Tag Archives: autism

Oxytocin is not a viable treatment for children and teenagers with autism, after all

New research reports that oxytocin, despite the hopes pinned on it by many, does not produce any signs of helping children with autism improve their social abilities.

Image credits Jesper Sehested / Flickr.

Oxytocin is a naturally occurring hormone, and an important neurotransmitter (brain messenger molecule). It is more commonly known as the ‘love hormone’, is released by the pituitary gland, and seems to play a pivotal part in helping us bond socially and/or with our children. There has also been research that implicated oxytocin in the emergence of autism; the emergence of this disorder seemed to be correlated to a mutation on the oxytocin receptor gene (OXTR).

However, this link does not seem to hold up to scrutiny. Despite mixed results in regards to oxytocin’s outcomes in improving social skills in children with autism in previous experiments, new research casts doubt on its potential. Although disappointing, such data will hopefully guide our attention to other, more promising candidate treatments.

Not the one

“There was a great deal of hope this drug would be effective,” said the study’s principal investigator and lead author, Linmarie Sikich, M.D., associate consulting professor in the Department of Psychiatry & Behavioral Sciences at Duke University School of Medicine. “All of us on the study team were hugely disappointed, but oxytocin does not appear to change social function of people with autism.”

Medically, oxytocin is administered mainly to help induce labor. But we do know that it functions as a neurotransmitter and, due to its effects on the workings of the brain, has been proposed as a treatment for autism. There was some evidence to back up this proposal, but it was inconsequential: some studies found it effective at the task, others reported it showed no benefit. Against this backdrop, Sikich’s team set out to determine whether this hormone could have practical applications in the treatment of the disorder or not.

They worked with 290 children ages 3-17, which they separated into groups based on how severe their autism symptoms were. All children were then randomly assigned to equal-sized groups and received either oxytocin or a placebo, via daily nasal sprays, over a period of 24 weeks.

Each child underwent screenings and assessments of their social abilities at the start of the trial to establish a baseline. These were repeated at the midpoint and end of the trial, to track their progress (i.e. the effectiveness of the oxytocin regimen in improving their symptoms). In addition to these, the researchers and the children’s parents also provided assessments using standard analytic tools for autism.

Overall, the authors explain that the oxytocin was well tolerated by the children and had few to no side effects. That being said, it didn’t produce any meaningful effect in those who received oxytocin over those who were administered a placebo. Given that this is one of the largest studies looking into the effectiveness of the hormone in the treatment of autism, such findings do not bode well for its future as a treatment option.

“Thousands of children with autism spectrum disorder were prescribed intranasal oxytocin before it was adequately tested,” says senior author Jeremy Veenstra-VanderWeele, M.D., of New York State Psychiatric Institute and Columbia University. “Thankfully, our data show that it is safe.”

“Unfortunately, it is no better than placebo when used daily for months. These results indicate that clinicians and families should insist that there is strong evidence for the safety and benefit of new treatments before they are provided to patients in the clinic.”

The team concludes, based on these findings, that there simply isn’t enough evidence of oxytocin having any effect in this role. They add that there’s too little here to even justify further research into its potential for treating autism spectrum disorders and that we should focus on more promising candidates instead.

Autism has taken up a large public interest in the last few years, maybe a decade or so. Personally, I think that part of this effect was caused by fear-mongering misinformation regarding vaccines (the famous ‘vaccines cause autism’ slogan). First off, I’d like to point out that autism itself is not as prevalent as we’ve been led to believe. Statistics do reveal broader trends than we’d be able to see using other means, but it can only be as effective and clear as the data we have on hand.

Still, for those whose loved ones might be on the spectrum, news such as this can definitely feel disheartening. I’d like to remind those of you who may be in such a position that autism is in no way a sentence to a bad life or to being shunned socially. Neurodivergent individuals can and do become valued, respected, and loved members of their social groups and wider societies. Their often unique skill sets and predispositions have been recognized and valued all throughout history.

There are certainly unique challenges that people with autism have to contend with. I have seen this through my own personal experiences with those who fall somewhere on the spectrum. Social skills can definitely be one of those more problematic areas. But I have also seen those who managed to overcome these issues, work around them, or find a way forward that makes them happy even without developing ‘normal’ social skills.

A treatment for autism would definitely be welcomed for those who desire it. But not having such treatment at hand is in no way a cause for despair. If you or someone you care for has to contend with autism, know that it is not a flaw that requires fixing. To be human is to be imperfect, and the measure of our lives is given by how well we can find happiness even through such imperfections.

The paper “Intranasal Oxytocin in Children and Adolescents with Autism Spectrum Disorder” has been published in the New England Journal of Medicine.

Human fecal transplant reduces autism symptoms by almost 50%, study finds

Two years after the transplant, a professional evaluator found a 45% reduction in core autism disorder symptoms  (ASD) such as language, social interaction, and behavior, raising new hopes for potential treatments.

“We are finding a very strong connection between the microbes that live in our intestines and signals that travel to the brain,” said Krajmalnik-Brown, a professor at the Biodesign Swette Center for Environmental Biotechnology at the Biodesign Institute and ASU’s School for Sustainable Engineering and the Built Environment. “Two years later, the children are doing even better, which is amazing.”

According to the CDC, about 1 in 59 children in the US is diagnosed with autism — “about half a million people on the autism spectrum will become adults over the next decade, a swelling tide for which the country is unprepared,” a CDC report notes.

Autism spectrum disorder is also very difficult to treat, which has spurred researchers to look for more innovative approaches. There are no medications that can cure ASD or eliminate the core symptoms. However, some medications can reduce some symptoms, and behavioral therapy and social therapy have also shown some promise. But in a new study, Krajmalnik-Brown and colleagues tried something else.

They started from a curious observation: autism and gastrointestinal problems seem to be strangely connected in some cases.

“Many kids with autism have gastrointestinal problems, and some studies, including ours, have found that those children also have worse autism-related symptoms,” said Krajmalnik-Brown. “In many cases, when you are able to treat those gastrointestinal problems, their behavior improves.”

So they set out to see if, by addressing gastrointestinal issues, they can also address autism symptoms. They opted for an innovative approach developed by Dr. Thomas Borody, an Australian gastroenterologist. The approach is called Microbiota Transfer Therapy (MTT), and it’s essentially a special type of fecal transplant. MTT is already showing benefits, especially in regards to treating  Clostridioides difficile infection.

The idea is pretty straightforward: people suffering from this infection have a damaged gut microbiome. If this microbiome can be restored, they can fight off the infection more effectively — and the benefits seem to extend to other intestinal problems as well. So the team used MTT to see if, indirectly, it can have an effect on autism syndrome. It did.

The treatment was applied to 18 patients (children), first showing substantial gut improvement — and two years post-treatment, most of the initial improvements remained. But something even more exciting happened: over the next two years, parents started reporting a steady reduction in autism syndrome symptoms. A professional evaluator found a 45% reduction in core ASD symptoms (language, social interaction, and behavior) at two years post-treatment compared to before treatment began. In other words, the improvements in terms of ASD symptoms also seem to be long-lasting.

This is especially promising as 30-50% of people with autism have some form of chronic gastrointestinal problems, most notably constipation or diarrhea. The chronic discomfort and pain can make sufferers more irritable and decrease their attention and learning power, negatively impacting behavior.

The fecal transplant study fits well with previous research, which found that only vancomycin (an antibiotic) had produced major temporary improvements in GI and autism symptoms — although the benefits were lost a few weeks after treatment stopped.

The question now is what’s going on in kids’ intestines, and how could it be improved in the long term?

A lack of healthy bacteria seems like the most likely problem.

 “Kids with autism are lacking important beneficial bacteria, and have fewer options in the bacterial menu of important functions that bacteria provide to the gut than typically developing kids,” Krajmalnik-Brown said.

“Understanding which microbes and chemicals produced by the microbes are driving these behavioral changes is at the heart of our work,” Krajmalnik-Brown said.

Another hint as to what was going on was how the symptoms evolved through time. It’s very unusual to see gradual improvement after the treatment stopped, which also seems to suggest that after the first transplant, it was a gradual transformation to a healthy microbiome. Also telling is the fact that many of the participants in the trial shared common traits such as birth by C-section, reduced breastfeeding, increased antibiotic, and low fiber intake — all of which are linked to gut bacteria deficiencies. It’s still a small trial and a “smoking gun” is missing, but all the evidence seems to point in the direction of microbiome health being the main problem.

The team is now working on optimizing and improving the treatment to improve benefits even more. They are also considering trying out a booster dose to see if it can help in some cases.

The study was published in Nature.

autism

High levels of estrogen in womb might increase risk of developing autism

Autism or autism spectrum disorder (ASD), refers to a broad-range of lifelong, developmental disability that affects how a person communicates with and relates to other people and how they experience the world around them. Research suggests that autism develops from a combination of genetic and nongenetic, or environmental influences.

Amniotic fluid surrounds the baby in the womb, as seen in an ultrasound. Image credits: Nevit Dilmen.

Scientists have recently identified a link between exposure to high levels of estrogen sex hormones in the womb and increased risk of developing autism. The findings of the research supported by the Autism Research Trust, the Medical Research Council, and Wellcome, are published in the journal Molecular Psychiatry.

This study is the first to show that elevated levels of prenatal amniotic estradiol, estriol and estrone are each associated with autism, with estradiol levels being the most significant predictor of the likelihood of autism.  The discovery adds further evidence to support the prenatal sex steroid theory of autism, which was first proposed two decades ago.

In 2015, a team of scientists at the University of Cambridge and the State Serum Institute in Denmark measured the levels of four prenatal steroid hormones. The scientists discovered that androgens in the amniotic fluid were higher in male fetuses who developed autism. These androgens are produced in higher quantities in male than in female fetuses on average, so it could explain why autism occurs more often in boys. They are also known to masculinize parts of the brain and to affect the number of connections between brain cells.

The same group of scientists has built on their previous findings by testing the amniotic fluid samples from the same 98 individuals sampled from the Danish Biobank. Amniotic samples from more than 100,000 pregnancies were measured but this time looking at another set of prenatal sex steroid hormones called estrogens. This is an essential next step because some of the previously-studied hormones are directly converted into estrogens.

All four estrogens were significantly higher, on average, in the 98 fetuses who developed autism later, compared to the 177 fetuses who did not develop autism. High levels of prenatal estrogens were even more predictive of the likelihood of autism than were high levels of prenatal androgens (such as testosterone). Prenatal estrogens have effects on brain growth and masculinize the brain in many mammals (contrary to the popular belief of estrogen feminizing the brain).

Professor Simon Baron-Cohen, Director of the Autism Research Centre at the University of Cambridge, who led this study and who first proposed the prenatal sex steroid theory of autism, said: “This new finding supports the idea that increased prenatal sex steroid hormones are one of the potential causes for the condition. Genetics is well-established as another, and these hormones likely interact with genetic factors to affect the developing fetal brain.”

Alex Tsompanidis, a PhD student in Cambridge who worked on the study, said: “These elevated hormones could be coming from the mother, the baby or the placenta. Our next step should be to study all these possible sources and how they interact during pregnancy.”

Dr Alexa Pohl, part of the Cambridge team, said: “This finding is exciting because the role of estrogens in autism has hardly been studied and we hope that we can learn more about how they contribute to fetal brain development in further experiments. We still need to see whether the same result holds true in autistic females.”

The team cautioned that these findings cannot and should not be used to screen for autism. “We are interested in understanding autism, not preventing it,” added Professor Baron-Cohen.

Dr. Arieh Cohen, the biochemist on the team based at the State Serum Institute in Copenhagen, said: “This is a terrific example of how a unique biobank set up 40 years ago is still reaping scientific fruit today in unimagined ways, through international collaboration.”

Yet another study shows that vaccines don’t cause autism

Researchers found that the mumps, measles, and rubella (MMR) vaccine does not increase the risk of autism, does not trigger autism, and is not associated with autism in any relevant way.

More than 20 years ago, Andrew Wakefield published what is perhaps the most horrid paper in modern history: he reported a hypothesis that linked the measles, mumps, and rubella (MMR) vaccine to autism. The paper has long been retracted and discredited, and Wakefield’s methodology was so flawed and fraudulent, that even his medical license got revoked. Study after study showed that there’s just nothing to the Wakefield study, but nevertheless, his ideas were picked up and became the seed that bloomed into the antivaxxing community. Today, vaccination rates are decreasing significantly in many parts of the world, with more and more children becoming sick and dying as a result.

Hoping to help change that perception, a team of Danish researchers studied the potential effect of the MMR vaccine on children who are at risk of autism.

“We see vaccine skepticism growing,” says the study’s lead author Anders Hviid, an investigator at the Statens Serum Institut, the national public health organization in Denmark. “So we thought it was a good idea to revisit the hypothesis and try to get scientific answers to the different criticisms from skeptics of the original study.”

Hviid and colleagues studied a total of 657,461 children, evaluating whether the MMR vaccine increased the risk of autism in children over more than 10 years, from 1999 to 2010. Vaccination rates were around 95%, and 6,517 children were diagnosed with autism over the study period.

There was absolutely no connection between vaccination and autism, neither in the general study population nor in the at-risk children. In other words, children vaccinated with MMR did not develop autism at a significantly different rate than those who were not vaccinated. Furthermore, the timing of autism diagnoses did not cluster after the MMR vaccination

Around the world, measles cases increased by 48.4% between 2017 and 2018, according to data from the World Health Organization (WHO). The WHO has declared vaccine hesitancy as one of the top 10 threats to global health. At this point, there have been 17 studies done across 3 continents involving millions of children, all finding the same thing: vaccines don’t cause autism.

The myth that vaccines cause autism needs to go away. It’s been disproven time and time again and it’s putting the health of children (and to a lesser extent, also adults) at risk.

“This idea that vaccines cause autism is still around and is still getting a lot of exposure in social media,” noted Anders Hviid, lead study author and senior investigator at Statens Serum Institut in Denmark.

 

Study reference: Hviid A, Hansen JV, Frisch M, Melbye M. Measles, mumps, rubella vaccination and autism: a nationwide cohort study. Ann Intern Med.

 

 

 

 

 

Individuals with absolute pitch (AP) had a more active auditory cortex than non-AP individuals. Credit: McKetton et al., JNeurosci.

Genetics may be more important for perfect pitch than musical training

Individuals with absolute pitch (AP) had a more active auditory cortex than non-AP individuals. Credit: McKetton et al., JNeurosci.

Individuals with absolute pitch (AP) had a more active auditory cortex than non-AP individuals. Credit: McKetton et al., JNeurosci.

“Perfect pitch” refers to the ability to instantly and effortlessly identify the pitch of a tone without the use of a reference tone. A person who possesses this rare gift can, for instance, hear any single note and tell if it’s an A or B-flat as easily as naming the color blue when seeing the sky. Mozart, Bach, and Beethoven are some famous composers who had perfect pitch.

It’s estimated that about 1 in 10,000 people are born with the propensity for absolute pitch. Even among trained musicians, this is a rather rare talent. According to previous studies, perfect pitch runs in the family, suggesting a genetic link. However, this happens most often in people who had musical training before age 6, and after age 9 it becomes virtually impossible to develop truly perfect pitch. It follows that musical training is also a core requirement for developing perfect pitch.

Which of the two has a larger relative contribution to absolute pitch has been a matter of debate, but a new study suggests that genetics may be more important.

Writing in the journal JNeurosciresearchers led by Keith Schneider, Associate Professor at the University of Delaware’s Department of Psychological and Brain Sciences, compared the auditory cortex of 20 participants. These included absolute pitch (AP) musicians, non-absolute pitch musicians, and a control group of individuals with minimal musical training. The brains scans suggest that AP musicians have a larger auditory cortex than the non-AP group, making it better equipped to represent distinct tones without a reference note.

Other things that seem to influence the acquisition of perfect pitch include autism and tonal languages in which pitch conveys meaning, such as Mandarin or Vietnamese. In 2009, British researchers found that 20% of 72 teens with autism they studied had a superior ability to distinguish pitch. Interestingly, a 2018 study found that music therapy makes children with autism spectrum disorder more socially aware.

Autism may actually extend across three spectrums, not just one

Credit: Pixabay.

Autism spectrum disorder (ASD) is a developmental disorder that mainly affects behavior and communication. The reason why it’s called a “spectrum” is that people with ASD can exhibit a range of symptoms. For instance, such individuals might have problems talking to other people or looking you in the eye when communicating. And as if the disorder wasn’t complicated enough, researchers now say that there may actually be three spectrums for autism.

The conclusion was made by a team of researchers led by Matthew Lerner, who is an associate professor of psychology, psychiatry, and pediatrics at Stony Brook University, New York. The authors analyzed the response to a 12-item questionnaire (Child and Adolescent Symptom Inventory-4R) by the parents of 3,825 individuals, ages 6 to 22. Among the participants, who were all suspected of some developmental disability or psychiatric issue, 1,043 were diagnosed with ASD.

By means of statistical analysis, the researchers wound up clustering the responses that appeared to go together. What they found was that ASD could be classed into three distinct spectrums, which are independent of one another: problems with social interactions, communication difficulties, and repetitive behaviors.

For instance, a parent might report that their child has difficulties socializing and playing with other children, but not that the child speaks in an odd way. The fact that communication problems and social deficits are related but distinct is countrary to current diagnostic criteria for ASD, where the two traits are merged.

“Based on comparison of 44 different models, results indicated that the ASD symptom phenotype is best conceptualized as multidimensional versus a categorical or categorical−dimensional hybrid construct. ASD symptoms were best characterized as falling along three dimensions (ie, social interaction, communication, and repetitive behavior) on the CASI-4R,” the authors concluded.

This clustering pattern is also true in other disorders such as attention deficit hyperactivity disorder (ADHD) and learning disabilities.

“We’re seeing that autism truly is dimensional,” Lerner told Spectrum News. “You can have two people who present really quite differently but are still experiencing autism.”

The authors say that although communication deficits obviously involve some social interaction, the two features should be grouped separately. Some disagree, however, arguing that the study’s findings are limited. One issue might be that the questionnaire used in the study is designed to detect only these three traits. The authors also did not include children in the general population.

The causes of ASD are not known, although research suggests that both genes and environment play important roles. More importantly, there is currently no single standard treatment for ASD. This is why this new study is important — if the new classification is validated, therapists will have to rethink the way they address ASD.

The findings appeared in the Journal of the American Academy of Child and Adolescent Psychiatry.

autism and music children

Music therapy makes children with autism more socially aware

A new study performed by Canadian researchers found that musical training significantly improves social communication in autistic children. The improvements were significant after only 12 weekly sessions, suggesting that music can have a lasting and profound effect on the quality of life of autistic children and their families.

autism and music children

Credit: Pixabay.

For decades, scientists have known that there’s some kind of relationship between autism spectrum disorder (ASD) and music, seeing how a disproportionate amount of those with this disorder have “perfect pitch” — the ability to instantly and effortlessly identify the pitch of a tone without the use of a reference tone. A person who possesses this rare gift can, for instance, hear any single note and tell if it’s an A or B-flat or anything else.

Absolute pitch seems to run in families, suggesting a genetic link. Some researchers also think studying this musical ability can also reveal valuable clues about some of the genes involved in autism and, more broadly, to how the human brain develops and functions.

It’s not all about perfect pitch, though — people with ASD seem to have a much finer auditory experience in general. They might be able to hear the buzzing of electricity in the walls or find noisy environments simply unbearable, something which was was previously confirmed by British researchers.

In a new study, scientists at the Université de Montréal and McGill University wanted to get a clearer picture of the impact musical lessons can have on individuals with ASD. They enlisted 51 children with ASD, ages 6 to 12, some of whom received a music-based intervention for three months.

The parents of each child first completed standard questionnaires to gauge the child’s social communication skills, the family’s quality of life, and the ASD symptom severity. MRI scans were performed for each child in order to establish a baseline of brain activity.

Children were randomly assigned to one of two groups: one received music-based therapy, the other did not. Both groups worked with a therapist whose main task was to foster reciprocal interaction. The music-therapy group, however, also sang and played different musical instruments for 45 minutes every week.

At the end of the music therapy sessions, parents of children in this group reported significant improvements in communication skills and family quality of life compared to those in the control group. Parents of children in both groups did not report reductions in autism severity.

“Importantly, our study, as well as a recent large-scale clinical trial on music intervention, did not find changes with respect to autism symptoms themselves,” said Megha Sharda, a postdoctoral fellow at Université de Montréal and lead author of the new research, published in Translational Psychiatry. “This may be because we do not have a tool sensitive enough to directly measure changes in social interaction behaviors.”

Brain scans suggest that the improved communication skills in the kids that received musical therapy may be the result of increased connectivity between the auditory and motor regions of the brain, and decreased connectivity between auditory and visual regions (which are commonly over-connected in individuals with ASD).

According to the Canadian researchers, when connectivity between these regions is sub-optimal, it becomes difficult to engage in social interaction. Tuning into a conversation implies a series of processes: paying attention to what the other person is saying, recognizing cues that hint when your turn to speak comes in, and ignoring irrelevant noise. All of these are easy tasks for most people, but can be challenging for individuals with ASD.

The findings show that musical intervention can make a major difference when it comes to improving social skills in children with ASD. Many teachers and parents could find it useful for school-age children to practice some form of music. What’s more, the neurological link between musical training and social communication adds to a body of evidence that suggests ASD also has an important influence on sensory processing in the brain.

“The universal appeal of music makes it globally applicable and can be implemented with relatively few resources on a large scale in multiple settings such as home and school,” said Aparna Nadig, an associate professor at McGill’s SCSD and co-senior author of the study with Krista Hyde, an associate professor of psychology at UdeM.

The findings appeared in the journal Translational Psychiatry. 

An airplane spraying DDT over Baker County, Oregon as part of a spruce budworm control project, 1955. Credit: Wikimedia Commons.

DDT exposure in pregnant women linked to autism in offspring

An airplane spraying DDT over Baker County, Oregon as part of a spruce budworm control project, 1955. Credit: Wikimedia Commons.

An airplane spraying DDT over Baker County, Oregon as part of a spruce budworm control project, 1955. Credit: Wikimedia Commons.

A study that followed more than a million pregnancies in Finland found that elevated levels of a DDT (dichloro-diphenyl-trichloroethane) metabolite in the blood of pregnant women are associated with an increased risk for autism in newborns. DDT is an insecticide that was widely used around the world, including the United States, until it was banned.

DDT is one of the first modern synthetic insecticides — an organochlorine that was first synthesized in 1874. It soon proved to be highly effective for insect control in crop and livestock productions, but also around private homes and gardens. It also showed remarkable success in controlling malaria, typhus, and the other insect-borne human diseases. Through its use, the number of soldiers dying from malaria dropped from 400,000 in 1946 to less than 10 in 1950.

But insects quickly developed resistance, and people started spraying the environment with increased amounts of DDT to compensate.

Scientists would learn, however, that DDT provoked many long-lasting adverse effects on the environment and wildlife. In 1972, the EPA issued a cancellation order for DDT based on its adverse environmental effects, including potential human health risks.  Today, DDT is classified as a probable human carcinogen by U.S. and international authorities following animal studies that linked the insecticide to liver tumors. A 2014 study also found that British people with the highest levels of the chemical in their system were four times more likely to develop Alzheimer’s. 

One of the many environmental issues associated with DDT is that it persists for a very long time. Although it was banned more than three decades ago in Finland, people are still exposed to the chemical because it’s still in the soil where food is grown. Because chemicals can be transferred across the placenta, newborns also become contaminated with DDT.

In 2011, a study found that pregnant women exposed to the insecticide are much more likely to give birth prematurely, or to full-term but low birth weight babies. Now, researchers at Columbia University linked autism in offspring with DDT exposure in pregnant women.

The research team analyzed a dataset comprising a million pregnant Finnish women whose children were born between 1987 and 2005. Researchers identified 778 cases of childhood autism. Mothers with DDE levels — a metabolite of DDT —  in the top quartile were twice as likely to birth children with autism that have an intellectual disability than those in the bottom quartile. Overall, the rate of autism was one-third higher among offspring exposed to elevated levels of maternal DDE, the authors reported in the American Journal of Psychiatry.

“We think of these chemicals in the past tense, relegated to a long-gone era of dangerous 20th Century toxins,” says lead author Alan S. Brown, MD, MPH, professor of Epidemiology at Columbia University’s Mailman School of Public Health and of Psychiatry at Columbia University Medical Center.

“Unfortunately, they are still present in the environment and are in our blood and tissues. In pregnant women, they are passed along to the developing fetus. Along with genetic and other environmental factors, our findings suggest that prenatal exposure to the DDT toxin may be a trigger for autism.”

The researchers found no significant association between PCBs — another class of banned environmental pollutants — and autism.

One reason why maternal DDE exposure may increase the risk of autism in newborns is that the metabolite is associated with low birth weight, while PCB is not. Previously, a study on rats found that DDE inhibits androgen receptor binding, which might cause autism in the rat model. In contrast, PCBs increases androgen receptor transcription.

DDT is still manufactured and used to this day in some countries. However, it’s not employed for agricultural purposes. Some countries in Africa, Asia, and South America need the pesticide for mosquito control in order to reduce the risk of malaria.

Children with autism are actually less likely to be vaccinated, new study finds

Amidst dangerous, pseudoscientific propaganda linking vaccines to autism, a study actually found that children suffering from autism, as well as their siblings, are actually less likely to be vaccinated.

Image credits: Laughlin Military Base.

All it takes is one bad study

Before we start discussing this new study, let’s get the elephant out of the room, shall we? In 1998, a man called Andrew Wakefield published a study linking the combined measles, mumps, and rubella (MMR) vaccine to cases of colitis and autism spectrum disorders. The study led to a sharp decline in vaccination rates and spurred a number of large epidemiological studies and reviews — all of which reported no connection between vaccines and autism or colitis.

Since replicability is one of the most important pillars of science and no one could replicate Wakefield’s results, this raised questions about the validity of his findings. After these questions were raised, people started looking more closely at the study itself, and that’s when it all became clear.

A 2004 investigation by Sunday Times reporter Brian Deer identified undisclosed financial conflicts of interest on Wakefield’s part. Deer passed his investigation on to the British Medical Journal, which found that his paper was essentially a fraud — Wakefield had just falsified results to fit his desired narrative.

The British General Medical Council (GMC) also conducted an inquiry into allegations of misconduct against Wakefield and two former colleagues, finding evidence of fraudulent activities and reporting that Wakefield had simply falsified results. The Lancet, the journal in which his paper was published, issued a complete retraction. Editor-in-chief Richard Horton described it as “utterly false” and said that the journal had been “deceived”.

Wakefield was struck off the Medical Register, meaning he could no longer practice as a doctor in the UK.

Since then, no other study has ever found any connection between vaccines and autism — after all, it was just one blatantly fraudulent paper and nothing else. However, this has proven sufficient to spur a long-lasting fear of vaccines, with numerous outbreaks (including fatal cases) due to Wakefield-inspired anti-vaccine propaganda.

Let’s write it out clearly: extensive research has shown that vaccines don’t cause autism. Wakefield was a fraud. Anti-vaxxing is a dangerous, pseudoscientific trend that threatens the well-being of kids and adults all around the planet. There. I’ve said it. Now let’s move on to the real science.

Now, on to the good study

To this day, you can’t say vaccines and autism in the same sentence without spurring a heated debate — and yet this study managed to find a different correlation between the two. They found that kids diagnosed with the autism spectrum disease (ASD) are significantly less likely to have been vaccinated than their counterparts.

“In this large and comprehensive study, we found that after children received an autism diagnosis, the rates of vaccination were significantly lower when compared with children of the same age who did not have an autism diagnosis,” said lead author Ousseny Zerbo, PhD, postdoctoral fellow with the Kaiser Permanente Northern California Division of Research.

Zerbo and his colleagues analyzed more than 3,700 children with autism spectrum disorders diagnosed by 5 years of age, and nearly 500,000 children without ASD, as well as their younger siblings. They report that 94% of children aged 7 or older without an ASD received all recommended vaccinations between 4 and 6 years of age — compared with 82% of those with an ASD. Interestingly, this trend also carried to the siblings of children suffering from an ASD.

The study was only observational — it didn’t attempt to explore any causal relationship between the two. However, it raises a significant red flag, which will hopefully be explored in future studies. It does call for a change, promoting more dialogue between parents and doctors, and explaining that the anti-vaxx trend is just that — a trend, without any science to back it up.

“Numerous scientific studies have reported no association between childhood vaccination and the incidence of autism spectrum disorders,” said co-author Frank DeStefano, MD, MPH, Immunization Safety Office, Centers for Disease Control and Prevention. “Nonetheless, this new study suggests that many children with autism and their younger siblings are not being fully vaccinated.

“We need to better understand how to improve vaccination levels in children with autism spectrum disorder and their siblings, so they can be fully protected against vaccine-preventable diseases.”

The study has been published in JAMA Pediatrics. 10.1001/jamapediatrics.2018.0082  

New objective blood test could diagnose autism in children

Scientists have found a link between autism and a set of proteins in the blood. This could be detected through a blood test, facilitating an earlier detection of the disorder.

Image in public domain.

Autistic spectrum disorder (ASD) is still a poorly understood condition. It affects information processing in the brain by altering how nerve cells and their synapses connect and organize, but the mechanism through which this happens is still unclear. Rather, autism is generally defined as a broad set of developmental disorders which cover a wide spectrum of behavioral problems. These problems can vary wildly in intensity and how they manifest themselves, potentially including speech disturbances, repetitive and/or compulsive behavior, hyperactivity, anxiety, and difficulty to adapt to new environments.

Since there is such a wide range of ASD symptoms, it can be extremely difficult to diagnose autism, especially at the early stages of development. Suspicious behavior of children can often be explained by natural causes, and symptoms can sometimes be quite subtle. This is why a direct, objective physical test would be extremely useful.

Researchers working in Bologna, Italy, locally recruited 38 children (29 boys and nine girls) who were diagnosed with ASD, as well as a control group of 31 healthy children (23 boys and eight girls) between the ages of five and 12. Blood and urine samples were taken from each of them.

The team noted the chemical differences in the samples and then inserted them into an Artificial Intelligence (AI) algorithm. The AI developed a mathematical equation that distinguishes between ASD and healthy controls. The outcome was a diagnostic test better than any method currently available.

Dr. Naila Rabbani at the University of Warwick and lead author of the study said that the discovery could lead to “earlier diagnosis and intervention.”

The false positive rate was very low (positive predictive value was 88%), while the overall accuracy was 88%, she told ZME Science in an email. She was also kind enough to detail exactly how the test works.

“The test is based on an optimum combination of markers of damage to protein in blood plasma. The damage is low level and of two main types: oxidative damage – likely linked to low-level inflammation, and damage caused by the reactive carbonyl metabolite, glyoxal – likely linked to increased lipid peroxidation. Similar damage may be occurring in the brain in autism. We also found some disturbance in the handling of the amino acid arginine which supports previous evidence of a genetic association with autism.”

She also added that their discovery can lead to a better understanding of the autistic specter, allowing us to understand what causes it and how it manifests throughout the body.

“We hope the tests will also reveal new causative factors. With further testing we may reveal specific plasma and urinary profiles or “fingerprints” of compounds with damaging modifications. This may help us improve the diagnosis of ASD and point the way to new causes of ASD.”

So far, the study only analyzed children from age of 5 – 12 years old — the applicability of the test in younger age groups remains to be assessed in future research. But since the test is objective and doesn’t require any psychological evaluation, it could be scaled and implemented in clinics around the world

“The test could be widely implemented and provided by well-equipped clinical centers. Our test is an objective, blood-based clinical chemistry test that does not require psychiatric expertise,” Dr. Rabbani told ZME Science.

“With further development, this test could help with the diagnosis, care and treatment of children with autism.”

ASD is caused by a combination of genetic and environmental factors. Genetic factors have been found to account for 30-35% of cases of ASD and the remaining 65-70% can be explained by a combination environmental factors, multiple mutations, and rare genetic variants.

This study is reminiscent of a previous effort which found that autism can be detected even in babies by monitoring brain activity. The idea is somewhat similar — you find the differences in the brains of ASD sufferers and feed them into an algorithm which then predicts autism incidence. The beauty of this approach is that you don’t even need to know exactly what you’re detecting, you just find enough differences, and that’s enough to successfully predict incidence.

Older fathers tend to raise geekier children

New research shows that older fathers tend to have more intelligent children, who are less concerned about fitting in but more focused on their own interests — traits usually bunched together as ‘geekiness’.

Darth Vader.

Luke I *hhhhhh* am your father. I’m also pretty old, that’s why you like tinkering with racing craft.
Image credits Jordi Voltordu.

Researchers from King’s College London and The Seaver Autism Center for Research and Treatment at the Icahn School of Medicine at Mount Sinai in the United States wanted to see how a father’s age influences their children’s personality. Towards this end, they looked at cognitive data from 15,000 pairs of UK twins, recorded as part of the Twins Early Development Study (TEDS). All in all, the older the father, the geekier their children tended to be, the team reports.

At the age of 12, the twins completed online tests that measured several of their cognitive traits, including some most people would bunch up as being ‘geeky’, such as non-verbal IQ, the strength of their focus on a subject of interest, and levels of social aloofness. Their parents were also asked to rate how much their child cares of the way their peers perceive them, and if they have any interests that take up a substantial chunk of their time. Using this data, the team calculated a ‘geek index’ for every child in the study.

Overall, children who scored higher on the index tended to have older fathers. This correlation held even after the team corrected for the family’s socioeconomic conditions, parent’s levels of education, and employment.

“Our study suggests that there may be some benefits associated with having an older father,” said Dr Magdalena Janecka from King’s College London and The Seaver Autism Center at Mount Sinai. “We have known for a while about the negative consequences of advanced paternal age, but now we have shown that these children may also go on to have better educational and career prospects”

Among these benefits, the team points out that the children who rated higher on the index tended to do better in school and rate higher in school exams several years after the measurements were taken, particularly for STEM (science, technology, engineering, and mathematics) subjects.

The team believes that there are several factors why older fathers may geekify their kids. For example, older fathers tend to have more well-established careers and a higher socioeconomic standing than their younger counterparts — so their children are more likely to be brought up in richer environments, have better education, and a higher exposure to STEM fields.

The findings could also help understand the links between higher paternal age, ‘geeky’ characteristics, and neurological conditions. Previous research has shown that children of older fathers are at a higher risk of some adverse outcomes, including autism and schizophrenia. Although the team couldn’t measure any effect directly, they hypothesize that some genes which encode geeky characteristics overlap with some of those who promote traits associated with autism — and older fathers are more likely to pass them along.

“When the child is born only with some of those genes, they may be more likely to succeed in school,” Dr Janecka adds. “However, with a higher ‘dose’ of these genes, and when there are other contributing risk factors, they may end up with a higher predisposition for autism.”

“This is supported by recent research showing that genes for autism are also linked with higher IQ.

The full paper “Advantageous developmental outcomes of advancing paternal age” has been published in the journal Translational Psychiatry.

Baby brain scans and machine learning algorithm can predict autism

Scientists have developed a surprisingly accurate mechanism of predicting autism — using a single brain scan.

The findings indicate that autism has a biological component. Image credits: Carolina Institute for Developmental Disabilities.

Predicting the unpredictable

There’s still a lot of disagreement and debate regarding the nature and causes of autism. We do know that it is a spectrum disorder, with all autistic people suffering from some level of problems, but the severity and nature of these problems differ greatly. Autism is caused by a combination of genetic and environmental factors, with some instances being associated with certain pregnancy infections or drug abuse, and others having no clear source. The diagnosis of autism is difficult because it is based on behavior, not a certain cause or a mechanism. Considering that autism affects an estimated 1 in 68 children (1 in 42 boys and 1 in 189 girls), having a possibility to not only diagnose it but predict it, through a simple brain scan, is truly exciting.

“We have been trying to identify autism as early as possible, most importantly before the actual behavioural symptoms of autism appear,” says team member Robert Emerson of the University of North Carolina at Chapel Hill.

He and his colleagues have developed an algorithm that analyzed brain scans of 6-month-old children and predicted, with almost perfect accuracy, which of them will develop autism.

For the study, they focused on babies with autism suffering siblings, which put them at a higher risk of developing the condition themselves; they settled for 59 infants aged approximately 6 months. They carried out a single brain scan (also a significant reduction from previous studies, and can be carried while the babies are sleeping) which gathered data from 230 brain regions, showing the 26,335 connections between them. Out of all these connections, researchers identified 974 regions possibly connected with autism, and put those into a machine learning algorithm. The results were impressive.

“When the classifier determined a child had autism, it was always right. But it missed two children. They developed autism but the computer program did not predict it correctly, according to the data we obtained at six months of age,” said Emerson.

The algorithm predicted that 9 of them were developing autism, and they did. Still, two more also developed the condition, which it didn’t catch. But the fact that it has no false positives is extremely encouraging, and could pave a new way for autism treatment and management. If parents know from 6 months that a child is highly likely to develop an autistic condition, they can start preparing accordingly and develop a proper environment and suitable therapies.

Vaccines don’t cause autism

This study also carries another interesting conclusion: if autism can be detected through a brain scan, it means that it has a biological component and is not fully environmental. Also, since the test was done before any vaccines were done, it invalidates (once more) the theory that vaccines cause autism. This had already been debunked several times, but for some reason, many people seem to still believe that.

“The study confirms that autism has a biological basis, manifest in the brain before behavioural symptoms appear, and that autism is not due to environmental effects that occur after 6 months, for example, vaccinations,” says Uta Frith of University College London. “This still needs pointing out.”

Of course, although results are encouraging, this is still a relatively small sample size, and it’s not clear how the algorithm would fare for different types of babies (with different brains). They will try to replicate the new findings on a broader sample size. The study comes on the heels of an earlier study that used two scans, at ages of 6 and 12 months, and had similar results in terms of accuracy.

“The more we understand about the brain before symptoms appear, the better prepared we will be to help children and their families,” said researcher Joseph Piven, also from the University of Carolina.

Journal Reference: Robert W. Emerson et al — Functional neuroimaging of high-risk 6-month-old infants predicts a diagnosis of autism at 24 months of age. DOI: 10.1126/scitranslmed.aag2882

Speech and language deficits aren’t to blame for autistic children’s tantrums

Children with autism are known for throwing more frequent tantrums, but contrary to popular belief it doesn’t come down to language or speech impediments, Penn State College of Medicine researchers report.

Pidgeon Tantrum.

Image credits Ann Larie Valentine / Flickr.

Raising a child with autism can be a very difficult job. They are known to go through more tantrums than children without the disorder, and communication can become difficult if not impossible with those on the higher end of the spectrum. Their outbursts are usually chalked up to these difficulties in expressing their wants and needs, but that isn’t necessarily the case.

To understand the relationship between communication and these tantrums, a team of researchers from the Penn State College of Medicine worked with 240 children with autism aged 15-71 months of age.

“There is a common pervasive misbelief that children with autism have more tantrum behaviors because they have difficulty communicating their wants and their needs to caregivers and other adults,” said Cheryl D. Tierney, associate professor of pediatrics at the College of Medicine and section chief of behavior and developmental pediatrics at Penn State Children’s Hospital.

“The belief is that their inability to express themselves with speech and language is the driving force for these behaviors, and that if we can improve their speech and their language the behaviors will get better on their own.”

Tierney and co-author Susan D. Mayes, professor of psychiatry at Penn State, addressed limitations in previous research by including a larger sample of children and recording data on more of their characteristics. The authors also note that unlike previous research, they measured IQ and considered speech and language as distinct elements that might play into the development of tantrums in children with autism.

IQ level is particularly important here because a child with the mental capacity to understand and use language will behave very differently from one who can’t do the same, the authors note. Furthermore, they make the distinction between language and speech as one represents a child’s ability “to understand the purpose of words and to understand what is said” while speech is their ability to use their mouth, tongue, lips and jaw to form the sounds of words and make those sounds intelligible to other people.”

They found that the children’s IQ, their ability to understand language and their ability to use words and speak clearly, accounted for less than 3% of their tantrums. They also report that 2-year-olds who could speak at the normal level of development still had more tantrums than children who could speak at their age level.

“We found that only a very tiny percentage of temper tantrums are caused by having the inability to communicate well with others or an inability to be understood by others,” Tierney notes. “We had children in our sample with clear speech and enough intelligence to be able to communicate, and their tantrums were just as high in that group.”

The authors write that while the paper doesn’t answer why these tantrums take place, the findings are enough to justify shifting the focus from improving speech to improving behavior. They note that a low tolerance for frustration and general mood deregulation (two common traits in the autism spectrum) likely play a part and should be the focus of future studies.

Applied behavior analysis is probably the most helpful method of working through these tantrums, and having a well-trained and certified behavior analyst on a child’s treatment team is key to a good outcome.

“We should stop telling parents of children with autism that their child’s behavior will get better once they start talking or their language improves, because we now have enough studies to show that that is unlikely to happen without additional help,” she said.

“This form of therapy can help children with autism become more flexible and can show them how to get their needs met when they use behaviors that are more socially acceptable than having a tantrum,” Tierney said.

The full paper “Tantrums are Not Associated with Speech or Language Deficits in Preschool Children with Autism” has been published in the Journal of Developmental and Physical Disabilities.

Wikimedia Commons

Autistic toddlers don’t avoid eye contact on purpose. They do, however, miss the social significance of the gaze

“This is important because we’re disentangling very different understandings of autism,” said Jennifer Moriuchi, a graduate student at Emory University. “Depending on why you think children with autism are making less eye contact, you might have different approaches to treatment and different ideas about the brain basis of autism. Drug treatments and behavioral interventions are already being developed and tested on the basis of these different explanations. By clarifying which explanation is correct, we can make sure that we’re addressing the correct underlying concern.”

There are two trains of thought that attempt to explained reduced eye contact. One suggests that autistic children avoid eye contact because they find it stressful. Indeed, there are many reports from adult people with ASD who describe the terrible stress they felt when well-meaning parents and teachers tried to force them to make eye contact during conversations. The other hypothesis, on the other hand, suggests children with autism make less eye contact because they do not find the social cues as particularly meaningful.

[ALSO READ] About 100,000 years ago, people with autism were championed, not shunned, and may even have shaped human evolution

 

Eye contact greatly helps people communicate their interest and attention to a conversation partner. There is a myriad of social cues that can be transmitted just by looking a person in the eyes. We can learn, for instance, whether the conversation partner is actually interested in maintaining the discussion or whether someone’s lying or not. Typically, failure to make eye contact is perceived as inattention or disinterest in the conversation, but that’s not necessarily the case — especially for autistic individuals. Autists can follow a conversation like any regular person and can engage in meaningful exchanges — it’s just that they might not look you in the eye.

The team of researchers from the Marcus Autism Center, Children’s Healthcare of Atlanta, and Emory University School of Medicine, used eye-tracking cameras to follow the gaze of 86 two-year-old children with and without autism. Each child with autism was tested on the day of their diagnosis in order to have clearer evidence about the initial underlying reasons for reduced eye contact.

Images show how the eye-tracking experiments were performed. Credit: Emory

Images show how the eye-tracking experiments were performed. Credit: Emory

The toddlers were shown a series of carefully made videos, and before each video, a small picture flashed that would capture the child’s attention. Once the attention-grabbing picture faded, a video started playing with the children’s gaze fixed in the same direction. In some situations, the gaze was directed at another person’s eyes or looking away from the eyes, depending on the videos’ contents.

“When we did this repeatedly, we found that young children with autism continued to look straight at the eyes. Like their peers without autism, they didn’t look away from the eyes or try to avoid the eyes in any way,” Moriuchi said.

As the tests progressed, the level of socially meaningful eye contact in the videos varied. The autistic toddler looked less at other people’s eyes than the control group.

“These results go against the idea that young children with autism actively avoid eye contact,” said Warren Jones. “They’re looking less at the eyes not because of an aversion to making eye contact, but because they don’t appear to understand the social significance of eye contact.”

The findings do not necessarily contradict the fact that eye contact for autistic children can be stressful. Social signals can be very confusing for autistic children and as they grow up, these signals can be even more challenging to decipher, hence stressful.

“Studies like this one help advance our understanding of autism and improve the way scientists and clinicians develop new treatments,” said Lisa Gilotty, Chief of the Research Program on Autism Spectrum Disorders at the National Institute of Mental Health, one of the agencies that funded the study. Additional support was given by the Autism Science Foundation, the Marcus Foundation, the Whitehead Foundation, and the Georgia Research Alliance.

Findings appeared in The American Journal of Psychiatry

 

About 100,000 years ago, people with autism were championed, not shunned, and may even have shaped human evolution

A University of York study found that roughly 100,000 years ago, primitive societies weren’t shunning people with autism — in fact, they were embraced as respected specialists in their groups for their unique abilities, allowing them to play a central part in human evolution.

Characteristics associated with the autistic specter, such as attention to detail and exceptional memory skills, can be identified in cave art.
Image credits University of York.

Humans are social animals. The life we know today, with roads, grocery shops, smartphones, is only possible because generation after generation, we’ve worked together, pooling our abilities to improve our collective lives. But it hasn’t always been the case. A study now estimates that this group-oriented attitude, known as collaborative morality, emerged through a subtle evolutionary shift some 100,000 years ago. By changing the focus from a person’s characteristics to their abilities, skills, and value to the group, collaborative morality opened up a social niche for one demographic likely ostracized before — people with autism.

Rather than being left behind, the team concludes that they assumed an important role in their social groups due to their unique traits. This, in the long run, allowed them to play a major part in human development and evolution.

“We are arguing that diversity, variation between people, was probably more significant in human evolutionary success than the characteristics of one person,“ said Penny Spikins, senior lecturer in the archaeology of human origins at the University of York and lead author of the study.

Geneticists believe that autism has a long evolutionary history in humans, likely appearing before the stone age. Today, fields such as engineering, mathematics, law, and other academia attract a high rate of people with autism, most notably Asperger’s syndrome. Coping with autism even in the modern world is difficult at best. But, the team argues that the traits which push modern individuals towards these fields provided a powerful advantage for the early social groups of a hunter-gatherer society.

For example, autism is often associated with heightened visual, olfactory, and taste perception, as well as exceptional memory skills (very useful in navigating the world without GPS). Asperger’s syndrome is associated with a heightened attention to detail (recognizing different plants or animals), understanding of systems (such as the behavior of prey), and increased focusing ability.

What these people lacked in social integration, they more than made up for it by sheer group utility.

“It was diversity between people which led to human success and it is particularly important as it gives you different specialised roles,” Spikins added.

In essence, they formed society’s first specialists, filling in roles that the others couldn’t perform as well. Neurosciencenews cites the example of a 2005 study of an elderly reindeer herder with autism from Siberia who “revealed a detailed memory of the parentage, medical history and character of each one of his 2,600 animals.” His knowledge made a huge contribution to the herd’s management and survival, having a direct effect on the group’s prosperity and well-being. Despite being “more comfortable in the presence of the reindeer than humans,” he was a well-respected and important person in the group, had a wife, a son, and even grandchildren. A person with similar abilities would have likely received a similar treatment in a group of early humans.

But finding verifiable proof of autism in archaeological records has always been tricky for researchers. There is no skeletal record of the condition. There is indirect proof to be had, however, in observing how other people that differ from the norm were integrated, as well as cave art or other artifacts from which autistic behavior can be inferred.

“There has been a long-standing debate about identifying traits of autism in Upper Palaeolithic cave art,” Dr Spikins said.

“We can’t say some of it was drawn by someone with autism, but there are traits that are identifiable to someone who has autism. It was also roughly at that time that we see collaborative morality emerging.”

The authors are asking the public to help them with an online survey of cognition and art perception, which you can fill out here.

The full paper, “Are there alternative adaptive strategies to human pro-sociality? The role of collaborative morality in the emergence of personality variation and autistic traits” has been published online in the journal Time and Mind.

Celebrities endorsing an anti-vaccine rally. Credit: io9 // Gizmodo

Why the Anti-Vaxxers Threaten Us All

Celebrities endorsing an anti-vaccine rally. Credit: io9 // Gizmodo

Celebrities endorsing an anti-vaccine rally. Credit: io9 // Gizmodo

In recent years, anti-vaccine proponents have been successful in persuading an increasing number of parents that their children don’t need to be vaccinated. Some anti-vaccine advocates, unfortunately, also come from the medical field. Dr. Andrew Wakefield’s articles allege that vaccines against measles cause autism. In addition, celebrities like Jenny McCarthy have made second careers of being concerned mothers crusading against vaccination.

The sad fact is that neither science nor sense are on their side. Wakefield’s research is thoroughly discredited. Scientists at both the U.S. Centers for Disease Control (CDC) and the National Institutes of Health, leading centers of U.S. medicine, are unequivocal that Wakefield’s data is not supported by the science behind either autism and vaccines.

There is no data indicating that vaccinations cause autism. In fact, researchers are still studying what does cause it. They have found that 90% of individuals with autism also have gastrointestinal problems — perhaps indicating a connection between autism and digestive health, but not between autism and vaccinations.

As for McCarthy, she is simply using a celebrity platform to promulgate what are in essence lies put into circulation by Wakefield and others.

Anti-Vaxxers Threaten Public Health

The other sad fact is that the growing ranks of anti-vaxxers are a danger to use all. A number of diseases that used to threaten illness or death have been eradicated by vaccines. Anti-vaxxers are bringing them back.

For instance, in 2002, the CDC announced that measles had been eradicated in the U.S. Measles can cause deafness and possibly death. However, measles is once again not only present in the U.S., but it’s on the upswing.

In Minnesota, measles was epidemic in 2015. A three-three-old Minnesota boy was identified as the patient zero, or the entry point. He exposed over 3,000 people.

His parents had read the erroneous reports that the measles vaccine caused autism. As a result, they didn’t vaccinate him, and he contracted measles on a family trip overseas.

They were not alone, either. In their community, vaccinations fell dramatically over the 2004 to 2014 period. In 2004, more than 90% of people were vaccinated. Ten years later, just over 50% were — and all as a result of the false information that there was a link between vaccines and autism.

Thanks to anti-vaxxer propaganda, the U.S. is no longer free of measles.

The vaccination of a large percentage of the population strengthens herd immunity. The anti-vaxxers threaten herd immunity.

Making a Good Health Measure Into Bad Health Fears

What the anti-vaxxers are doing has the potential to roll back one of the major medical successes of the twentieth century. Throughout the 1900s, one disease after another was fought into submission.

Influenza was a major epidemic in 1918, killing thousands of people. Flu still has the potential to kill people worldwide in pandemics. Even milder strains can kill the elderly. However, for the population as a whole, flu vaccine protects from common flu strains.

Polio was a major crippler of twentieth-century children until a vaccine was developed. Polio meant that an afternoon swim could result in contracting the disease, potentially resulting in life-long paralysis. The vaccine changed all that.

[ALSO SEE] Vaccines work: only 15 polio cases in 2016 — by 2020 it should be completely eradicated

One of the tragedies is that the public health successes of vaccines made life seem safer, and inadvertently set the stage for the anti-vaxxers. Although infectious diseases are still among us (Zika virus and Ebola come to mind), it has been decades since such childhood diseases like measles and polio were commonly viewed as threats.

Because of vaccinations, they ceased to be present dangers — to the point where the anti-vaxxers seem to have forgotten that the world is full of health dangers.

Anti-vaxxers draw on a historical wellspring of fears concerning vaccination. Historians of medicine point out that people a century ago feared that vaccines would cause disease — partly because some vaccines were made of live viruses. But such fears were ill-founded then, just as they were ill-founded now.

Anti-vaxxers also seem to be people who are more swayed by alarmism and anecdote than by science and rational thought. They may also be more politically conservative and distrust government claims such as those by the CDC.

Again, though, the data here is clear: There is no link between autism and vaccinations. Yet the science has not persuaded anti-vaxxers.

When a Personal Choice Affects All of Us

Anti-vaxxers frequently emphasise the role of personal choice in the vaccination decision. The backdrop is the increasing emphasis on personal choice in contemporary life.

However, the anti-vaxxer choice is not solely a personal choice. Because diseases are spread among social units — many of them are carried through bodily fluids or through the air — the choice to exert a precaution against diseases is a social one as well.

After all, society has supported quarantines of people with infectious diseases when there was no readily available treatment in decades past. Those suffering from yellow fever and tuberculosis, for example, were isolated until the disease had passed. Indeed, as we’ve seen with the Zika virus and Ebola, treatment for untreatable infectious diseases includes quarantine and protection for medical personnel now.

In some ways, vaccination is the positive side of disease protection, and perhaps it ought to be treated as more mandatory than a choice because of is potential social impact.

Autistic people have feelings and emotions, study finds

It pains me that studies like this have to be conducted. The myth of the cold, calculated autistic shooter is just that – a myth. However, this stereotypical and deeply flawed perception is picking up more and more followers, and something had to be done. A joint study by the SISSA research institute in Italy and the University of Vienna in Austria found that autistic people exhibit a similar empathic response to the rest of the population.

Students and families walk to support Autism Awareness Month.
Photo by: Lance Cpl. Andrea Ovall

Empathy and the autistic brain

“[Autistic people] are cold, calculating killing machines with no regard to human life,” reads a Facebook Group called Families Against Autistic Shooters. The group was since discontinued or hidden, but the fact that such groups are started in the first place is disturbing. This group, like several others, spurred after the collective hysteria provoked by yet another mass shooting in an American school last October, in this case by a 26-year-old boy who was later reported to be affected by autism. This caused an uproar against autistic people which only amplified a stigma against the people suffering from the condition.

Autism is an umbrella term for neuropsychiatric disorders with a wide spectrum shared by individuals with varying degrees of cognitive skills. In other words, autistic people can be more or less socially functional, but many of them have problems adapting. For this reason, they are often perceived as emotionless or as lacking empathy – but the science says otherwise.

“According to our studies, it is quite the opposite: the autistic trait is associated with a normal empathic concern for others and is actually associated with greater tendency to avoid causing harm to others,” says SISSA researcher, Indrajeet Patil, first author of a recently-published study in Scientific Reports. “The mistaken stereotype is most likely due to another personality construct, which is often found in the autistic population, but can also be found in those who are not afflicted, called alexithymia.”

Alexithymia is a “subclinical” condition (as opposed to a disease), which can be found in the general as well as the autistic population (with an incidence of 50% in the latter group). It is what most people would call “psychopathy” – the inability to understand one’s own emotions and the emotions of others.

“For a long time, the alexithymia trait in patients was confused with autistic symptoms, but today we know that they are distinct,” says Giorgia Silani, former SISSA neuroscientist, now of the University of Vienna, who led the study. “In alexithymia, there is a lack of understanding emotions. In autism, however, we know that what is reduced is the theory of the mind, or the ability to attribute thoughts and mental states to others.”

The higher incidence of alexithymia in autistic people is by no means a reason to ostracize them. The authors agree that tools for identifying and distinguishing between alexithymia and autistic disorders must be further enhanced, but this is an important first step. It is also important that news outlets emphasize this condition instead of autism. Lastly, if we want to fight shootings, the controversial issue of gun control in the US also must be addressed.

autism sniff test

A simple sniff test might diagnose autism in toddlers

Children with autism spectrum disorder do not react as well to pleasant or foul smells compared to non-ASD children. Previously, autistic toddlers were found to have a dampened response to sight, sound and touch. For their study, the researchers at the Weizmann Institute of Science in Israel used a novel technique to gauge the smell response in both ASD and control groups, with 81% accuracy. The test is unobtrusive and doesn’t require a personal account from behalf of the children – something that can be difficult to do with autistic children, who more often than not are highly uncommunicative. If the test can survive the test of time and other trials, it could very well be used to diagnose autism.

autism sniff test

Image: Greenmylife

Our respiration constantly shifts to accommodate the various smells we come in contact with. If you sense a pleasant aroma, you will likely breath in more. If you sense a stench, though, you’ll adjust to “low-magnitude sniffs” to lower your response to the awful stimulus. To measure how autistic children differ in this kind of response, the researchers used a specifically designed contraption called the olfactometer. The device delivers scents through a small tube that fits in the nostril, while a second tube measures how much air the children were breathing for each round of scent. In other words, the device measures how much time they spent smelling or much of a sniff they inhaled.

For the experiment, 36 children were selected: 18 diagnosed with ASD and 18 non-ASD children which acted as the control group. The scents were altered between pleasant smells, such as roses or shampoo, and unpleasant smells, such as sour milk or rotten fish. The control group adjusted their response according to the scent, taking a longer sniff for roses and a shorter one for rotten fish. This shift happened very quickly, within one third of second after being exposed to a new smell. The autistic children typically didn’t change their breathing, though.

“The difference in sniffing pattern between the typically developing children and children with autism was simply overwhelming,” says Noam Sobel of the Weizmann Institute of Science in Israel.

autism test

Image: Current Biology

It’s not clear though whether the children actually have a dampened sense of smell or it has more to do with their response: internal action models (IAM).

The study says: “We do not hypothesise that children with ASD will be unable to sniff, but rather that they will generate an inappropriate sniff given a particular odour.”

The results might also explain why so many autistic children have trouble eating.

“It could be muscular problems, with swallowing and chewing, but smell is a big part of taste and children with autism may not perceive smell in the same way as other children,”  Dr. Paul Wang, senior vice president and head of medical research for Autism Speaks.

The olfactometer test correctly identified 12 of the 18 children who had autism, and 17 of the 18 control children who did not have autism.

“We can identify autism and its severity with meaningful accuracy within less than 10 minutes using a test that is completely non-verbal and entails no task to follow,” Sobel says.

“This raises the hope that these findings could form the base for development of a diagnostic tool that can be applied very early on, such as in toddlers only a few months old. Such early diagnosis would allow for more effective intervention.”

While the test could work well for children with developmental problems, it might not be that accurate in the field. Specifically, this kind of limited response might not be unique to autism spectrum disorder. Right now, the main mode of diagnosing autism is behavioral. Either the children are doing things that typical children don’t do, or they are not doing things that typical children are doing.

The fact that the test is very simple to take and doesn’t require any kind of involvement from the part of the children (the participants were sited while watching cartoons), makes it a promising tool, though. For it to be really effective, it should prove accurate for younger children. The average age of the participants was 7, but previous work shows that marking improvements can be seen if ASD children are given behavioral therapy before the age of 4. This could prove challenging to implement. First, a new study should be made with younger children, then these children should be followed as they mature to see if they actually developed ASD.

 

MDMA and autism reserach

Ecstasy might be used to relieve Anxiety in Autistic adults in new clinical trial

Some researchers are considering a pilot treatment that involves MDMA, the active psychoactive ingredient in ecstasy pills, to help adults diagnosed with autistic spectrum disorder (ASD) ooze out anxiety.  ASD adults typically report difficulties in bonding with other people and often feel nervous in a social setting. Though illegal in the United States, MDMA has been recently explored for psychotherapeutic purposes with promising results reported in battling addiction or post traumatic stress disorder. If it receives approval – and there’s a great deal of paperwork that needs to be filled before they get the green light – this would make it the first MDMA-assisted therapy for the treatment of social anxiety in autistic adults.

MDMA and autism reserach

Image: Autism Daily

The team – a join venture between the Los Angeles Biomedical Research Institute and the Multidisciplinary Association for Psychedelic Studies – published the proposed methods and study rationale in  Progress in Neuro-Psychopharmacology & Biological PsychiatryWhile there’s a potential for addiction and abuse, in small doses and under a controlled setting MDMA is considered safe. Somewhat similar in structure and psychoactive effects to amphetamines and mescaline, MDMA reportedly makes people feel less vulnerable and more open. In one survey of users, 72% reported that the drugs made them “more comfortable in social settings,” and 12% further noted that this effect persisted for more than two years.

People with an ASD often find social situations very difficult. There are so many social rules that people without an ASD learn instinctively, but people with an ASD often have to work at learning these rules. Some have more trouble integrating than others, depending on how severe the diagnosis is. The most severely affected individuals seem aloof and uninterested in people. Others desire contact, but fail to understand the reciprocal nature of normal social interaction.  It can often be confusing and cause anxiety as many social rules are unwritten and not spoken about. This is where MDMA might come in handy –  administered infrequently in clinical settings – to ease anxiety and promote productive social bonding.

The drugs prescribed so far for anxiety retrieval don’t seem to work that well for ASD adults. “Conventional anti-anxiety medications, including selective serotonin reuptake inhibitors (SSRIs), MAOIs, and benzodiazepines, lack substantial clinical effectiveness in autistic adults,” write the authors. 

There’s reason to believe MDMA might work. Alicia Danforth, a Ph.D. candidate in clinical psychology with a focus on psychedelic research, published a research study on adults with autism who have self-administered ecstasy. Of course, since the people in question purchased the drugs illegally and took them in an uncontrolled setting one has to keep in mind that the results didn’t pass the rigors of an FDA-approved clinical trial. However, Danforth reports  positive and promising results out of her survey study. Over half of the people she interviewed spontaneously made reports in improvement in social anxiety.

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Autism symptoms dramatically improved after treatment with Vitamin D

There’s a growing body of evidence suggesting Vitamin D plays an important role in regulating serotonin. This means it could cause (deficiency) or treat Autism Spectrum Disorder (ASD) symptoms (supplement). For instance, one study prescribed Vitamin D3 to autistic children in an open trial and had a 80% success rate – that is, the children became less hyperactive, irritable, and engaged far less in stereotypical behavior. The children were also more responsive and compliant to their families.

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Vitamind D is produced endogenously when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Image: Mercola

In the US, one in 68 kids is affected by ASD, making the fastest growing development disorder in the country. Studies so far have garnered that the condition is caused by both genetic and environmental factors. Among the latter, Vitamin D3 (cholecaliferol) seems to play a significant role. The prohormone is naturally released in the body when exposed to sunlight. Previously, Patrick and Ames published a paper in which they show the vitamin D hormone (calcitriol) activates the transcription of the serotonin-synthesizing gene tryptophan hydroxylase 2 (TPH2). This suggests that a specific level of vitamin D may be required to produce adequate serotonin, a neurotransmitter thought to affect social behavior. The paper also explains 4 major characteristics associated with autism: the low concentrations of serotonin in the brain and its elevated concentrations in tissues outside the blood-brain barrier; the low concentrations of the vitamin D hormone precursor 25-hydroxyvitamin D [25(OH)D3]; the high male prevalence of autism; and the presence of maternal antibodies against fetal brain tissue.

The scientists in Egypt prescribed Vitamin D3 supplements (300 IU/Kg/day not to exceed 5,000 IU/day) to 122 autistic children aged between three to nine years. The treatment was administered for three months, then compared to a control group. Once in the liver, Vitamin D3 is converted into 25-hydroxyvitamin D3. Despite side-effects including skin rashes, itching and diarrhea, 80% of the children involved in the study fared better at CARS scores, which gauges the severity of ASD symptoms. Findings appeared in Nutritional Neuroscience.

Elsewhere, doctors in China are reporting that treatment with vitamin D appeared to produce dramatic improvements in a toddler with autism. Blood tests showed that the boy had borderline low blood levels of vitamin D (12.5 ng/mL). The doctors administered a monthly injection of vitamin D3 (150,000 IU) and prescribed a daily oral supplement (400 IU). After two months, the boy’s vitamin D blood levels had risen to 81.2 ng/mL, and his parents were reporting clear improvements. The boy had stopped running in circles and banging his head. He was responding to his name, playing with toys and asking his parents to hold him in their arms.

Dr. John J Cannell is the founder of the Vitamin D council in the United States, and one of the supporters of the study’s findings made in Egypt. Cannell met lead author  Khaled Saad while seeking more related information about Patrick & Ames study. 

“My experience, having treated about 100 children with autism, is that 25% respond dramatically to high dose vitamin D, 50% respond significantly and 25% do not respond at all I don’t know why,” Cannell said for ZME Science. “80% of the children responded to 5,000 IU/day so it is about what I have found. My hopes for the future is that a randomized controlled trial is done using high dose vitamin D,” he added.

Regarding a randomized trial for Vitamind D3 and autism – the golden standard typically employed for determining causal relationships – Cannell doesn’t express much hope.

“Unfortunately, the trial will probably be negative for two reasons. They will not use enough vitamin D and, two, their ethics committee will not allow the placebo group to remain deficient thus rendering the trial useless,” Cannell said.

Cases of children diagnosed with autism spectrum disorders (ASDs) increased by 30% in the last couple of years, according to a reported issued by the  Centers for Disease Control and Prevention. A piece I wrote previously for ZME Science argues that autism might not actually be on the rise and the increased prevalence might actually be a statistical mishap due to under-reporting and the way doctors have changed what falls under an ASD diagnosis. As far as Cannell is concerned, he believes “the prevalence of autism is increasing in direct proportion to sun avoidance, which is still increasing.”

Hopefully, we might actually see some results from some randomized trials, maybe made in the US. A lot of parents go bankrupt to treat their kids, with roughly $60,000 expenses a year on average per family. Vitamin D is as inexpressive as sunlight.