Category Archives: Research

The Autism Impact Measure: The New Gold Standard

Autism Impact Measure

Tools, measures, and assessments for diagnosing what is now called Autism Spectrum Disorder have been around since the early 1960s when treatment plans began to take shape.

ASD first appeared as ‘Infant Autism’ in 1980 in the DSM III. Since then, the name, markers, and symptoms for autism have changed in almost every version of the DSM up until the umbrella term Autism Spectrum Disorder was used. Through the years, many types of tools have been created to diagnose cases of ASD, and many adhered to the definition and symptoms described in the current version of the DSM (III through V). 

Currently, the DSM V has made major changes to how autism is seen in the clinical world, and the diagnosing process has widened the spectrum. Previously, the two ‘gold standards’ of diagnosing tools were the Autism Diagnostic Observation Schedule (ADOS), and the Autism Diagnostic Interview Revised (ADI-R). While these two still hold the spots for top diagnostic tools, they have many limitations that call for a revision of assessments. 

The ADOS and ADI-R, while reliable in diagnosing cases, are not well suited to assess and track the outcome measures of treatments, meaning that they are unable to assess chances in core symptoms of ASD over time. These tools focus on placing an individual onto the spectrum through ‘categorical caseness’, which leaves no room for changes in core symptom expression during and after treatments. Luckily, there is a new player in town.

In 2013, Kanne and his team created a new measure for assessing and diagnosing cases of ASD while focusing on a “finer gradation of symptom expression both short and long term”. The Autism Impact Measure, or AIM, targets the sensitivity of changes in core ASD symptoms during and after treatment sessions. The assessment itself is a 24 item questionnaire which looks at frequency and intensity of behaviours and symptoms of the individual. It has proven to have high reliability and validity when measured by professionals in the field.

This measure would be issued by a behavioral therapist during a regular session with the individual. It is used with a 2 week recall period, meaning that the initial measure is followed up two weeks after with a second assessment. Using this assessment tool in regular treatment settings allows for the individual’s immediate team to watch as their symptoms change in a natural fluid way, rather than have the individual placed on a scale and have them stagnate there. This means that if the the ‘gold standard’ becomes the Autism Impact Measure, individuals would have a constantly updated version of their symptoms on file, as well as a completely tailored treatment plan that would help them thrive.

By Sydney Chasty, Carleton University



Study on Baby Horses Starts New Research on Autism

baby horses and autism research

It was an unexpected scene- soon after a baby horse was born, owner Ellen Jackson noticed it avoiding its mother and refusing to nurse.

After a few more similar incidents she contacted the University of California Davis veterinary expert John Madigan. He explained that these baby horses are being born with that is called neonatal maladjustment syndrome (MNS), which account for the detachment from their mothers.

To fix the issue he performs “the squeeze” technique where a soft rope is tied around the baby horse’s body. Then it is squeezed to apply increased pressure until the baby horse falls over and goes to sleep. After a few minutes have passed the pressure is released and the baby horse wakes up. When that is complete they see, in almost all cases, an improvement of interaction between the mother and baby horse.

But how does all this relate to humans with autism spectrum disorder? Madigan and a group of researchers are exploring the connection between high levels of neurosteroids (brain steroids) in the blood and development of autism. He states that their effects at different birth stages could give more insight as to why ASD develops later on.

The researchers believe that this study can provide important information on the development of Autism for pre-term infants, cesarean born babies, and newborns who spent little time in the birth canal. Madigan suggests that a lack of pressure through the birth canal prevents the body from receiving the proper signal to lower brain steroid levels.

Pas statistics have shown that those born within these circumstances have a higher likeliness to develop Autism. But is it due to the levels of brain steroids? That is what future research will tell. Madigan’s study on baby horses has prompted a new perspective on discovering a possible explanation for the development of ASD.

David Stevenson, a professor of pediatrics at Stanford University, has come together with Madigan to bring “the squeeze” technique to human infants. Although a little different, they will be using a method called “kangaroo care” which is more commonly used for premature babies. This method requires an almost naked infant is placed on the parent’s, or caregiver’s, chest for a long period of time. They hope to measure the steroid levels to see if there is a drop after this technique has been performed. They will then use these results to expand their research further and possibly find a connection with ASD.

Written by Raiza Belarmino



Unfocused Infant Gaze- Early Sign of Autism?

autism eye gazing

Eyes are said to be a window into the soul. They express emotions, personality, and depth beyond which any facial expression can hide. In certain cases, eyes do not only tell us important things about the nature of the soul; they may also signify early developmental issues.

Recently, researchers have postulated that tracking the eye movements of infants may indicate the emergence of ASD later in their toddlerhood. Thus far, they have noted that these children tend to focus their eyes less and look much more rapidly (and in many different directions) than do typically developing children.

Researchers believe that this rapid eye movement may signal possible learning deficiencies exhibited later on in development. One explanation for this could be that rapid scanning signifies a disengagement from one’s surroundings. This also may be related to rapid processing, which is a trait commonly found in autism. However, it could also simply demonstrate a child’s need for stimulation within their environment.

By studying 100 six-month-old infants who looked at a static image, researchers at the University of London found that the infants who would later develop ASD tended to move their eyes around more than infants who followed a more typical path of development.

As mentioned earlier, this could simply be a sign of the infants’ differing needs to stimulation. However, it could also signify an easily identifiable early sign to enable an early autism diagnosis. More research needs to be conducted but for the time being, diagnosticians are taking these findings seriously in looking at infants who already demonstrate early risk factors.

Sara Power, Fordham University



Emotional Regulation and Coping Strategies with ASD

autism emotional regulation

Regulating emotions can be a very daunting task for some individuals. Likewise, in an emotional situation or environment, keeping control can be very difficult.

If a situation which requires a higher level of composure is coupled with mental illness or a cognitive disorder such as Autism Spectrum Disorder, emotional control has the potential to become a secondary issue in this situation.

A recent study has recently been completed which demonstrates a neurological disconnect that may contribute to the inability of a person with ASD to handle a high stress/high sensory situation.

The study included 30 participants (15 with ASD and 15 without), and had them complete an emotional regulatory task while in an fMRI. This task had all participants view various pictures of people with neutral faces and no emotional cues. They were instructed to think positive, negative or neutral thoughts while viewing these pictures, and the neural areas that ‘lit up’ were recorded.

The results showed that regardless of instructed emotion, the participant’s pupils all dilated (meaning they were thinking hard about changing their emotion), and the prefrontal cortex and limbic systems of those without ASD ‘lit up’ much more than those with ASD. These two areas of the brain are significant as the limbic system is technically an evolutionarily ‘old’ part of the brain, and in tandem with the prefrontal cortex they control the regulation of emotions, decision-making, and needs.

These two areas were slow to start up and did not activate as strongly in participants who did not have ASD. If the structure that regulates emotion works differently in people with ASD, then emotions are expressed differently as well.

There have been many publications regarding overall strategies to help a child or individual cope with this unique style of emotional regulation. All of these publications include suggestions for the three pillars of ASD: communication, socialization, and behavioral patterns. In general, these strategies are repeated through each publication, which means they are tried and true for most cases.

Depending on who the tip sheet is written for, the child or individual is referred to as someone’s child, a student, or a client (if it is geared towards a behavioral therapist). Suggestions include having access to communication tools at all times and knowing how to paraphrase and simplify sentences without talking down to the child, helping the child/student understand common language like slang and puns, etc.

A key issue that is discussed is to not use sarcasm and to explain body language. Strategies to improve socialization include personal coping skills like not taking rude remarks/behavior personally, as well as using reinforcers to help condition proper social behavior. The child can be taught to recognize their behavior and emotions in addition to the behavior and emotions of those around them while working on simple social skills.

Finally, helping a child create positive habitual behavior patterns can begin to be accomplished by simply giving reinforcement, creating a routine, and being aware of anything that could cause anxiety. By utilizing resources that are aimed to help create a positive environment for an individual with ASD, one ensures their strongest chance for success and reaching their very best potential.

By Sydney Chasty, Carleton University



Shema Kolainu Reaches out to Support Autism Parents

 

chani katz shema kolainu

Family time is crucial for building confidence in a child’s life. For parents of a special needs child, the everyday challenges for managing behavior and raising a self-sufficient child are magnified.

Yesterday’s Shema Kolainu workshop at Hotel Pennsylvania, hosted by IEP Coordinator Chani Katz, MA, BCBA, gave support for parents who have an autistic child. Ms. Katz presented strategies for parents to cope with routine issues, ranging from sibling relationships to toilet training.

Whether public or private, parenting a child with autism can feel stressful and even lonely. Others around will be quick to judge a parent’s methods before they have ever tried to walk in their shoes. Shema Kolainu- Hear Our Voices strives to not only provide top-notch education for our students, but also to help give parents the tools for success.

“It definitely brings a lot of lessons to the family when everyone is able to become more nurturing and empathetic,” Ms. Katz said when addressing the crowd.

Milestone’s in a young child’s life such as sleeping through the night or using the toilet properly can put them outside of their comfort zone. For an autistic child, creating a training schedule can prove quite helpful since they love structure. Other tips that have proven effective are to use positive reinforcement of good behaviors and to create a calming environment for activities the child may feel overwhelmed by.

When parenting a special needs child, it is important to remember that each sibling deserves just as much love. The other children may feel jealous and lonely when they feel that their sibling gets priority and extra attention. Some things that parents may do to combat this is to involve themselves daily in their children’s hobbies. Even if they only have a few minutes to devote to a child at the end of the day when they are drawing pictures, for instance, it makes them feel special.

It also helps to reach out for support when tasks become too overbearing for parents. Behavioral intervention services from a professional are often quite important for a child’s development. Parents may also choose to seek out support groups of other children like them to share wisdom. Sometimes, the help of a housekeeper can ease stress.

Above all, educating the public about autism seems to be the most effective way to minimize negativity from other. Katz suggests helping more “atypical” siblings through difficult situations by encouraging them to talk about it, and also to be open with others in the community about a child’s special needs.



Intense Auditory Behavioral Training Shows Promise

auditory autism therapy

A new study conducted by researchers in Mississippi and California was published in the Proceedings of the National Academy of Sciences earlier in February and claims they may have found a way to rewire the brain to possibly treat autism.

Dr. Rick Lin, a professor of neurobiology and anatomical sciences at the University of Mississippi Medical Center and co-author of the study, explains how researchers were able to use a method called intense auditory behavioral training on rats to observe outcomes of the treatment.

The rats were first injected with a drug in order to stimulate serotonin receptors, causing the rats to exhibit autism-like symptoms.  They began to show antisocial behavior towards each other and acted very atypical of a normal rat.

“The rats, they were just not going to play with one another,” Lin explained.  “Just how a child with autism prefers to play by himself, so were these animals.  They were also super nervous, and when we would try to excite them with noise, they would just freeze – that’s not typical of a rat.”

Dr. Michael Merzenich of UCSF worked alongside the teams to subject the rats to a series of tones and ticks that Dr. Ian Paul, professor of psychiatry and human behavior at UMMC, explains can create “plasticity”, meaning the brain actually changes over time.  Dr. Paul explained that when the rats heard the noises, they were hearing them at distorted frequencies, causing them to sound muffled – similar to what children with autism sometimes experience.

“Through this training, animals progressively sharpened their abilities to distinguish the fine difference between the sounds that they had heard.  This training had a dramatic impact on all of the autism-like neurological distortions in their brains,” Merzenich concluded.

The study lasted two months and showed promising results for the populations of male rats exclusively.  Scientists still don’t know why, but autism is four times more likely to affect males than females.  In proportion, if this treatment was to be conducted on humans, it would last about two years in a normal child’s life.  Although this treatment is still new, the researchers of the study are confident that their findings in coordination more support and effort can bring hope to families suffering from the effects of autism.

Written by Mara Papleo, Cleveland State University



Untying Knots of ASD and Associated Syndrome

understanding autism: untying knots

Autism spectrum disorder (ASD) is like a dense bundle of knots. Getting to its core can only be done by unraveling the complexities of numerous syndromes that are linked to ASD, one by one.

Doctor Alexander Kolevzon is currently working to comprehend Phelan-McDermid syndrome (PMS). A clinical director at Mount Sinai, Kolevzon directed a pilot study that aimed to improve the social impairments of those suffering of PMS, many of which also have ASD. The study was originally published in the December 12 issue of the journal Molecular Autism.

“Because different genetic causes of ASD converge on common underlying chemical signaling pathways, the findings of this study may have implications for many forms of ASD,” Kolevzon reported. The chemical signaling pathways he refers to involve the role of SHANK3, a gene found on chromosome 22. SHANK3 is highly involved in synapses, the gaps between neurons through which chemical messages are passed to reach individual target cells. Mutations and deletions of the gene cause developmental and language delays, as well as poor motor skills.

While the deletion or mutation of the gene causes PMS, it has remained unclear whether there exists a link between variations of the gene and autism until now. Mount Sinai’s preclinical study persuaded Doctor Kolevzon that a link exists, and inspired the hospital to conduct the first controlled trial of any treatment for PMS. Using SHANK3 deficient mouse models and neuronal models of SHANK3 deficient humans, the preclinical study indicated that reversal of synaptic plasticity and motor learning deficits may occur due to insulin-like growth factor-1, or IGF-1. IGF-1 is highly involved in synaptic transmission; it boosts synaptic circuits viability by promoting nerve cell survival and synaptic maturation. In addition, IFG-1 increases synaptic plasticity, the tendency for synaptic connections to change in structure and function to efficiently process novel stimuli.

The Mount Sinai placebo-controlled, double-blind study exposed nine PMS-suffering children, ages 5 to 15, to three months of IGF-1 treatment and three months of placebo. The order of treatment was random. Major improvements were observed during the IGF-1 phase as opposed to the placebo phase. Specifically, the children showed fewer signs of social withdrawal and restrictive behaviors, two indicators that standard behavior scales such as the Aberrant Behavior Checklist and the Repetitive Behavior Scale employ when assessing the effects of ASD treatments. Thus, the study became the first to explore the probability that the growth hormone IGF-1 can greatly ameliorate social impairment linked with ASD.

This study is just the beginning. Improving PMS symptoms helps untangle the cluster of knots that is ASD. Joseph Buxbaum, PhD, Professor of Psychiatry, Genetics and Genomic Sciences and Neuroscience at Mount Sinai, affirmed that “this clinical trial is part of a paradigm shift to develop targeted, disease modifying medicines specifically to treat the core symptoms of ASD.”

Maude Plucker, Tufts University



Unique As a Snowflake: Study Finds No Two Cases of Autism the Same

autism cases are unique

If you were to put a group of children together, the differences in their personalities would be obvious- the extroverted kids would lead the game, the shyer would hang back, friends would form bonds and take on a partnership role, and the rest filling the various dynamics of the group.

It is the same as children affected with Autism Spectrum Disorder- if they were to fill a room, their personalities shine and their unique differences would be immediately seen.

Although it has been commonly accepted that no two people with ASD are the same, the Hospital for Sick Children in Toronto, (Canada) recently conducted a study which looked at the genetic makeup of siblings affected with autism and their respective parent’s. They found that a significant (69.4%) amount of these siblings’ DNA code had varying aspects of ASD, making them as “unique as snowflakes”.

This means that siblings who both have the same autism diagnosis can have a different coding scenario, in turn showing a greater variation in their expression of the disorder. This helps to explain how a family with two children with the same diagnosis of autism can show significant differences in their behavior, as any other family can attest.

In the above mentioned article, Valerie South’s two sons (Thomas and Cameron) were both diagnosed with a type of low-functioning autism, which leads to difficulties in learning development. And like most brothers, they have their own expressions of self, different from one another.

In the study, their entire DNA sets were assessed, and it was found that, although they had the same diagnosis, the expression of the ASD-related genes were largely differentiating. The study had 170 participants with ASD, and looked at all genetic variations that were relevant to the disorder (both their genetic makeup and the outward expression of the gene). It also looked at the structural variation of the genes associated with the spectrum.

With almost 70% of the siblings showing significant genetic variation in relevant genes, this scientifically backed hypothesis confirms the anecdotal knowledge parents with children of ASD have known for years; the variability between siblings is as significant as any brothers or sisters without the disorder, and ultimately, no two cases of autism are ever the same.

This innovative study brings to light how Autism Spectrum Disorder is viewed, studied, and treated. The concept that no expression of this development disorder can be considered thesame calls for complete tailoring of therapies, treatments, as well as how people are diagnosed.

The image of this disorder as a spectrum has now been reinforced with the information from this new study, and it is time to open the discussion on how these individuals should be cared for, and how we talk about autism.

Written by Sydney Chasty



How a child with Autism Processes Social Play

autism children play

In a first-of-its-kind study, researchers at Vanderbilt University examined social play exchanges on multiple levels, revealing associations among brain regions, behavior and reactions in children with autism.

“Play is a fundamental skill in childhood and an area in which children with autism often have difficulty,” said the study’s principal investigator, Blythe Corbett, Ph.D., associate professor of Psychiatry and a Vanderbilt Kennedy Center investigator. “However, the psychobiological study of play in autism is seldom comprehensively investigated using multiple levels of analysis.”

Children were given an MRI that tested how they reacted to being placed in playful situations with new children, familiar children, and by themselves. When the child was placed in a playful situation with an unfamiliar child, he resorted to playing alone. What this MRI taught us is that it is important for parents of children with autism to recognize that their child has to gain familiarity with others in order to socialize.

ICare4Autism is an advocate for relationship building and socializing.Children with Autism are not Anti-Social.  We believe that a child should be given the necessary time he or she needs to get to know someone. Take your time teaching your child who’s in their presence and allow them time adapt.



UW is Funded $3.9 Million Used for Early Autism Detection Program

bigstock-doctor-using-a-digital-tablet-31270601

 

The University of Washington was recently granted $3.9 million from the National Institute of Health to continue a program that uses tablets as a way to detect early Autism, a condition that now affects one in every 68 children.

Dr. Wendy Stone, who has been leading UW in the development of the new Autism detection technique, explains that the grant money will be used to purchase tablets that will assist physicians in diagnosing children with early Autism.  Parents will be able to fill out the web-based M-CHAT (Modified Checklist for Autism in Toddlers) questionnaire using one of the tablets in the physician’s office.

The goal of having parents fill out the M-CHAT is to help doctors detect Autism as early as possible, and the tablets could assist tremendously.  Often times doctors become too busy, and follow-up questions for the M-CHAT are not addressed.  The tablets, however, can and will help parents thoroughly complete all parts of the questionnaire.

Dr. Stone, who has been researching Autism since the 80’s, points out that although there is still no definitive cause or cure for Autism, early detection is the best possible way to hinder the disorder.

“Twenty-five years ago, when we diagnosed autism it was in older children and we would have to say to families, ‘Your child has Autism, and your child is always going to have this disorder.’  Now when we diagnose at 18 months or 24 months we say it’s a whole different story for parents.”

ICare4Autism has been a great advocate and source for parents needing help with early detection. Early detection can make a huge difference in the life of a child living with autism.

Mara Papaleo, Kent University