Background: Prenatal exposure to certain medications can affect embryonic and fetal development. For some women of childbearing age, the need to take medication before or during pregnancy is vital. Valproate, for example, is used to treat epilepsy and psychiatric conditions. Previous studies have drawn a tentative link between valproate use during pregnancy and an elevated autism spectrum disorder (ASD) risk in children.

What’s new: A new study published April 24, 2013 in the Journal of the American Medical Association evaluated ASD risk from prenatal exposure to valproate for all children born in Denmark between 1996 and 2006. Of the children with prenatal exposure to valproate (due to being born to mothers with epilepsy) approximately 4.1% received an ASD diagnoses with 2.9% receiving a diagnosis of severe childhood autism. For children born to mothers with epilepsy but not exposed to valproate in the womb, only 2.44% developed ASD and 1.02% developed severe childhood autism.

Why it’s important: This study suggests that prenatal exposure to valproate significantly increases a child’s risk of ASD and severe childhood autism. However, the study did not evaluate the associated risk of seizures during pregnancy (should the mother fail to take anti-seizure medication) to the development of autism in the offspring. The authors of the study suggest that women of childbearing age should discuss the use of valproate compared to alternate medications with their doctors.

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Are there any links between maternal drug use and autism?

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Background: Previous research has shown that children with Autism Spectrum Disorders (ASD) have deficits in executive functioning, such as poor impulse control, problems maintaining working memory, and difficulty quickly shifting between tasks. Studies of executive functioning in children with ASD have typically been conducted in artificial laboratory settings and fail to follow children over the course of their development. The real-world pattern and development of executive function deficits in children with ASD remains unclear.

What’s new: A recent study published in the January 2013 issue of the journal Neuropsychology investigates executive function in children with ASD at home and across a broad developmental period spanning 5 to 18 years of age. The authors report that executive functioning impairments increase as children with ASD age, as compared to neurotypical children, according to data collected from parental reports on 185 children with ASD.  This was most profound in “metacognitive” abilities, such as following multistep directions, keeping school materials organized, and exhibiting self-motivational behavior.

Why it’s important: According to this study, children with ASD have increasing difficulty in working memory, initiation, and organization as they develop to ages where they are entering school and obtaining jobs.  These situations likely exacerbate these impairments, making continuing executive function intervention and support critical during these periods.  Awareness of this problem is particularly relevant in this age group because school and clinical resources are often not as accessible to children with ASD at these ages.

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Brain Biology

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