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RESEARCH

IMFAR: Obesity, Hypertension, And Diabetes Linked To Autism Risk

By Jarret Morrow M.D. hivehealthmedia.com
     
      Obesity, hypertension, and diabetes linked to autism riskResearch presented at the International meeting for autism research in San Diego suggests that women who have diabetes, hypertension, or who are obese before pregnancy are more likely to have children with autism. According to Irva Hertz-Picciotto, PhD, an autism researcher at the University of California, Davis MIND Institute, “For mothers with at least one of these conditions, there was a 60% increased risk for autism in the offspring…"
      According to the CDC, approximately 1 in 110 U.S children have autism spectrum disorder or ASD. ASD are a group of developmental disorders that can result in significant problems with social, behavior, and communication.
      In total, 1001 children were enrolled in the CHARGE study which is an acronym for Childhood Autism Risks from Genetics and the Environment. Of these 1001 children, 508 had ASD, 178 had developmental delays, and 315 were normally developing children.
      After adjusting for other confounding variables such as the mother’s education, the researchers found that mothers of children with autism were 60% more likely to have one of the three previously mentioned conditions (obesity, diabetes, or hypertension).
      In fact, the mothers of children who were developmentally delayed were 150% more likely to have one of these three medical conditions.
      The researchers speculated that a metabolic disruption such as an inflammatory pathway might be linking these conditions.
      Experts who attended the conference such as Alycia Halladay, PhD, a researcher for Autism Speaks, suggest that the best advice for women who have diabetes, high blood pressure, or are obese before pregnancy is to see a high-risk obstetrician.
      As a disclaimer, these research findings are still considered preliminary as they have not as of yet undergone a peer-review process which accompanies being published in a medical journal.
      Source: WebMD

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IMFAR: Boys With Autism
More Likely to Be Bullied

Deficits in social and cognitive functioning may place them at higher risk

      HealthDay News
     
      Adolescent boys with an autism spectrum disorder (ASD) have deficits in areas of social and cognitive functioning that appear to place them at higher risk of peer victimization than their counterparts without the condition, according to research presented at the International Meeting for Autism Research, held from May 12 to 14 in San Diego.
      Elizabeth Anne Kelley, Ph.D., of Queen's University in Kingston, Canada, and colleagues evaluated 68 adolescent boys between 11 and 18 years of age (31 with a primary ASD diagnosis and 37 typically developing) to assess deficits in various social and cognitive factors that may contribute to peer victimization in adolescent boys with and without an ASD.
      The investigators found that high-functioning adolescent boys with an ASD experienced more peer victimization than their typically developing peers. In addition, adolescents with an ASD had more difficulty with the social use of language, understanding of their emotions as well as other's emotions, regulating their behavior, and reflecting on their thinking processes and behavior. The investigators also found that an adolescent's ability to manage their own stress and control their emotions predicted how frequently their peers bullied them.
      "Difficulty modulating emotional responses appropriately and a lack of ability to cope with stress appear to place adolescents with and without an ASD at risk for peer victimization," the authors write.
      + Read more.
     
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IMFAR: Child With Autism
May Affect Family Income
Study Shows Mothers of Autistic Children Are Less Likely to Be Employed

By Kathleen Doheny WebMD Health News

Reviewed by Laura J. Martin, MD

      Having a child with autism adversely affects family employment and income, new research suggests.
Mothers of children with autism are less likely to be employed than other mothers and likely to earn less when they do work, says researcher David Mandell, ScD, associate director of the Center for Autism Research at The Children's Hospital of Philadelphia. Fathers aren't affected in the same ways.
      However, family income suffers. "It turns out, autism is also associated with a large reduction of family income -- a 27% reduction in family income," Mandell says. That translates to earnings of $17,640 less than families with children without autism, according to his study.
      Mandell presented the findings at the International Meeting for Autism Research in San Diego.
      Autism is an autism spectrum disorder, a range of neurodevelopmental disorders marked by difficulties in social and communication skills and repetitive behavior.
      Economic Impact of Autism Mandell used data from the Medical Expenditure Panel Survey from 2002 to 2007. This annual survey includes information on health care use, costs, work characteristics, and other information for a representative sample of U.S. households.
The researchers identified those children with autism. They then matched children with parents to evaluate the data.
      The researchers looked at mothers and fathers separately. They estimated average loss of earnings associated with having a child with autism. They found differences between mothers and fathers in terms of work.
      Of the more than 47,000 children living with the mothers surveyed, 147 were diagnosed with autism.
Among the findings: 62% of the mothers with children with autism were employed outside the home, compared to 71% of mothers of other children without autism.
      Average weekly work hours for mothers of children with autism were 34, compared to 35 for other mothers.
      Mothers of children with autism earned 39% less than mothers of healthy children.
Of the nearly 35,000 children surveyed whose fathers were present in the home, 113 had autism.
Among the findings: 91% of the fathers of children with autism were employed, while 95% of the other fathers were.
      Average weekly work hours of the fathers of children with autism were 46; for those without, 44 hours.
      Explaining the Income Gap "A big question," Mandell says of his findings, "is why?"
He speculates that many families raising children with autism "don't have a care system the way other families do."
      For instance, he says, a family raising a child with spina bifida, a congenital abnormality, has a clear pathway through the system and knows what is needed.
      However, the needs of children with autism, because the characteristics and severity of symptoms can vary, are not as clear-cut.
The families raising children with autism, Mandell says, "are cobbling together services, fighting with health insurance."
      The efforts may require so much time that someone's job has to give. "I think what is happening is the mother drops out of the labor market to be the case manager for the child," Mandell says.
+ Read more.

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IMFAR: Difficult Labor and Fever
Tied to Autism Risk

By HealthDay News

      Influenza during pregnancy and non-elective cesarean delivery do not appear to be associated with an elevated risk of autism spectrum disorder (ASD); however, fever during pregnancy, especially in the first or second trimester, and factors associated with difficult labor are associated with an increased risk of ASD, according to research presented at the International Meeting for Autism Research, held from May 12 to 14 in San Diego.
      Using data from the Childhood Autism Risk from Genetics and Environment (CHARGE) study, Ousseny Zerbo, of the University of California at Davis, and colleagues evaluated 462 children with ASD, 136 with developmental disorders but not autism, and 265 typically developed children between ages 2 and 5 (when recruited) to determine whether maternal influenza infection or fever during pregnancy was associated with an increased risk of ASD.
      The investigators found no association between maternally reported influenza during pregnancy and ASD. However, mothers of ASD-affected children were twice as likely to report having had a fever during pregnancy as compared with mothers of typically developing children, with the risk especially elevated if the fever was during the first or second trimester.
      Also using data from the CHARGE study, Robin L. Hansen, M.D., of the University of California at Davis, and colleagues evaluated medical records documenting the course of labor and delivery for mothers of 477 children with a diagnosis of ASD and 272 population-based frequency-matched controls.       The investigators found that non-elective cesarean delivery itself was not associated with ASD but that factors associated with difficult labor courses may raise the risk. Other research revealed that maternal diabetes and other conditions related to elevated insulin resistance may play a role in the development of ASD among offspring, and that elevated tumor necrosis factor levels in amniotic fluid are associated with a significantly increased risk of ASD.
      "Our analysis suggests that it is not birth by cesarean itself that is associated with ASD. Rather, it appears that factors associated with difficult labor courses, including prolonged labor and membrane rupture, as well as occult and overt infection within the amniotic cavity may drive the relationship between non-elective cesarean delivery and ASD," Hansen and colleagues write.
+ Read more.

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• • •

IMFAR: Adults With Autism
Face Health Problems With Age

By Denise Dador, Los Angeles, KABC

      New research is coming out of a major autism conference. One of the biggest concerns parents who have kids with autism is what will happen to them when they become adults. With so many more kids being diagnosed, scientists are looking to the future and what's in store for these individuals.
      Nurse manager Kathryn Smith answers parents' questions all day long: How do I know if my child has autism? What are the signs? Lately she's been getting a lot of calls from parents who have older teens transitioning into adulthood.
      "Typically families are looking for services," said Smith, who works at the Boone Fetter Clinic at Children's Hospital Los Angeles.
There aren't very many. Smith works primarily with families who have kids with autism at Children's Hospital L.A.
      "A lot of the service focus for individuals with autism is really in the younger ages," said Smith.
At the International Meeting for Autism Research in San Diego, scientists examined what happens to these kids as they age.
      Researchers found the older a child with autism gets, they experience fewer behavior problems and they hang on to their functional abilities. But compared to other adults, those with autism were significantly more likely to be in poor health. And they experienced a more rapid decline after age 45.
      Smith says finding a doctor who can deal with this combination of health issues is a major challenge.
"The bad news is trying to find providers who feel comfortable taking care of a person with a chronic condition who also has a diagnosis of autism," said Smith.
      During the 10-year study of 400 individuals with autism, 11 died, some from heart attacks and others as a result of accidents.
      Researchers also found adults on the autism spectrum end up relying on the public service system and family for most of their lives.
Smith says this type of research shows the issue is only going to get bigger as our population ages.
      "Given the increasing numbers of individuals with autism, that policymakers really need to take a look at how to serve these people better," said Smith.
      The 10th Annual International Meeting for Autism Research officially kicks off Thursday in San Diego. More than 1,900 researchers, clinicians and specialist will gather, all devoted to a better understanding of autism.

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PEOPLE

Mother of Disabled Child Wins A $7 Million Settlement
Tests might have prompted her to choose abortion

By Travis Andersen, Boston Globe

      A superior court judge approved a $7 million settlement yesterday in a lawsuit brought by a Shrewsbury woman against four medical professionals at a Worcester hospital, whom she accused of failing to offer or explain tests that could have prompted her to have an abortion rather than carry her now-disabled child to term, her lawyer said yesterday.
      An obstetrician at UMass Memorial Medical Center, a nurse practitioner, a geneticist, and a genetic counselor did not tell Ran Zhuang, who is in her early 40s now, during her prenatal treatment at the hospital in 2007 that tests were available to determine if her unborn child had a genetic disorder, according to her lawyer, Frederic Halstrom of Boston.

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RESOURCES

ADHD: 5 Surprising Causes

By fyiliving.com/

     ADHD, attention deficit/hyperactivity disorder, is on the rise. ADHD is diagnosed in 3% to 7% of school-aged children, according to a report by the Centers for Disease Control and Prevention. As the most diagnosed childhood mental health problem, identifying causes and treatment of ADHD is imperative. Here is the most up-to-date list of potential causes of ADHD.
      1. Food Dyes: The FDA is reviewing evidence that suggests artificial food dyes may exacerbate attention deficit/hyperactivity disorder (ADHD) in kids that have the condition. The only role of these food dyes is to make foods look more appealing, so it should be pretty easy to remove them if the FDA finds adequate evidence that they are indeed harmful to children.
      2. Western Diet: A recent study suggests that diet may play a role, as it indicated that teenagers with ADHD were more likely to consume a so-called “Western-style” diet. The “Western” pattern was characterized by a high intake of total fat, saturated fat, sugar, sodium, and a low intake of omega-3 fatty acids, fiber, and folate. Major food groups included take-out, sweets, red and processed meats, refined grains, full-fat dairy, and soda The researchers found that the adolescents who consumed the “Western” diet were 2.2 times more likely to have ADHD than their counterparts who consumed the “healthy” diet.
      3. Smoking and Lead Exposure: A first-of-its-kind national study has found that pre-birth exposure to cigarette smoke and high levels of lead in children can be linked to higher rates of attention deficit/hyperactivity disorder (ADHD) in youth. Children who were exposed to both prenatal smoke and registered high lead levels had a greater than eightfold increased in the likelihood of having ADHD.
      4. Pesticides: New research suggests there may be a link between children with measurable breakdown products of organophosphates (the most commonly used type of pesticide) in their system and Attention Deficit Hyperactivity Disorder (ADHD). The study also suggests that those subjects presenting with a mental disability like autism or schizophrenia were twice as likely to also have ADHD.
      5. Genetics: New research coming out of Cardiff University in Wales is suggesting that chromosomal defects are responsible for ADHD. The study also suggests that those subjects presenting with a mental disability like autism or schizophrenia were twice as likely to also have ADHD.
Most of the 4.4% of the adults in the United States who suffer from ADHD use medication to help them get by, but a new study in the Journal of the American Medical Association shows that adding cognitive behavior therapy may reap more benefits.
+ Read more at FYI Living:

• • •

TREATMENT

Elephant Therapy Aims To Help
Thai Autistic Kids
Condition is incurable, but therapy can improve speech, learning, social problems

Autistic children ride Nua Un, a female elephant, during an animal therapy program in Lampang, Thailand, on April 21. The program seeks to help autistic children through interaction with the well-trained pachyderms.



By Denis D. Gray, The Associated Press

      Lampang, Thailand — Kuk-kik, a 14-year-old boy, punctuates his few, slurred words with yelps. Kong screams and bites his fingers when he can't figure out how much to pay for bananas. Other children freeze mid-motion, fix their gazes on minute objects and withdraw.
      Enter Nua Un and Prathida — two gentle, lively and clever female elephants — and the mood among the autistic teenagers in Thailand changes as they begin their therapy, the world's first using these charismatic animals.
      They scrub and soap their bristly hides, play ball games with the well-trained pachyderms and ride them bareback, smiling.
      "Chang, chang (Elephant, elephant). Children, have you ever seen an elephant?" the group sings, clapping hands to the traditional Thai nursery tune and hugging the elephants' trunks. Disco-like, Nua Un bobs her head and sways.
      Everyone cheers in a rousing climax to another day in this program in the forests of northern Thailand, which seeks to help autistic children through interaction with elephants.
      Animal therapy for people with developmental disabilities — notably using dolphins, dogs and horses — is not new, and has provoked skepticism — especially in connection with expensive swimming-with-dolphins programs. But some anecdotal evidence and studies have shown positive results.
      Wittaya Khem-nguad, the elephant project's founder, says parents "see improvements after the elephant therapy and that gives them this hope."
Nuntanee Satiansukpong, in white, the head of occupational therapy department, rides Nua Un, a female elephant, during an animal therapy program in Lampang, Thailand, on April 22.
      A small preliminary observation found improvements among four boys after three weeks of elephant therapy, but more research with larger samples is needed, says Rebecca Johnson, who heads the Research Center for Human Animal Interaction at the University of Missouri. A presentation on the Thai program was recently made at the school's Thompson Center for Autism and Neurodevelopmental Disorders.
      Autism is incurable but therapy and medication can improve speech, learning and social problems, and reduce behavior like tantrums.
      Elephants have lost their traditional roles in Thailand as trucks, teak loggers, and battle tanks, Wittaya, who gave up a career in advertising to work with elephants, started the project as a way to help the endangered animals regain their usefulness. After reading about horse riding therapy, he approached Chiang Mai University, where Nuntanee Satiansukpong, head of its occupational therapy department, suggested elephants might help those with autism.
      Elephants, she says, provide the rich, attention-grabbing "sensory menu" beneficial to the autistic, while the animals' intelligence and other traits allow for a wide range of interactions with humans. Additionally, elephants are woven into the fabric of Thai culture, familiar to children since birth.
+ Read more.

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COMMENTARY

Your Presence Is Making Us Uncomfortable
A family fights to release their relative from an institution.

By Chantal Sicile-Kira in The Autism Advocate.

      In honor of Mental Health Month (as is May) I am posting an essay by my friend and disability advocate, Diana Pastora Carson. This is her story, and the story of her brother, Joaquin, and their battle for his release form an institution so that he may live near his family. Coincidently, I worked at that same institution years ago, preparing the first group of individuals that would live in group homes in the community. Now I am preparing my own 22 year old, Jeremy, for life as an adult. I hope I never have to go through what Diana and her brother are going through. There are no words, except Diana's, that can do Joaquin's story justice.

Your Presence is Making Us Uncomfortable: A Broken System Doesn't Get It

By Diana Pastora Carson

      The bureaucrats were well aware of who I was and why I was waiting outside of their staff meeting, my power boots pacing between the two doors of their conference room. Their floor-to-ceiling, wall-to-wall windows gave them full view as I smiled and said good morning to passersby for the two hours that I waited for their boss to come out and talk with me.
      This administrator had refused to return my calls personally and instead had her subordinate call me on two occasions, unable to answer my questions about why my brother was still living in an institution when nearly two months ago, after three years of our family advocating on his behalf, they agreed that he is ready to return to the community.       At that time, our family was told that it would take one to two weeks to have his plan approved by administration. After seven years in an institution, the result of medication side effects, Joaquin would finally be returning to his own community, where friends and family await him.
      But two months after coming to this agreement, now, once again, their promises had not been kept. I wanted answers. I had been calling to get answers for nearly a month. And still I had none. I was committed to my brother's freedom and life quality. So I took a day off from work to get the answers in person. After two hours of patiently and respectfully waiting outside their meeting room, the executive assistant came out to tell me that my presence was "making staff uncomfortable."
      I wondered what she thought I should have done differently so that they could be comfortable with my presence? Had it been my responsibility to make them comfortable, maybe I could have brought them all Starbucks? Or maybe I should have dressed down for the occasion? Not look so put together, respectable, and capable?
+ Read more.

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