September 2008 Archives

September 29, 2008

Eye Contact and Autism: An Early Marker?

Any parent with a child with autism knows that eye contact is a key identifier of the condition.  Children with autism tend to give little to no eye contact to anyone.  The less eye contact, often the more severe the autism.  Well, a group of researchers from Yale University decided to test a theory regarding eye contact patterns in the early diagnosis of autism in children.  There findings are published in the journal Archives of Preferential Psychiatry.They took 15 children 2 years old with confirmed autism and showed them 10 videos with a person looking right into the camera and interacting as a care giver.  They also used 15 developmentally delayed but non-autistic children, and 36 children who were typically developing as the control.  These groups had their eye patterns traced to determine whether or not eye contact was being made, and to what degree.As expected, the children with autism focused less on the "caregiver's" eyes than the other children.  What was interesting is that they (the children with autism) focused instead on the mouth of the "caregiver".  But why should this even matter?  What does it mean, all this focus on eye contact?  Well, the context of the study focuses on the need for eye contact to interact socially with the world.  This same behavior has been seen in social animals, and this same phenomenon has been confirmed to happen with infants within the first week of life.  Generally infants will focus on the eyes of their caregiver, and even give preferential attention to their eyes.  The focus of this study was to prove that decreased eye contact in infants could be a conclusive method of identifying autism in children at a very early age.  This is great for researchers, because they can focus on genetic markers from children confirmed to have autism at an early age, and gives more credibility to the genetic focus of autism.  The next phase of this study would be a long one, focusing on infants with decreased eye contact to determine if they do indeed grow to have autism.  But there is another benefit, if this becomes confirmed for infants:  parents will be able to educate themselves early on before their child gets too far behind, and help to retrain their neurons while still developing.  Quite honestly, if this study proves to be a marker with infants, parents will be better prepared to meet this challenge head on.

September 23, 2008

Fragile X Syndrome Treatment And Autism-Like Symptoms

This morning NPR ran a story regarding the effects of the Fragile X syndrome that can cause symptoms of autism and mental retardation, and a treatment that could potentially reverse those symptoms.  The story is fascinating, but is billed as a treatment for autism in general.  Let's understand the effects of the condition.  Fragile X Syndrome is a mutation on the X chromosome that effectively disrupts the system in the brain that regulates synapses, which can cause mental retardation and symptoms on the autism spectrum.  This happens because there is an increase in these synapses, but no regulation to reduce them.  Therefore synapses are running out of control.  Until recently there has been no treatment for this condition, but that has now changed as the recent study has begun human testing.  There are some risks, in that not all on the autism spectrum will respond to the treatment, and the drugs are potentially dangerous.  The tests are going forward with caution, and I hope they find an effective treatment for this syndrome.  But I also want to point out that this condition isn't the only cause for autism.  Recent studies (such as those I have previously posted) point to an overgrowth of neurons during the developmental ages, with a decreased, delayed, or lack of pruning at age 6 as a primary cause of autism.  The effects are the same, because you have either a system that doesn't slow down synapses, or increased synapses caused by an overgrowth of neurons.  Both have increased synapse activity, and therefore cause the same symptom.  So while I think the treatment is ground breaking and definitely worth praise, I want to caution parents out there that this is not the silver bullet for autism.  Autism can be caused by a number of conditions, only one of which has been found to have a treatment.  Not all children with autism will have the Fragile X Syndrome.  The really positive thing is the focus on genetic mutations that are the cause of autism, as opposed to environmental effects.  Hopefully this study will lead to more funding and focus on other genetic causes that lead to the majority of those on the autism spectrum.

September 19, 2008

Autism, Brain Overgrowth, and Pruning

For many families that have children with autism, they live in a frustrating fog of uncertainty.  They don't know what "causes" autism, nor do they know what people are doing about it.  In fact, as with the case of my wife and I, many have no clue what autism is until faced with the challenges and joys of having a child with autism.  My first question was what caused it, and then what I could do about it.  Well, recently (within the last 12 months), a study was completed and presented to the neuropsychological community that suggests an overgrowth of brain neurons could contribute to autistic behavior.  Basically, this is what happens from birth to age 6:  A child's brain will grow a lot of neurons that are randomly connected.  This allows the brain to absorb and record a lot of information at a very young age.  Once that information starts to process, children begin to go through a "pruning" process, which is accelerated at age six.  This pruning process removes many of the random neurons in the brain, leaving those that have developed.  But with some autistic children, the brain tends to "overgrow", developing more random neurons than most "normal" children.  This means they are processing more information from visual, tactile, auditory, olfactory or gastronomical inputs.  Often this input is so overwhelming that they need to "unplug".  This presents the bulk of autistic behavior.  Your face is too detailed for them to take in, so they can't look you in the eye.  They get overwhelmed with the sights, sounds, and smells in a store, so they need to cling to you or start to scream.  Often they will just lay down on the floor to try to get sense of their surroundings, or focus on one object very intently, trying to block everything else out.  If that were not enough, children with autism tend to either have a delayed pruning period, or do not prune at all.  Those children with more severe autism would most likely fall within this group, with Asperger's children having an overgrowth in the brain, and those with PDD will have a delayed pruning period.  At least, that makes the most sense to me.  It will be interesting to see if that is confirmed with subsequent studies.  So what does this mean to the parent that is uncertain?  It means that there is hope!  Children with autism can "rewire" their brain by going through intensive training.  Going through tasks at each step, each sub-task, each skill that is required to complete the entire task.  As such, even if pruning is delayed or fails to happen, the neurons can be directed and merged into those tasks, allowing the autistic child to operate at a more functional level.  For a more detailed explanation of the Pruning portion of the neurological studies on Autism, check out this article I have on my website from the Department of Neuropsychiatry, University of South Carolina, as published in the Brain and Development, The Official Journal of the Japanese Society of Child Neurology.  It outlines the impact of pruning, and the discoveries found in classic autistic children.

September 18, 2008

Chelation Study Cancelled

While reading the daily news this morning, I came across this article by Reuters regarding a clinical study in chelation as an autism treatment.  The treatment was deemed too risky in relation to the potential benefits, and therefore considered an overall hazard.What is chelation?  It is a therapy given to those with a heavy metal poisoning, such as mercury poisoning.  A man-made amino acid, EDTA, is added to the blood to purge out the heavy metals causing sickness.  The treatment is based on the belief that the rising cause of autism in children is due to the increased levels of mercury that come from childhood vaccines, such as the Flu vaccine.  As such, the patient is treated for mercury poisoning.  The controversy behind this is that many physicians have dismissed this theory, believing rather that there are genetic causes for the condition.  Of course this wouldn't necessarily account for the rising number of diagnoses, but then psychologists are more sensitive to autism now, and the entire autistic spectrum.  My older brother has all the signs of Asperger's, but was never diagnosed.  Why?  They didn't diagnose that condition in the 70's, and there was another condition that he had that was used as an excuse.  But if the study was to be the final proof to debunk the theory behind mercury poisoning, why would they cancel it?  That was the question I had.  How was it dangerous?  What did this amino acid do if it didn't find significantly high levels of heavy metals to purge?  I checked the old reliable:  Google Scholar.  I found an article outlining the death of one child because of a medication error, causing a calcium deficiency.  The potential for permanent damage to the child was so high, and the perceived benefit of the study so low, that the risk was just not worth it.  So where do parents go from here? Well, in the case of my own child, I work with the condition.  I know that my child is special, with special needs.  I know that he is also very brilliant, able to work out mechanics very quickly and has a gift with music.  All I need to do is help him train his brain to work within the accepted "norms" of society so that he can share his gifts and talents.  Now, I don't claim that this will work for every child with autism.  I'm blessed with a child that is very high functioning.  Some children with autism are not high functioning.  It's scary, it's frustrating, and no parent wants to believe that their genes caused this condition.  All I can say is the levels of grief will be travelled, and at the moment all you can do is make it through another day.  The good news is that geneticists are working on the theory that Autism Spectrum Disorders are linked to a multi-gene condition, as opposed to a single gene condition.  Perhaps there will be a gene therapy that will come from these studies, perhaps not.  At any rate, the more they work to understand the cause of autism, the less parents will feel like there has to be blame associated with it, whether on themselves or on an "industry" that is "heartless and greedy".  Remember, every company out there has real people working for them, and I bet some of them have children with autism as well.

September 10, 2008

The Future of Higher Education: Tighten Your Belt

On October 28th at the University of Utah, President Young will be talking about the future of higher education.  I'm not sure what he will talk about, but I thought I would mention what I found out looking at the current state of affairs in higher education (particularly with state funded schools).  Essentially, the future is to tighten your belt.  What does this mean?  This means that the current economic climate has put funding into a lockdown.  You have whole states that are looking at huge deficits across the country, and as such they need to start cutting funding somewhere to bring themselves into a less bright color of red (if not in the black).  Traditionally, in periods of economic stress, the first areas to go are education and parks.So educational facilities are generally asked to be more judicious in their spending.  Some schools are asked to cut as much as 15% from their overall budgets, which generally means that people are let go and departments are consolidated.  I lived through that at the Salt Lake Community College, where my department was essentially wiped out, and people were leaving (or asked to leave) in order to come under budget.  Outsourcing becomes the new standard for many services for which the school couldn't or wouldn't pay.Currently, from what I have heard through the grape vine, that will not be happening at the University of Utah.  But budgets will still need to be tightened, and costs slashed for all divisions.  Running lean and mean is something that needs to happen in order to better service the student and offer the right programs at the right time to the right people.  One way to save in the costs of doing business is to develop curriculum in house.  This means creating a class environment from scratch, including all the teaching materials.  I wouldn't do this with Certification courses, such as Linux, Mac, or CCNA (after all, they are specifically designed already, and high income classes), but all of our one-day classes could be redesigned.  So what is the benefit of curriculum development over purchasing external course materials?  One is your control of the course.  Students are given a guided list of skill sets that are most important for them to know and/or build upon to get to the next level.  It means utilizing the ADDIE process extensively.  I've blogged about this before, and now I'm going to be spending a lot of significant time focusing on these steps as I redesign some of my courses away from expensive books.  For those of you working in higher education, what have you seen as the future?  Do you see a lot of belt tightening, or are your programs well funded and see no decline?  How about those in private institutions vs. State institutions?  How many of you develop your own course materials in lieu of mainstream published materials?

September 9, 2008

My Child with Autism Starts Preschool

Today my son starts his first full afternoon in preschool.  The Granite School District has a preschool specifically for children with autism, and I must say I am impressed with what they are doing.  The teacher is currently working on her masters degree in Special Education at the University of Utah, and there are 3 aides working with her in the class of 10 students (they cap the class at 10).  We attended the Open House yesterday afternoon to meet the aides and the teacher.  All of them were well prepared for Jonathan, and were actually quite impressed with his abilities.  Of course, nothing brings pride up higher for a parent than to hear their child praised.  The techniques they use in class are pretty standard when it comes to Special Needs.  They focus on backwards chaining and targeted, consistent requests.  Backwards chaining is pretty self-explanatory.  Children are helped through their tasks until the very end, when they are then able complete the rest of the task by themselves.  A couple of successful completions later, they are then left to do more of the task on their own, always at the end.  This progresses until they can complete the task on their own without any help or prompting for initiation.  This process is actually very effective overall when working with children of all abilities.  It's the easiest way to feel accomplished while learning a process in that they complete the process each time on their own, while progressively learning how to complete each step of the task.  The child is able to remember more of the task because they have completed the end of the task more times than the beginning, meaning that end of the task becomes second nature.  I've even used the same process while trying to memorize speeches, lessons, or lines in a play.  The next technique they focus on is one I can't quite remember, at least not what it is called.  The process is pretty clear though.  You make your request in as few positive words as possible (Jonathan, please sit down).  You then count 5 seconds in your head, waiting for the request to register.  If it does not, then you make the request with more urgency (Jonathan, I need you to sit down please), and then wait another 5 seconds.  The final time you make it urgent and let the child know you will help them complete the task (Jonathan, I need you to sit down now and I will help you).  Every request is made within 3 to 5 feet of the child for their comfort, and every request is made positive.  The distance is necessary, particularly for children with autism.  Autism is usually accompanied with highly acute senses, usually visual or auditory.  As such, children with autism tend to see and hear everything.  You have over 20 people talking at once?  A child with autism can hear them all, often distracting them from a conversation.   As such, it's necessary to help the child focus on one thing.  If you are trying to talk to them from across the room, they will be too distracted to understand, and ignore your requests.  Too close, and they will feel threatened (little tip I got from Super Nanny!).  3 to 5 feet is ideal for children with autism as it keeps them comfortable and allows for focus.  And then there is the positive aspect.  Children with Autism will often not hear the "don't" or "won't" of a statement.  You can't tell a child with autism "Don't run!" because they just hear "Run!".  This has been the most difficult thing for me to work on.  I'm pretty relaxed in my parenting skills, generally letting my son explore his surroundings and learn without interference.  If it means a little bit of cleanup, that's just part of the experience.  So when I do step in, it's usually to keep him from doing something that could be destructive, damaging, or hurtful.  That usually means saying, "don't".  I've had to rethink my statements for my son, which has been a challenge.  So far, in my one half day of trial, it's been very effective.  So all in all, I'm very impressed and excited about my son attending a Public school.  The teacher knows what he needs, and I've seen her interact.  We know what his lesson schedule is, and how to help him learn along with the class.  I'm looking forward to working more closely with the classroom, and even taking some time off to see them at work with all 10 students.
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