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NEWS

Study Provides New Insights Into The Implications Of Autism Onset Patterns

      physorg.com is.gd/bB1yJ

      Kennedy Krieger Institute announced today new study results showing that when and how autism symptoms appear in the first three years of life has vital implications to a child's developmental, diagnostic, and educational outcomes. Published this month in the Journal of Autism and Developmental Disorders (Epub ahead of print), this study found children with 

Dr. Rebecca Landa, co-author and director of Kennedy Krieger's Center for Autism and Related Disorders
early developmental warning signs may actually be at lower risk for poor outcomes than children with less delayed early development who experience a loss or plateau in skills.
        Researchers collected data from 2,720 parents through the Interactive Autism Network, the nation's largest online autism research project. Through custom questionnaires and standardized rating scales, researchers examined differences in early milestone achievement (e.g., first words, walking, phrase speech, etc.), autism symptom severity and diagnosis, and educational supports between children with three different patterns of autism symptom onset: Regression (n=44%): A loss of previously acquired social, communication or cognitive skills prior to 36 months Plateau (n=17%): Display of only mild developmental delays until the child experiences a gradual to abrupt developmental halt that restricts further advancement of skills No Loss and No Plateau (n=39%): Display of early warning signs of autism spectrum disorders without loss or plateau Results from the study, currently the largest to have examined regression in autism spectrum disorders, provides strong evidence for poorer developmental outcomes in children who experienced regression, a controversial topic among autism researchers. More specifically, children with regression had a significant increase in severity of autism symptoms, the greatest risk for not attaining conversational speech, and were more likely than any other group to require increased educational supports. These findings were markedly worse for the children whose parents reported the regression as severe.
      This study was also one of the first to examine the implications of developmental plateau, which tended to occur around the child's second birthday. When compared to children with No Loss and No Plateau, these children were more likely to need educational supports and receive an autistic disorder diagnosis, which is typically more severe than other diagnoses on the autism spectrum (i.e., Asperger's syndrome or Pervasive Developmental Disorder - Not Otherwise Specified). Children with No Loss and No Plateau were at the least risk for poor outcomes.
      "Children who plateau or regress have a later manifestation of autism, but when it manifests it devastates their development," said Dr. Paul Law, corresponding study author and Director of the Interactive Autism Network at Kennedy Krieger. "Children with developmental plateau are an especially under-researched group, and these findings have important implications for those designing and prioritizing clinical evaluations."
      Previous studies have reached a variety of different conclusions concerning outcomes for children with regression. Some research has found these children fared worse in the long-term, while other studies found no differences in outcome between these children and those without regression. In examining these discrepancies, the current study suggests researchers who require children to have near typical development prior to regression may be missing the most severely impaired children in their findings. In fact, 35 percent of parents in this study had concerns about their child's general development before they noticed the more obvious signs of skill loss.
      "Parents have good instincts when it comes to their children," said Dr. Rebecca Landa, co-author and director of Kennedy Krieger's Center for Autism and Related Disorders. "If they're concerned, they shouldn't wait to see a professional for immediate in-depth screening and developmental surveillance. We know from other research that the sooner you can diagnose autism and start intervention, the better the child's outcomes."
      Provided by Kennedy Krieger Institute





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• • •

The Man Who Would Prevent Autism

Dr. Phillip Landrigan, pioneering pediatrician, lead investigator of the National Children's Study and winner of the 2010 Heart of Green "Protector" Award.

      By Dan Shapley thedailygreen.com  is.gd/bB1b7


     
        Dr. Philip Landrigan, director of the Children's Environmental Health Center at Mt. Sinai Medical Center, and winner of a 2010 Heart of Green Award.   Photo: Mt. Sinai

      One in every 110 American children today is diagnosed with autism, and the first diagnosis often comes in the first few years of life.
      Within that same span of time - just a few short years - Dr. Philip Landrigan may have deciphered the code for the cause of autism - written in genetics and exposures to chemicals in the environment. Dr. Landrigan, the director of Children's Environmental Health Center at Mount Sinai Medical Center in New York City, is leading a landmark effort to understand chronic childhood diseases - not just autism, but asthma, obesity, attention deficit disorder and other illnesses that have for years beguiled doctors as they afflict more and more children. The National Children's Study has recently begun to sign up patients, and researchers will ultimately follow 100,000 American children from their mother's wombs until they reach the age of 20.
      "The study is not just out there on a fishing expedition. It's guided by a set of specific hypotheses that are looking at specific diseases," Dr. Landrigan told The Daily Green. "We anticipate that we'll get information on different diseases at different points in time. Within a few years, after we have a sufficient number of babies in the study, we're going to be able to talk about connections between prenatal exposures and prematurity, pregnancy problems and low birth weight. A few years after that, we'll have data on learning disabilities, attention deficit disorder, autism and asthma."
      It's a bold claim, but Dr. Landrigan is not your average pediatrician. He's one of The Daily Green's 2010 Heart of Green Award winners, and for good reason.
      Dr. Landrigan has received several citations, from the Environmental Protection Agency, the American Public Health Association and others. He is the Ethel Wise Professor and Chair of the Department of Preventive Medicine at Mt. Sinai. He is a retired Navy Captain, having served for a decade in the Medical Corps, and he remains the Deputy Command Surgeon General of the New York Naval Militia.
      In the early 1970s, he studied the IQs of children in El Paso, Texas, where a lead smelter was operating. His results showed 60% of those children had lead poisoning, and that even low-level lead poisoning was causing irreparable harm to their brains. His research prompted Congress to crack down on lead pollution, banning or reducing its use in gasoline, paint and ultimately toys and other products. Those actions have reduced lead poisonings in America by 90%, raised American children's IQs by an average of six points, and injected $200 billion annually into the economy that had been lost to diminished economic productivity.
      At the behest of Sen. Patrick Leahy, D-Vermont, Dr. Landrigan later turned his attention to pesticides. Before his studies, federal regulators considered the health effects only on adult men who weighed 150 pounds; after his studies, the Environmental Protection Agency began contending with the disproportionately large effects that chemicals can have on children, who absorb more chemicals per pound than adults do, and whose organs are still going through critical stages of development.
+ Read more: is.gd/bB1b7

• • •

Indiana 4th In Nation
For Children With Autism

1 In 100 Hoosier Children Diagnosed With Disorder

is.gd/bAXij

      Indianapolis -- Autism is the fastest-growing developmental disability in the nation, and Indiana ranks near the top.
      The state is fourth highest for the number of children living with the challenging and confusing disorder, 6News' Stacia Matthews reported.
      Across the country, the number of children diagnosed with autism has exploded upward by 600 percent in the last 20 years.
      Nationwide, the disorder strikes 1 in 110 kids, while the rate is 1 in 100 in Indiana.
      Doctors attribute the higher number to a statewide system of highly trained doctors who can diagnose the disorder early on.
      "We're having a better awareness overall, due to better education with doctors, also a change in the diagnoses and earlier diagnosis," said Molly Cross with Nobel of Indiana.
      Autism is made up of a complex collection of behaviors that typically surface around the age of two. Some children are highly functional, while others aren't able to speak.
      There has long been debate about the cause of the disorder, but experts said more study is needed.
      "There are a lot of different reasons," Cross said, "but we need to keep research going so we can find if a one single cause, or if it's an assortment of different reasons."
      6News will take an in-depth look at autism next week to mark Autism Awareness Month. Experts will be on hand on Thursday to answer questions during a Call 6 For Help phone bank. A number will be provided later in the week.

• • •

Texas Has Low Rates Of Autistic Hispanic Children

is.gd/bB0a0

       The low rate of autistic Hispanic children may seem as good news considering the fact that El Paso has a large Hispanic population. However, a recent

El Paso, Texas.
study done by the American Journal of Public Health to figure out why this is so yielded some interesting findings.
      The results of the study showed that Hispanic children were less likely to be diagnosed as autistic but the main reason behind this is still inconclusive. As the flux of Hispanic students into the Texas school districts rose, an overall decrease in autism diagnosis was reported. However, learning disabilities rose 2% and intellectual disabilities rose 8%.  Researchers theorize that the low autism rates in the Hispanic community could be due to a number of complex factors. These factors include little to no communication with health care providers, conversely, health care providers may show applied biases when treating Hispanic children. Cultural factors may also play a role in the lower autistic rate.
      So the fact remains that there are lower rates of autistic Hispanic students in Texas but the reasons behind this remain unknown. For more information on this study you can check out the link below.

ajph.aphapublications.org



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• • •

PUBLIC HEALTH

60% U.S. Doctors, Healthcare Workers & Minorities Do Not Get Vaccinated


is.gd/bAYqy

      Reuters - Doctors and minorities still have a dangerous mistrust of vaccines that became painfully clear during the H1N1 swine flu pandemic, U.S. Health and Human Services Secretary Kathleen Sebelius said on Monday.
      But she said the United States had "unprecedented" levels of flu vaccination for the past season and pointed to nearly $500 million in government funding to improve decades-old influenza vaccine technology.
      "We shouldn't have to convince health providers that vaccines are safe and that they work. But, despite the fact that we had more health providers than ever getting vaccinated last year, there was still a sizable number who did not," Sebelius told a meeting of vaccine experts at the U.S. Centers for Disease Control and Prevention in Atlanta.
      In an average year, fewer than 40 percent of doctors, nurses and other healthcare workers get flu vaccines. "Tell them to get vaccinated," Sebelius urged her audience.
      Even though 90 million doses of influenza vaccine had been administered of the 162 million doses shipped across the country, minorities often got left out, Sebelius said. "Too many people in these communities still don't believe that vaccines are safe, or even that they work," she said.
      "But with so many African Americans, Hispanics, American Indians, and others experiencing rising rates of chronic disease, not getting vaccinated is many times more dangerous than even the perceived threat of the vaccine."
      The CDC estimates that H1N1 has killed 12,000 Americans and put more than 265,000 in hospital. People with chronic diseases such as asthma or diabetes, pregnant women and children were at highest risk.
+ Read more: is.gd/bAYqy

• • •

Psychotropic Medications Overprescribed to Children, Study Suggests

is.gd/bB0Ds

      ScienceDaily — A new study from the Journal of Marital & Family Therapy warns of the dramatic rise in the use of psychotropic medications for children. One in every fifty Americans is now considered permanently disabled by mental illness, and up to eight million

children take one or more psychotropic drugs.
      The authors, James P. Morris, Ph.D. and George Stone, LCSW, state that there is little evidence available to warrant the widespread use of psychotropic drugs for children, and little long term data regarding its long term impact on development. According to the authors the mental health field is currently designed to treat adults with psychotropic medications, but they are often misused in the case of children and adolescents, "This presents an ethical challenge to marriage and family therapists, who should be very cautious about these medications as an option for children. The long-term research on their safety for children is uncertain."
      As an example, the diagnosis of early onset bipolar disorder and attention deficit hyperactivity disorder has climbed drastically in the past decade. Drugs designed to treat the above two disorders show a fair short term risk-benefit ratio, but a poor long-term benefit. Morris and Stone indicate, "If the psychiatric community has been misled by pharmaceutical companies in thinking that these drugs are safe for their children, the parents of these children have been in turn deluded into putting their children in harm's way."
      The authors continue that the pharmaceutical industry is largely influenced by the desire for economic profit, and the marketing muscle behind the industry, and leniency of institutions such as the FDA, tout benefits that are not yet properly evaluated for pediatric use. Between 1994 and 2001, psychotropic prescriptions for adolescents rose more than sixty percent; the rise post-1999 was connected to the development and marketing of several new psychotropic drugs and the rebranding of several older ones.
      Morris and Stone claim that family health professionals are put in the line of fire when children begin to experience the negative consequences of long-term use of these medications. They are left with the challenge of evaluating the quality of evidence-based care offered to their pediatric clients by the psychiatric community, and the negative effects of the medications without sufficient empirical evidence or information.
      
• • •

PEOPLE

Arkansas Toddler found Dead


By KSPR News is.gd/bB2GG

      The body of 3-year-old Aiden Bell was found on the side of a creek bed.
      The little boy had been missing since Monday afternoon.
      Aiden disappeard from his grandparents' home in Osage, Ark.
      Hundreds of volunteers
had been searching for


the boy. His body was found early Tuesday afternoon along the Osage Creek. Investigators are not sure what caused the boy's death, but they believe he tried to cross the creek and possibly drowned.
      Aiden was reportedly autistic and scared of strangers.

• • •

Red Flags Overlooked In Prescription Drug Death Of 12-Year-Old

      By Carol Marbin Miller Miami Herald is.gd/bAXMD
     
      Born with autism, 12-year-old Denis Maltez was “hyper, needy, pesty,” his psychiatrist wrote following a May 2007 visit.
      Dr. Steven L. Kaplan solved the 70-pound 


Denis Martez and mother, Martha Quesada
boy’s problems with a prescription pad, writing orders for two different anti-psychotic drugs along with a tranquilizer and a mood stabilizer — three of them in the highest doses recommended for adults, records show.
      When state medical regulators sent Kaplan letters suggesting the dosages were worrisome, he ignored them.
      Two weeks after Kaplan last saw the boy, on May 23, 2007, Denis simply stopped breathing. The Miami-Dade Medical Examiner’s Office attributed the death to a life-threatening side effect of over-medication, records show.
      “I . . . never had any suspicion he was being overmedicated,” Kaplan testified in a November 2009 sworn statement.
      A review of records from three state agencies, however, makes clear that plenty of other people did.
      Though a number of Florida agency heads have wrung their hands about Kaplan’s methods for more than three years, he has never been disciplined. The state Medicaid program, which insures the needy, asked the state Board of Medicine to investigate Kaplan in 2008, but the complaint was dismissed, records show.
      Disability administrators encouraged underlings to send him new patients just as the agency’s chief described his practices as “very disturbing."
      Florida’s regulatory history with Kaplan — which includes four state agencies and thousands of pages of records — raises important questions. Among them: Does the state have an adequate regulatory scheme for doctors who work with the most vulnerable? Can the state effectively oversee doctors who reject advice from their peers? “Three agencies all raised concerns and red flags, and each agency was saying this is somebody else’s job to take it a step further,” said Department of Children & Families Secretary George Sheldon. “I’m not sure what the solution is."
      Sheldon blamed much of the problem on historically poor billing rates for doctors who are paid by Medicaid, the state and federal insurance program for the poor and disabled.
      “I think it’s difficult to recruit in the Medicaid arena any child psychiatrist,” Sheldon said. “The rates really do have an impact on who is willing to do it."
      Kaplan, who mainly practices in Miami-Dade, declined to speak with a Miami Herald reporter.
+ Read more: is.gd/bAXMD

• • •

Odgren's Father Says He Showed Early Signs Of Mental Problems

       By Milton Valencia and Martin Finucane, Boston Globe. is.gd/bAWLP

       Woburn, Mass. -- The father of the 19-year-old accused of fatally stabbing a classmate at Lincoln-Sudbury High School testified today that his troubled son threatened to shoot a student who had bullied him in third grade with "a golden gun" and jabbed a pencil into another student's chest in fifth grade.


John Odgren
      Paul Odgren testified in Middlesex Superior Court that his son, John, who faces a first-degree murder charge, showed signs of mental problems even as a baby and eventually was diagnosed with major depression, Asperger's Syndrome, attention deficit hyperactivity disorder, and obsessive-compulsive disorder.
      John Odgren admits that he fatally stabbed James Alenson, a 15-year-old freshman in a bathroom at the high school in January 2007. But his defense is that he is insane. Paul Odgren, who is a cell biology professor at the University of Massachusetts, testified for two hours today for the defense.
      The father said the son displayed awkward, anxious tendencies even as a baby and in second grade his parents became concerned when he said he was going to kill himself. That year, he became agitated while swimming with other kids at a lake and just took off swimming. He was rescued from the middle of the lake.
      Odgren said said his son had trouble relating to other kids and was bullied as he bounced around from school to school.
      After being bullied by some girls in third grade, the son "had thoughts of getting a golden gun and shooting at one of them," his father testified.
      Legal analysts say Odgren's team faces a monumental task in employing a seldom-used and rarely successful defense, the Globe reports this morning.
      Odgren, who was 16 at the time, stabbed Alenson, a freshman whom he did not know, on Jan. 19, 2007.

• • •

Mother Wants Answers In Son's Death

is.gd/bAWEb

      Lexington, KY AP - The mother of a 21-year-old autistic man who died after police tried to handcuff him is asking for details into the actions that led up to his death.
      The Lexington Herald-Leader reports Roland Campbell died Sunday at St. Joseph Hospital.
      Fayette County Coroner Gary Ginn says a cause of death could not be determined, but preliminary autopsy results ruled out physical trauma and disease.
      Campbell's mother, Pecola Campbell, says she will find out what happened to her son no matter what it takes.
      Lexington police say they were called to a group home Sunday in response to a call that someone was out of control. Police say they handcuffed Campbell once without incident but he escaped his restraints, and as officers were cuffing him a second time, he lost consciousness.
     
• • •

COMMENTARY

How the GMC Framed Doctors Wakefield, Walker-Smith and Murch


      By Martin Hewitt on the AgeofAutism Blog. is.gd/bAZ0h

      1.  Introduction
      In 1998 the Lancet published a short case series of 12 autistic children admitted to the Royal Free Hospital (RFH) in London for treatment of bowel symptoms.1 The paper was one of the first to bring
to the medical community's attention an unexplained association between autism and bowel disease, describing the children's clinical 


findings and noting that parents timed the onset of eight of their children's conditions from the MMR vaccination. Twelve years later the General Medical Council, the UK medical regulator, concluded that the way the three senior authors of the paper -- Dr Wakefield, and Professors Walker-Smith and Murch -- had researched and written the paper amounted to serious professional misconduct, especially in the way the children were selected and subject to invasive investigations, in the doctors' unethical research practices and Dr Wakefield's failure to disclose his conflict of interest. In the sanctions stage of the hearing that began in April 2010 the prosecution is recommending that Wakefield and Walker-Smith are erased from the register of medical practitioners and that Murch is suspended.
      Following evidence from the prosecution and defence in the largest and most expensive hearing in the GMC's history, the fitness to practice (FtP) panel faced the apparently small issue of  deciding which of two ethical approvals applied to the 1998 Lancet paper: approval 162-95 in 1995 or approval 172-96 in 1996. For the doctors, however, this one year's difference was momentous, even after 15 years of passing. The entire case would be won or lost on this one decision.
      The GMC prosecution claimed that 172-96, granted by the RFH Ethics Committee (EC), was the only ethical approval for the Lancet case series. The defendants, however, referred to 162-95 as the appropriate approval. Accepting approval 172-96 would shift the entire findings of fact, in effect changing the goalposts.
+ Read more: is.gd/bAZ0h
     

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  In This Issue:















































NEWS
Study Provides New Insights Into The Implications Of Autism Onset Patterns

The Man Who Would Prevent Autism

Indiana 4th In Nation For Children With Autism

Texas Has Low Rates Of Autistic Hispanic Children

PUBLIC HEALTH
60% U.S. Doctors, Healthcare Workers & Minorities Do Not Get Vaccinated

Psychotropic Medications Overprescribed to Children, Study Suggests

PEOPLE
Arkansas Toddler found Dead

Red Flags Overlooked In Prescription Drug Death Of 12-Year-Old

Odgren's Father Says He Showed Early Signs Of Mental Problems

Mother Wants Answers In Son's Death

COMMENTARY
How the GMC Framed Doctors Wakefield, Walker-Smith and Murch






            

Send your LETTER   












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Copyright Notice: The above items are copyright protected. They are for our readers' personal education or research purposes only and provided at their request. Articles may not be further reprinted or used commercially without consent from the copyright holders. To find the copyright holders, follow the referenced website link provided at the beginning of each item.                           

Lenny Schafer editor@sarnet.org                                              The Schafer Autism Report is a non-profit corporation
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