Tuesday, November 30, 2010

Medical News: Groups Assail Vision Therapy as Remedy for Learning Disabilities - in Pediatrics, General Pediatrics from MedPage Today

Link to the original article: Medical News: Groups Assail Vision Therapy as Remedy for Learning Disabilities - in Pediatrics, General Pediatrics from MedPage Today

I don't like to cross post, and Google hates it when I do, but this is an excellent article on "vision therapy," a form of therapy that many of my clients come to me and ask about. Here's what the medical professionals have to say:

"Behavioral vision therapy, eye exercises, and colored lenses have no role in treatment of dyslexia and other learning disabilities, according to the American Academy of Pediatrics. The academy came down hard on these "scientifically unsupported" alternative treatments in a joint statement with the American Academy of Ophthalmology and other vision organizations. Because learning disabilities are difficult to treat and have long-term consequences for education and socioeconomic achievement, unproven therapies have become highly visible, Sheryl Handler, MD, of the AAO, and colleagues wrote in the August issue of Pediatrics. "Ineffective, controversial methods of treatment such as vision therapy may give parents and teachers a false sense of security that a child's learning difficulties are being addressed, may waste family and/or school resources, and may delay proper instruction or remediation," they cautioned.

I'm not too sure there really is much more to say than that. Read the article, watch the video. The world is full of people telling parents of children with autism, Aspergers, ADHD and related learning disabilities they should spend thousands of dollars on medical treatment that fixes their child. Often, rather than research, we see many many parent testimonials. I've heard them from parents in my office. Vision therapy CURED my child. While that was going on there was a change in classroom teacher, a new support teacher tried a new methods, the child matured and a medication was tried. But the providers of these services stressed how without them nothing would have changed. Do not rely on testimonials. Talk to your doctor. Make science based choices.

This web page/blog is NOT meant as medical advice. NEVER get your medical advice from a blog, or from the internet. If you find something, press print. Take it to your medical doctor and ask what he or she thinks. Go to someone who has the training and experience to help you make good medical and educational choices.

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My web page lists a number of resources you can make use of yourself in dealing with Autism Spectrum Disorder and Asperger's, as well as many other learning disabilities. Please visit it at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.

Autism assessment and treatment services are offered for individuals, couples, families, children, adolescents and adults in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education assessments, autism assessments as well as behavioural and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com

Mitochondrial Dysfunction Seen in Some Kids with Autism

Medical News: Mitochondrial Dysfunction Seen in Some Autistic Kids - in Pediatrics, Autism from MedPage Today

In medical news: A small exploratory study has found that children with autism seem more likely to have problems with their mitochondria than children with typical neurodevelopment. Children recruited from an ongoing case-controlled study found those with autism appeared to have lower oxidative phosphorylation capacity, as well mitochondrial DNA abnormalities, Cecilia Giulivi, PhD, of the University of California Davis, and colleagues reported in the Dec. 1 issue of the Journal of the American Medical Association. Although this small study suggests that mitochondrial defects in children with autism may be more common than in controls, it is a cross-sectional study and causality cannot be determined. That seems to be something missed in the mainstream press, which tout this report as proof of causation. Findings from this preliminary cross-sectional study, which included only 10 cases and 10 controls, cannot establish a causal relationship between mitochondrial dysfunction and autism.

"Whether the mitochondrial dysfunction in children with autism is primary or secondary to an as-yet unknown event remains the subject of future work," the authors wrote. But, they further note that "mitochondrial dysfunction could greatly amplify and propagate brain dysfunction, such as that found in autism, given that the highest levels of mitochondrial DNA abnormalities are observed in postmitotic tissues with high energy demands (e.g., brain)." Giulivi and her colleagues analyzed a subset of children ages 2 to 5 participating in the ongoing Childhood Autism Risk from Genes and Environment (CHARGE) study in California. The researchers looked for mitochondrial problems in the peripheral blood lymphocytes of the 20 children included in the analysis.

"The team identified several factors indicative of defective or abnormal mitochondria in children with autism. Additionally, although there were no between-group differences in glycemia or lactate levels, there was a significantly higher mean plasma pyruvate level in the children with autism (P=0.02) -- consistent with the lower pyruvate dehydrogenase activity seen among the cases. Defects in pyruvate dehydrogenase activity result in insufficient energy production, according to the researchers." The authors acknowledged some limitations of the study, including the relatively small sample size, the possibility of type I errors, and the fact that the children with autism in this substudy were higher functioning than those from the original study.

If a correlation eventually leads to us accepting a causation, what does this mean? mitochondria are called the "powerhouses" of cells, they create energy for cellular metabolism and when they are dysfunctional, cells do not operate efficiently. Essentially they are the key to concerting what we eat into energy within the cell. Poor performance of the mitochondria is disruptive for cells, and we would assume especially for brain cells which have high very energy demands. A lack of energy in brain cells during early development could explain why the brains of children with autism spectrum disorder don't function properly. Mitochondria have already been shown to accompany other neurological conditions, including Parkinson's disease, Alzheimer's disease, schizophrenia and bipolar disorder. What does this mean for treatment? Nothing right now. i'm sure within a week every supplement out there will be mentioning how they help address this issue with this pill or that diet, but the truth is, as you can see, this research is in its very basic stage. While many want to make giant leaps to specific supplements they either sell or advertise, we do not yet understand this relationship clearly enough,m nor do we know what to do about the dysfunction of the mitochondria. What I am sure of is that fish oil pills are not an easy answer.

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My web page lists a number of resources you can make use of yourself in dealing with Autism Spectrum Disorder and Asperger's, as well as ADHD and many other learning disabilities. These posts, however, are not meant to provide medical advice. NEVER use internet blogs as your key to making medical decisions. Print out things you find and wonder about and take them to your medical doctor and ask the expert.

Please feel free to visit my website at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.

Autism and ADHD assessment and treatment services are offered for individuals, couples, families, children, adolescents and adults in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education assessments, autism assessments as well as behavioural and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com

Wednesday, November 24, 2010

Study shows autism linked to education....sort of. (But not)

NPR (National Public Radio) may have gotten the title wrong, but the news article itself got the information correct. Click HERE to go to NPR's web page and listen to the radio broadcast.

This story is about research that looks at clusters of children diagnosed with autism and how they tend to occur in places where parents are older, more educated, and white. The study (U of California, Davis) found, and this is important to those who are convinced otherwise, there is no link to local pollution or chemical exposures. This particular result is important to all those parents that want to have all the "toxins" removed from their children, or who over protect them with fad diets and social isolation because they hear about "toxins" in the air, water and food.

The study results suggest that areas in California with apparently high rates of autism spectrum disorders are probably just places where parents are more likely to obtain a diagnosis for their child. In other words, they look like areas with high autism rates, but they are in fact the same as other areas of California, except the parents can afford medical care, psychologists and ....lawyers to help with school issues. And these are of course areas where parents have jobs that require higher education, and therefore ..... not much in the therefore area here. It's as simple as it sounds.

"It doesn't necessarily mean that higher education causes autism," says Irva Hertz-Picciotto, one of the study's authors and a researcher at the UC Davis MIND Institute. "It gets you the diagnosis more frequently."

The UC Davis study looked at the geographic distribution of about 10,000 children who were born in California from 1996 through 2000 and later diagnosed with an autism spectrum disorder. A "cluster" was defined as a community in which the proportion of children diagnosed with autism was at least 70 percent higher than in surrounding areas. 70%. That's pretty high, and tells you what money and education get for children. A diagnosis, and treatment! (This study should be done by the department of political sciences, with an action plan.)

The study found that differences in parents' age, education and ethnicity explained the cluster most of the time. It doesn't necessarily mean that higher education causes autism. Having parents with a higher education, and I suppose salary and better medical insurance, gets you the diagnosis more frequently. The study found that children of parents who finished college were at least four times more likely to be diagnosed than children of parents who didn't finish high school.Interestingly, children were also more likely to be diagnosed if they were born in a community near a regional service center for people with autism. (Some, I suppose, would think that living near a regional service center causes autism....but most of us get the point.)

The study may be most interesting because it did not find any environmental explanation for higher autism rates, says Steven Novella, a neurologist at Yale University and the author of the blogs "Neurologica," and "Science-Based Medicine." "You can't prove a negative," Novella says. But the results of this and other studies suggest that "if there are environmental factors, they're small."

The California results also show how widely autism diagnosis rates can vary from place to place, Novella says. In some areas of the state, children were four times as likely to be diagnosed as in other areas.That suggests that in many areas there are still a huge number of children with autism spectrum disorders who are slipping through the cracks, Novella says. I wonder how many, and what that says about us here in Canada, where the government won't pay for private practitioners..licensed and registered medical and psychological professionals.... to perform a diagnosis but instead put you on a long waiting list for Provincial services. (When is that going to change? WHY can't the government pay for a private practitioner to administer a diagnostic exam? Could it be a way to avoid paying for services for those they would diagnose? No, that couldn't possibly be it.)

This is a nice article, and it's an excellent way to look at what science tells us, and what it doesn't. As we always say, "correlation does not equal causation."

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My web page lists a number of resources you can make use of yourself in dealing with Autism Spectrum Disorder and Asperger's, as well as many other learning disabilities. Please visit it at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.

Autism assessment and treatment services are offered for individuals, couples, families, children, adolescents and adults in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education assessments, autism assessments as well as behavioural and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com

Saturday, November 20, 2010

Autism Caught On Tape - Technology To Help Children With Autism

Click here for the link and video. (http://www.sciencedaily.com/videos/2007/1103-autism_caught_on_tape.htm)

ScienceDaily () -- Computer scientists have devised two tools to help people interact with autistic children. Videotaping interactions allows teachers or parents to replay situations and evaluate the cause of particularly good or bad behavior. Cataloging actual data, rather relying on memory or interpretation, proves to be a more accurate measure of a situation. These tools are demonstrated in a simple but startling video. You need to watch this video and ask yourself, "How close to this can I get my child's school?"

For a couple years, as a provincial consultant with POPARD, my job was to drive or get on a plane and arrive at a school where there were severe behaviour problems going on. The tool I used to figure out the problem was simple: I watched. That's what this video system does for the teacher, it watches. And more important, it avoids the many pitfalls of relying upon memory of what happened. When teachers try to remember what happened before and after a behaviour of concern they are often unaware of the environment (watch the video!) or they may already have preconceived notions of what is causing the behaviour, and look for that "thing" to happen. Coming in as an outside observer I am often able to avoid both these problems. But this video system...well, I've been replace!

Some simple variations on this tracking system would be to just video times of the day when you know there will be a problem. But you need to collect data to understand the issues.

What the tape skips is the reason we are doing this. Watching you'll see a young boy starts hitting himself. Why? Often times we will hear 1) To get attention , or 2)for self stimulation. Neither of these were the reason in this case, and usually are not. Self abuse and violence with young children with autism is often for communication. Data, information, helps us understand the FUNCTION of a behaviour. Once we understand the function we can do two things: 1) Change the environment so the child doesn't need to engage in the behaviour, and 2) Teach a new skill to meet the function. In the video the child want's something, and can't communicate quickly and easily enough to get what he wants. Yes, he needed to get someone's attention to get it, but attention is not the goal. By watching the situation carefully we can understand the function of the behaviour and teach a new skill to meet that function. MAybe in this case the child needs some visual supports to help communicate (a communication book or pad?). Maybe he needs to practice and be successful at using a sign? I don't have enough details about this child's level of communication skills, but what is important is that we always need to specify how we are going to gather data, gat information, to answer our questions. Video is one possible means. And if your child is having a severe problem at school, I'd have the school watch this video and figure out how they intend to collect that data they need to complete a reliable Functional Behaviour Analysis (FBA).

This blog is not offered as medical advice or as a means of diagnosing or treating autism, Asperger's disorder or any other disorder. Don't go on-line and take an "autism test." The diagnosis is complex, and it involves not just looking for symptoms of autism, but also ruling out other disorders that might look just like autism, Aspergers and other disorders related to ASD. So avoid these on-line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for that. Medical doctors can diagnose autism, but the diagnosis is complex and often they will make a referral to a Registered Psychologist. You can obtain a referral from the British Columbia Psychological Association for a psychologist near you. The Ministry of Family Services can also advise you on obtaining many diagnostic services for free in your community.

My web page lists a number of resources you can make use of yourself in dealing with Autism Spectrum Disorder and Asperger's, as well as many other learning disabilities. Please visit it at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.

Autism assessment and treatment services are offered for individuals, couples, families, children, adolescents and adults in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education assessments, autism assessments as well as behavioural and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com

Friday, November 12, 2010

Autism study reveals how genetic changes rewire the brain

ScienceDaily (2010-11-08) -- Using a blend of brain imaging and genetic detective work, scientists have illustrated how genetic variants rewire the brain. The discovery offers the crucial missing physical evidence that links altered genes to modified brain function and learning.

"In children who carry the risk gene, the front of the brain appears to talk mostly with itself," explained first author Ashley Scott-Van Zeeland, now a Dickinson Research Fellow at Scripps Translational Science Institute. "It doesn't communicate as much with other parts of the brain and lacks long-range connections to the back of the brain."

Researchers could test whether specific therapies actually change brain function by measuring connectivity of patients before and after therapy, she added.
The authors emphasized that the patterns of connectivity found in the study still fall along the spectrum of normal gene variation. "One third of the population carries this variant in its DNA," noted Geschwind. "It's important to remember that the gene variant alone doesn't cause autism, it just increases risk."

The story can be found by following this link CLICK HERE

For information about my private practice you may go to my website at www.relatedminds.com and look for autism services. You can also find out more about my services for children, adolescents and adults with autism or Asperger's Disorder at my PsychologyToday website or my BCAMFT/AAMFT website.