RESEARCH
Critical Work of Dr. Andrew Wakefield Replicated
Clinical Presentation and Histologic Findings at Ileocolonoscopy in
Children with Autistic Spectrum Disorder and Chronic Gastrointestinal
Symptoms www.la-press.com/article.php?article_id=1816
Authors: Arthur Krigsman, Marvin Boris,
Alan Goldblatt and Carol Stott Publication Date: 27 Jan 2021 Autism
Insights 2010:2 1-11
Abstract Background: Children with
developmental disorders experience chronic gastrointestinal symptoms. |
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Aims: To examine the nature of
these gastrointestinal symptoms and histologic findings in children
with autism spectrum/developmental disorders and ileocolonic disease.
Methods: Chart review. 143 autism
spectrum/developmental disorder patients, with chronic gastrointestinal
symptoms, undergoing diagnostic ileocolonoscopy.
Results: Diarrhea was present in
78%, abdominal pain in 59% and constipation in 36%. Ileal and/or
colonic lymphonodular hyperplasia (LNH), defined as the presence of an
increased number of enlarged lymphoid follicles, often with hyperactive
germinal centers, was present in 73.2%. Terminal ileum LNH presented
visually in 67% and histologically in 73%. Colonic LNH was multifocal
and presented histologically in 32%. Ileal and/or colonic inflammation
presented in 74%, consisting primarily of active or chronic colitis
(69%). Ileal inflammation presented in 35%. Presence of LNH
significantly predicted mucosal inflammation. Patients with ileal
and/or colonic LNH had lower mean/median age than those without;
patients with ileal and/or colonic inflammation had lower mean/median
age than those without. There was a significant association between
ileo and/or colonic inflammation or LNH, and onset of developmental
disorder; plateaued or regressive onset conferred greater risk than
early onset.
Conclusions: Patients with autism
or related disorders exhibiting chronic gastrointestinal symptoms
demonstrate ileal or colonic inflammation upon light microscopic
examination of biopsy tissue. Further work is needed to determine
whether resolution of histopathology with appropriate therapy is
accompanied by GI symptomatic and cognitive/behavioral improvement.
+ Full paper here: www.la-press.com/article.php?article_id=1816
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• • •
Cleveland
Clinic Doctor Finds Brain Connection To Autism
By Monica Robins, wkyc.com is.gd/7cgbf
Science has long known that Autism is
some type of developmental disorder in the brain but there's never been
a definitive answer for its cause.
Now a Cleveland Clinic researcher
released a study that may provide one.
The center part of your brain, called
the corpus collosum, allows each side of the brain to communicate. The
study found them to be much smaller in children with autism.
When five-year-old Paul first came to
the Cleveland Clinic Center for Autism, he could not communicate and
had serious behavioral problems.
But after early intervention, he has
made much progress.
Thomas Frazier, Ph.D. thinks autism is
linked to the size of the corpus collosum in the brain.
"So, you can imagine if your corpus
collosum is not working right, then the two sides of the brain aren't
going to communcate correctly," Frazier says.
People with autism typically are not
able to process complex social and emotional cues.
If a smaller corpus collusum means brain
neurons can't develop, it may explain part of the disorder and
scientists can start looking for the genes responsible.
"The best way to study the genetic side
is not to study every kid with autism like they have the same disorder.
It's to actually look at more specific aspects of the disorder like
brain structure," Frazier says.
It brings hope for Paul's mom, Amy
Witzigreuter, of Lakewood.
"This is proof that there are areas of
their brains that are different and affect the way they develop," Amy
says.
Aletta Sinoff, Ph.D. runs the Clinic's
autism program. She's seen first hand how early intervention treatment
helps many children with autism go mainstream.
She hopes Dr. Frazier's research
develops a way to actually measure if treatment improves brain
connections.
"That would allow us to predict for
particular children what treatment works better than others," Sinoff
says.
While a handful of genes have been
linked to autism, Dr. Frazier thinks there's hundreds more yet to be
found.
Amy is just glad there are researchers
looking for the answers.
"If in our lifetime we can not only
understand and identify those genes but manipulate them to change the
outcome of autism, wow, that's just that justs makes everyday working
with your child easier."
Dr. Frazier's study actually looked at
several other studies regarding children and autism that included
detailed MRIs of the brain and corpus collusum.
Study partcipants ranged in age from 3
years to 22. Two hundred and fifty of them were diagnosed with autism
and were compared to 250 others who were not.
It's published in the Journal, Biology
Psychiatry.
• • •
A
New Way to Look for Diseases’ Genetic Roots
By Nicholas Wade, NY Times. is.gd/7cgZ9
The hunt for the genetic roots of common
diseases has hit a blank wall.
The genetic variants found so far
account in most cases for a small fraction of the genetic risk of the
major killers. So where is the missing heritability and why has it not
showed up? A Duke geneticist now suggests that the standard method of
gene hunting had a theoretical flaw and should proceed on a different
basis. The purpose of the $3 billion project to decode the human
genome, completed in 2003, was to discover the genetic roots of common
diseases like diabetes, cancer and Alzheimer’s. The diseases are called
complex, meaning that several mutated genes are probably implicated in
each.
A principal theory has long been that
these variant genes have become common in the population because the
diseases strike late in life, after a person has had children. Bad
genes would not be eliminated by natural selection at that age, as they
would if the diseases struck before the child-bearing years.
So to find disease genes, the thinking
went, do not decode the entire genome of every patient — just look at
the few sites where genetic variations are common, defined as being
present in at least 1 percent of the population.
These sites of common variation are
called SNPs (pronounced “snips”), and biotech companies have developed
ingenious devices to recognize up to 500,000 SNPs at a time. The SNP
chips made possible genomewide association studies in which the genomes
of many patients are compared with those of healthy people to see which
SNPs are correlated with the disease.
The SNP chips worked well, the studies
were well designed, though enormously expensive, and some 2,000
disease-associated SNPs have been identified by university consortiums
in the United States and Europe.
But this mountainous labor produced
something of a mouse.
In each disease, with few exceptions,
the SNPs accounted for small percentage of the genetic risk. A second
puzzling feature was that many of the disease-linked SNPs did not occur
in the DNA that codes for genes, but rather in the so-called junk
regions of the genome. Biologists speculated that these SNPs must play
an as-yet-undefined role in deranging the regulation of nearby genes.
In an article this week in the journal
PLoS Biology, the Duke geneticist David B. Goldsteinph.d and his
colleagues propose an explanation for both findings.
+ Read more: is.gd/7cgZ9
• • •
NEWS
The General Medical Council vs. Wakefield,
Walker-Smith, and Murch
This week, the Age of Autism blog
is running several posts about
the UK
General Medical Council Hearing. To learn more: is.gd/7cjUB
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TREATMENT
Research Center Finds Behavior Imaging Technology a Tool
for Treating
Autism
is.gd/7bJmo
Online PR News - Initial findings of an
autism behavioral intervention study being conducted in Phoenix, AZ,
reveal that Behavior Imaging (B.I.) technology can significantly aid
families and health professionals in more effectively treating children
with autism.
The study, which began in January 2009
and will continue through 2010, is being funded by the Organization for
Autism Research and conducted by the Southwest Autism Research and
Resource Center (SARRC). The study centers on the use of B.I. CARE™, a
unique health record platform which allows health events captured on
video and other documentation to be immediately shared between parents
and their healthcare professionals privately via the internet. B.I.
CARE was developed by Caring Technologies, Inc., of Boise, Idaho.
In the study, parents using a Flip
Video® camera digitally record their child’s behavioral events from
their homes. They then share three recordings each week via B.I. CARE
with SARRC, where a behavior professional observes the child’s
behavior, makes annotations about appropriate interventions right on
the video, and sends the comments back to the family through B.I. CARE.
Like a health record, B.I. CARE also tracks SARRC’s clinical
recommendations while documenting the child’s progress and / or needs,
allowing SARRC to effectively treat these children over extended
treatment periods regardless where the family lives.
The study includes 15 families of
children with autism, each who met with SARRC counselors and received
one week of intensive training on behavior interventions. At the end of
the week, eight of the families were given access to Behavior Imaging
technology and ongoing professional support from SARRC counselors. A
control group consisting of the remaining seven families received
minumal support.
Among the families participating in the
study are Heather and Bruce Clarke, two traveling nurses who currently
live in Tucson, AZ, and their 3-year-old son Nathan, who was diagnosed
with autism at 26 months of age. After three months in the study, both
the Clarkes and Kristen Treulich, Clinical Supervisor at SARRC, have
seen a steady improvement in Nathan’s behavior since the project began.
“Nathan’s behavior used to be very
disruptive,” said Heather Clarke. “He wouldn’t talk or look at us or
sit at the table to eat. Now, after just a few months, he talks and
will sit and eat at the table, and he also plays. We’ve learned so much
about how to better interact with him and what triggers certain
behaviors. It has really changed our lives."
Treulich said the families in the B.I.
CARE group maintain and even improve their skills as their children's
skills progress throughout the three month study process. She said the
skills of the non-B.I. Care families are reduced after the first month
as a result of receiving minimal feedback for that month.
According to Treulich, a benefit of
Behavior Imaging technology is that it allows intervention to be done
in the child’s natural environment and in a place where they are
comfortable and it is convenient. The technology also enables her to
counsel three to five times the number of patients that can be seen
during traditional in-office appointments and it lets her view and
analyze behaviors that may not show up during face-to-face appointments.
+ Read more: is.gd/7bJmo
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• • •
PEOPLE
Mom Camps Out To Get Spot In Mental Ward For Son
By Michael Biesecker. is.gd/7bHCk
Raleigh -- Salima Mabry watched over her
son Tuesday as he slept awkwardly in the chair where he had spent eight
days waiting for a bed in a state mental hospital.
Joshua Stewart, 13, is severely autistic
and has an IQ of 36. He can only speak in short, single words, such as
"Ma" or "hurt."
He first arrived at Wake County's Crisis
and Assessment unit for people with mental illness in the back of a
squad car on Jan.18 after he attacked his mother and little brother.
The mother and son began a second week
in a small interview room with no bed, no television and a single
window. There was also no shower. Mabry had been sponging Joshua off
over the sink in a public restroom down the hall. In a corner of the
room are several plastic shopping bags stuffed with clothes.
"I'm exhausted," she said. "Most people
flip out if they have to wait an hour to see the doctor. We've been
here eight days. They say we've broken the record for waiting."
Joshua is among thousands of patients
within the last year who have languished in emergency rooms or mental
health clinics waiting for an open bed in a psychiatric hospital.
Years of budget cuts and failed reforms
have left North Carolina's mental health system without sufficient
resources to care for all those who need help.
The budget Gov. Bev Perdue signed in
August cut $155million from an already struggling system, resulting in
the loss of 354 jobs at state hospitals.
"Sadly, this young man is just one of
many who will be stuck as the cuts to state services really hit home,"
said Vicki Smith, director of the advocacy group Disability Rights
North Carolina. "People aren't getting the help they need; they go into
crisis and then require crisis care and hospitalization."
Children's ward empty On their first
night at the Wake facility, Joshua was approved for admission to the
children's unit at Central Regional Hospital, a 378-bed facility n
Butner that opened in 2008. Though a whole children's ward at the
$138million hospital sits empty because there are too few staff members
to open it, Wake officials were told for the past week that the
hospital could not take Joshua until another child checked out.
Though Central Regional theoretically
has the capacity for 72 children, only 13 were there Tuesday because
the hospital didn't have the workers to accommodate more.
At the county crisis unit, which is
designed only for short stays, staff members made 67 calls over the
past week to the state's four mental hospitals and 11 private
facilities in search of an available bed. Each time, they were told
there was either no space or the facility was not equipped to serve
Joshua.
+ Read more: is.gd/7bHCk
(Thanks to Jean Curtin.)
• • •
Long
Prison Term For Suicidal Minn. Mom Who Killed Son With Drug
Patricia
Becht, who pleaded guilty, had counted out pills for her son,
her daughter and herself after telling them that heaven was like
Michael Jackson's Neverland.
By Joy Powell, Star Tribune is.gd/7cege
The South St. Paul mother who killed her
10-year-old son and overdosed herself and her young daughter as part of
a suicide pact will serve at least 25 1/2 years in prison, a Dakota
County judge ordered Wednesday.
Patricia Ann Becht, 42, had told her
children that heaven was like the late Michael Jackson's Neverland --
and that going to such a place would be part of their suicide plan.
Becht tearfully admitted her guilt in
court Wednesday, including that she had confessed to police that she
counted out pills to give her children. They were Seroquel, an
antipsychotic medication that had been prescribed both for her and her
autistic son, Michael Becht, whom she killed by overdose.
Police also found that Becht planned her
acts so meticulously that she had a "to-do list" and had left notes for
an older daughter who was not home.
The younger daughter, Erica, who was 11
at the time, was hospitalized after a cousin found her gravely ill,
Michael dead and Becht vomiting in their home last July 6.
On Wednesday, Dakota County District
Judge Thomas Poch sentenced Becht to 38 years in prison; she'll be
eligible for release in a little more than 25 years. Earlier in the
hearing, she had pleaded guilty to second-degree intentional murder and
attempted second-degree murder. Poch ordered the sentences to be served
consecutively.
"This was a very difficult and tragic
case," said Dakota County Attorney James Backstrom. "It was not an easy
decision to reach to enter into a plea negotiation in a matter that
took the life of a child in our community."
The father of the slain boy wanted as
long a prison term as possible, while Patricia's Becht's family wanted
leniency.
Backstrom said that in accepting a plea
agreement, he took into account the mother's mental health, along with
the further trauma that would be inflicted upon her surviving children
if they were forced to testify in a trial.
• • •
EDUCATION
Your Guide To Restraint And Seclusion
By Michelle Diament,
disabilityscoop.com is.gd/7bUk4
A scathing report released one
year ago brought unprecedented attention to the use of restraint and
seclusion tactics in schools, documenting rampant examples of abusive
and even deadly practices primarily involving special education
students.
Now Congress is set to consider
legislation this year to institute the first-ever federal oversight
regulating these tactics. Meanwhile, a handful of states have made
changes in an effort to promote student safety. (Read all of Disability
Scoop’s coverage of restraint and seclusion >>)
Yet, for students who enter classrooms
everyday, the battle is far more personal. Relatively few protections
are in place in most states and consideration of the pending federal
legislation will take time. That means parents and students themselves
must be on the watch, says Curt Decker, executive director of the
National Disability Rights Network, which issued the initial report
last January and is currently preparing a follow up report.
Don’t condone it
Most importantly, Decker says, don’t
give schools a free pass.
“The IEP should not contain any sanction
of seclusion and restraint,” he says. “It’s not proper programming when
you have to accept a restraint or a seclusion methodology in order to
keep your kid in an integrated classroom."
Rather, it is the purpose of the IEP
meeting to establish appropriate programming and positive behavior
supports designed to avoid severe behavior problems, Decker says.
If a child’s IEP currently includes
provisions for restraint or seclusion, now is the time to request that
such tactics be stripped from the plan. Should the federal legislation
pass as it’s currently proposed, such measures will not be allowed in
IEP plans anyway.
Watch for the signs
In most cases, parents have no idea that
their child is experiencing restraint or seclusion at school. So, even
if your child’s IEP doesn’t mention the techniques, that doesn’t mean
school staff aren’t employing them.
Keep a keen eye for signs of
disciplinary measures gone wrong, especially if you’re dealing with a
child who can’t tell you what’s going on at school. Pay attention if a
child is nervous about school, refuses to go or is acting out in any
way.
“A lot of parents realize that their
child was restrained or secluded 85 times before they even found out
about it,” Decker says. “If the parents walk into the classroom and the
kid is tied to a chair, then yeah, that’s pretty obvious, but too many
parents just don’t even know this is happening."
+ Read more: is.gd/7bUk4
(Thanks to Connie Frenzel.)
• • •
MEDIA
Temple
Grandin (2010)
Reviewed by Jennifer Armstrong is.gd/7ckKP
Start Date: Feb 06, 2010; Genres: Biopic, Drama; With: Claire Danes
Are you a person who clamors for
films that tackle both autism and cattle handling? Well, then, you are
an unusual individual. The beauty of HBO's biopic Temple Grandin,
however, is that it makes the
title character's autism — and the unique
insight it gave her into livestock psychology —
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relatable
to anyone
with a heart, and fascinating to anyone with a brain. The fact that it
does so with such a singular story only makes the movie that much
greater.
The well-plotted script does what so
many biographical movies fail to do: put us right inside the mind of
its subject. In this case, that's Temple Grandin (Claire Danes), who
was diagnosed with autism as a child in the 1950s but blew past a
lifetime full of unsympathetic teachers and classmates to earn a Ph.D.
in animal science, revolutionize farm systems, and become an outspoken
expert on autism itself. Director Mick Jackson uses a variety of
techniques — onscreen graphics, quick cuts, fantastical flashes, and
heightened sound effects — to give viewers a sense of what it feels
like to be autistic. As Temple explains, she "thinks in pictures." She
remembers everything she sees. Her brain is a crowded and overwhelming
place. Because we're given visual glimpses of how she thinks, we begin
to understand cows and horses the way Temple does — and the next thing
you know, we're entranced by her design for an elaborate, and more
humane, cow-washing system. (To be clear, we are not generally very
interested in bovine cleansing.) This thoughtful treatment also helps a
severely deglammed Danes — all gawky posturing, close-cropped curls,
and shouty speech cadences — transcend a standard awards-bait
performance. She in turn gets a nice boost from a strong but
understated supporting cast: Julia Ormond as Temple's worn-out mother,
Catherine O'Hara as an understanding aunt, and the always reliable
David Strathairn as the science teacher everyone wishes they had.
Grandin also sneaks in some social
commentary, slyly presenting a harsh take on the '50s and '60s, a
pre-Rain Man time when autism was so misunderstood that doctors blamed
it on maternal neglect and suggested lifelong institutionalization.
Sexism, too, threatens to set Temple back in more insidious ways,
especially once she enters the cowboy territory of farm life. If you
think things were already hard for women in the '60s, then imagine what
it was like for a woman who was more interested in telling men how to
run their stockyards than in making them coffee or flirting. Even bull
testicles dumped on her windshield by a ranch boss do not deter Temple
— in fact, they add to the power of her finely rendered story.
• • •
EVENTS
Live From The United Kingdom
The General Medical Council: The Verdict of The Hearings
Thursday, January 28, 2021
11:00 a.m. Eastern Time
Linderman LIVE!
www.autismone.org
Join Curt and Kim Linderman reporting
with Polly Tommey of The Autism File and others in the U.K. following
the verdict on the hearings involving Drs. Wakefield, Murch, and
Walker-Smith. Selected U.K. and U.S. attendees will be
interviewed.
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In
This Issue:
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•
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•
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RESEARCH
Critical Work of Dr. Andrew Wakefield Replicated
Cleveland Clinic Doctor Finds Brain Connection To Autism
A New Way to Look for Diseases’ Genetic Roots
NEWS
The General Medical Council vs. Wakefield, Walker-Smith, and Murch
TREATMENT
Research Center Finds Behavior Imaging Technology a Tool for Treating
Autism
PEOPLE
Mom Camps Out To Get Spot In Mental Ward For Son
Long Prison Term For Suicidal Minn. Mom Who Killed Son With Drug
EDUCATION
Your Guide To Restraint And Seclusion
MEDIA
Temple Grandin (2010)
EVENTS
Live From The United Kingdom
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