Video

Autism TED Talk

Worth reading if you don’t want to watch:

Based on epidemiological data, we know that one of the causes, or one of the associations, I should say, is advanced paternal age, that is, increasing age of the father at the time of conception. In addition, another vulnerable and critical period in terms of development is when the mother is pregnant. During that period, while the fetal brain is developing, we know that exposure to certain agents can actually increase the risk of autism. In particular, there’s a medication, valproic acid, which mothers with epilepsy sometimes take, we know can increase that risk of autism. In addition, there can be some infectious agents that can also cause autism.

And when you look at those concordance ratios, one of the striking things that you will see is that in identical twins, that concordance rate is 77 percent. Remarkably, though, it’s not 100 percent. It is not that genes account for all of the risk for autism, but yet they account for a lot of that risk, because when you look at fraternal twins, that concordance rate is only 31 percent. On the other hand, there is a difference between those fraternal twins and the siblings, suggesting that there are common exposures for those fraternal twins that may not be shared as commonly with siblings alone.

As we did this, though, it was really quite humbling, because we realized that there was not simply one gene for autism. In fact, the current estimates are that there are 200 to 400 different genes that can cause autism. And that explains, in part, why we see such a broad spectrum in terms of its effects.

How are we going to intervene? It’s probably going to be a combination of factors. In part, in some individuals, we’re going to try and use medications. And so in fact, identifying the genes for autism is important for us to identify drug targets, to identify things that we might be able to impact and can be certain that that’s really what we need to do in autism. But that’s not going to be the only answer. Beyond just drugs, we’re going to use educational strategies. Individuals with autism,some of them are wired a little bit differently. They learn in a different way. They absorb their surroundings in a different way, and we need to be able to educate them in a way that serves them best. Beyond that, there are a lot of individuals in this room who have great ideas in terms of new technologies we can use, everything from devices we can use to train the brain to be able to make it more efficient and to compensate for areas in which it has a little bit of trouble, to even things like Google Glass. 

Join the interactive autism network.

Autism and SSRIs

Recent research may have discovered a link between maternal use of SSRIs and child autism. This correlation supports earlier research that states that the cortex of children with autism is already affected in the womb. Also, this link might help to explain the recent rise in autism rates.

The article can be accessed here.

Autism and Theory of Mind

One of my courses is focusing this week on Nonliteral Language ability. For this module, I read An Exploration of Causes of Non-Literal Language Problems in Individuals with Asperger Syndrome. This article claims that the Theory of Mind is underdeveloped in individuals with autism. Theory of Mind is the ability to understand that someone else’s mental state differs from one’s own. Researchers have tested the presence of Theory of Mind by hiding an object with the child’s knowledge and asking the child where the object is. The researcher would then ask the child where someone not present would think the object is. In the absence of Theory of Mind, the child would respond with where the object really is.

Theory of Mind involves many pragmatic language skills. Without these skills, children with autism will not understand irony — rather, they will understand the speaker to be lying. How does a speech pathologist support a child in development of Theory of Mind?

I found some resources while trying to understand how to apply this theoretical information clinically:

Practical Theory of Mind Games available from Linguisystems.

At Amazon:

Teaching Theory of Mind: A Curriculum for Children With High Functioning Autism, Asperger’s Syndrome, and Related Social Challenges

Teaching Children with Autism to Mind-Read: A Practical Guide for Teachers and Parents

Pair Up Free — Preschool Brain Matching Puzzles

However, there is one activity I can think of that uses the child’s interests to stimulate Theory of Mind. I used to tutor a child with autism, and he loved to play chess. However, since he lacked Theory of Mind, he struggled to guess which move I would make following his. I capitalized on this and allowed him to move his piece and then come to my side of the board and look at the chess situation from my perspective.

Although this did not fix all of his pragmatics issues, I believe it was an important stepping stone to later skills of understanding how someone else feels.

If your child does not like chess, any strategy game should be sufficient. One game I love playing even as an adult is to choose a question and have everyone write down their answers to the question. Then one person reads all the anonymous answers and has to guess who said what. My friends and I sometimes answer for ourselves and for someone else, like a mutual friend, teacher, or even Julius Caesar. This game requires a higher level of Theory of Mind that might be appropriate for the developing child who needs extra guidance in this pragmatic language skill area.

This game is available at Amazon, but you don’t need the question cards to play it. You can make your own. Some example questions are given below.

Questions:

What do you do when nobody is looking?

What is your favorite book?

What is your favorite movie?

If I could have any superpower, what would it be?

What is your favorite dessert?

Where would you travel if you could go anywhere?

How would you spend one million dollars?

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Martin, I., & McDonald, S. (2004). An exploration of causes of non-literal language problems in individuals with Asperger Syndrome. Journal of Autism & Developmental Disorders, 34(3), 311-328.

 

Autism starts in the womb

The incidence of diagnosed autism cases in the US is rising. The CDC reports that 1 of every 42 American boys now is affected by the disorder (CNN).

The school system is responsible for providing services to these children, as the Individuals with Disabilities Act requires. The school system currently spends approximately 8.5 thousand dollars to provide services for each child on the autism spectrum (CNN).

With more children being diagnosed each day, the search for an identifiable etiology and a cure continues.

A recent NPR article highlights a study (NEJM) that suggests autistic changes to the brain begin in the womb.

In the neurotypical children who participated in this study, the cortical regions of the brain were composed of six layers. The children with autism who participated in the study, however, had disorganized collections of cortical cells.

Why is this exciting? We still really have no idea what causes autism and how to treat it. If autism starts in the womb and is correlated to atypical cortical layers, then this might be a step forward in treating. Early intervention might mean better outcomes, especially if future advances in therapy allow children with autism to develop new neural pathways where there are congenital problems.

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Sources:

http://www.npr.org/blogs/health/2014/03/26/294446735/brain-changes-suggest-autism-starts-in-the-womb

http://www.cnn.com/2014/03/27/health/cdc-autism/index.html

http://thechart.blogs.cnn.com/2014/02/11/schools-picking-up-autism-tab/