candy shop. I didn’t know where to start. You know? What’s your favorite color? What do you want to be when you grow up? I mean, you know, all the things you ask your child over the years. Every day, there was a whole new set of things I was finding out.”
They learned that Dov is interested in religion and history and is a surprisingly good mathematician.
60 Minutes II asked Dov how he had learned so much when no one had formally taught him. He told us that all those years when people thought he was lost in his own world, he was actually listening to everything around him.
Although Soma’s method has not yet been studied scientifically, Merzenich is one of many researchers who think it should be taken seriously: “I think it’s almost certain that this method can be used with many, many autistic children, and the initial indication from the studies in Los Angeles is that it might apply even to the substantial majority of these children.”
But one thing is certain. The ability to communicate has had a profound effect on Dov's life. He's happier now - and you don't have to be a scientist to understand why. “I can tell others my feelings,” writes Dov.
After this report aired in January, Cure Autism Now received thousands of letters from families asking Soma to work with their children. Since then, she's worked individually with some 70 kids with autism. The results, parents tell us, have been remarkable. Soma and Portia are now finishing a manual that will teach others how to use the Rapid Prompting Method.
Wednesday, September 19, 2007
Testosterone in Womb Linked to Autism
Science Daily — Foetuses that produce high levels of testosterone have more autistic traits during development, said Professor Baron-Cohen from the University of Cambridge at the BA Festival of Science on September 11, 2007.
Current research by Baron-Cohen and Bonnie Auyeung at the same university shows a significant link between amniotic testosterone levels and the number of autistic traits in children. Baron-Cohen is following the development of children from 235 mothers, whose prenatal levels of testosterone were determined by amniocentesis.
So far, the children have been observed at 4 stages in their development: 12, 18, 46 and 96 months.
A difference between the children was observed as early as one year old.
The typical autistic traits observed in the children with high amniotic testosterone levels included poor empathy and social skills, and good pattern recognition and numerical reasoning.
The babies with higher testosterone levels were less likely to look at their mother’s face during playtime. Once they reached eighteen months, high-testosterone babies performed badly in vocabulary tests and were able to recognise fewer words.
At 8 years old, the children with high testosterone levels performed well in pattern recognition tests and badly in empathy tests.
The causes of elevated foetal testosterone levels are not known. There is not thought to be a link between foetal and maternal testosterone levels. Smoking and alcohol have been discounted as possible causes.
A genetic and/or environmental factor may be to blame. Twin studies have shown similar testosterone levels in identical twins, giving weight to the genetic argument.
In cases of non-identical twins, with one male and one female twin, which share the same amniotic sac, the female twin has higher testosterone levels than normal.
The Medical Research Council is funding an expansion of Professor Baron-Cohen’s study to include diagnosed autistic children. Baron-Cohen will collaborate with Denmark to match their register of autistic patients against its biobank of amniotic samples.
In future, it may be possible to select foetuses based on testosterone levels. This would raise the question of whether it is right to select children on the basis of extreme ‘maleness’ characteristics.
It is well known that men have higher foetal testosterone levels than women. Testosterone has been linked to the typical male characteristic of good problem solving.
Current research by Baron-Cohen and Bonnie Auyeung at the same university shows a significant link between amniotic testosterone levels and the number of autistic traits in children. Baron-Cohen is following the development of children from 235 mothers, whose prenatal levels of testosterone were determined by amniocentesis.
So far, the children have been observed at 4 stages in their development: 12, 18, 46 and 96 months.
A difference between the children was observed as early as one year old.
The typical autistic traits observed in the children with high amniotic testosterone levels included poor empathy and social skills, and good pattern recognition and numerical reasoning.
The babies with higher testosterone levels were less likely to look at their mother’s face during playtime. Once they reached eighteen months, high-testosterone babies performed badly in vocabulary tests and were able to recognise fewer words.
At 8 years old, the children with high testosterone levels performed well in pattern recognition tests and badly in empathy tests.
The causes of elevated foetal testosterone levels are not known. There is not thought to be a link between foetal and maternal testosterone levels. Smoking and alcohol have been discounted as possible causes.
A genetic and/or environmental factor may be to blame. Twin studies have shown similar testosterone levels in identical twins, giving weight to the genetic argument.
In cases of non-identical twins, with one male and one female twin, which share the same amniotic sac, the female twin has higher testosterone levels than normal.
The Medical Research Council is funding an expansion of Professor Baron-Cohen’s study to include diagnosed autistic children. Baron-Cohen will collaborate with Denmark to match their register of autistic patients against its biobank of amniotic samples.
In future, it may be possible to select foetuses based on testosterone levels. This would raise the question of whether it is right to select children on the basis of extreme ‘maleness’ characteristics.
It is well known that men have higher foetal testosterone levels than women. Testosterone has been linked to the typical male characteristic of good problem solving.
Monday, August 20, 2007
Autism school opens in Chambersburg
Autism school opens in Chambersburg
By KEITH PARADISE Staff writer
Less than a year ago, one in 166 people were diagnosed with autism.
Today, those numbers are one in 150.
Just as the amount of people being diagnosed with the disorder is increasing, so too are the number of facilities and methods to treat them.
Northwestern Human Services Inc.'s autism school will be opening its doors in Chambersburg for Wednesday for an information session from 3:30 p.m. to 6:30 p.m. Representatives from each school district and parents of autistic children have been invited to see the school and what it offers. The school will open to students when classes start Aug. 27.
The school was created to provide specialized teaching for autistic students - a service that is often unavailable in school districts.
"There are a lot of families that are frustrated with the autism services available in their districts," said Sharon Greene, director of the NHS school in Hermanie.
Autism is a neurobiological disorder that typically lasts throughout a person's lifetime and is part of a group of disorders known as Autism Spectrum Disorders. The disorder, which can usually be diagnosed in a child by the age of 3, occurs in all ethnic groups and males are four times as likely to be diagnosed with it than girls. Autism impairs a person's ability to communicate and relate to others and can also lead to rigid routines and repetitive behaviors.
NHS was started in 1996 as behavioral support for schools and then opened the first school with an autism-based curriculum in Hermanie, Westmoreland County, in 2003. The school started out contacting individual school districts and offering its service. The school now has numerous school districts throughout the county referring students to them.
"There were a lot of parents out there asking, 'How am I going to educate my child?'" said Greene.
The curriculum concentrates on developing communication and life skills, behavioral, emotional and social development, and academic skills. The school also offers an individualized goal selection based on the appropriate needs of each student. Students are also given a monthly report card showing their progress and also giving parents goals that they can work with the child at home.
NHS also operates schools in Philadelphia, Carlisle and Altoona. The Chambersburg school is one of four that NHS is opening this year in Pennsylvania, along with Reading, State College and York. The Chambersburg school will be serving students from Franklin, Fulton and parts of Adams counties.
Parents cannot simply enroll their child in the school and pay a tuition. The child must first be recommended to the school by the school district after being assessed by staff from NHS and the district. A child is only recommended to the school if the district, NHS and parents agree that the school would provide the best learning environment. The district would then provide tuition for the child's schooling.
Children ages 5 through 21 who have been diagnosed with an Autism Spectrum Disorder are eligible for the school. The Chambersburg school currently has three classrooms available with enough space to accommodate five. All of the teachers hired by the school have training and experience in autism.
"We don't have any staff that can't help our kids," Greene said.
The goal for the students is for them to eventually transition into the least restrictive environment possible and for them to have the skills needed to be productive when they're adults.
"The goal is to be able to get them mainstreamed back into the school district and society," said Lou Ann Jones, director of the Chambersburg school.
By KEITH PARADISE Staff writer
Less than a year ago, one in 166 people were diagnosed with autism.
Today, those numbers are one in 150.
Just as the amount of people being diagnosed with the disorder is increasing, so too are the number of facilities and methods to treat them.
Northwestern Human Services Inc.'s autism school will be opening its doors in Chambersburg for Wednesday for an information session from 3:30 p.m. to 6:30 p.m. Representatives from each school district and parents of autistic children have been invited to see the school and what it offers. The school will open to students when classes start Aug. 27.
The school was created to provide specialized teaching for autistic students - a service that is often unavailable in school districts.
"There are a lot of families that are frustrated with the autism services available in their districts," said Sharon Greene, director of the NHS school in Hermanie.
Autism is a neurobiological disorder that typically lasts throughout a person's lifetime and is part of a group of disorders known as Autism Spectrum Disorders. The disorder, which can usually be diagnosed in a child by the age of 3, occurs in all ethnic groups and males are four times as likely to be diagnosed with it than girls. Autism impairs a person's ability to communicate and relate to others and can also lead to rigid routines and repetitive behaviors.
NHS was started in 1996 as behavioral support for schools and then opened the first school with an autism-based curriculum in Hermanie, Westmoreland County, in 2003. The school started out contacting individual school districts and offering its service. The school now has numerous school districts throughout the county referring students to them.
"There were a lot of parents out there asking, 'How am I going to educate my child?'" said Greene.
The curriculum concentrates on developing communication and life skills, behavioral, emotional and social development, and academic skills. The school also offers an individualized goal selection based on the appropriate needs of each student. Students are also given a monthly report card showing their progress and also giving parents goals that they can work with the child at home.
NHS also operates schools in Philadelphia, Carlisle and Altoona. The Chambersburg school is one of four that NHS is opening this year in Pennsylvania, along with Reading, State College and York. The Chambersburg school will be serving students from Franklin, Fulton and parts of Adams counties.
Parents cannot simply enroll their child in the school and pay a tuition. The child must first be recommended to the school by the school district after being assessed by staff from NHS and the district. A child is only recommended to the school if the district, NHS and parents agree that the school would provide the best learning environment. The district would then provide tuition for the child's schooling.
Children ages 5 through 21 who have been diagnosed with an Autism Spectrum Disorder are eligible for the school. The Chambersburg school currently has three classrooms available with enough space to accommodate five. All of the teachers hired by the school have training and experience in autism.
"We don't have any staff that can't help our kids," Greene said.
The goal for the students is for them to eventually transition into the least restrictive environment possible and for them to have the skills needed to be productive when they're adults.
"The goal is to be able to get them mainstreamed back into the school district and society," said Lou Ann Jones, director of the Chambersburg school.
Wednesday, July 25, 2007
New Model For Autism Suggests Women Carry The Disorder And Explains Age As A Risk Factor
Science Daily — A new model for understanding how autism is acquired has been developed by a team of researchers led by Cold Spring Harbor Laboratory (CSHL) and Albert Einstein College of Medicine. Autism is a developmental disorder, characterized by language impairments, social deficits, and repetitive behaviors. The researchers analyzed data on autism incidence and found a previously unrecognized pattern.
The pattern can be explained by assuming that spontaneous germ-line mutation is a significant cause of the disorder. Parents, especially women, who acquire the mutation – but do not exhibit severe symptoms of the disorder – have a 50% chance of passing the mutation on to their children. Sons often show the most severe symptoms.
Spontaneous mutations are changes in a chromosome that alter genes. Germ-line mutations are newly acquired in a germ cell of a parent, and sometimes are transmitted to offspring at conception. Men and women are equally as likely to acquire a spontaneous mutation that can cause autism, but autism is three times more likely in men, making women the more likely carriers of new mutations. “The fact that germ-line mutations increase with age places older parents at a higher risk of having children with autism, explaining a pattern that has been recently observed,” said CSHL co-author of the study Michael Wigler, Ph.D.
The model proposes two prominent risk classes for families affected by autism. Low risk families give rise to sporadic autism, the more common form, by spontaneous germ-line mutation. The children, mostly female, who receive such a mutation, but do not display the disorder, are the source of the high risk families.
The data show that the transmission pattern to boys in high risk families is often of a dominant pattern that may account for a quarter of autism. Although the data does not answer whether there is a gradation of lower risk, the model builds on recent CSHL findings that spontaneous mutation is frequent in sporadic autism and less frequent in children from high risk families.
Wigler suggests that “what we now know about spontaneous mutations and autism offers an alternative to traditional thinking about genetic disorders as purely heritable from a parent. This has implications for other disorders such as morbid obesity, schizophrenia, and congenital heart disease.”
The full citation of the paper published in the July 31, 2007 print edition of the Proceedings of the National Academy of Sciences is: "A unified theory for sporadic and inherited autism," by Xiaoyue Zhao, Anthony Leotta, Vlad Kustanovich, Clara Lajonchere, Daniel H. Geschwind, Kiely Law, Paul Law, Shanping Qiu, Catherine Lord, Jonathan Sebat, Kenny Ye and Michael Wigler.
The research was funded by the Simons Foundation and utilized databases from the Autistic Resource Exchange (AGRE) Consortium, the University of Michigan, and the Interactive Autism Network (IAN). IAN is an on-line national autism registry and database launched in April by the Kennedy Krieger Institute.
Note: This story has been adapted from a news release issued by Cold Spring Harbor Laboratory.
The pattern can be explained by assuming that spontaneous germ-line mutation is a significant cause of the disorder. Parents, especially women, who acquire the mutation – but do not exhibit severe symptoms of the disorder – have a 50% chance of passing the mutation on to their children. Sons often show the most severe symptoms.
Spontaneous mutations are changes in a chromosome that alter genes. Germ-line mutations are newly acquired in a germ cell of a parent, and sometimes are transmitted to offspring at conception. Men and women are equally as likely to acquire a spontaneous mutation that can cause autism, but autism is three times more likely in men, making women the more likely carriers of new mutations. “The fact that germ-line mutations increase with age places older parents at a higher risk of having children with autism, explaining a pattern that has been recently observed,” said CSHL co-author of the study Michael Wigler, Ph.D.
The model proposes two prominent risk classes for families affected by autism. Low risk families give rise to sporadic autism, the more common form, by spontaneous germ-line mutation. The children, mostly female, who receive such a mutation, but do not display the disorder, are the source of the high risk families.
The data show that the transmission pattern to boys in high risk families is often of a dominant pattern that may account for a quarter of autism. Although the data does not answer whether there is a gradation of lower risk, the model builds on recent CSHL findings that spontaneous mutation is frequent in sporadic autism and less frequent in children from high risk families.
Wigler suggests that “what we now know about spontaneous mutations and autism offers an alternative to traditional thinking about genetic disorders as purely heritable from a parent. This has implications for other disorders such as morbid obesity, schizophrenia, and congenital heart disease.”
The full citation of the paper published in the July 31, 2007 print edition of the Proceedings of the National Academy of Sciences is: "A unified theory for sporadic and inherited autism," by Xiaoyue Zhao, Anthony Leotta, Vlad Kustanovich, Clara Lajonchere, Daniel H. Geschwind, Kiely Law, Paul Law, Shanping Qiu, Catherine Lord, Jonathan Sebat, Kenny Ye and Michael Wigler.
The research was funded by the Simons Foundation and utilized databases from the Autistic Resource Exchange (AGRE) Consortium, the University of Michigan, and the Interactive Autism Network (IAN). IAN is an on-line national autism registry and database launched in April by the Kennedy Krieger Institute.
Note: This story has been adapted from a news release issued by Cold Spring Harbor Laboratory.
Spontaneous mutation seen as major factor in autism: study
Most apparently random cases of autism may be just that, a function of freak genetic accidents, rather than a product of an inherited genetic predisposition that is passed down through generations, according to a study released Monday.
The authors of the study suggest that spontaneous mutations in the DNA of an afflicted child or their parent may play a much larger role than previously thought in sporadic cases of autism, where there is no family history of the devastating childhood developmental disorder.
The genetic origins of the neurological condition are still unclear, but in a recent paper, US researchers reported that spontaneous mutations, or tiny glitches in the DNA, were common in about 10 percent of the autistic patients they studied.
The pattern was particularly noticeable in cases of sporadic autism which is the most common form.
In the light of this finding, investigators at Cold Spring Harbor Laboratory and Albert Einstein College of Medicine in New York did a mathematical analysis of three databases on the incidence of autism to see if this new theory could account for the distribution of cases.
They concluded that a previously unrecognized pattern could be explained by assuming that spontaneous mutations are a significant cause of the disorder and that parents, especially women, who acquire the DNA glitches, have a 50 percent chance of passing it on to their child.
The researchers suggest that in this way, women who carry these spontaneous mutations, which are in effect missing or duplicate stretches of DNA, while themselves asymptomatic, are the source of high-risk families, which feature one or more autistic children.
"For the first time, we have a model that explains the sporadic and the inherited forms of autism," said Michael Wigler, a geneticist at Cold Spring Harbor Laboratory.
Given that spontaneous mutations in DNA increase with age, and that many women in industrialized nations are postponing childbirth until the last minute, the theory may also explain why older parents are at greater risk of having autistic children, Wigler said.
The little-understood disorder is characterized by poor social and communication skills and afflicts one in 150 children, most of them boys, according to the latest estimates from US public health authorities.
The study appears in the Proceedings of the National Academy of Sciences.
The authors of the study suggest that spontaneous mutations in the DNA of an afflicted child or their parent may play a much larger role than previously thought in sporadic cases of autism, where there is no family history of the devastating childhood developmental disorder.
The genetic origins of the neurological condition are still unclear, but in a recent paper, US researchers reported that spontaneous mutations, or tiny glitches in the DNA, were common in about 10 percent of the autistic patients they studied.
The pattern was particularly noticeable in cases of sporadic autism which is the most common form.
In the light of this finding, investigators at Cold Spring Harbor Laboratory and Albert Einstein College of Medicine in New York did a mathematical analysis of three databases on the incidence of autism to see if this new theory could account for the distribution of cases.
They concluded that a previously unrecognized pattern could be explained by assuming that spontaneous mutations are a significant cause of the disorder and that parents, especially women, who acquire the DNA glitches, have a 50 percent chance of passing it on to their child.
The researchers suggest that in this way, women who carry these spontaneous mutations, which are in effect missing or duplicate stretches of DNA, while themselves asymptomatic, are the source of high-risk families, which feature one or more autistic children.
"For the first time, we have a model that explains the sporadic and the inherited forms of autism," said Michael Wigler, a geneticist at Cold Spring Harbor Laboratory.
Given that spontaneous mutations in DNA increase with age, and that many women in industrialized nations are postponing childbirth until the last minute, the theory may also explain why older parents are at greater risk of having autistic children, Wigler said.
The little-understood disorder is characterized by poor social and communication skills and afflicts one in 150 children, most of them boys, according to the latest estimates from US public health authorities.
The study appears in the Proceedings of the National Academy of Sciences.
New Theory about Autism Roots
It appears that some boys have as much as a 50 percent risk of developing the mysterious disorder
In work that may one day lead to earlier detection of children at risk of developing autism, a team of scientists has devised a genetic model for the enigmatic disorder. The two-tiered theory integrates families with one or more autistic children.
An estimated one in every 150 children born in the U.S. develops autism, according to the Centers for Disease Control and Prevention (CDC); it is four times more prevalent in boys than in girls. The condition is characterized by cognitive deficiencies and symptoms ranging from antisocial (not responding to one's name and / or avoiding eye contact) to obsessive, repetitive behavior. The most popular theory about its genesis is that there are flaws in several genes passed down through generations of a family that culminate to predispose a child to the disorder, especially if exposed to certain environmental factors such as toxic chemicals or a lack of oxygen at birth.
"People thought there was this uniform risk—if you have an autistic child, then there's some uniform, but fairly low, risk that you'll have another one," says Michael Wigler, a professor of genomics at Cold Spring Harbor Laboratory (CSHL) in Long Island, N.Y., and senior author of the new model described in Proceedings of the National Academy of Sciences USA. "None of the population geneticists, in my experience, had thought that there might be two classes of families: low risk and high risk."
Wigler's rethinking of autism's cause stems from an exhaustive analysis of risk based on a database of families with more than one autistic child. (The Autism Genetic Resource Exchange, or AGRE, manages the database.) The team determined that most cases of autism arise from novel, spontaneous mutations passed down from one or both parents, resulting in large gaps in a person's genome often encompassing several genes, which are then disrupted or inactivated. (This loss of genetic code—known as copy number variation—results in an offspring receiving only one of the standard two copies of a gene, which could cause an insufficient amount of protein to be produced by those genes.) In most instances, this mutation will result in an autistic child. However, in some cases—more likely in girls than boys—the recipient of this mutation will not produce any symptoms.
"When that child matures and becomes a parent, they have a 50 percent chance of transmitting … [their mutation] … to a child that might not be as lucky as they were, especially if … [its] … a boy," Wigler says. "So, they will be transmitting this with close to a 50 percent frequency—and that is the source of the high-risk families."
Wigler says that the team will continue to update its model as new figures are added to the AGRE database and try to gain new insight into the mechanism that gives girls greater resistance than boys. "To understand that [disparity] at a molecular or genetic level would be very important, because you could theoretically treat kids … you could detect something early and intervene," Wigler says. "I view it as the most important thing to understand."
Maja Bucan, an associate professor of genetics and gene variation at the University of Pennsylvania, says that the new autism model is a creative way to interpret the familial data. "It's important to come up with new theories and then just test them once we have more data," she explains. "I don't think we have enough data [yet] to say whether this theory is right or wrong."
According to Wigler, the new model "certainly changes the way you think about autism. The paradigm shift is … something can be genetic without being heritable. The field has ignored the contribution of spontaneous mutation for a whole range of things that matter a lot to society," which, he adds, includes schizophrenia and morbid childhood obesity.
In work that may one day lead to earlier detection of children at risk of developing autism, a team of scientists has devised a genetic model for the enigmatic disorder. The two-tiered theory integrates families with one or more autistic children.
An estimated one in every 150 children born in the U.S. develops autism, according to the Centers for Disease Control and Prevention (CDC); it is four times more prevalent in boys than in girls. The condition is characterized by cognitive deficiencies and symptoms ranging from antisocial (not responding to one's name and / or avoiding eye contact) to obsessive, repetitive behavior. The most popular theory about its genesis is that there are flaws in several genes passed down through generations of a family that culminate to predispose a child to the disorder, especially if exposed to certain environmental factors such as toxic chemicals or a lack of oxygen at birth.
"People thought there was this uniform risk—if you have an autistic child, then there's some uniform, but fairly low, risk that you'll have another one," says Michael Wigler, a professor of genomics at Cold Spring Harbor Laboratory (CSHL) in Long Island, N.Y., and senior author of the new model described in Proceedings of the National Academy of Sciences USA. "None of the population geneticists, in my experience, had thought that there might be two classes of families: low risk and high risk."
Wigler's rethinking of autism's cause stems from an exhaustive analysis of risk based on a database of families with more than one autistic child. (The Autism Genetic Resource Exchange, or AGRE, manages the database.) The team determined that most cases of autism arise from novel, spontaneous mutations passed down from one or both parents, resulting in large gaps in a person's genome often encompassing several genes, which are then disrupted or inactivated. (This loss of genetic code—known as copy number variation—results in an offspring receiving only one of the standard two copies of a gene, which could cause an insufficient amount of protein to be produced by those genes.) In most instances, this mutation will result in an autistic child. However, in some cases—more likely in girls than boys—the recipient of this mutation will not produce any symptoms.
"When that child matures and becomes a parent, they have a 50 percent chance of transmitting … [their mutation] … to a child that might not be as lucky as they were, especially if … [its] … a boy," Wigler says. "So, they will be transmitting this with close to a 50 percent frequency—and that is the source of the high-risk families."
Wigler says that the team will continue to update its model as new figures are added to the AGRE database and try to gain new insight into the mechanism that gives girls greater resistance than boys. "To understand that [disparity] at a molecular or genetic level would be very important, because you could theoretically treat kids … you could detect something early and intervene," Wigler says. "I view it as the most important thing to understand."
Maja Bucan, an associate professor of genetics and gene variation at the University of Pennsylvania, says that the new autism model is a creative way to interpret the familial data. "It's important to come up with new theories and then just test them once we have more data," she explains. "I don't think we have enough data [yet] to say whether this theory is right or wrong."
According to Wigler, the new model "certainly changes the way you think about autism. The paradigm shift is … something can be genetic without being heritable. The field has ignored the contribution of spontaneous mutation for a whole range of things that matter a lot to society," which, he adds, includes schizophrenia and morbid childhood obesity.
Saturday, June 23, 2007
Boys with Autism, Related Disorders, Have High Levels of Growth Hormones
Boys with autism and autism spectrum disorder had higher levels of hormones involved with growth in comparison to boys who do not have autism, reported researchers from the National Institutes of Health, the Centers for Disease Control and Prevention, the Cincinnati Children’s Hospital and the University Of Cincinnati College Of Medicine.
The researchers believe that the higher hormone levels might explain the greater head circumference seen in many children with autism. Earlier studies had reported that many children with autism have very rapid head growth in early life, leading to a proportionately larger head circumference than children who do not have autism.
The researchers found that, in addition to a larger head circumference, the boys with autism and autism spectrum disorder who took part in the current study were heavier than boys without these conditions.
“The study authors have uncovered a promising new lead in the quest to understand autism,” said Duane Alexander, M.D., Director of the National Institute of Child Health and Human Development, the NIH institute that funded the study. “Future research will determine whether the higher hormone levels the researchers observed are related to abnormal head growth as well as to other features of autism.”
Autism is a complex developmental disorder that includes problems with social interaction and communication. The term autism spectrum disorder (ASD) refers to individuals who have a less severe form of autism.
The study was published on line in Clinical Endocrinology.
The researchers compared the height, weight, head circumference and levels of growth-related hormones to growth and maturation in 71 boys with autism and with ASD to a group of 59 boys who did not have these conditions.
The investigators found that the boys with autism had higher levels of two hormones that directly regulate growth (insulin-like growth factors 1 and 2). These growth-related hormones stimulate cellular growth. The researchers did not measure the boys’ levels of human growth hormone, which for technical reasons is difficult to evaluate.
The boys with autism also had higher levels of other hormones related to growth, such as insulin-like growth factor binding protein and growth hormone binding protein.
In addition to greater head circumference, the boys with autism and those with autism spectrum disorders weighed more and had a higher body mass index (BMI). BMI is a ratio of a person’s weight and height. A higher BMI often indicates that a person is overweight or obese. The boys’ higher BMI may be related to their higher hormone levels, said the study’s principal investigator, NICHD’s James L. Mills, M.D., a senior investigator in the Division of Epidemiology, Statistics and Prevention Research’s Epidemiology Branch. Dr. Mills and his coworkers also found that there was no difference in height between the two groups of boys.
The levels of growth-related hormones were significantly higher in the boys with autism even after the researchers compensated for the fact that higher levels of these hormones would be expected in children with a greater BMI.
“The higher growth-related hormone levels are not a result of the boys with autism simply being heavier,” said Dr. Mills.
While it has long been noted that many children with autism have a larger head circumference than other children, few studies have investigated whether these children are also taller and heavier, Dr. Mills added.
Researchers analyzed medical records and blood samples from 71 boys diagnosed with autism and ASD who were patients at Cincinnati Children’s Hospital Medical Center from March 2002 to February 2004. The researchers compared the information on the boys with autism and autism spectrum disorders to other boys treated for other conditions at the hospital and who do not have autism. Children with conditions that may have affected their growth — such as being born severely premature, long-term illness, or the genetic condition Fragile X were not included in the study. Girls are much less likely to develop autism than are boys, and the researchers were unable to recruit a sufficient number of girls with autism to participate in the study.
Dr. Mills explained that the bone age of the boys with autism — the bone development assessed by taking X-rays and comparing the size and shape of the bones to similarly-aged children — were not more advanced in the group of boys with autism. For this reason, Dr. Mills and his coworkers ruled out the possibility that they were merely maturing more rapidly than were the other boys.
Dr. Mills said that future studies could investigate whether the higher levels of growth hormones seen in children with autism could be directly related to the development of the condition itself.
The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s Web site at http://www.nichd.nih.gov/.
The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.Study links autism with growth hormones, big heads
Boys with autism and related disorders had higher levels of growth hormones than other boys, which may explain why children with the condition often have larger heads, researchers reported on Friday.
Boys with autism and autism spectrum disorders were also heavier than boys without these conditions, the teams at the National Institutes of Health, the Centers for Disease Control and Prevention and the Cincinnati Children's Hospital reported.
Other studies had already shown that children with autism have very rapid head growth in early life.
"The study authors have uncovered a promising new lead in the quest to understand autism," said Dr. Duane Alexander, Director of the National Institute of Child Health and Human Development.
"Future research will determine whether the higher hormone levels the researchers observed are related to abnormal head growth as well as to other features of autism," Alexander said in a statement.
No one knows what causes autism, a complex developmental disorder that includes problems with social interaction and communication.
Symptoms range from mild awkwardness seen in Asperger's syndrome, to severe disability and mental retardation. A recent CDC survey found that 1 in every 150 U.S. children has autism or an autism spectrum disorder, a less severe condition related to autism, such as Asperger's.
Writing in the journal Clinical Endocrinology, Dr. James Mills of the NICHD and colleagues said they compared the height, weight, head circumference and levels of growth-related hormones to growth and maturation in 71 boys with autism to a group of 59 healthy boys.
The boys with autism had higher levels of two hormones that directly regulate growth -- insulin-like growth factor-1 and IGF-2. The boys also had higher levels of hormones that indirectly affect growth.
The researchers did not measure the boys' levels of human growth hormone, which for technical reasons is difficult to evaluate.
The boys with autism and those with autism spectrum disorders had a greater head circumference on average, weighed more and had a higher body mass index than the other boys, although there was no difference in height between the two groups of boys.
Girls are much less likely to develop autism than boys, and the researchers were unable to recruit enough girls with autism to participate in the study.
Several genes have been linked with autism, but environmental factors may also play a role, experts say.
UCLA Imaging Study Provides Clues About Inability To Imitate And Empathize In Autistic Children
New imaging research at UCLA shows that impairments in autistic children's ability to imitate and empathize can be linked to dysfunction in the brain's mirror-neuron system.
In research presented at the annual International Meeting for Autism Research in
Mirror neurons fire when an individual performs an action with a goal in mind. They also fire when one watches another individual perform that same action. Neuroscientists believe this "mirroring" is the neural mechanism by which the actions, intentions and emotions of other people can be automatically understood.
Individuals with autism can't rely on this system to read the minds of other people. Symptoms of autism include varying levels of difficulty with social interaction, including verbal and nonverbal communication, imitation, and empathy. These findings bolster the growing body of evidence that points to a breakdown of the MNS as the mechanism behind these symptoms.
"These results support the notion that a dysfunctional mirror-neuron system may underlie the impairments in imitation and in empathizing with other people's emotions typically seen in autism," said Mirella Dapretto, associate professor of psychiatry and biobehavioral sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA and the David Geffen School of Medicine at UCLA. Dapretto and Stephany Cox, a research assistant in Dapretto's lab, are the lead authors of the study. "Together with other recent data, our results provide further support for a mirror-neuron theory of autism."
To measure mirror-neuron activity, the research used functional magnetic resonance imaging (fMRI) in 12 high-functioning children with autism as they viewed and imitated faces depicting several emotional expressions, such as anger, fear, happiness or sadness. Prior to the fMRI experiment, the children's imitative behavior was measured using scores from the Autism Diagnostic Interview (ADI-Revised), an instrument widely used to assess symptoms of autism. Children's empathic behavior was assessed using a child-modified version of the Interpersonal Reactivity Index (IRI), a previously validated scale that assesses four distinct facets of empathy.
The researchers found that, as expected, the level of brain activity in "mirroring" areas was related to the children's tendency to spontaneously imitate others, as well as to empathize with them. Specifically, significant negative correlations were found between symptom severity on the imitation items of the ADI-R and activity in the mirror area located in the brain's right inferior frontal gyrus. Additionally, significant positive correlations were observed between children's total scores on the empathy scale and activity within this mirror area and two other key regions in the brain involved in emotional understanding and empathy, the insula and amygdala.
"Simply put," said Cox, "the more the children tended to spontaneously imitate social behaviors or to empathize with the plight of others, the more brain activity we saw in the frontal component of the mirror-neuron system in the right inferior frontal gyrus. Conversely, the greater their impairments in these domains, the less activity we saw in this mirroring brain region.
"Importantly, these results indicate that abnormalities in the mirror-neuron system may negatively affect imitative behavior," she said. "In turn, this may lead to a cascade of negative consequences for the development of key aspects of social cognition and behavior in children with autism."
Monday, June 4, 2007
Top of the class: Santa Rosa student overcomes autism to graduate with honors
By CLARISSA MARTINEZ SANTA ROSA — Danny Canales is a role model.
But with guidance from his family and members of the education community, Danny graduated — with honors and among the top 10 in his class — from Santa Rosa High School on Friday night. “It’s a lot of feelings at one time,” Danny said. But graduation didn’t come without overcoming struggles.
Danny, 19, began an Early Childhood Intervention Program when he was 3 years old.
“At the time he was severely autistic,” Canales-Cabrera said. “Children with autism, they live in their own little world, they build a world around them.”
Instead of separating Danny, Canales-Cabrera worked with his teachers and speech therapist to try to help Danny learn how to cope in a regular classroom. “He spent two years in kindergarten in the hopes that his social skills would improve,” Canales-Cabrera said.
By first grade, Danny was in the classroom, without any academic assistance but with behavioral modification. “Basically, every year I would speak to teachers and explain what to expect from him,” Canales-Cabrera said.
While in high school, Danny was involved in the high school band, 4-H and student council.
It was his interest in extra-curricular activities that surprised his mother. “Autistic children do not become cheerleaders,” Canales-Cabrera said. “Danny made it to All-American Cheerleaders.”
But Canales-Cabrera said she had to explain to coaches, teachers and even cheerleading judges about Danny’s autism so they could understand his behavior.
She compared it to building a bridge between his world and the rest of society.
“That bridge may break down a couple of times, but you go back and rebuild,” Canales-Cabrera said. “And in the end there is success.”
A success she was told couldn’t be reached.
When Danny was first diagnosed, a doctor recommended that he be institutionalized.
“I made up my mind that day that I would never give up,” Canales-Cabrera said. “I guess I have to thank that doctor for telling me that, because I did totally the opposite.”
Danny’s sister, Kassandra, a junior in high school, said her brother is a role model who carries his enthusiasm for school with him every day. “He actually likes coming to school,” Kassandra said. “He’s always doing something.”
Kassandra is often involved in the same activities as her brother.
“It makes life so much easier,” Canales-Cabrera said.
But Kassandra said Danny has his own interests, like his love of the Weather Channel and architectural design. “It’s just that I’m a very creative person,” Danny said about enjoying architecture. Danny has been accepted to Texas A&M University in Corpus Christi, something that the family is addressing both financially and logistically.
“His autism is never going to go away, but yet he appears normal that society has forgotten,” she said. “My biggest goal is for people to understand that autism is not a disability unless you make it so.”
“I have hope someone will read Daniel’s story, and have faith that this can happen,” Canales-Cabrera said, trying to hold back tears. “Because we went through a lot.”
When asked by his mother if he had a message to other autistic children, Danny spoke about hope and persistence.
“There’s hope,” Danny said. “No matter how dark the tunnel is, there is always going to be some sort of a light.”
Boy dies during autism treatment
By Karen Kane and Virginia Linn, Pittsburgh Post-Gazette
A 5-year-old autistic boy died Tuesday in a Butler County doctor's office while undergoing an increasingly popular though controversial medical treatment touted by some as a cure for the lifelong neurological and developmental disorder.
Abubakar Tariq Nadama died while receiving chelation therapy, an intravenous injection of a synthetic amino acid that latches onto heavy metals and is then passed in the urine.
State police at Butler are investigating Nadama's death, which occurred at about 10:50 a.m. Tuesday in the office of Dr. Roy Eugene Kerry in Portersville.
Authorities said Kerry's office reported that the child was receiving an IV treatment for lead poisoning when he went into cardiac arrest.
The boy was being treated with EDTA, or ethylene diamine tetraacetic acid, which has been approved by the Food and Drug Administration for use only after blood tests confirm acute heavy-metal poisoning.
Exposure to heavy metals, especially mercury, has been linked by some researchers as a contributing cause to autism. Removing those metals, they believe, can improve a child's condition. The theory is a matter of dispute among scientists and within the autism community.
A family friend said the boy and his mother, Marwa, who are from England, moved here in the spring, specifically to receive chelation therapy, and were living in Monroeville.
In the autism community, the use of chelation as a way to detoxify environmental contaminants in children has exploded since 2000 as more and more families have reported miraculous improvements and even cures. But skeptics in the community say they fear the procedure is at best risky and possibly lethal.
"It was just a matter of time before something like this would happen," said Howard Carpenter, executive director of the Advisory Board on Autism-Related Disorders.
"Parents of children with autism are desperate. Some are willing to try anything," he said.
"I can't sit there and endorse it as a viable treatment. It's not something published in peer review journals and studies," said Dr. Gary Swanson, a child psychiatrist at Allegheny General Hospital who works with autism patients. "It's probably a quack kind of medicine."
If the child's death is tied to chelation therapy, it would be the first associated with the procedure since the 1950s, said Dr. Ralph Miranda of Greensburg. Miranda is the former president of the American College for Advancement in Medicine, a group that sets clinical practice and education standards for chelation and other, similar therapies.
Chelation can be administered through pills, skin creams or other transdermal methods, nasal sprays, sauna baths and intravenously. Miranda said it is unusual to give a young child IV treatments unless he has an extremely high level of heavy metals.
He said although EDTA is a "very safe drug" he usually administers an oral form of chelation drugs to children to remove toxins because pills are safer. It does, however, take longer to remove the toxins with the pills.
"There are people out there suggesting using the IV to get faster results. I'm not," he said.
Marwa Nadama said yesterday she did not want to comment except to say that she is not blaming chelation for her son's death, at least not at this point.
"Let's wait until we have the results of the autopsy," she said.
An autopsy conducted yesterday on the child's body by the Allegheny County coroner's office was inconclusive. Results on the cause and manner of death are pending additional testing which could take up to five months to complete, authorities said.
Kerry, who is a board-certified physician and surgeon, advertises himself as an ear, nose and throat specialist, dealing with allergies and environmental medicine. He operates out of offices in Greenville and Portersville under the name Advanced Integrative Medicine Center Inc. Kerry did not return calls to his offices yesterday.
Doctors affiliated with the National Institutes of Mental Health and American Academy of Pediatrics do not endorse the use of chelation therapy to remove heavy metals for autism. Such drugs used in the process can cause liver and kidney damage and other problems.
Cindy Waeltermann, director of the Pittsburgh-based national advocacy group AutismLink, issued a statement to members yesterday warning that caution needs to be used as parents seek help for their autistic children.
"Please, before you try any new therapies, we urge you to research the physician, the methods, and the safety. Some of these therapies are quite dangerous. We're not telling you what to do, we're just urging you to use caution. We all do what we think is best for our children, and sometimes we are desperate. While we've heard stories of chelation success, it is definitely a dangerous process," Waelterman wrote.
She said parents on her group's online forum have referred to Kerry as a known practitioner of chelation therapy.
News of the death soared across the autism community yesterday, alarming proponents and foes of the treatment.
"It's just terrible. My heart is just dying for the family," said J.B. Handley of San Francisco, who helped found Generation Rescue, an international advocacy program for the use of biomedical treatments that include chelation therapy to help autistic children.
He claims his son Jamison, now 3, has dramatically improved since undergoing chelation therapy to remove mercury, the metal most associated with autism because of its presence in some childhood vaccines. He and his wife launched their international group in May.
He said that, in 2000, perhaps a dozen autistic children were treated with chelation therapy. This year, it's more than 10,000.
Thursday, May 31, 2007
Still a mystery, autism spectrum cases growing rapidly
Date Published | May 30, 2007
BY DAVID DUCHARME
It has quickly become one of the biggest issues in medical science, and the fastest growing developmental disorder worldwide.
It’s commonly known as autism. But autism spectrum disorder (ASD) is now the umbrella idiom for the group of neurological disorders to which children are born predisposed.
No one person with an ASD responds or behaves exactly like another, even with the same diagnosis. But each has common ties.
Autism affects and changes the way the brain processes information, resulting in difficulties with communication and social interaction; unusual patterns of behaviour, activities and interests.
Disturbingly, what causes and triggers ASD is still unknown. The frequency of diagnosed cases, however, is increasing at an alarming rate.
The autism field is a young one.
Coined by Leo Kanner in a 1943 research paper entitled, Autistic Disturbances of Affective Contact, the term ‘autistic’ literally translates to “alone.”
An excerpt from that paper reads, “Since 1938, there have come to our attention a number of children whose condition differs so markedly and uniquely from anything reported so far, that each case merits - and, I hope, will eventually receive - a detailed consideration of its fascinating peculiarities.”
Kanner’s subjects each displayed symptoms of communicative and interactive difficulties and unusual interests. The children he identified were (often) previously labelled as schizophrenic and institutionalized.
Classic autism is a common spectrum disorder. It’s symptoms are “classic” in that they are most often associated with autism. They include: a lack of formal communication; rocking, head banging and hand flapping, lack of eye contact and the inability to interact socially. It is a spectrum disorder because its impairments differ greatly on a case-by-case basis.
Asperger’s Disorder is a fascinating, rare segment of the spectrum. Those with Asperger’s are often extremely high functioning, intelligent and verbal. However, they have difficulty with social interaction, interpreting unspoken social cues and are prone to eccentric behaviour.
They can become experts on topics and may only want to discuss those topics, but are unaware that what they are interested in may be of little interest to others.
Comedian Dan Aykroyd is one of the few public figures in Canada to have openly discussed having the disorder.
“I have a fascination with police and I always have to have a badge with me,” Aykroyd said in a 2004 NPR interview. “My grandfather was a Mountie. If I don’t have a badge on me, I feel naked.”
Aykroyd was diagnosed with Tourette’s syndrome and Asperger’s as a child in the early 1960’s.
Albert Einstein and Sir Isaac Newton are among history’s diagnosed or ASD suspected.
No biological marker is linked to autism. There is no chromosomal or blood test in existence to indicate if a child is autistic.
To be diagnosed, children must be observed displaying: difficulty with social interaction, impairment in communication and a pattern of restricted interests.
But the expression of symptoms can vary greatly among individual children. Also, kids labelled “normal” can often be observed behaving in ways generally classified as autistic.
So the question becomes not only does a child truly have a particular symptom, but also to what degree do they have it and where in the spectrum does a child fit?
The process can be quite subjective, according to Sudbury pediatrician Dr. Shawn Murray.
Murray is a specialist in the diagnosis and medical treatment of ASDs. He says a variety of factors combine to make assessment and diagnosis difficult for everyone.
“Once families are in a professional’s office, it becomes a balancing act. The diagnosis still has a stigma attached to it as well. It can take a lot of time for families to come to terms,” he said.
Murray is among a small group of three local doctors struggling to keep up with the sharp rise in ASD caseload. With a lack of services in Sudbury, long waiting lists can leave families in a state of limbo.
“From a resource point of view, it can be very difficult to get a timely diagnosis,” added Murray.
Early intervention is key. But barriers to formal, standardized treatment in Sudbury are a lack of available professionals, waiting lists and expense.
Applied behaviour analysis (ABA) is the most widely accepted form of treatment for autism. ABA is a behavioural modification approach to learning based on the work of Dr. B. F. Skinner. Highly structured and rigorous, it is centred on behaviour analysis and one-on-one teaching, making strategic use of rewards.
Intensive behavioural intervention (IBI) is based on the basic principles of ABA and is most effective in teaching pre-school-aged children. IBI includes frequent and direct measurement of a child’s development, making changes in learning or behaviour highly discernable.
Speech and language therapies are often effective in less severe cases.
While families continue to cope with the realities of ASD, Canada’s federal, provincial and territorial governments have a challenge ahead in allocating resources at a level that matches the rise in caseload.
And as research continues, medical science is left to fuse together a jumbled mix of traditional views and new findings.
The Yale School of Medicine released a study on April 21 of this year that found toddlers with ASD who have trouble making eye contact with people do not have difficulty in looking at photographs of faces. They also spend most of the time looking at photos examining…the eyes.
“This is a surprising finding, given that avoiding eye contact is one of the classic hallmarks of autism,” said Chawarska, in a Yale University news release.
Such are the mysteries of autism.
Wednesday, May 23, 2007
Autism on the rise
Local schools, families struggle to keep up
By Monique Balas / The Bulletin
Published: May 20. 2007 5:00AM PST
Colin O'Connor's mischievous blue eyes twinkle when he laughs, which is often, and he moves with a frantic energy. The 6-year-old enjoys playing games with his stuffed dolls, using them to mimic social situations, and he is friendly to strangers.
Colin is also autistic.
Autism, a developmental disorder that has no known cause, comes in as many shapes and sizes as children do. The fact that there are so many more children with the disorder now than there were only six years ago presents unexpected challenges for school districts and families of children with autism.
Colin's mother, Terri O'Connor, estimates her family spends about $2,000 each month to supplement her autistic son's education with tutors, a slew of therapists - speech, occupational, physical - and a developmental physician to work with Colin.
"The district has provided as best they can," she said. "What my experience is, their caseload is astronomical. There is just no way that they can think about my child ... 10 minutes before they have to meet with me."
The O'Connors, the school district and the High Desert Education Service District have all been feeling the effects of a creeping increase in the number of students diagnosed with some form of autism.
In Bend-La Pine Schools, there currently are 124 students receiving specialized education for autism, said Patti Craveiro, director of special programs for Bend-La Pine Schools. In December 2001, there were 67, an 85 percent increase in six years.
By comparison, the district saw a roughly 13 percent increase in student enrollment in that same time period, according to numbers from Fiscal Services Director Brad Henry.
"For a town that I still consider to be small compared to Portland, San Francisco or L.A., I think there is a very large number of children that receive a diagnosis on a continual basis with ASD (autism spectrum disorder)," said Tracy Kennedy, the lead teacher of Stepping Stones School. Kennedy's school is a preschool program offered by the High Desert ESD for children ages 3 to 5 with autism spectrum disorder.
"They're coming here, and we're doing our best to serve them," Craveiro said.
But some parents say the district simply cannot provide the type of one-on-one attention their children need to succeed.
"They don't have enough time. They don't have enough resources to give a kid resources to get him talking," said Jill Sauter, who home-schools her autistic son, Derek.
She decided to take Derek, 14, out of school because she said he needs attention he simply cannot get in the classroom. Derek had trouble speaking and reading. But thanks to the time he and his mom spent doing mouth drills, with Sauter rewarding him with positive reinforcement, she said his skills have greatly improved. He is now an eighth-grader and only goes to High Desert Middle School for physical education class.
If the school district were to integrate Derek into a regular education classroom, his mother said, he would fall too far behind.
"They're doing book reports, he's trying to read," Sauter said. "He's learning how to put letters together to make a word."
But if he were grouped with other students with disabilities, he risks falling even further behind, Sauter said.
"If he was in a room with 10 other kids that had autism, he's not going to succeed in that situation," she said. "He needs to be with peers that can talk and ask questions."
What is autism?Because of its many forms, autism usually is referred to as a continuum, which is why it is referred to as a spectrum disorder.
Autism spectrum disorders are developmental disabilities that cause major impairments in social interaction and communication, sometimes resulting in unusual behaviors and interests. People with ASDs often learn, think and react differently than other people, according to the Centers for Disease Control and Pre-vention Web site.
For example, during a recent session at home with his private reading tutor, Heather Wingate, Colin worked on phonetics.
Wingate encouraged Colin to make an "ah" sound.
"Ahhhh," Colin responded, tapping his mouth repeatedly with his hand. Wingate then began a grammar lesson.
"Leo and Quincy was a very good boy," Wingate read aloud from a book. "Should we keep the 'was?'"
"I have brown hair!" Colin responded.
Autism rates are going up nationally. The CDC reported in February that about one in every 150, or 6.7 out of 1,000, children has some form of ASD. The agency said it is unclear whether the increase is due to changes in how autism is identified or if there is an actual increase, according to its Web site.
No one knows what causes autism, although some theories blame vaccines, genetics or environmental factors. They tend to occur in people with other medical conditions or in children whose mothers took thalidomide during their pregnancy, according to the CDC.
Under the federal Individuals with Disabilities Education Act, school districts are required to look at a student's needs and provide an education that addresses those needs, Craveiro said.
Teachers, specialists and parents work together to determine a plan for the child's educational goals and how to reach them, known as an individualized education plan.
Colin's is 25 pages long.
For instance, his plan involves having an educational aide who works in his classroom and a speech therapist, provided by the school district, who works with him three times each week.
The goal is to get special needs students into regular education classes as much as possible, Craveiro said.
How Bend-La Pine schools are coping
On behalf of the school districts, the ESD provides autism specialists who work in schools throughout Central Oregon to determine whether students are eligible for special education due to autism, said Paul Andrews, the director of special programs for the High Desert ESD.
Carol Cooley-Reid, an autism specialist and consultant who serves the Bend-La Pine and Redmond school districts for the ESD, said she is so busy traveling between schools that making autism diagnoses is her primary function. Six full-time and two part-time specialists divide seven counties among them.
In the ESD's service area, there were 163 autistic students in 2001. In 2006, there were 227 children with ASD, Andrews said. That's a 39 percent increase in five years.
"We are attempting to get more staff, because of course there's an increase in students," Cooley-Reid said. "All the schools want us there all the time."
Kennedy of Stepping Stones School has a staff of six, including herself, and together they are currently teaching 15 children at her school. Ideally, there would be one teacher per student. Since the program began in 1999, "I have never not ended up full," she said.
While Stepping Stones was designed to serve children one on one, the ESD is required by law to service all children whose parents apply. That means Kennedy must adjust the weekly schedule so that some students come only two days a week and some come only three days a week.
Continued from previous page
“I believe that I could service more children if I had additional staff,” Kennedy said. “Right now, my hands are tied to take any more children ... There are basically no resources to hire another staff person should a student arrive on my doorstep who has the diagnosis and would benefit from the strategies that we use.”
Kennedy puts on a fundraiser each year to pay for new equipment to use in her classroom, but in the past two years, the money raised has gone toward hiring an additional staff person, she said. At High Lakes Elementary School, Colin’s teacher, Gaile Pascua, said she has “most definitely” noticed more autistic children over the years. She has worked with his mother to make sure his needs are met every day.
Because Colin cannot specifically articulate what happens at school, Pascua fills out a form that tells his mother how his day went. One day several weeks ago, for example, O’Connor found out that Colin changed his pants because he spilled something on the pair he was wearing.
“Some of my kids were not able to read, so we had to use all pictures, some were not able to talk,” she said. “So I have to find ways to make it work for them. Once I establish a way to teach them, then they got used to that, then it was easier to work with.”
The school district has been getting some increased funds from the state and federal government, but it is not enough to keep pace with the costs of hiring additional staff as well as providing for increases in salaries, health benefits and retirement benefits, Craveiro said.
Bend-La Pine has gotten about $1.9 million more in state funding and $1.3 million more in federal funding to serve special education students since 2001, according to information supplied by Henry, the fiscal services director.
What that means for the school district is that it is unable to add new programs or additional resources to deal with more autistic students, Craveiro said.
“We have to absorb those costs from the general fund,” she said. “That means I’m working harder, we’re all working harder at training our staff on autism, making sure that people understand that disability.”
How families are coping
Colin has the benefit of an educational aide all day long in his classroom, which his mother said happened only after a lot of back and forth with the school district.
Any time she asks for something, she said she must provide substantial proof that it will benefit her son. The O’Connors, Colin’s teachers and the school staff work together to determine how an addition to his education plan will help. Every decision they make is backed by loads of paperwork. O’Connor has file cabinets full of documentation from the school district.
“I never thought I needed an MBA to get my child educated, but you do,” she said with a wry smile.
Craveiro said one-on-one aides are only provided if a child truly needs them.
“I would never want to feel that we were unnecessarily or unwisely distributing resources based on the child’s needs,” she said. “It may not be the Cadillac version, but it is appropriate.”
Still, O’Connor insists that it is only through her frequent and forceful intervention that they have found a structure that works.
“For parents that are not really tenacious, their kids don’t get the services they need,” she said.
In addition to his aide, the school also provides Colin with a speech therapist three times a week to help him with basic socializing. O’Connor purchased the $75 textbook that Colin and his therapist use. And the therapist is unfamiliar with autistic children, she said.
Lynda Albers also has taken her child’s education into her own hands.
Her son, Robert, 15, has Asperger syndrome, a high-functioning form of autism. The disorder is often characterized by difficulty with social interaction, such as reading nonverbal cues, and occasionally an exceptional talent or skill, according to OASIS, or Online Asperger Syndrome Information & Support.
One day at school, a teacher raised her voice at Robert to take off his hat.
He does not respond well to yelling and reacted by screaming a list of obscenities, Lynda Albers said.
“An Asperger kid can function in the real world,” she said. “It’s really (an) embarrassment that’s going to set these kids off.”
Robert’s repeated troubles in school, which his mom blames on a lack of understanding, led to him withdrawing from school earlier this year.
“I worry about parents trusting the school system and not knowing what the laws are and their kids getting in a lot of trouble versus getting the correct services,” Lynda Albers said. “If they’re misidentified, they become problem children. They’re really not problem children, they’re just mis-identified.”
Craveiro, Bend-La Pine’s special programs director, could not discuss the case because she said the school district is bound by confidentiality laws.
Craveiro acknowledged that the district’s budget is tight, but she said they do a good job with what they have.
“It’s hard to add on additional staff and program developments,” she said. “What that means is we need to readjust our priorities, refocus our energies so we’re keeping up with the needs. And we are good at doing that.”
Parents still wish there were more resources accessible to them.
“I think there needs to be more in this community that’s specifically geared toward helping the parents,” O’Connor said. “It’s such a 24/7, 365 disability that impacts the family. If you empower the family to help teach the child, that’s less that the school has to do.”
Albers agreed.
“There’s not a whole lot of support here for parents,” she said.
Sunday, May 20, 2007
The challenge of autism
Treatment demands long hours of work for children, parents
Two-year-old Jace Burgett loves to be tickled. He craves hugs from his mom, Cara Burgett, and he despises sharing with his little brother, Elliot.
So Jace is not that different from any other toddler his age in many ways. How he is different is that he has a full-time job that entails hours of physical and mental activity - a job with inflexible hours and no vacation time.
In between the hugs, tickles and other standard two-year-old activity, Jace receives four hours of speech therapy a week, two hours of occupational therapy a week, and up to 25 hours of applied behavioral analysis therapy per week. Add all that up and this tiny toddler works a full-time job without pay.
But for Jace, this kind of lifestyle is crucial. What may seem rigorous and unnecessary to parents of normally developing children is key to ensuring Jace reaches his full potential.
The extent of his developmental capacity will not be known for several years, but his parents, Cara and Tony Burgett, are making sure he gets there.
Only time will tell.
Autism is a complex developmental disability that typically appears during the first three years of life, according to the Autism Society of America, and impacts the normal development of the brain in the areas of social interaction and communication skills.
Although Cara and her husband were devastated by the diagnosis, and even hoped it might be wrong, they proceeded to do the research and follow through with recommended therapies, making their first appointment immediately.
"As much as we wanted to deny it, in our hearts we knew," Cara said from her family's Fairview Heights home. "We took the approach that this is precious time, and we've seen (from research) that early intervention is key."
Evidence shows that early intervention increases dramatically the positive outcomes for young children with autism, the Autism Society reports. Various therapies are recommended, including speech and language, occupational, physical, music, art sensory integration, and dietary interventions, among numerous others.
"Some of these kids go through more work than we do," said occupational therapist Kim David, who works with small children with autism, including Jace. "They are on these intense programs ... it's a whole change of lifestyle for a family."
Cara first noticed that something was amiss with Jace when he began to lose the language he had acquired at about 19 months of age.
"The first thing we noticed was that the word 'please' kept getting distorted to where it was soon just a 'puh'," she said. "He eventually lost all the words together, any word at all, except for 'up.' That was the only word he ever retained."
The lack of social interaction was something Cara only noticed after learning that it was a characteristic of autism. She would often take Jace to the park and observed that he never partook in the games children his age were playing. Instead, he walked the outline of the park or wandered along the fence.
"At the time we wondered what was going on," Cara said. "That didn't ring the autism bell for me."
Although lack of social interaction and the ability to verbally communicate are, in a sense, stereotypical of autism, there is no standard "type" or "typical" person with autism, said Sandra Rodenberg, Educational Services director at the Illinois Center for Autism in Fairview Heights.
"Autism encompasses a large group that go from all the way from individuals with severe or profound mental retardation, to individuals who are normally developing intellectually, but have the social and communication difficulties," said Rodenberg.
The Illinois Center for Autism has 143 students, Rodenberg said, and to say that all 143 students are alike is absolutely not true.
Consequently, working with children with autism poses a unique challenge to the professionals, and parents, who work with them. In addition, there is no real known cause of autism, though there are several theories floating around.
The Autism Society reported that current research ties autism to biological or neurological differences in the brain, and although no genetic link has been identified, there appears to be a pattern of autism or related disabilities in many families who have children with autism.
Autism is not, however, a mental illness, the society stressed, and children with autism are not unruly children who choose not to behave.
"Individuals with autism are not kids who decide just not to behave," Rodenberg reiterated. "These are kids with poor impulse control who become very frustrated when they are unable to communicate their needs."
Adding to their communicative frustration, children with autism also do not process sensory information as a normal child would, David said. As a result, the child will "do something," like hand flapping, rocking or even experiencing a total meltdown, to essentially readjust his nervous system to the environmental stimulant, which can range from the harsh florescent lights of a grocery store or the intense buzzing of an air conditioner.
"I work with kiddos to appropriately integrate and process the sensory information they experience everyday," David said. "It really decreases their ability to function because they are unable to deal with their senses."
Cara said she often feels ostracized when doing what would be considered normal activities for a mother and her young son, like going to the grocery store or running errands.
"One time we were in a store, and he had some real issues with the florescent lights," Cara said. "We ended up having to leave."
Jace has some stereotypical movements, like hand flapping, which can draw some odd looks from passersby, Cara said. It's hard to ignore those stares sometimes, she said.
"You say you don't care, but it still hurts when people stare," she said.
David, who works with five children with autism on a weekly basis, said the remark she hears most often from parents include the need for community awareness and understanding, as they often deal with comments about "controlling their children," she said.
"Don't be so quick to judge," David said. "There is just too much comparison. My heart really goes out to these patients."
Autism is a developmental disorder, but it doesn't have to be a devastating diagnosis, particularly if family, friends and the community rally around the issue and work to create an awareness, professionals said.
"These children are far from unintelligent," said Rodenberg, who has been working with children with autism for 10 years. "They just see the world far differently than we do."
With the recent discovery that autism now affects one in 150 children, as opposed to the previous one in 166, a person with autism is bound to touch a person's life in some manner.
In Illinois, the number of children receiving special education with autism as a primary diagnosis has grown from 1,960 to 9,455 in just 10 years. Whether society wants to acknowledge it or not, experts agree that autism is becoming more prevalent, though it is unclear why.
"Autism knows no social, economic or racial boundaries," Rodenberg said. "If we continue to educate all of the people that touch the lives of these children, I think the future holds great things."
Tuesday, May 15, 2007
Doctors look for early autism signs
By LINDSEY TANNER, AP Medical WriterMon May 14, 4:37 PM ET
Within days of their birth, healthy babies will look you in the eye. By 4 months, they will delight in others. And by 9 months, they will exchange smiles. Jacob Day did none of those things.
"We used to say it was like it burned his eyes to look at you," said his mother, Tamie Day of Antelope, Calif. "It was like a physically painful thing for him. It wasn't just that he wasn't looking at us; he was purposefully looking away."
Day, who has a psychology degree, suspected her son might have autism. She enrolled him in a study, published in April, that found that babies like Jacob are indeed at high risk for autism if they do not respond to their names by 12 months of age.
At 18 months, he was formally diagnosed with autism, about a year earlier than usual. Before he turned 2, Jacob began daily intensive behavior treatment designed to help him lead a more normal life.
He is part of a growing field in psychiatry called infant mental health. Doctors and scientists are increasingly looking for early signs in babies of autism, attention deficit disorder and other mental problems that just a generation ago, scarcely anyone thought could appear in children so young.
Some scientists even believe that intensive treatment in some susceptible babies can actually prevent autism, attention deficit disorder and other problems.
An influential Institute of Medicine report in 2000 helped energize this idea. The report emphasized the plasticity of babies' brains. It also explained how interacting with babies can change their brain wiring.
"We used to say `nature versus nurture,' but now people really think it's 'nature through nurture,'" said the University of Chicago's Dr. Lawrence Gray.
Tamie Day noticed the first ominous clue the night she and her husband, Chris, brought Jacob home after his birth.
"We walked in the door and he wouldn't stop looking at our ceiling fan," she said. "The next day, that's all he would look at."
Babies typically begin making eye contact soon after birth, and "understand at a basic, perhaps hardwired level, that eyes are special — they look more at eyes than at other parts of the face," said Sally Ozonoff, an autism specialist at the University of California at Davis' MIND Institute.
When his mother expressed her autism concerns at Jacob's 6-month checkup, the doctor said "we were being a little overzealous," Day said.
Still, there was no pointing, no clapping, no shared smiles, and when Jacob would laugh, it seemed like his own private joke. So his parents sought out UC-Davis specialists, who gave them the heartbreaking diagnosis.
Jacob, now 3 1/2, has made meaningful progress thanks to treatment, his mother said, including a breakthrough moment at age 2. It still makes her cry to recall it.
She was giving Jacob a bath, playing the "itsy bitsy spider" finger game, when he looked up and really gazed into her eyes. "He was smiling up at me and I realized that was the first time he had done that," she said. "He has gorgeous blue eyes, and I was like, `My God, your eyes are so beautiful.'"
Interest in infant mental health has been boosted by awareness of the prevalence of attention deficit disorders and autism, which government officials said in February affects 1 in 150 U.S. children and may be more common than previously thought.
In April, researchers from the federal Centers for Disease Control and Prevention and the Interdisciplinary Council on Developmental and Learning Disorders presented a report emphasizing earlier diagnosis and treatment.
The report said that about 17 percent of U.S. children have a developmental disability such as autism, mental retardation and attention deficit-hyperactivity disorder, but that fewer than half are diagnosed before starting school.
The authors say warning signs include failure to:
_focus on sights and sounds by 2 months.
_initiate joyful behavior with parents by 4 months.
_exchange smiles and sounds with parents by 8 to 9 months.
_take a parent's hand to find a toy and point to objects by 12 to 16 months.
Last year, the American Academy of Pediatrics recommended that pediatricians routinely evaluate children for developmental problems such as autism starting in infancy, and begin testing at age 9 months.
"Waiting until a young child misses a major milestone such as walking or talking may result in late rather than early recognition ... depriving the child and family of the benefits of early identification and intervention," the academy said.
Some critics worry that the trend will trigger needless diagnoses in children with normal variations in behavior.
Dr. Michael Fitzpatrick, a London physician, said that while early recognition and treatment of true disorders are important, "the extension of these categories to include 20 to 30 percent of all children reflects a social trend of pathologizing and medicalizing children's lives, which seems to reflect difficulties of parents and teachers in dealing with familiar problems of childhood development."
Dr. Stanley Greenspan, a psychiatry professor at George Washington University who co-authored the CDC-Interdisciplinary group report, said the idea is not to slap a label on babies and give them medication. Greenspan said the goal is to raise awareness about early warning signs and to encourage treatment to increase the chances that children can develop normally.
Research on identifying early clues and testing treatments is booming. For example:
_Dr. Fred Volkmar at Yale University is studying potential ways to diagnose autism in the first months of life, including whether looking at objects rather than people is a sign. "I think we're on the verge of being able to do a much better job" of diagnosing autism in infancy, Volkmar said.
_Researcher Stephen Porges at the University of Illinois at Chicago is starting a five-year study of whether excessive crying past 6 months of age might be an early sign of autism, attention deficit or other behavior problems.
_Greenspan is launching a multimillion-dollar study involving parents and babies at risk for autism or attention deficit disorder. One group will receive intensive behavior training, the other will not; both will be compared through age 5.
While rigorous scientific evidence is needed to prove that early intervention succeeds, Greenspan said his work with patients has shown promise.
Jacob didn't say his first word, "more," until he was in treatment and almost 2 — about a year later than normal. He didn't say "mama" until he was 3.
He gets 33 hours of weekly home treatment with trained college students, including six hours most days. The tab is $70,000 yearly, paid for by California, one of the few states that pay, through state and federal funds, for early intensive autism treatment.
Jacob's sessions involve lots of repetition, and rewards, including praise and treats, for a job well done. For example, to improve eye contact, teachers bounce him on a favorite giant ball, then stop. If he turns to look at them, he gets praise, maybe a piece of candy, and more bouncing.
To teach language, they use activities like swinging that get him excited enough to make sounds, then offer rewards for sounds like vowels or consonants rather than humming. Then they name objects, encourage mimicking, and offer more rewards.
Now he knows the alphabet, understands commands like "Bring me the cow and the horse toy," and can say simple sentences like "I want juice," his mother said.
"We definitely hope to mainstream him. We hope that he will have a job and have a life where he can take care of himself and be happy," Day said. "Everyone has given us reason to believe that's not an outlandish expectation."
Thursday, May 10, 2007
UCLA Imaging Study Provides Clues About Inability To Imitate And Empathize In Autistic Children
10 May 2007
New imaging research at UCLA shows that impairments in autistic children's ability to imitate and empathize can be linked to dysfunction in the brain's mirror-neuron system.
In research presented at the annual International Meeting for Autism Research in Seattle, UCLA scientists demonstrated a clear link between a child's inability to imitate expressions on the faces of other people and a lack of activity in the mirror-neuron system (MNS).
Mirror neurons fire when an individual performs an action with a goal in mind. They also fire when one watches another individual perform that same action. Neuroscientists believe this "mirroring" is the neural mechanism by which the actions, intentions and emotions of other people can be automatically understood.
Individuals with autism can't rely on this system to read the minds of other people. Symptoms of autism include varying levels of difficulty with social interaction, including verbal and nonverbal communication, imitation, and empathy. These findings bolster the growing body of evidence that points to a breakdown of the MNS as the mechanism behind these symptoms.
"These results support the notion that a dysfunctional mirror-neuron system may underlie the impairments in imitation and in empathizing with other people's emotions typically seen in autism," said Mirella Dapretto, associate professor of psychiatry and biobehavioral sciences at the Semel Institute for Neuroscience and Human Behavior at UCLA and the David Geffen School of Medicine at UCLA. Dapretto and Stephany Cox, a research assistant in Dapretto's lab, are the lead authors of the study. "Together with other recent data, our results provide further support for a mirror-neuron theory of autism."
To measure mirror-neuron activity, the research used functional magnetic resonance imaging (fMRI) in 12 high-functioning children with autism as they viewed and imitated faces depicting several emotional expressions, such as anger, fear, happiness or sadness. Prior to the fMRI experiment, the children's imitative behavior was measured using scores from the Autism Diagnostic Interview (ADI-Revised), an instrument widely used to assess symptoms of autism. Children's empathic behavior was assessed using a child-modified version of the Interpersonal Reactivity Index (IRI), a previously validated scale that assesses four distinct facets of empathy.
The researchers found that, as expected, the level of brain activity in "mirroring" areas was related to the children's tendency to spontaneously imitate others, as well as to empathize with them. Specifically, significant negative correlations were found between symptom severity on the imitation items of the ADI-R and activity in the mirror area located in the brain's right inferior frontal gyrus. Additionally, significant positive correlations were observed between children's total scores on the empathy scale and activity within this mirror area and two other key regions in the brain involved in emotional understanding and empathy, the insula and amygdala.
"Simply put," said Cox, "the more the children tended to spontaneously imitate social behaviors or to empathize with the plight of others, the more brain activity we saw in the frontal component of the mirror-neuron system in the right inferior frontal gyrus. Conversely, the greater their impairments in these domains, the less activity we saw in this mirroring brain region.
"Importantly, these results indicate that abnormalities in the mirror-neuron system may negatively affect imitative behavior," she said. "In turn, this may lead to a cascade of negative consequences for the development of key aspects of social cognition and behavior in children with autism."
Wednesday, May 9, 2007
Dog Helps 9 Year Old With Autism
May 8, 2007 05:44 AM
(CINCINNATI) -- No doctor can say what causes autism or knows a cure. Research now shows one in 150 children have it. And families are learning to cope, sometimes in a unique way.
FOX19's Meghan Mongillo introduces us to a Montgomery family who's enlisted the help of a different breed.
We introduced you to 9-year-old Sam Leach last August.
A computer device helps him communicate and an alarm system makes sure he doesn't slip away. But now his mom Carol is trying something new.
"Excuse us.."
John Boy is Sam's service dog.
The black lab is trained to follow the direction of his front collar which Carol controls and ignore the leash on his back which Sam grabs onto.
"I've never known anything to work as well for Sam to be as happy about it," says carol. He really likes walking with the dog it seems to calm him down
The family's had the dog for a month now and Carol, Sam and John Boy are all learning how to work together.
"Get a hold of John Boy..no..there we go.."
Carol says the occasional wrong move is nothing compared to her grocery store trips before.
"Once we'd go past the cereal aisle he'd make a mad dash back to it 2 or 3 times it was like being an octopus."
"So why does it work. Why does sam react so well to John Boy? To get some answers we came here to Cincinnati Children's Hospital."
Dr. Patricia Manning specializes in developmental pediatrics. She gave us some insight on what a child like Sam may be thinking.
"The dog's not talking or giving me a directive it's just moving and I'm moving with the dog verses I have to interpret verbal directives and decide if I want to comply. It's an innate response some kids react to animals presence and pressure vs. Our human voice and communication."
Dr. Manning warns that not every child with autism will benefit from a service dog.
Getting one is expensive - with training it costs 15 to 26 thousand dollars - and there's no guarantee it'll work.
But for the Leach family..it was worth it - John Boy can even track Sam's scent if he ever wanders off.
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