What Causes Autism? Science is slowly approaching an understanding.

"Notes on Autism Assessment and Treatment" are written by Dr. Jim Roche. These autism notes are not meant to provide a guide to either diagnosis or treatment. For information on diagnosis and treatment contact your medical doctor or a registered/licensed psychologist for an appointment and assessment. Information about Dr. Roche's services can be found at these addresses:

Relatedminds: http://www.relatedminds.com
ADHD Help BC: http://www.adhdhelp.ca
At Psychology Today: http://therapists.psychologytoday.com/rms/70682
At the BCPA website: http://bcpa.pixelmountainarts.com/users/jimroche
At CounsellingBC: http://www.counsellingbc.com/listings/JRoche.htm
At Psyris: http://psyris.com/drjimroche
At Autism Community Training: http://www.actcommunity.net/jim-roche.html

What causes autism, Autism spectrum disorder and Asperger's Syndrome? We now know more about the cause of autism than we have for a long long time. But we need to be careful not to allow the anti-vaccine / anti-scient crowd misdirect us. Moises Velasques-Manoff, the author of "An Epidemic of Absence: A new Way of Understanding Allergies and Autoimmune Diseases" has written an excellent summary of the latest research for the New York Times. It can be found here:

http://www.nytimes.com/2012/08/26/opinion/sunday/immune-disorders-and-autism.html?smid=pl-share

Velasques-Manoff points out that one subset of those with autism, which makes up at least if not more than 1/3 of those with autism, seem to have some type of inflammatory disorder. And this inflammatory disease doesn't start as a result of vaccinations - it's starts way before that, in the womb. We know this is true because the brain changes that are associated with autism are noted prior to the age of immunizations, and there is no correlation between those getting these vaccines and those who develop autism. Hopefully, someday, the uninformed will start to notice the basic problems with their science, or maybe start to have some respect for science.

What the research Velasques-Manoff writes about notes is that a large number of mothers of autistic children have had some sort of immune compromising condition while they were pregnant. This leads to a inflammatory reaction, in both the mother and child, and this effects the astroglia and microglia - which ar enlarged from chronic inflammation.

 A population-wide study in Denmark spanning two decades indicates that infections during pregnancy increases the risk of autism in children.  Sounds simple enough, doesn't it? Infections during pregnancy ...must cause autism. So cut down the number of infections. But again, the epidemiology doesn't lead in that direction. Like much of science, it's more complicated than that. You see, while world wide viral and bacterial infections have gone down ....autism rates have gone up. Especially places where there are fewer infections! Somewhat of a contradiction.

You see while infections and other disorders have decreased, the number of inflammatory disorders HAS gone up.  And the relationship between these inflammatory infections and autism is very clear. A mother with rheumatoid arthritis, an inflammatory disorder, has an 80 percent increase in the chance of having a child with autism. A mother with celiac disease increase her risk 350 percent.

So the questions now becomes why we are now so prone to inflammatory disorders, and if there is anything we can do to decrease these risks?  There are several suggested therapies - for the mother - and these oddly follow the idea of doing something about what Velasques-Manoff calls our "microbial deprivation." (Remember: dirt and parasites are "famous for limiting inflammation.")

 Probiotics? "domesticated parasites?"  These are just some of the thoughts Velasques-Manoff and others are looking at. What we do know is that we have spent too much time looking at the effects of dysregulation in the child with autism, and not enough time looking at dysregulation and other problems in parents .... remember, it's a genetic disorder to a great degree.

Click on the above link to get the New York Times article, and check out some of Velasques-Manoff's writing elsewhere.

Autism Risk and Parental Age

Another research paper points to the problem of older men having children, something most thought was not an issue a few years ago. The research shows that older men are more likely than young ones to father a child who develops autism or schizophrenia. This is because of random genetic mutations that become more numerous with advancing paternal age. This study of the effects of parental age on likelihood of having a child with autism is the first study to quantify the effect as it builds each year. The study also notes that the age of mothers had no bearing on the risk for these disorders. What you need to remember is that this is just one of MANY risks that we have associated with autism. One risk that isn't related to autism is vaccinations, which, in spite of the overwhelming evidence is still thought of as an issue by many uninformed parents, especially those who rely on pseudo-scientific research for answers.

Click here for the article in the New York Times, which does a great job of explaining the research these scientists undertook:

http://www.nytimes.com/2012/08/23/health/fathers-age-is-linked-to-risk-of-autism-and-schizophrenia.html?smid=pl-share

Autism and Pets

(From MedPage) "Getting a pet may help autistic children improve their social skills, a small study showed." "Children with autism who acquired a pet after age 5 showed gains in two prosocial behaviors -- "offering to share" and "offering comfort" -- compared with those who had never had a pet (P<0.0014 for both), according to Marine Grandgeorge, PhD, of the Centre Hospitalier Regional Universitaire de Brest in France, and colleagues." "Autistic children who had had a pet since birth, however, showed no differences compared with their pet-less peers, the researchers reported online in PLoS One." "Given the potential ability of individuals with autism to develop prosocial behaviors, related studies are needed to better understand the mechanisms involved in the development of such child-pet relationships," the authors wrote. Click here to read the entire article: Pets Boost Social Skills in Kids with Autism Click http://www.medpagetoday.com/Neurology/Autism/34012 For information on services I provide for children, adolescents and adults with Autism Spectrum Disorder, Asperger's Syndrome and ADHD visit my website at www.relatedminds.com

Sensory Processing Disorder and ASD

According to a policy statement from the section on Complementary and Integrative Medicine of the American Academy of Pediatrics Sensory Processing Disorder should not be used as a medical diagnosis. They express concern with it's overuse, and the application of sensory based therapies for which there is little if any evidence of effectiveness. Regretfully, even with a diagnosis of Autism Spectrum Disorder or Asleger's Syndrome many school district produce IEPs (Individual Education Plans) that rely heavily on these unproven treatment- while they avoid the use of validated behavioural treatments. Often the reason for this is that sensory based treatments are easier to implement with untrained staff, and there is simply a lack of trained professionals in the field of behavioural interventions (or classroom management). Click http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/33018 for the full story The statement says, "Pediatricians should not use sensory processing disorder as a diagnosis, according to a policy statement from the American Academy of Pediatrics. Although there are standardized measures of a child's sensory processing abilities, there is not a widely accepted framework for diagnosing the disorder, members of the AAP's Section on Complementary and Integrative Medicine wrote in the June issue of Pediatrics." The reort notes, "that the committee developing the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has called for further research before officially recognizing sensory processing disorder." In addition, the authors wrote, "it is unclear whether children who present with sensory-based problems have an actual 'disorder' of the sensory pathways of the brain or whether these deficits are characteristics associated with other developmental and behavioral disorders." The report suggests that instead of diagnosing sensory processing disorder, pediatricians should perform a thorough evaluation -- usually with appropriate referral to a developmental and behavioral pediatrician, child psychiatrist, or child psychologist. The report continues, "consideration should be given to other developmental and behavioral disorders that may be associated with difficulty tolerating or processing sensory information, including autism spectrum disorders, attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorders, and childhood anxiety disorders." "Pediatricians should inform families that occupational therapy is a limited resource, particularly the number of sessions available through schools and through insurance coverage," the authors wrote. "The family, pediatrician, and other clinicians should work together to prioritize treatment on the basis of the effects the sensory problems have on a child's ability to perform daily functions of childhood." Here in Bc there has been tremendous growth in school based "sensory rooms." Often children with ADHD, Autism Spectrum Disorder or Asperger's Syndrome are removed from class and sent to the "sensory rooms" in an effort to calm them down, rather than the school completing an appropriate Functional Behavioral Assessment and developing a behavior based intervention plan that either teaches new skills or uses behavioural techniques (long known about and familiar to experts in the field) such as controlled exposure, relaxation and thought stopping interventions to teach the child appropriate ways to deal with unwanted sensory input. Little effort is made to help the child develop coping skills, self-southing skills or other alternative behavioural skills to deal with the sensory issues. Many parents feel that the over use of sensory rooms and removal from the teaching environment do little more than reinforce inappropriate and unwanted behaviours. A second look at the over use of the "sensory Processing Disorder" diagnosis seems like an appropriate place to start. While here in BC excessive removal from a classroom (Time Out / Time Away) due to behavioural issues seems acceptable. In the United States such removal would be considered a "change in educational placement" and would require approval by both the school special education team and parents. An excellent source of information on how behaviours that interfere with learning should be addressed in the classroom through well know and scientifically supported educational and behavioural techniques can be found at this web page: http://www.pent.ca.gov The PENT website offers free materials which any school district could use to address problematic behaviours which interfere with learning. An appropriate Functional Behavioural Assessment (FBA) is the place to start when addressing these kinds of issues. I have used the PENT training materials to implement training programs in completing and writing Functional Behavioural Assessments for almost 10 years and it is really unmatched ....and FREE. All of these training materials are....FREE. Rather than providing easy interventions that are not supported by science. I would hope that every school instead provides science based assessment and intervention programs that directly assess the behaviours of concern and use interventions techniques we know work. The problem comes down to this: If your child has a serious behavioural problem at school, you should expect that the school would implement strong, science based interventions that are designed to directly address the problem AND teach new adaptive behaviours. Changing the child's environment, and removing them from the classroom, is not a plan. Sensory room or not. If your having such problems with your child in school I would suggest contacting an expert in the field, a psychologist or professional educator, to visit the school, observe the situation and complete an FBA (Functional Behavioural Assessment)