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Tuesday, May 24, 2011 Vol. 15 No. 28
NEWS
Developmental Disabilities, Including Autism and ADHD, Are on the Rise
EDUCATION
Validating Preschool Programs for Children With Autism
RESEARCH
Most Effective Seizure Treatments For Children With Autism Spectrum Disorder
New Method to Localize the Epileptic Focus in Severe Epilepsy
TREATMENT
Methylphenidate (Ritalin) May Reduce ADHD Symptoms in Autism
RESOURCES
iPad Holds Promise For Dealing With Autism
FREE Live Video Streaming AutismOne/Generation Rescue Conference
COMMENTARY
The Attack on Mark and David Geier
NEWS
Developmental Disabilities, Including Autism and ADHD, Are on the Rise
By Meredith Melnick Time Magazine.
Mom hugging autistic son and
guide dog
Victoria Yee / Photographer's Choice via Getty Imges
Victoria Yee / Photographer's Choice via Getty Imges
One in six American children now has a developmental disability — a 17%
increase over the past decade, driven largely by increases in autism
and attention deficit hyperactivity disorder (ADHD)according to
government researchers.
While researchers saw increases in a wide range of developmental problems, including stuttering and learning disabilities, the most significant increases were seen with autism and ADHD. Autism rates nearly quadrupled over the study period, from 0.19% of children in 1997-99 to 0.74% in 2006-08. But, overall, ADHD accounted for the greatest number of developmental disability cases; rates rose by 33%, from 5.7% of children in 1997-99 to 7.6% by 2008.
Nearly twice as many boys as girls had a disability. ... This might be because some genetic disabilities are more likely to be inherited by males, although it could also be that the symptoms of ADHD and other disabilities are more obvious in boys, and are therefore more likely to be diagnosed, the study notes.
Rates were also substantially higher than average among children from low-income families and children on Medicaid. Hispanic children had lower rates of disabilities than white or black children, which perhaps reflects language difficulties and other barriers to accessing health services rather than the true rate of disability.
The Centers for Disease Control and Prevention (CDC) study was based on data from the National Health Interview Surveys, which included in-person interviews with nearly 120,000 children. Researchers asked parents across the country to report their kids' diagnoses of autism, ADHD, learning disabilities, mental retardation, cerebral palsy, seizures, stuttering or stammering, hearing loss and blindness.
The reasons for the increases are not clear, but the researchers suggest they may be due in part to increases in preterm birth and the older age of parents. Data show that children who are born prematurely are 30% to 60% more likely to develop ADHD. And a 2010 study found that mothers older than 40 were 50% more likely to have a child with autism than mothers in their 20s (although even among the high-risk group, the odds were still less than 4 in 1,000).
Other key reasons for increases in diagnosis, particularly with autism, are better screening, more awareness and less stigma, and increased vigilance among parents, teachers and pediatricians, the researchers said.
The more children are diagnosed with developmental disabilities, the more demand there is for health and educational services. Particularly with disorders like autism, research suggests that early diagnosis and treatment may be crucial for improving symptoms or even preventing the condition before it develops.
"We are more aware that early intervention is the key to the greatest success in these kids, [but] we need the resources to do that," Alan Hilfer, the director of psychology at Maimonides Medical Center in New York City, told Health.com.
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EDUCATION
Validating Preschool Programs for Children With Autism
ScienceDaily — Researchers from the University of Miami (UM) Department of Psychology participated in a multi-site study to examine different teaching models for children with Autism Spectrum Disorder (ASD). The study is one of the first to look at the fidelity of treatment models for preschoolers with autism. The findings are published online in the current issue of the journal Research in Autism Spectrum Disorders.
The report concludes the first phase of a four-year project to analyze the comparative efficacy of preschool programs for children with ASD. It involves developing and validating assessment measures to demonstrate that the classrooms in the study are actually implementing the teaching models at high levels of adherence.
The researchers found that the assessment instruments they developed accurately measured how well the models were executed in the classrooms and that these measurements were able to discriminate between diverse teaching approaches. The goal is for these tools to provide an evaluation method for intervention programs for children with autism, all over the country, explains Michael Alessandri, clinical professor of Psychology, in the College of Arts and Sciences, executive director of UM/Nova Southeastern University Center for Autism and Related Disabilities, (UM-NSU CARD), director of the Division of Community Outreach and Development at UM and principal investigator for the UM component of the project.
"This is an important first step. We hope that the utilization of these kinds of fidelity tools will enable schools to more closely monitor the degree to which intervention methods are being delivered, relative to what the model intends," he said. "If these useful methods are adopted, parents will have a way to assess the quality of their child's treatment."
The scientists looked at two comprehensive programs for autistic
children in preschool: the Treatment and Education of Autistic and
Communication Handicapped Children (TEACCH) and the Learning
Experiences and Alternative Programs for Preschoolers and Their Parents
(LEAP). The two models were chosen because they are well established
and widely used in public school systems in the U.S.The study took place in 34 classrooms, during four months of the school year. A maximum of four observations were made in each class. The findings may help explain differences in children's responses to different intervention treatments, explains Anibal Gutierrez, assistant scientist of UM-NSU CARD and co-author of the study.
"If we can ensure that the different programs are all good programs, implemented at a high level of fidelity, then we may be able to attribute differences in outcomes to individual child differences," said Gutierrez. "We could explain why children with a particular profile may benefit from one program over another."
Understanding how closely an intervention model adheres to its intended plan may also help to scale up programs within the broader community, explains Drew Coman, Ph.D. student in the Department of Psychology at UM and co-author of the study.
"I believe these measure not only provide a brief guide to implement one of these treatment programs, but they also provide a way to see the strengths of a particular classroom as well as identify the features that may need a bit more support and improvement," said Coman. "Ultimately, these measures provide a means to conduct such evaluations, and will hopefully lead to more support for teachers, better classrooms, and ideally improved student outcomes for students with ASD."
The study was funded by U.S. Department of Education Institute Of Education Sciences.
• • •
RESEARCH
Most Effective Seizure Treatments For Children With Autism Spectrum Disorder
Roughly 25-35% of individuals with autism eventually develop seizures and many of the remainder have subclinical seizure-like brain activity. However, little is known about which traditional epilepsy treatments and commonly used non-traditional alternative treatments are effective for treating seizures or epilepsy in children and adults with autism spectrum disorder. A study just published in BMC Pediatrics by Dr. Richard E. Frye from the University of Texas in Houston and Dr. James B. Adams from the Arizona State University in Tempe has now provided insight into which traditional and non-traditional medical treatments are most beneficial for individuals with autism spectrum disorder and seizures. These researchers surveyed 733 parents of children with autism spectrum disorder and seizures, epilepsy and/or subclinical seizure-like brain activity to rate the effectiveness of 25 traditional and 20 non-traditional medical treatments on seizures.
The survey also assessed the effect of those treatments on other
symptoms (sleep, communication, behavior, attention and mood) and side
effects. Overall, antiepileptic drugs were reported by parents to
improve seizures but worsened other symptoms. Overall,
non-antiepileptic drugs were perceived to improve other symptoms but
did not improve seizures to the same extent as the anti-epileptic
drugs. Four anti-epileptic drugs, valproic acid, lamotrigine,
levetiracetam and ethosuximide, were reported to improve seizures the
most and, on average, have little positive or negative effect on other
symptoms. Certain traditional non-anti-epileptic drug treatments,
particularly the ketogenic diet, were perceived to improve both
seizures and other symptoms.“The information gained from this study will help physicians more effectively manage children with autism spectrum disorder and seizures” says Dr Frye. Prof. Adams states that “This study suggests that several non-traditional treatments, such as special diets (ketogenic, Atkins, and gluten-free, casein-free), are worth further investigation as adjunctive treatments for treating seizures.” The full study is published in BMC pediatrics, and is now available at here.
New Method to Localize the Epileptic Focus in Severe Epilepsy
ScienceDaily — The first two stereo-EEG explorations in Finland were carried out by neurosurgeons of the Epilepsy surgery team in Helsinki University Central Hospital this spring. The method reinforces other examination methods already in use and opens an excellent opportunity in the exploration of the electric activity of both the surface and the deep brain structures during epileptic seizures. The examination also enables exact localization of the functionally important areas of the brain and improves safety of epilepsy surgery at a later stage.
The stereo-EEG examination was developed already in the 1960's, but the recent modifications of the method in the last few years have made it safer and more feasible. The introduction of the method at HUCH benefits particularly patients with severe, drug resistant epilepsy
For the patient, the stereo-EEG is a considerably more pleasant experience than the earlier-used intracranial recording methods: no large craniotomy is required as thin recording electrodes are placed into the brain through small holes. The recording time can also be increased with the new method from one to as many as four weeks.
Epilepsy surgery in Finland has been centred in two university hospitals. In Helsinki University Central Hospital about 30 epilepsy surgery operations are performed each year, and the results are extremely good: more than half of the patients will be completely seizure-free thanks to the operation.
The new stereo-EEG method will be in active use.
"We have a large number of patients at the examination stage, and the ability to localize their epileptic foci through stereo-EEG is very beneficial. About a quarter of the presurgical patients will need an intracranial evaluation," neurosurgeon Atte Karppinen from HUCH Neurosurgery department informs.
Getting ready for Deep Brain Stimulation
HUCH neurosurgery clinic is also getting ready to introduce the so-called deep brain stimulation therapy. The equipment and methods used in the DBS and in the stereo-EEG follow the same basic principles. In HUCH they have several decades' experience and expertise in DBS surgery regarding other illnesses, such as Parkinson's disease.
"Starting DBS therapy in the treatment of epilepsy is well-founded at the stage when we have sufficient, reliable research-based information on the results of the method in the treatment of epilepsy," Dr Karppinen says.
"The methods we use complement each other, and our team's technical research facilities, expertise and results achieved by surgery represent the cutting edge in the whole world. We have all the knowhow and capacity for DBS surgery, but we proceed with patience."
+ Read more.
• • •
TREATMENT
Methylphenidate (Ritalin)
May Reduce ADHD Symptoms in Autism
By Norra MacReady Medscape
Presented here at the International Meeting for Autism Research 10th Anniversary Meeting by investigators at the University of Texas Medical School at Houston, the randomized, controlled, crossover study showed ER-MPH in these children was associated with significant improvement in ADHD symptoms, particularly in the realms of hyperactivity and impulsivity, with no increase in irritability or decline in social function.
Comorbidities are common in children with ASD, Dr. Pearson told Medscape Medical News.
"Many of these children have the core ADHD symptoms of inattentiveness, hyperactivity, and impulsivity," she said.
Depending on the research methods, studies estimate ADHD occurs in 14% to 80% of this patient population and may be even more troublesome than the core symptoms of autism.
Lack of Research "Left untreated, patients with ASD and ADHD have a high risk of suboptimal outcomes, first as children, then later as adolescents and adults," Dr. Pearson told meeting delegates.
Stimulants are frequently used to control ADHD symptoms in these patients, yet efficacy data from randomized controlled trials are scarce.
Of the few studies conducted, perhaps the best known is the 2005 trial conducted by the Research Units on Pediatric Psychopharmacology (RUPP) Autism Network, which showed that immediate-release methylphenidate (IR-MPH) decreased hyperactivity, improved attention span, and possibly enhanced communication skills in ASD and ADHD children.
However, IR-MPH also was associated with an increased risk for irritability and corresponding social withdrawal, and response rates varied widely, Dr. Pearson noted.
Using the RUPP study as a model, the investigators conducted the double-blind, placebo-controlled, crossover trial on 19 boys and 5 girls with ASD who also had significant symptoms of ADHD.
The study goals included examining the effect of ER-MPH on behavior and determine whether increasing doses were more effective or whether the initial gains associated with higher doses were followed by lesser improvements or even behavioral declines, as had been reported by some studies from the 1980s.
The subjects had a mean age of 8.9 years and were considered high functioning, with an average IQ of 80. All the children had significant symptoms of ADHD as rated by parents and teachers. The study began with a week-long placebo washout period.
Then the children received 4 different dosing regimens on 4 successive weeks: placebo on week 1, low-dose MPH on week 2, medium-dose MPH on week 3, and high-dose MPH on week 4. Throughout the study, the children took the ER-MPH at 8 am, followed by IR-MPH at 4 pm. The medication doses ranged from 10 to 40 mg in the morning and 2.5 to 10 mg in the afternoon, depending on the subjects’ weight and the study week.
+ Read more.
• • •
RESOURCES
iPad Holds Promise For Dealing With Autism
Computer developers at Apple didn’t design the iPad with autism in mind, but it seems like it, according to parents of children with the disorder.
By Randy Hanson, Hudson Star-Observer
Brandon Fellrath plays a matching game on his iPad with some guidance from special needs teacher Melissa Blake. Photo by Randy Hanson
Computer developers at Apple didn’t design the iPad with autism in mind, but it seems like it, according to parents of children with the disorder.
After hearing about how other autistic children had benefitted from iPads, Kendra Wiesemeyer purchased one for her 15-year-old son Elliot at the beginning of the school year.
Elliot has been using the touch-screen computer tablet for entertainment and to speak for him. It also is increasing his word recognition.
“We have a lot of hope in this technology for breaking through to these boys,” said Wiesemeyer. She hopes the iPad improves his language skills, behavior and enjoyment of leisure time.
When educators saw how Elliot responded to the iPad, the school district purchased devices for other students with intense autism.
They include Brandon Fellrath, a 13-year-old student at Hudson Middle School.
Brandon’s mother, Angie, also is optimistic about the potential for the iPad to improve her son’s social skills.
Through the Proloquo2Go application, students are able to touch a picture on the screen and have the iPad speak for them.
Brandon has a vocabulary of 1,000 words, but rarely uses them. Now he can touch a picture to express his wishes — for example, when he wants to order a cheeseburger from a fast-food restaurant.
“A tool like this will help him in those situations,” Fellrath said.
Autistic children are hyper-sensitive to sensory inputs, she explained. Having a conversation with someone is so stimulating that the child is unable to speak.
“They may know in their heads what they want to say, but are unable to get it out. So something like this (the iPad) is going to do the communicating. They are going to be able to express that using this basic tool,” Fellrath said.
Autism is a general term used to describe a group of complex developmental brain disorders. It affects the brain areas controlling language, social interaction and abstract thought, and is characterized by a lack of response to other people and a limited ability or desire to communicate.
Families usually begin to notice their children’s communication problems around the age of 3.
“We definitely felt like one day there was something different,” said Fellrath, speaking for herself and husband Brady. “One day he just didn’t respond. We actually brought him in for hearing tests because we thought he had a hearing loss overnight. And he got clumsy overnight."
Brandon had been using at least five words before becoming non-verbal.
Elliot never talked. “That was our key. He just never talked,” said Wiesemeyer.
Both boys have what is sometimes termed intense autism.
“Articulation is very difficult. Word retrieval is very difficult — especially when they are under stressful circumstances,” Wiesemeyer said. “They cannot hold a conversation with you. This is a low-incidence autism."
Wiesemeyer and Fellrath met 10 years ago through the Wisconsin Early Autism Project, a home-based therapy program for children with the disorder.
“That kind of started our journey,” said Wiesemeyer.
“We’ve been very supportive of each other because we can understand each other and relate,” added Fellrath.
+ Read more.
• • •
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• • •
COMMENTARY
The Attack on Mark and David Geier...
Opinion by Consumer Advocate Tim Bolen
Bolen Report
An attorney friend of mine, Bob Reeves, a mainstay in the mercury in health care wars, called me last April 28th, 2011 and asked me to look into some strange occurrences regarding Mark Geier MD and his son David Geier. As everyone knows, the Geiers are severe critics of the fact that Thimerosal (mercury - deadly toxic to humans) has NOT, despite false claims and misrepresentations from the vaccine industry, been removed from vaccines.
Bob asked me, as a Crisis Management Consultant, to analyze the situation and give him, and the Geiers, my Opinion and make some Recommendations. This, below, is the Public Version. The Private Version is much grittier.
Who are these Geier guys?
In short, they are the nemesis of the world-wide vaccine industry.(1) Last January 27th, 28th, 29th, 2011 the Geiers, along with their colleague Lisa Sykes attended, by invitation as an official NGO , the United Nations Environment Programme - Intergovernmental Negotiating Committee to prepare a global legally binding instrument on Mercury (INC2) . There, they officially presented, to the shocked international delegates, convincing evidence that mercury in vaccines, HAS NOT actually been removed, and represents a serious threat to the people of Planet Earth. The Geiers have since been invited to present again at the next conference in Nairobi, Kenya, in October, 2011.
(2) The Geiers have been a mainstay in the State legislative actions banning Thimerosal in vaccines across the US, and the world. More than half of the States are involved in Thimerosal ban legislation. Already, New York, Delaware, Iowa, Missouri, Illinois, California, and Washington state have legislated those bans.
(3) The Geiers, through their non-profit corporation CoMeD recently
sued the FDA for, as attorney Bob Reeves say "The failure of the FDA to
follow their own regulations and require testing for the safety of
vaccines."(4) Press Releases - the Geiers, through their organizations, have issued Press Releases documenting mercury in vaccine issues. There are five of them. You can read them by clicking on each one: One , Two , Three , Four , Five.
(5) Their peer reviewed studies, over a hundred, cover a broad range of Thimerosal caused issues including two extremely shocking revelations: (a) Thimerosal in vaccines is 300 times more toxic to the human brain than the bacteria in the vaccines it is designed to destroy, (b) there is a Thimerosal substitute that is twenty times more destructive to bacteria and it has NO affect on the human brain. You can find many of these published papers here .
+ Read more.
Note: The opinions expressed in COMMENTARY are those of the author and do not necessarily represent the views of the Schafer Autism Report.
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