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Monday, February 8, 2010 Reader Supported |
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April is Autism Awareness Month
Promote your Fundraiser Now! AUTISM CALENDAR DEADLINE February 25 ! For March 2010 Submit listing here free!  RESEARCHStudy: Moms Over 40 Nearly Twice As Likely To Have Autistic ChildrenThe study of California births finds that in most cases, the father's age plays little role in the likelihood of the disorder. By Thomas H. Maugh II, LA Times. is.gd/7XzkW
The number of women over age 40 in California giving birth increased by 300% in the 1990s, while the diagnosis of autism increased by 600%. At first glance, it might seem that the rise in older pregnancies could be responsible for the rise in autism, which is now thought to affect as many as one child in every hundred. But the authors of the paper, from UC Davis, calculate that older mothers account for less than 5% of the increase in autism diagnoses. "There is a long history of blaming parents" for the development of autism, said Dr. Irva Hertz-Picciotto of the UC Davis MIND Institute, the senior author of the report. "We're not saying this is the fault of mothers or fathers. We're just saying this is a correlation that will direct research in the future." Researchers have long known that the age of the parents plays a role in the risk of developing autism, but how big a role and how that role varies with the sex of the parent has remained confusing, with contradictory results reported in different studies. To investigate, Hertz-Picciotto, Janie E. Shelton and Daniel J. Tancredi analyzed all the singleton births in California during the 1990s for which information was available about the ages of both parents, a total of about 4.9 million births and 12,529 cases of autism. Because of the large sample size, they were able to show how the likelihood of autism was affected by each parent's age. They reported in the journal Autism Research that women over 40 were 77% more likely to deliver an autistic child than those younger than 25 and 51% more likely than those aged 25 to 29, independent of the age of the father. For men over 40, there was a 59% increased risk of autism if the mother was younger than 30, but virtually no increased risk if the mother was over 30. The researchers also calculated that the recent trend toward delayed childbearing contributed about a 4.6% increase in autism diagnoses over the decade. "Five percent is probably indicating that there is something besides maternal age going on because we are seeing a rise in every age group of parents," Shelton said. "We don't know what the biology is. . . . We can't say if it is age or something that is a proxy for age," such as lifetime exposure to environmental pollutants, which accumulate in the body over the years. Also, noted Hertz-Picciotto, older women are more likely to have problems with fertility and require intervention. They may be followed more closely during pregnancy, which would mean more ultrasounds. They are more likely to suffer gestational diabetes and to develop autoimmune disorders, which have been shown to play a role in autism. All are fertile areas for further research. "We still have a real long way to go" in determining the causes of autism, she concluded.
• • • Autism Risk Rises With Mother's Age The Older the Mother, the Higher Her Child's Autism RiskNOTE: This article is on the same research reported above. It provides more bulleted data. – editor.By Daniel J. DeNoon WebMD Health News. Reviewed by Louise Chang, MD is.gd/7XYEU The older a mother is when she gives birth, the higher her child's risk of autism, new data show. A smaller effect also is seen for the age of the father, but only when the child is born to a father over age 40 and a mother under age 30. The new findings come from a comparison of reported autism cases in California to state singleton birth records from 1990 to 1999. Over that time, there were about 5 million births and more than 12,000 autism cases. The results: Women over age 40 are 77% more likely than women under age 25 to have a child with autism. Women over age 40 are 51% more likely than women aged 25-29 to have a child with autism. Women aged 35-39 are 31% more likely than women aged 25-29 to have a child with autism. Women aged 30-34 are 12% more likely than women aged 25-29 to have a child with autism. Women under age 25 are 14% less likely than women aged 25-29 to have a child with autism. Men over age 40 are twice as likely as men under age 25-29 to have a child with autism, but only if the mother is under age 25. It's tempting to think that the trend for women to delay childbirth is behind the continuing rise of autism. But that's not the case. This trend accounts for less than 5% of the autism increase in California over the decade 1990-1999, calculate study researchers Janie F. Shelton, Daniel J. Tancredi, PhD, and Irva Hertz-Piccioto, PhD. So what's going on? That isn't clear. Older parents' genes can undergo changes caused by aging and by the environment. "We need to understand biologically why this is happening," Shelton tells WebMD. "It would be premature to tell older moms not to have a child. It could be the risk is associated with an exposure, and avoiding the exposure would be more important than not having kids at age 40." Exactly what is a woman's risk of having a child with autism? The figures from the study come from 1990 to 1999. Autism cases increased throughout that decade -- and throughout the next decade, too. "By now the rates are much higher," Hertz-Piccioto tells WebMD via email. She also notes that the cases counted in the study are only those receiving services from the state of California,- so the risks she and her colleagues calculate are underestimates. From 1990 to 1999, the risk of having a child with autism was: 1.6 per 1,000 women under age 25 2.3 per 1,000 women aged 25-29 3.1 per 1,000 women aged 30-34 3.85 per 1,000 women aged 35-39 4.4 per 1,000 women aged 40 and older It's clear that a parent's age is only part of the autism puzzle, notes Geraldine Dawson, PhD, chief science officer for Autism Speaks, a group that advocates for autism research. "This study does not say advanced mother or father age causes autism," Dawson tells WebMD. "This is one risk factor among many factors that contribute. In the majority of cases, we are not going to find that any one factor accounts for any individual child's autism. Parental age is just one risk factor that is interacting with other genetic and environmental factors that lead to a child developing autism." The Shelton paper was in the Feb. 8 online advance issue of the journal Autism Research. • • • TREATMENTWhen to Worry if a Child Has Too Few WordsBy Perri Klass, M.D., NY Times. is.gd/7YeW9 There is nothing simple about speech, and there is nothing simple about speech delay — starting with the challenge of diagnosing it. Every pediatrician knows the frustration of trying to quantify the speech and language skills of a screaming toddler. How many words can he say? Can she put two or more words together into a sentence? Can people besides you understand him when he talks? Questions like these, put to the parents, are the quick and somewhat crude yardsticks we often use. Crude or not, the assessment is crucial: the earlier it is made, the earlier the speech-delayed child can get some help, and the earlier the help, the better the prospects. “The physician who understands delayed speech understands child development,” said Dr. James Coplan, a neurodevelopmental pediatrician in Rosemont, Pa., who created the Early Language Milestone Scale to measure children’s language from birth to age 3. Guidelines by age can be found on the Web site of the American Speech-Language-Hearing Association: asha.org/public/speech/development/chart.htm. “Children within the first year start to understand much of what they hear around them,” said Diane R. Paul, the group’s director of clinical issues in speech-language pathology. One-year-olds, she continued, “start to use single words and follow simple directions and point to body parts and listen to simple stories.” By about 2, they start putting words together; by 3, they should be using sentences of three words at the very minimum. The early utterances may be simple, but what produces them is very complex. When a child is not meeting those milestones, there can be a multitude of reasons. Dr. Coplan, who is also the author of “Making Sense of Autistic Spectrum Disorders” (Random House, 2010), says he looks at speech delay in a very broad context, from cognition to communication. Is it purely a problem with speech and language, or is there some more global delay? Has something gone awry in the child’s social connections? The first question to ask is whether the child can hear. Nowadays, all newborns have their hearing screened before they leave the nursery, but later testing can pick up progressive or acquired hearing loss. Next question: What about the rest of the child’s development? Speech and language delay can be one way parents and pediatricians first notice more global developmental delay. “You’ll see delayed receptive language, delayed use of visual skills like pointing, adaptive skills like using a spoon or using a crayon,” Dr. Coplan said. “An 18-month-old not following commands, not using a spoon to dig with, now you’re looking at global delay." Speech and language issues can also be early clues to neurodevelopmental disorders, including the various forms of autism. Not all children with autism will have delayed speech, though often they are not using their words to communicate; such a child may have memorized the alphabet, Dr. Coplan said, but without ever learning Mama or Dada. If the child’s hearing and development are fine, one more question to consider is environment. Is anyone talking to this baby? Is something getting in the way — maybe an exceptionally chaotic household, maybe a severely depressed parent? Speech and language development requires stimulation. Pediatricians have been faulted in the past for dragging our feet in making speech-delay diagnoses, but times have changed; Dr. Coplan credited parent advocacy and the federally mandated early intervention program, which makes it possible for children younger than 3 to get a free evaluation. + Read more: is.gd/7YeW9
Comparison of Data Collection Methods in a Behavioral Intervention Programis.gd/7XSfCA Center for Autism and Related Disorders, Inc. (CARD) research study, “Comparison of Data Collection Methods in a Behavioral Intervention Program,” finds that collecting data on all trials versus only the first trial in a block of ten trials during discrete trial teaching show no difference in indication of mastery or maintenance of skills. The Journal of Applied Behavior Analysis (JABA) has published the findings in its current issue. It’s common for ABA providers to collect data on all trials that are conducted with children during their behavioral intervention programs. However, there is a group of ABA providers who have started using what is called a “cold probe” data collection method. This involves collecting data only on the first trial conducted for each of the children’s lessons. The idea is that the first trial is a good test of how the child is doing because it follows a period of no practice and absence of receiving feedback on performance. All decisions about whether the child has mastered skills and has maintained this mastery over time are made based on first trial data. This study compared whether conclusions regarding mastery and maintenance of skills would differ if decisions were based on only the first trial of data collected versus on all 10 trials of data collected. Eleven children with autism participated in this study. During sessions, data were collected on all trials during teaching sessions which were 10 trials in length. Then, data were graphed as percentage correct based on both the first trial only and also based on all 10 trials. The graphs were then compared to determine when decisions about mastery would be made. The mastery criterion was defined as three consecutive sessions above 80% correct responding (all-trials condition) or three consecutive sessions of 100% correct responding (first-trial condition). Using the all-trials versus first-trial methods, the mean number of sessions to mastery were 7.45 and 7.77, respectively, indicating little difference between the data collection methods. The mean percentage of correct responding on the target skills during maintenance probes for all children, in the all-trials, versus first-trial methods yielded 95.23% and 97%, respectively. Again, this indicated no differentiation between the data collection methods. In summary, results suggested that there was no difference in terms of the number of sessions in which participant displayed mastery performance and in the percentage of correct responding during maintenance probes using either the all-trials or the first-trial data collection method. + Read more: is.gd/7XSfC • • • MEDIAAn Emmy for Claire Danes in 'Temple Grandin'?By Kevin Lewin of World Entertainment News Network. LA Times. (Image: HBO)  Wow! And I mean WOW!!! Claire Danes had better hit the hardware store and pick up a good-sized wheelbarrow because she's going to clean up at all the TV awards ceremonies this year. All bets are off! I can't remember the last time I was so moved by a performance in a TV movie and HBO's "Temple Grandin" just blew me away — so much so that I feel compelled to tell everyone in blogland that you HAVE to see this piece of magic. And who knew Ms. Danes was the new Streep? Maybe playing the great one's daughter in "The Hours" rubbed off. Don't get me wrong, Danes isn't exactly terrible — I loved her in "Shopgirl" and a handful of other roles, but I raised an eyebrow when I first learned she'd be portraying the brilliant Temple G. I now feel I must publicly apologize to the new Mrs. Dancy for doubting her. I truly thought this role would be a tremendous reach for her. Sorry, Claire. Obviously, I'm not an expert on animal husbandry, autism or Temple Grandin for that matter, but I know when I'm watching something of great worth, and this HBO gem would have been an Oscar contender in many categories if it had been a cinema release. Kudos to HBO again. From Mick Jackson's expert direction and the wonderful support of Julia Ormond, Catherine O'Hara and the always brilliant David Strathairn, this is a TV movie you have to see. Just breathtaking. And, again, apologies to Ms. Danes. I will now be at the front of the line for anything you do. Enjoy the acclaim. • • • PUBLIC HEALTHEthics Debate Over Blood/DNA From Newborn Safety TestsBy Lauran Neergaard is.gd/7Y33h AP - A critical safety net for babies - that heelprick of blood taken from every newborn - is facing an ethics attack. After those tiny blood spots are tested for a list of devastating diseases, some states are storing them for years. Scientists consider the leftover samples a treasure, both to improve newborn screening and to study bigger questions, like which environmental toxins can harm a fetus' developing heart or which genes trigger childhood cancers. But seldom are parents asked to consent to such research - most probably don't know it occurs - raising privacy concerns that are shaking up one of public health's most successful programs. Texas is poised to throw away blood samples from more than 5 million babies to settle a lawsuit from parents angry at what they call secret DNA warehousing. A judge recently dismissed a similar lawsuit in Minnesota. Michigan just moved 4 million leftover blood spots into a new "BioTrust for Health," planning a public education campaign about the research potential and how families can opt out. Advisers to the U.S. government hope to have national recommendations by spring on how to assure all babies still get their newborn tests while allowing parents more say in what happens next. "It's a critical thing that we take action," says advisory board member Sharon Terry of the nonprofit Genetic Alliance. She says distrust over the leftover blood spots threatens public confidence in newborn screening itself. "The sunshine on the information - educating parents - is the way lesser threat. Done well and done right, there will be an enormous benefit overall to the system," she says. Newborn screening isn't new. It began in the 1960s, and today every baby is supposed to be tested for at least 29 rare genetic diseases in hopes of catching the fraction who need early treatment to help avoid brain damage or death. Now being added to the list: Bubble-boy disease, formally known as SCID for severe combined immune deficiency. The program catches about 5,000 babies a year in need of treatment. + Read more: is.gd/7Y33h • • • FINANCESNew Yorkers: Do You Need Financial Help to Raise Your Grandchild?Apply for the Non-Parent Caregiver Grant (Also called the Child-Only Grant) The non-parent grant offers financial assistance for grandparents raising grandchildren or other relative caregivers. Find out if this grant could help you. Financial Assistance • Grant pays an average of $400 per month if caring for 1 child • $525 for 2 children • $650 for 3 children Eligibility • Child's income ONLY considered. (Caregivers' income NOT included in application) • Legal custody or guardianship NOT required • Caregivers must be caring for the child full-time How to Apply For more information or to get assistance filling out the grant, contact the New York State Navigator: 1-877-KinInfo or 1-877-454-6463 mailto:navigator@nysnavigator.org www.nysnavigator.org The NYS Kinship Navigator can help you by providing: • Access to a kinship specialist via a toll free phone • Answers to FAQs on kinship care • Guides on kinship caregiving for each NYS county • Forums for grandparent and relative • • • PEOPLEA Weighty DiagnosisBy Courtney Cutright. roanoke.com is.gd/7Xt2b.
Molly has an autism spectrum disorder, a neurological condition that affects communication, social interaction and behavior. The Centers for Disease Control and Prevention estimates an average of one in 110 children in the U.S. is diagnosed with autism spectrum disorders each year, and boys are affected four times as often as girls. It is called a spectrum disorder because it affects individuals differently, ranging from mild to severe. Molly’s diagnosis falls in the moderate range. Peter is unaffected by autism. The cause of autism is unknown and there isn’t a cure, but thousands of Virginia families are caring for children with the disorder. Many of the families struggle to pay for therapies and other out-of-pocket costs not covered by health insurance. Virginia’s lawmakers last year voted down bills that would have required insurance companies to cover treatments, but one proposal is still on the table again this winter. Looking at the Roanoke twins, it is difficult to detect much of a difference between them. Molly is considered high-functioning: She talks, she plays and she is toilet-trained. She greets guests and gives hugs. According to McConnell, Molly has made a complete turnaround since starting intensive applied behavior analysis therapy a year ago at the achievement center. Molly and Peter have attended the center’s peer-model preschool class since summer. "Most [peer models in the preschool class] are employees’ kids," said Angie Leonard, who started the center in 2002 after her son was diagnosed with autism. "We want them there so our autism kids will follow their lead. They might not know what the teacher says but can follow what the peer models do." At school, Peter stands up, puts his right hand across his midsection and recites the Pledge of Allegiance with as much intent and gusto as the youngster can muster. Molly follows the lead of her preschool classmates and stands up, but she doesn’t put her hand over her heart and she doesn’t say the words. Instead she stares somewhat blankly ahead. "I think it’s good she can mimic her classmates, but I’m looking forward to the day when she really knows what she is doing," Wu said. There’s a good chance Molly has learned the words to the pledge, but getting her to recite it at the right time can be challenging. It is just one of the mysteries of autism spectrum disorders. Molly has the ability to memorize and retain the words; later she throws her head back and belts out the words to "Row, Row, Row Your Boat" while riding a tricycle in the school’s gymnasium. (Thanks to Worshed Ridgerunner. -ed.) • • • LETTERSOn " Retracting a Medical Journal’s Autism Study," NY Timesis.gd/7XR4h To the NY times: The original findings of enterocolitis in many but not all autistic children has been replicated several times (eg, 1-3). Furthermore, a month after Wakefield et al was published in The Lancet (Feb 1998), the journal Pediatrics published a study reporting that among various vaccines related to mumps, measles, and rubella, the MMR was by far the most likely to induce neurologic damage or even death. The abstract of that study is available free online and merits perusal (4). The speculation of an autism-MMR connection as offered by Wakefield et al 1998 was not as far afield as The Lancet editor would have us believe. 1. Enterocolitis in children with developmental disorders Am J Gastroenterol. 2000 Sep;95(9):2285-95. 2. Autistic enterocolitis: Fact or fiction? {excellent, brief overview} Can J Gastroenterol. 2009 Feb;23(2):95-8. Link. 3. Clinical Presentation and Histologic Findings at Ileocolonoscopy in Children with Autistic Spectrum Disorder and Chronic Gastrointestinal Symptoms Autism Insights 2010:2 1-11; 27 Jan 2010 Link. 4. Acute Encephalopathy Followed by Permanent Brain Injury or Death Associated With Further Attenuated Measles Vaccines: A Review of Claims Submitted to the National Vaccine Injury Compensation Program Robert E. Weibel et al. From the Division of Vaccine Injury Compensation, National Vaccine Injury Compensation Program, Health Resources and Services Administration, Public Health Service, Rockville, Maryland; and the DaggerOffice of the General Counsel, United States Department of Health and Human Services, Rockville, Maryland. PEDIATRICS Vol. 101 No. 3 March 1998, pp. 383-387 Link. — Teresa Binstock Ms. Binstock I looked at the abstracts and results of two of the three articles you listed. Neither one of them came to a clear conclusion and used very guarded language in reporting their findings. Parents of autistic children would be better off seeking information about behavioral and cognitive therapies. — Citizen Mom  Send your LETTER
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