December, 2012

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Study Explores How Autistic Children View Friendship

By Stacy W. Kish on December 20, 2012


Background: Autism Spectrum Disorder (ASD) is characterized by impaired social and communication skills. Many programs now aim to improve socialization of autistic children. However, few studies examine an autistic child’s perspective.


What’s new: Researchers at the University of London investigated how autistic children experience friendships with cognitively able children in a mainstream setting. The team evaluated friendship from the child’s perspective, from the parent’s perspective, and from the teacher’s perspective.


The results from this study suggests that autistic children desire social relationships, but that autistic children define friendship in terms of companionship rather than emotional bonding. Importantly, the degree and nature of friendships did not correlate with cognitive abilities in the autistic children.


Parents and other family members played a significant role in the development of friendships by helping the autistic child engage effectively in social settings. Teachers reported that structured games with rules during lunch and playtime proved an effective mechanism to include autistic children in the class setting.


Why it’s important: Even though teachers felt that autistic children still resided on the periphery of friendship circles despite intervening efforts, the majority of autistic children reported satisfaction with their friendships. The study suggests that intervention methods to support friendship may be more successful when taking the individual child’s views and perspectives into account.

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Resting State Brain Activity Shows Familial ASD Risk

By Chelsea E. Toledo, M.A. on December 19, 2012


Background: Recent evidence suggests that activity in the default mode network (DMN), a collection of brain areas that becomes active during restful waking states—such as during daydreaming—may be associated with Autism Spectrum Disorder (ASD). Researchers can use functional magnetic resonance imaging (fMRI) to visualize brain activity while individuals are at rest or performing goal-oriented tasks. The DMN becomes inactive during task performance. In individuals with ASD, however, task-dependent deactivation of this network is reduced.


What’s New:  In a report published in the November issue of PLoS ONE, researchers examined the DMN’s activity in high-functioning adults with ASD as they performed tasks related to language, discerning themselves from others, and theory-of-mind, which involves attributing emotions or beliefs to themselves and others. Using fMRI to measure the brain activity of 13 individuals with ASD and 14 typically developing counterparts, they were able to detect that the DMN of autistic individuals mapped differently during theory-of-mind tasks in particular. While the typically developing individuals’ DMN were inactive during those tasks, the DMN was more active in the autistic individuals. An additional study, published in Molecular Autism, observed altered DMN patterns both in autistic individuals and in their siblings who did not have ASD.


Why it’s important: In addition to finding differences in the DMN activity between autistic and typically developing individuals, the authors of the PLoS ONE study used that measurement to identify autistic individuals with 96.3 percent accuracy. In conjunction with the Molecular Autism paper, that finding suggests that measuring DMN activity could prove a reliable assessment of familial risk for ASD.

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Parents of Children with ASD Want Genetic Testing

By Stacy W. Kish on December 14, 2012


Background: The diagnosis of Autism Spectrum Disorder (ASD) by behavioral observations often comes years after the parents suspect a problem with their child’s development. However, children diagnosed at a younger age can begin receiving interventions that show improvement in language skills, adaptive behavior, and IQ scores. Parents with one child diagnosed with ASD report increased rates of anxiety for their younger children.


What’s new: Genetic testing is a major area of focus in ASD.  In this study, researchers surveyed parents with at least one autistic child to gather parents’ input on their interest in a genetic test. Overwhelmingly, 80 percent of parents with one autistic child would consider genetic testing if it becomes available to help establish the risk of the disorder in younger children. Parents also seek clear and honest answers from their doctors.


Why it’s important: Parents are interested in a genetic test that could indicate risk of ASD, even if the test cannot confirm a diagnosis. Diagnosing children at a younger age improves intervention treatments and parental acceptance of the diagnosis.

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Inclusive Preschools May Improve Autism Outcomes

By Chelsea E. Toledo, M.A. on December 13, 2012


Background: Since 1990, the Individuals with Disabilities Education Act has required that states provide appropriate early intervention and special education to children with disabilities. However, little research has investigated what type of preschool placements are best for children with Autism Spectrum Disorder (ASD).


What’s New:  A study published in the journal Autism investigated the differences in outcomes when autistic children were placed in preschools serving only children with ASD, in preschools educating children with a variety of disabilities, or in preschools including children with ASD alongside those with typical development. While the 98 children studied were similar based on demographics and level of initial impairment, the 36 who attended inclusive preschools--where they learned alongside children with typical development--showed greater improvement on cognitive test scores than those attending non-inclusive preschools.


Why it’s important: Among those children attending inclusive preschools, those with the most severe social and behavioral deficits but at least baseline communicative skills experienced the greatest improvement. Further research could help define which preschool placements are most appropriate for children across the autism spectrum.

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ER Use for Psychiatric Problems High in ASD

By Mark N. Ziats on December 12, 2012


Background: Children with Autism Spectrum Disorders (ASD) have a high incidence of other psychiatric problems like anxiety, mood disorders, or psychosis.  These children often have difficulty accessing proper psychiatric care in the community, and as a result may utilize hospital Emergency Rooms (ER) for their psychiatric complaints.  However, the frequency and nature of psychiatric ER visits among children with ASD is unknown.


What’s new: A new study published in the journal Pediatric Emergency Care examined the prevalence and characteristics of psychiatry-related visits among children with ASD using data obtained from a national registry of ER visits.  The authors discovered that psychiatry-related ER visits from children with ASD were nine times more frequent than visits from children without ASD.  These visits were most commonly for externalizing and psychotic disorders.  In contrast, children with ASD were less likely to present to ERs with mood and anxiety disorders than other children were.  Additionally, the authors found that ER use for psychiatric problems was more common among children with ASD who had private health insurance, as compared to children with ASD using public assistance programs.


Why it’s important: This study suggests that better community psychiatric care is needed for children with ASD.  Furthermore, increased education of Emergency Room staff on autisms’ clinical manifestations may improve the outcomes of these visits.  Lastly, a further assessment of the influence of insurance benefits on psychiatric care usage among children with ASD is important to develop more targeted outpatient psychiatric care.

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Brain Imaging Checks Functional Network Structure in ASD

By Mark N. Ziats on December 7, 2012


Background: Brain imaging studies of individuals with Autism Spectrum Disorders (ASD) have demonstrated that functional brain networks—combinations of different brain regions working together for a task—are abnormally connected in autism.  However, results from these prior studies are often conflicting, and it remains unclear how deficits in functional brain networks relate to known abnormalities in the brain structures of people with ASD.


What’s new: A recent study published in the journal PLoS One assessed the structural relationships of two prominent functional networks that are abnormal in ASD.  Researchers used a brain imaging technique called structural covariance magnetic resonance imaging (scMRI), which can track similar variations in grey matter volume across multiple individuals. They compared the structure of brain regions involved in the salience network, known to be involved in emotional processing, and the default mode network, thought to be important for task-independent introspection, between 49 males with ASD and 49 age- and IQ-matched controls.


According to the study, the salience network was underdeveloped in individuals with ASD as compared to controls.  In contrast, the default mode network was either over- or under-connected, depending on the brain region assessed.


Why it’s important: This study provides important insight into the relationship between abnormal brain structures and functional networks underlying autistic behaviors.  Understanding how variations in the brain relate to functional network modifications is crucial to elucidating the physiological mechanisms that contribute to ASD.

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Health Care Providers Create Autism Clinical Database

By Stacy W. Kish on December 6, 2012


Background: The Centers for Disease Control and Prevention estimates that 1 in 88 children have been diagnosed with some component of autism spectrum disorder (ASD). ASD describes a group of symptoms associated with abnormal brain development. Previously, researchers established the Interactive Autism Network (IAN), an internet-based registry. The network, however, required parents to self-register their child and fill out forms.


What’s new: Kaiser Permanente and Harvard Pilgrim are pooling data retrieved from electronic medical records to create one of the largest autism database to date. Using these resources, the health care providers identified 20,000 people with ASD. Unlike similar networks, this database contains standardized information that will aid researchers as they study the disorder.


Why it’s important: The clinical and scientific community can use this data to understand the prevalence of ASD and current methods used to treat symptoms. In addition, researchers could comb the database to recruit individuals for clinical trials. Finally, organizations hope to develop autism awareness campaigns to help educate underserved communities about the condition. The database will not become available to researchers until privacy issues associated with medical records are resolved.

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