Friday, January 28, 2011

Medical News: Autistic Children Slower to Integrate Multiple Stimuli - in Pediatrics, Autism from MedPage Today

Medical News: Autistic Children Slower to Integrate Multiple Stimuli - in Pediatrics, Autism from MedPage Today

Children with autism spectrum disorders are slower at integrating various types of sensory information than those with a more typical development, researchers reported.

The finding -- based on recordings of electrical activity in the brain -- is concrete evidence that children with autism spectrum disorders process information differently than typical children, according to Sophie Molholm, PhD, of Albert Einstein College of Medicine in New York City, and colleagues.

As well as occurring later, so-called "multi-sensory integration" was also less extensive than in typical children, Molholm and colleagues reported online in Autism Research.
Action Points
Explain to interested parents that children with autism spectrum disorders are slower and less effective at integrating various types of sensory information ("multi-sensory integration") than those with a more typical development.


Explain further that it is unclear how such changes in multi-sensory integration affect specific types of behaviors found in children with autism spectrum disorders.
The notion that difficulties with multi-sensory integration lie at the root of autism spectrum disorders has been popular for some time. "It's a new catch-all term," Molholm told MedPage Today.
But there has been little verification of the idea and what research has been done has had equivocal results, she said.

"There is basically absolutely no empirical data to support the idea or to guide how you would deal with it if it were a problem," Molholm said.

Despite that, there is a cottage industry on the Internet that offers to treat deficits in multi-sensory integration in children with autism spectrum disorders.

To help fill the information gap, she and colleagues measured electrical activity in the brains of 17 children ages six to 16 with autism spectrum disorders while they watched a silent movie and were given unrelated auditory and tactile sensations.

Seventeen typically developing children -- matched for age and intelligence quotient -- underwent the same testing, in which the auditory and tactile sensations were given separately and then together.

The researchers summed the responses to the single sensations, as measured by high-density electrophysiology, and compared them with responses to the combined stimuli.

The combined responses of all the children exceeded the sum of the single responses -- an indication of multi-sensory integration. But the autistic children had less pronounced differences, the researchers said, suggesting their integration was less effective.

As well, the multi-sensory integration took place within about 100 to 200 milliseconds of the stimuli in the typical children, the researchers found, but only occurred after about 300 milliseconds in the autistic children.

The finding doesn't mean the autistic children can't integrate different types of stimuli, but it does show that they do it differently, Molholm said. The research also says nothing about how such differences affect behavior.

"That's the ultimate quest, but we aren't there yet," she told MedPage Today. "This is straight brain measurement, which we don't yet correlate with behavior."

It's also a highly artificial experiment, she said, and she and colleagues are now trying to see what happens in more real-life situations.

For instance, it's known that typically, people hear speech better if they can see the lips of the person speaking. What's not known is if people with autism spectrum disorder get the "same boost in perception" from the multiple sensory inputs, she said.

Tuesday, January 18, 2011

ADHD and Autism

Kids with ADHD deserve action

Here is an excellent letter to the editor from the local Burnaby paper (click above).

Every year kids come to school with a variety of learning disabilities and mental health disorders, these include Autism, ADHD/ADD, depression, anxiety and related disorders. And recently studies have shown that BC is one of the places in Canada that is very unlikely to be prepared to help children with one of the most common of these disorders, ADHD, or ADD as many people mistakenly call it.

As the writer of this letter states, "Our Ministry of Education, as well as school communities, needs to know that ADHD is not a behaviour issue, that it can't be "cured" by changing diet, that it's not a result of poor parenting and that the kids who suffer from it aren't bad kids. And they need to know that I am not unnecessarily "drugging" my child. They need to know it's a genuine medical condition, that many kids with ADHD are very bright, that it affects up to 12 per cent of school children, that it's stressful for parents and hard to deal with for kids."

Well, I couldn't have said it better myself, and I am often frustrated by the way ADHD/ADD is treated or should I say not treated in the schools. This is especially important to parents of children with ASD or Asperger's Disorder. Treatment is often non-existant for ADHD. There is an assumption that behaviours are the result of choice, that the problems and failures are purposeful. While the provincial government had taken steps to address the need to provide treatment in the schools and community for autism and Asperger's Disorder, there is really very little available in the schools for children with ADHD/ADD. While there is a large percentage of children with ADHD/ADD you very seldom find a school district providing ADHD specific training for it's staff or parents. While I have spoken in dozens and dozens of schools throughout BC on autism and Asperger's Disorder, and provided training, consultation and observations focused on children with autism, it is nearly impossible to get a school to ask for a workshop, training session or a consultation on ADHD. And often our children with autism and Asperger's have ADHD as a co-morbid disorder. It is seldom addressed in Individual Education Plans (IEPs) and when a school does deal with the symptoms / behaviours that result from ADHD they apply "warnings" and punishments as the "treatment." This is something that sooner or later has to be addressed by our schools. This week alone three of the children seen in my practice were being punished for their ADHD symptoms. A school would never punish a student for their behaviours-symptoms of anxiety, or punish a student for behaviours-symptoms of Tourette's syndrome (although I have to admit, I have spent more than one full semester dealing with just this issue in a major school district in California). More than ny other disorder I have heard negative comments from teacher's and staff when addressing the simplest behaviours relating to ADHD/ADD. Sometimes it's like they have either never heard of the disorder, or if they agreed it existed out entire society would fall.

For parents I have suggested reading "So I'm Not Lazy, Crazy or Stupid," Mel Levine's "The Myth of Laziness" or Dr. Barkley's many works on ADHD. (All of these can be found on my web page.

Often different disorders have separate"camps" of supporters. There are "autism awareness" days, walks, Depression awareness days...all sorts of support groups and programs. Oddly, there is no ADHD walk or ADHD day in any school's or towns I've been to. That's too bad. ADHD more than any other disorder needs to be brought out of the closet and addressed, and those who deny that it is a real disorder, or that it's really a choice a ten year old is making to fail all his subjects and lose all his friends needs to be confronted and dealt with.

I can offer this one piece of advice to parent. Get a copy of the diagnosis for both Autism/Aspergers AND ADHD. Make a copy. LEarn it. Mark the important terms in yellow, underline them. Make a copy for everyone on your child's IEP team. And then make sure everyone know that punishment for symptoms went out about 100 years ago. We don't punish individuals who have a diagnosed disorders like autism, Aspergers, Tourette's syndrome or ADHD for exhibiting their symptoms. Ever. If they try, ask for the research that shows such a "technique" is a good idea. What supports that as an intervention? Instead redirect everyone back to answering how we as a team, parents and school, are going to provide positive behavioural support through the IEP process to teach your child how to do better and succeed. That's what an IEP is all about!

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The Autism blog is not offered as medical advice or as a means of diagnosing or treating Autism or Asperger's Disoder. The diagnosis of autism is complex and involves not just looking for symptoms of autism, which is all that those “web tests” do, but also involves ruling out other disorders that might look just like autism. Often individuals who think they or their child has autism or Asperger's Disoder have other disorders, and may have co-morbid disorders such as depression, anxiety or OCD. A simple check off sheet of “symptoms” doesn’t differentiate these. 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 a real diagnosis. Medical doctors can diagnose autism, but the diagnosis is complex and often they will make a referral to a Registered Psychologist for a full understanding of a patient’s symptoms. You can obtain a referral for a psychologist with expertise in autism from the British Columbia Psychological Association (BCPA). The professional you select needs specific training and needs to use specific tools in British Columbia, including the ADI-R and ADOS, and also needs to complete a psycho-educational assessment. The government of BC provides these services for free, there is a waiting list, and some parents prefer private practitioners.

In my practice I offer autism assessment and treatment services for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education, cognitive rehabilitation for problems with memory and concentration and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site. Please feel free to call if you have questions about ADHD or other cognitive issues.

My autism web page can be found by clicking here. (www.socialcognitivetherapy.com)


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

Saturday, January 15, 2011

Medical News: Pertussis Outbreaks Costly for Local Health Depts - in Infectious Disease from MedPage Today

Medical News: Pertussis Outbreaks Costly for Local Health Depts - in Infectious Disease, General Infectious Disease from MedPage Today (click to see the original story)

Illustrating the lingering threat of pertussis, an outbreak that infected an estimated 8,383 people and killed 10 infants is currently winding down in California -- although a "relatively high" number of cases were still being reported through the end of December -- according to the state's Department of Public Health. This is just one of many new outbreaks of preventable disease we are experiencing across north America due to the continuing influence of the anti-vaccine activists, poor public education on the part of governments and scientifically misleading publications spread by local newspapers that still use headlines to get attention rather than spread the truth and protect the public.

Get you children vaccinated today. Protect them, your family, your friends and the public. Get the facts from your medical doctor.

For those who continue to not understand the process of science and the science of statistics and probability I suggest reading an entertaining and enlightening book on probability. Yes, I said and entertaining book on probability. It's been on the New york Times Best Seller list and should be on your list of books to read. It will make you a competent consumer of information: The Drunkard's Walk by (Click here to purchase at Amazon.ca) This book will help you understand the difference between correlation and causation, and help you understand why many things we see as connected and meaningful are much less so than we think. Right now science, health and the future of our society seems to be at question because the general public has such poor training in science, math and logic. This is a really good place to start.

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For information on the assessment and intervention services I provide in my private practice please go to www.relatedminds.com or www.socialcognitivetherapy.com. I am a member of the RASP and an approved autism service provider.

Dr. Jim Roche
Registered Psychologist, BC
jimroche@gmail.com
778.998-7975

Wednesday, January 12, 2011

Fraud and Being Wrong About Vaccines and Autism

Click here to watch a clear, truthful and direct video about the fraud perpetrated by Dr. Wakefield upon the public. Here is the link: click here.

This video is by Dr. Paul Offit from the Division of Infectious Diseases and the Vaccine Education Center at Children's Hospital, Philadelphia. Dr. Offit has written several books on the connection, of lack of connection, between MMR vaccine and autism. His writing are a great resource, he goes through the research and demonstrates why there is not only no scientific evidence of a connection, but pretty clear proof there is none. For this Dr. Offit has been threatened, his family and children have been threatened, and I am rather surprised he has made such a public video available. The reason, it seems, is his deep concern for the health and well-being of the many children injured by the fraud.

Dr. Offit says, "I'm sure many of you know that what Dr. Wakefield claimed was that because the MMR vaccine was given as a combination vaccine, it overwhelmed the immune system, allowing the measles component of that vaccine to enter the intestines and cause intestinal damage, which allowed for the ingress of encephalopathic proteins. Not a single aspect of that hypothesis was correct, and more importantly, nothing was studied, because Dr. Wakefield's initial publication was merely a case series. The studies were to come later, and there were 14 of them that looked at hundreds of thousands of children who either did or didn't receive the MMR vaccine. These studies found that the incidence of autism, not surprisingly, was the same in the vaccinated group as it was in the unvaccinated group."

This little video (and a transcript is supplied) puts it all out there in a simple to understand way. I find it amazing that in spite of the fact that every single aspect of the study has been shown to be wrong, incorrect and often made-up and manipulated, there are still many individuals who believe Dr. Wakefield and his disproven theories. Usually these are individuals who, based upon Wakefield's disproven paper seek out therapies that have no logical reason to work, no scientific support and are simply put forth with a series of "testimonials" instead of testing, data and evidence. Often these individuals will stand by something they heard, in spite of the fact that over and over again the evidence shows its untrue.

Dr. Offit and others (like Dr. Steven Novella) have taken the time and shown the courage to refocus us all on science, the scientific method and a real search for a cure for autism. Something we have too long been distracted from. Take a look, it's a nice, straight forward little piece.

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For information on the assessment and intervention services I provide in my private practice please go to www.relatedminds.com or www.socialcognitivetherapy.com. I am a member of the RASP and an approved autism service provider.

Dr. Jim Roche
Registered Psychologist, BC
jimroche@gmail.com
778.998-7975

Sunday, January 9, 2011

Jenny McCarthy's autism fight grows more misguided

Jenny McCarthy's autism fight grows more misguided

Excellent article outlining the ridiculous and dangerous assertions still being made by Jenny McCarthy and others about vaccines and autism. Again, there is NO CORRELATION between vaccines and autism. This nonsense continues. It is nothing more than the deliberate misuse of data and the misleading of the public. Take a read.


Jim Roche
www.relatedminds.com
www.socialcognitivetherapy.com

Thursday, January 6, 2011

Medical News: BMJ Lifts Curtain on MMR-Autism Fraud - in Pediatrics, Autism from MedPage Today

Medical News: BMJ Lifts Curtain on MMR-Autism Fraud - in Pediatrics, Autism from MedPage Today

Another version of the story about the fraud perpetrated by Dr. Wakefield.

Vaccines DO NOT cause autism. Something else does and we don't know what.

"Can Vaccines cause autism?" NO, but when I scan the internet these are the kinds of idiotic scar mongering headlines I see all over the web, I'm always thinking there is some new study supporting this idea. You see these headlines in newspapers and magazines and on TV. And these are the headlines for articles that are going to CORRECT this false notion that there is some connection when there is NOT! There are articles that will eventually, after scaring you, tell you the facts. Regretfully few people remember the article and just remember the headline. This nonsense, this cheap thrill garbage reporting has to stop once and for all! People are failing to get their kids vaccinated, and as a result children and adults are dying of diseases that are preventable. It has to stop!

Let's make this clear: There is no research connecting vaccines to autism.

Although signs of autism often begin to appear around the same time that children are vaccinated, it is just a coincidence, not a cause. We give kids vaccines at the time when their language centres are developing, and then, looking back, think one caused the other. Well research has looked at that over and over again, and it just ain't so. See the many research articles listed below.

The truth is vaccines are extremely important for providing protection against illnesses and many long-term side effects of illnesses for everyone, not just children, but adults. Especially adults with compromised immune systems. For example, natural exposure to polio could cause lifelong paralysis. The mumps can cause hearing loss and meningitis and measles can sometimes be fatal. Vaccinations can prevent these types of illnesses and the disease-related side effects from occurring. People are dying, right now, because they made the choice not to be vaccinated. And others are dying because they were infected by one of those people. Am I making this up? check out the epidemics happening in California and the West Coast.

Back to these articles published in local papers and on the web using these misleading scar tactic headlines. one reader wrote: "I do wish those working to counter the misinformation and propaganda spread by the anti-vaxxers would stop using the question to headline their positive efforts. There is not a question involved here. There is only vaccine which does prevent disease and does not cause autism and on the other hand there are these wildly irresponsible scaremongerers who have made names for themselves and put entire populations of children at risk. These two things are not equal. Please stop the pretence of giving them equal consideration in a rational argument."

One of these recent articles was published by a hospital! Why? To get reader's attention. A lot of us thing these kinds of articles do more damage than good because the short headlines continue to reinforce misinformation. And there is a lot of misinformation out there. Too much.

For those that prefer research over hype and emotion, here are some useful references:

California study: "The DDS data do not support the hypothesis that exposure to thimerosal during childhood is a primary cause of autism." Click here:
http://archpsyc.ama-assn.org/cgi/content/abstract/65/1/19

Independent testing of Wakefield's MMR/autism hypothesis - test failed to support Wakefield's conclusions. Has links to several other supporting studies: Click here:
http://www.sciencedaily.com/releases/2008/09/080904145218.htm

Italian study looking at kids who received different levels of thimerosal, comparing their brain development 10 years later. Click here:
http://pediatrics.aappublications.org/cgi/content/abstract/123/2/475

Danish study of 440,000 kids who got MMR and 97,000 who didn't. No significant different in autism and ASD rates. Click here:
http://www.nejm.org/doi/full/10.1056/NEJMoa021134#t=abstract


Japanese study to see if switching from MMR to single-dose vaccines affected autism rates. It didn't. Click here:
http://www.medicine.ox.ac.uk/bandolier/booth/Vaccines/noMMR.html

Montreal study of 27,000 children actually found somewhat LOWER rates of developmental disorders in the children exposed to thimerosal. Click here:
http://www.ncbi.nlm.nih.gov/pubmed/16818529

2010 Detailed study of 250 ASD kids versus 750 controls. No relationship between ethyl mercury exposure and ASD: Click here:
http://www.ncbi.nlm.nih.gov/pubmed/20837594


Comprehensive list of science-based resources on vaccines and autism: Click here:
http://sciencebasedmedicine.org/reference/vaccines-and-autism/


But now there is even more damaging information coming forward about the non-relationship between vaccines and autism. Here is what was published by NPR this week: (For an excellent analysis of the article and the research it's based upon I would click here and read the review in Science-Based Medicine: http://www.sciencebasedmedicine.org/?p=9552

Here is the NPR report: Click here.

Now I know there are still those who think the research is ...well...lies. That big pharma is making these things up to make a profit, and doctors are poisoning their patients to make money. (Actually, most doctors and hospital provide vaccines at a financial loss!). One of their heros is Dr. Wakefield. They believe there is a giant conspiracy on the part of the government, medical licensing boards, medical journals, medical associations and corporations to hide the truth that Dr. Wakefield has to tell. This NPR story clearly points out what was really going on. Why the articles Wakefield published falsely claiming a connection between vaccines and autism were withdrawn, and why his medical license was taken away. Here is some of what the report says:

"The first study to link a childhood vaccine to autism was based on doctored information about the children involved, according to a new report on the widely discredited research.

The conclusions of the 1998 paper by Andrew Wakefield and colleagues was renounced by 10 of its 13 authors and later retracted by the medical journal Lancet, where it was published. Still, the suggestion the MMR shot was connected to autism spooked parents worldwide and immunization rates for measles, mumps and rubella have never fully recovered.

A new examination found, by comparing the reported diagnoses in the paper to hospital records, that Wakefield and colleagues altered facts about patients in their study."

Let's make this clear, the study shows some of the children ALREADY had signs and symptoms of autism or neurological disorders BEFORE they were vaccinated, that Wakefield knew this and that he used the information anyway.

"The analysis, by British journalist Brian Deer, found that despite the claim in Wakefield's paper that the 12 children studied were normal until they had the MMR shot, five had previously documented developmental problems. Deer also found that all the cases were somehow misrepresented when he compared data from medical records and the children's parents."

"In an accompanying editorial, BMJ editor Fiona Godlee and colleagues called Wakefield's study "an elaborate fraud." They said Wakefield's work in other journals should be examined to see if it should be retracted. Last May, Wakefield was stripped of his right to practice medicine in Britain. Many other published studies have shown no connection between the MMR vaccination and autism. But measles has surged since Wakefield's paper was published and there are sporadic outbreaks in Europe and the U.S. In 2008, measles was deemed endemic in England and Wales."

Yes, surges of measles.... and whooping cough and other preventable diseases.

Why did Wakefield do this? Some think that it may have something to do with the fact he prepared the report while being paid by a law firm that wanted to sue vaccine makers and they needed proof...and that he was connected to a proposed alternative vaccine. Hmmmm.... Yes, big pharma and corporations ARE at the heart of this, but not the way people think. They wanted to make money convincing people that vaccines were dangerous. And regretfully, that part of this plot seemed to work out.

A final note: again this week one of my articles supporting the idea that parents get their children vaccinated against deadly childhood diseases upset someone and they made a phone call and made threatening statements. This has happened before, sometimes at 3 a.m. I really don't understand this behaviour. These are people who seem to believe in vast and complicated conspiracy theories, they are convinced the government and big business are poisoning their children. But I'm not the only one who is threatened because we try to spread science and data. Dr. Paul Offit (who wrote "Autism's False Prophets") can't even go to a book signing because he and his family have been threatened and book stores fear violence (read this article in the NYTimes: click here). And then there are parents who often report top me that they too are harrassed and often bullied because they make some public statement about medicine, vaccines and science. Click here for one report from Canada: http://www.leaderpost.com/technology/Vaccine+book+brings+hidden+support+Author/1301769/story.html?id=1301769 At some point we all have to take a stand for science and modernity before we slip into another dark ages.

We can start by being careful with how we title articles. Autism is something that is destroying individuals, families, schools ....and we still don't have any idea what causes it or how to prevent it. Our skills for treating it are improving, but minimal. We need to stop wasting time and money on false accusations, phoney data and conspiracy theories and start focusing on science.

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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 social-cognitive deficits and 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
www.socialcognitivetherapy.com