Notes from Dr. Jim Roche:
NPR has an interesting story about autism and early brain development. You can read the transcript of listen to the report by clicking here: http://www.npr.org/2011/06/02/136882002/looking-for-early-signs-of-autism-in-brain-waves
Monday, June 27, 2011
Thursday, June 23, 2011
Autism testing while asleep? Maybe....
First, a reminder that my blogsite is moving to Wordpress. You can find the new WordPress version at: www.relatedmindsbc.com/blog My professional site is now at www.relatedminds.com
Medical News: Brain Out of Sync in Tots With Autism - in Pediatrics, Autism from MedPage Today
This new and interesting study finds that toddlers with autism displayed weaker interhemispheric synchronization as shown by functional magnetic resonance imaging testing conducted during sleep compared with those with language delay or typical development. The investigators suggested that this might provide an early diagnostic tool which could then prompt earlier intervention. While none of these tools will be terribly useful as stand alone instruments, they will help us differentiate on disorder from another, saving time, getting appropriate treatment to the correct children and in the long run, saving money.
The study demonstrates that toddlers with autism have poorer synchronization between the hemispheres of the brain during sleep, potentially providing a biomarker that can aid in early diagnosis of the disorder, researchers found. Among children ages 1 to 3½, those with autism had significantly worse synchronization in two areas of the brain associated with language production and comprehension than other kids, according to Ilan Dinstein, PhD, of the Weizmann Institute of Science in Rehovot, Israel, and colleagues. How does this related to autism? Well the inferior frontal gyrus is positively associated with verbal ability and negatively associated with the severity of autism-related communication problems.
"These results suggest that poor neural synchronization is a notable neurophysiological characteristic that is evident at the earliest stages of autism development and is related to the severity of behavioral symptoms....The ability to measure this characteristic during sleep, when task compliance and subject cooperation are not required, suggests its utility as a possible diagnostic measure to aid growing efforts of identifying autism during infancy," they concluded, adding that early identification would lead to earlier intervention. Yes, this is a test we might be able to use with children who are uncooperative, sometimes seemingly untestable...while they sleep.
The researchers say that "the fact that poor synchronization was found in the language system of toddlers with autism, and not in toddlers with language delay (both groups exhibited similarly low expressive language scores), suggests that reduced synchronization may reflect the existence of a specific pathophysiological mechanism that is unique to autism."
This is where our limited autism funding should be going, rather than more testing of alternative medicines that have no logical hope of cure, or searching for causes that have been ruled out multiple times. We need to focus on where the science drives us, not politics.
Medical News: Brain Out of Sync in Tots With Autism - in Pediatrics, Autism from MedPage Today
This new and interesting study finds that toddlers with autism displayed weaker interhemispheric synchronization as shown by functional magnetic resonance imaging testing conducted during sleep compared with those with language delay or typical development. The investigators suggested that this might provide an early diagnostic tool which could then prompt earlier intervention. While none of these tools will be terribly useful as stand alone instruments, they will help us differentiate on disorder from another, saving time, getting appropriate treatment to the correct children and in the long run, saving money.
The study demonstrates that toddlers with autism have poorer synchronization between the hemispheres of the brain during sleep, potentially providing a biomarker that can aid in early diagnosis of the disorder, researchers found. Among children ages 1 to 3½, those with autism had significantly worse synchronization in two areas of the brain associated with language production and comprehension than other kids, according to Ilan Dinstein, PhD, of the Weizmann Institute of Science in Rehovot, Israel, and colleagues. How does this related to autism? Well the inferior frontal gyrus is positively associated with verbal ability and negatively associated with the severity of autism-related communication problems.
"These results suggest that poor neural synchronization is a notable neurophysiological characteristic that is evident at the earliest stages of autism development and is related to the severity of behavioral symptoms....The ability to measure this characteristic during sleep, when task compliance and subject cooperation are not required, suggests its utility as a possible diagnostic measure to aid growing efforts of identifying autism during infancy," they concluded, adding that early identification would lead to earlier intervention. Yes, this is a test we might be able to use with children who are uncooperative, sometimes seemingly untestable...while they sleep.
The researchers say that "the fact that poor synchronization was found in the language system of toddlers with autism, and not in toddlers with language delay (both groups exhibited similarly low expressive language scores), suggests that reduced synchronization may reflect the existence of a specific pathophysiological mechanism that is unique to autism."
This is where our limited autism funding should be going, rather than more testing of alternative medicines that have no logical hope of cure, or searching for causes that have been ruled out multiple times. We need to focus on where the science drives us, not politics.
Monday, June 20, 2011
Reminder: AutismBC Blog relocated
Reminder: My autism blog has moved to a new server and site: http://www.relatedmindsbc.com/blog
Sunday, June 12, 2011
Canadians resist call to screen all babies for autism
Reminder: the autismvancouver blog is becoming part of my wordpress blog space and after a couple more weeks will only be found there. Please go to: http://www.relatedmindsbc.com/blog to find my wordpress blog.
Canadians resist call to screen all babies for autism
Another article on early diagnosis of autism focuses on how Canadian doctors approach this issue. The article can be found here: Canadians resist call to screen all babies for autism.
What does this mean? Sounds pretty horrible? If you read this in local papers this week you might be wondering what it means. Heres the story:
Canadian researchers are warning that not nearly enough evidence exists to support a move to screen every preschooler for autism, as U.S. doctors are urging.
In the U.S. paediatricians are being urged by their professional body (the American Academy of Pediatrics) to routinely check toddlers for signs of autism at 18 to 24 months of age during regular visits for checkups or vaccinations, regardless of whether the parents have any concerns about their babies. The are screening, and recently I addressed ways that this screening can take place, even at this age, through simple procedures and an interview.
But from McMaster University in Hamilton, Ont., we hear that current screening tools not good enough, “there is no evidence yet that such a program would do more good than harm.” It may be hard to understand, but sometimes when we do screening, based upon no reason at all, just screening everyone, we end up finding many false positives. Mass screenings for several adult disorders have come under fire recently just for this reason.
So while some feel that if autism screening were added to routine baby visits, virtually every child potentially could be reached, while others find that none of the screening techniques available today are sensitive enough to reliably detect — or rule out — autism. (Dr. Jan Willem Gorter, a researcher in McMaster’s CanChild Centre for Childhood Disability Research.) And there are many potentially negative impacts of a wrong diagnosis.
“These conclusions ( in Dr. Gorter's report) raise a fundamental question: what do we aim to achieve when we screen for a non-preventable condition for which there is currently no research evidence that intervention strategies improve the daily lives of all children with autism spectrum disorder and their families?” I know that may seem harsh, but realize they are saying that there is no evidence that early...ages 2,3,4 ....interventions will help, at all.
Others argue that early diagnosis and intervention are crucial. "Parents of children with autism have reported seeing signs of trouble before their baby’s first birthday but autism usually isn’t diagnosed until age three or four. Wait lists for diagnosis and treatment can stretch a year or more." So we have a situation where parents report they see early signs, however what we know about autism (right now, which isn't a lot) is that the physical changes that cause the symptoms we see in behavioural changes don;t occur till ages 3-4. So, do we screen every child, and possibly make a good number of mistakes when diagnosing, or do we wait? Those who think the mistakes are worth it don't take into account the funding and limited resources, those who don't feel that there are no proven effective treatments for children of this age anyway. Both sides seem to have a point.
So, with the limited resources, do we diagnose? Or do we wait? And what difference will there really be? The truth is, sometimes screening can cause more harm than good. It's not an easy problem to solve, but we need to be sensitive to doctors and professionals on either side of the argument. Both sides have the best interests of the children in mind.
Read more: http://www.ottawacitizen.com/health/Canadians+resist+call+screen+babies+autism/4934804/story.html#ixzz1PCORkrOh
Canadians resist call to screen all babies for autism
Another article on early diagnosis of autism focuses on how Canadian doctors approach this issue. The article can be found here: Canadians resist call to screen all babies for autism.
What does this mean? Sounds pretty horrible? If you read this in local papers this week you might be wondering what it means. Heres the story:
Canadian researchers are warning that not nearly enough evidence exists to support a move to screen every preschooler for autism, as U.S. doctors are urging.
In the U.S. paediatricians are being urged by their professional body (the American Academy of Pediatrics) to routinely check toddlers for signs of autism at 18 to 24 months of age during regular visits for checkups or vaccinations, regardless of whether the parents have any concerns about their babies. The are screening, and recently I addressed ways that this screening can take place, even at this age, through simple procedures and an interview.
But from McMaster University in Hamilton, Ont., we hear that current screening tools not good enough, “there is no evidence yet that such a program would do more good than harm.” It may be hard to understand, but sometimes when we do screening, based upon no reason at all, just screening everyone, we end up finding many false positives. Mass screenings for several adult disorders have come under fire recently just for this reason.
So while some feel that if autism screening were added to routine baby visits, virtually every child potentially could be reached, while others find that none of the screening techniques available today are sensitive enough to reliably detect — or rule out — autism. (Dr. Jan Willem Gorter, a researcher in McMaster’s CanChild Centre for Childhood Disability Research.) And there are many potentially negative impacts of a wrong diagnosis.
“These conclusions ( in Dr. Gorter's report) raise a fundamental question: what do we aim to achieve when we screen for a non-preventable condition for which there is currently no research evidence that intervention strategies improve the daily lives of all children with autism spectrum disorder and their families?” I know that may seem harsh, but realize they are saying that there is no evidence that early...ages 2,3,4 ....interventions will help, at all.
Others argue that early diagnosis and intervention are crucial. "Parents of children with autism have reported seeing signs of trouble before their baby’s first birthday but autism usually isn’t diagnosed until age three or four. Wait lists for diagnosis and treatment can stretch a year or more." So we have a situation where parents report they see early signs, however what we know about autism (right now, which isn't a lot) is that the physical changes that cause the symptoms we see in behavioural changes don;t occur till ages 3-4. So, do we screen every child, and possibly make a good number of mistakes when diagnosing, or do we wait? Those who think the mistakes are worth it don't take into account the funding and limited resources, those who don't feel that there are no proven effective treatments for children of this age anyway. Both sides seem to have a point.
So, with the limited resources, do we diagnose? Or do we wait? And what difference will there really be? The truth is, sometimes screening can cause more harm than good. It's not an easy problem to solve, but we need to be sensitive to doctors and professionals on either side of the argument. Both sides have the best interests of the children in mind.
Read more: http://www.ottawacitizen.com/health/Canadians+resist+call+screen+babies+autism/4934804/story.html#ixzz1PCORkrOh
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