Recently in autism Category

July 1, 2013

Placental Abnormalities: Autism's Early Warning System?

Identifying the risk of autism is a pediatrician's holy grail for ASD. Right now, parents who are unaware of any autism predisposition in the family need to wait until the developmental signs start to emerge. For those who are aware, this may be as long as 18 months, and for those completely unaware, it could be as long as 4 plus years. In childhood developmental terms, that can be a lifetime. So early diagnosis is critical for all parents, children, and pediatricians.

But do to a recent study as published in Biological Psychiatry, it appears that newborns can be considered at risk of autism with various placental abnormalities. That means that doctors can regularly examine placental folds and cell growths for abnormalities, and with higher numbers of abnormalities children are more likely to have autism.

It's scary, I know, thinking that your child may not be "normal" in an accepted sense, will most likely not have much of a social life, and often will struggle to communicate. But, with knowledge at birth, parents can make sure their children have the therapy needed as soon as possible. That means more likely success in integrating them into society.

The research is still out as to how reliable this method will be, as the article indicates the additional growths increase likelihood of autism by 74%. But it's exciting research, because it will give parents a chance to prepare early for the signs, get organized, and be prepared for autism when it comes.

Of course, a "heads up" like this is only useful when all the other pieces are in place, such as parental training for autism, screening apps for parents to evaluate their children's development at various stages, and basic tools and methods to help children work through their autism and be able to communicate. But at least this piece, the early warning system, looks promising.

June 28, 2013

Pollution and Autism: Let's Focus on Research

Recent reports have surfaced again, trying to make the claim that pollution is causing autism. This has seen it's research done in the past, often calling for more research to be done (meaning the results look promising, but not yet conclusive). Since then media outlets have been regularly giving their opinions as facts before scientists have a chance to let stand the hypothesis or disprove it.

In answer to these assertions, Forbes posted an opinion piece Autism and Air Pollution Caveats Again, which asks some pretty targeted questions that challenge many of the assumptions made. Now, don't think of this as a criticism of either the researchers working on pollution causality studies or those questioning the link, but rather look at it in the the following framework: autism is a behaviorally diagnosed disorder, not a genetically or medically diagnosed disorder. That means we are looking at what causes the behavior, which up to this point looks like brain development. Anything can affect brain development, from environmental toxin exposure to genetic predisposition, to being dropped on the head. Therefore, note that autism behavior could be caused by multiple factors, not just one.

That being said, the media reports regarding the recent studies seem to be making the case that all autism is caused by pollution. And much like the "all autism is caused by MSG", "all autism is caused by vaccinations", "all autism is caused by gluten allergies", and "all autism is caused by fire retardant chemicals in furniture and carpets", I'm wary of any claim that all autism is caused by any one thing. Autism research isn't anywhere near the point where we can point to a single cause. Perhaps it's time we let the research speak for itself.

I applaud those who are making assumptions and challenging them in the pursuit of knowledge in science. It's a tough job that gets little praise, requires long hours, lots of graduate, post-graduate, and doctorate input, and lots of funds that are not easily acquired in this current economic state. For those of you doing the research, thank you. For those of you who aren't but making the claims anyway, don't you think we should be patient?

June 11, 2013

New Research for Eye Contact and Autism

Eye contact for children with autism is frustrating. We are so used to having people look you in the eye, if only for a brief time, to acknowledge that they are paying attention and not drifting off into some other thought. It's also a known sign of autism to have someone refuse to look you in the eye. I noticed that with my sons, both of which would be hesitant to look you in the eye if they don't know you. For years, those of us in the autism community thought it was because they just couldn't do it.

But, according to LiveScience, kids with autism avoid eye contact because they process more in their peripheral vision. That is, they don't process stuff by looking right at you, but rather from the side.

Brain scans of children with autism vs. neurotypical children have shown that the brain's cortex of a child with autism is more active with peripheral vision, while those neurotypical children are more active with objects in their direct field of vision. So by not looking at us directly, our children with autism have been gathering more information than if they were forced to look at us directly.

For the past five years, I have been working hard to get my oldest to look me in the eye, and at times he can do it. Now I find out that the exercise is less advantageous for him based on this study! The study also sets forth the hypothesis that social withdrawal is a learned process associated with not looking directly into the eyes of those around us. We withdraw from the child with autism because we think they have withdrawn, and it starts a vicious circle of learned social separation.

It's important to note that this is still all hypothetical, and the study needs additional peer review, but it's an interesting development. It could impact a lot of what we think we know about autism and limitations, and could expand a whole new set of skills for those on the spectrum.

May 31, 2013

A Clinical Use for Google Glass: Diagnosing Autism?

Article first published as A Clinical Use for Google Glass: Diagnosing Autism? on Technorati.

Boy with autism in a sun hat, sun glasses, and using an iPod Touch.Not long ago I posted an article questioning the usefulness of Google Glass for those with autism. Using it as intended, those with autism (and other disabilities) would have difficulty interacting with the device.

But then I read an article outlining research that uses eye-tracking technology to diagnose autism. It appears that children with autism move their gaze more slowly, and therefore even with babies as young as 7 months old, an autism diagnosis can be made by tracking eye movements.

Of course, this is all well and good, but technology currently used to measure eye movement can be expensive, cumbersome, and not very mobile. Enter Google Glass. Eye tracking is built into the device, though it is only looking for specific movements. Should the device be significantly open enough to allow access to the eye tracking technology, it's possible some enterprising software developer could turn Google Glass into an eye-tracking diagnosis tool for any doctor, specialist, or parent.

Eye tracking studies are not new in autism research. Zillah Boraston and Sara-Jayne Blakemore published a paper in the Journal of Physiology outlining the application of eye-tracking technology in the study of autism (6 Jun 2007, Vol. 581, Issue 3, pages 893-898). In the past autism research and eye tracking has targeted focus points, finding that those with autism tend avoid the eye region of the face (therefore lack of eye contact). The same research has been applied to mirroring emotions in others (Dapretto et al, Understanding emotions in others: mirror neuron dysfunction in children with autism spectrum disorders, Nature Neuroscience 9, p.28-30, 2005). But to date this is the first case of tracking the speed of eye movements and it's relationship to autism that I've read.

So, perhaps there is a use for Google Glass in the world of autism after all, if only a use for clinicians and not directly for those with autism. It would be fascinating to see how this research progresses, and if Google Glass becomes a very useful tool in identifying those children who will need autism support services.

May 28, 2013

Useful Tools for Navigating the Waters of Autism

Article first published as Useful Tools for Navigating the Waters of Autism on Technorati. Boys with autism and their mother, posing for photo.

Autism is confusing, frustrating, and often misleading when looking from the outside in. Trying to understand someone else with autism is difficult, because you have to understand what they know versus what they repeat, what they learn versus what they don't, and what they can do versus what they can't. In the past five years since my oldest son was diagnosed, I thought I would go mad. Everyone had a theory, everyone had something to say, nothing seemed to be remotely relevant to the situation my family was in.

Fortunately I had a few tools that have managed to bring focus to my life as I wrestle with the enigma that is autism in my family.

  • Google Scholar: The Internet is a rather vast place, and perhaps the best example of ordered anarchy. As such, everyone with any kind of supposition, theory, or guess is able to publish to others who are willing to accept that "information" as truth. Fortunately Google has provided Google Scholar, a repository for searching scholarly journal articles that are peer reviewed. Of course, you do need to have access to those journals in order to read the research in their entirety, which is why it's so useful to work for a University. With this resource, I have been able to find out the myriad research points about autism being done, and just how credible they are based on the evidence.
  • Blogging: Blogging is more than a cathartic method of releasing frustrations, concerns, or sharing news. For me, it's been a useful method of getting feedback from industry leaders, concerned parents, and even proponents of various other theories regarding autism therapy and research. I've also been able to share my experiences.
    Another aspect of blogging is reading other blog entries of other family members, parents, social workers, psychologists, neuro-psychologists, pediatricians, and therapists who experience the world of autism first hand, and share their expertise.
  • When Technorati first offered to allow me to post directly to their news as a specialist in the Lifestyle Family section, I was blown over! I had no idea just how popular my blog had become, and how many people were following it. It was thrilling to know they wanted me as a contributor. It's been helpful to widen my reach with posts, get the word out there, share with others, and hear from so many it there.
  • Facebook: I never thought I would have believed it, having had so many negative experiences with students using social media while in class (hint: not a good thing to do with your teacher), but Facebook has become a useful source of news and information about autism, autism research, and autism therapies. It's still some sifting through chaff to get to the good kernels, but still a great sauce of information.
  • Twitter: Just like Facebook, Twitter has provided some good information about autism, though still requiring sifting.
  • Google News: A lot of good sources can come through Google News, with a special search for autism. A lot less sifting, so that means more time reading up in scholarly journals.
  • Google +: Another unexpected source of relevant information, Google + has become a valuable tool in learning about research, therapies, and keeping in contact with families from all over the world.

Without these sources from which to refer, I would have been lost in the sea of uncertainty that first enveloped me when my son was diagnosed. Sure, you can read Piget and his developmental psychologist theories, spend hours in a bookshop looking at this book or that, but how do you know which source is accurate, and which is just looking to make money from a demographic desperate for answers? It's so nice to have real sources and science on your side, if only to point out that there are no answers...yet.

May 18, 2013

Could Google Glass Work for Someone with Autism?

A boy with autism at Turtle Reef in Sea World San Diego.

First posted on Technorati as Could Google Glass Work for Someone with Autism?

Google Glass has been in the news quite a bit lately, with concerns about privacy, the "cool" factor, and some businesses already wanting to ban the thing before it hits mainstream.

Sergey Brin, co-founder of Google, praised Glass for it's more socially acceptable use over smartphones.

Glass reacts to your eye movement, finger gestures on the side, or voice commands. The video Google provides is pretty compelling, with lots of exciting things being done and hands-free computing being done at the same time. 

But it got me thinking: could someone with autism use Google Glass? Could someone with a disability use Glass? 

Smartphones can be very enabling in many cases. Apple, for one, uses Voiceover to make it possible to use an iOS device if you are blind. And while Android doesn't seem to have the same technology built in, there are code projects that are available for download. Being able to interact with the device directly with or without looking at it is ideal. Can Glass do the same thing? 

A marketing professor at Gallaudet University (a University for the deaf and hard of hearing) presented the Google Glass demonstration videos to his Intro to Marketing classes. The response was almost unanimous: It wasn't deaf friendly. Anything that requires spoken word for interaction would be unaccessible to someone who communicates through sign language. That means that this current iteration of Glass at least would only provide minimum support for someone who doesn't communicate verbally. 

But could it be used by someone with autism? Smartphones and tablets have been adopted with gusto by the autism community, because they are intuitive to use and allow persons on the spectrum who cannot communicate verbally interact with their world. The capacitive screen allows for accuracy without an implement beyond the human finger, and the display is a natural place to look when "reading". 

Now take Glass. 

  • Glass uses eye-tracking technology, not a useful bit of tech for someone who has a hard time with eye contact as is common with those with autism.
  • Glass can use voice commands, but if you don't speak, it's not much use.
  • Glass can use finger gestures on the side, but it requires more fine motor skills than touching a tablet, and a direct correlation between what you see and what you do. While this is natural with the keyboard and mouse crowd, a tablet is far more useful in this regard, you are "touching" the "thing" with which you interact, not touching an interface point on the side of your head when the thing is in front of you.
  • Glass requires something to touch you. That alone is a deal breaker with a community that is known for it's sensitivity to sensory events. Speaking for my children alone, I think it would be difficult to get my eldest to wear it at all.

There would be a lot of hurdles to overcome in order to make Glass accessible to someone with autism. But once accessible, would it be of benefit? Honestly, I can't see a situation when using Glass would help someone with autism beyond displaying social stories in real time with an augmented reality (which would be awesome!). 

If given the choice, right now, I don't think I would recommend anyone get Google Glass for someone with autism, at least until the interface is worked out. And even then, only if an augmented reality app was invented with built-in social stories based on location were available. Given that as the killer autism app, it would be worth a look. But given a choice between a tablet and Glass? The tablet's versatility wins hands down.

April 8, 2013

Diners, Noise, and Autism: A Good Experience at Denny's in Kearny Mesa

I am hesitant at best to go to a diner with our boys on the spectrum. The noise is severe, they are often very busy, and the service is often very slow. Normally this isn't a problem, because it gives the patrons a chance to talk, gossip, and socialize. For people with autism, however, the noise is painful, the wait unbearable.dennys.png

This past week we had some family visit, and at the end of their visit we went out to breakfast at Denny's on Kearny Villa Road and Clairemont Mesa Boulevard. The diner was quiet, as it was early in the morning, with only a few patrons. We had a large group (10), so it took them some time to arrange our seats.

When we sat down, my oldest started to exhibit signs of a meltdown. We made our drink order, and shortly afterward our server came and got our food order. After making our order, I specifically asked that the boy's food be brought out first because they have autism and it would alleviate any problems with the wait. Our server, Andrea, took note and went away.

As the family talked, I took my oldest for a walk as we waited for our food. We walked to the rest room, he washed his hands, and we walked back. Shortly after returning to our seats, the food came for the boys! I was surprised, as this is the first time when I have asked for the boy's food first at a restaurant, and it actually came first. I was very impressed.

But there was a slight problem: the cooks made the breakfast with pancakes instead of toast. Andrea apologized, and said she didn't want to take the plates back, but would bring out the toast when it was done. This was also very impressive, as we were not charged for the pancakes. Andrea did her best to make sure our boys were comfortable.

When we left, I made sure her manager knew just how helpful Andrea was in accommodating our son's needs. She did a stellar job, and I hope she is commended for it.

As I said earlier, we don't often go to diners as they are perfect places for meltdowns. But this Denny's experience was perhaps the best possible experience we could have had, with staff that were understanding and willing to accommodate. I would recommend them to any family who have children with autism in the San Diego area.

April 2, 2013

World Autism Awareness Day

It's World Autism Awareness Day today, April 2nd. That means it's time for the World to focus on what autism is, how it impacts families, and what we need to do as a world community to help those who are unable to help themselves.

According to the latest CDC estimates, 1 in 50 children between the ages of 6 and 17 have autism, with the official number for all children still holding at 1 in 88. Think about that. Put 50 first graders in a room, and at least one will have autism. That's where we are.

So where do we go? A lot of energy is focused on finding out why autism is so common, and from there what action needs to be taken. Some people talk of cures, some people talk of lawsuits, others say it's who they are and don't try to "cure" me. Personally, the causes don't mean a whole lot for those that currently have autism, as they just need to know how to manage themselves in this world.

But in order for that to happen, they need to find a place. Our children need to find schools that will educate them based on their needs. They need healthcare that is supportive, willing to provide for the very expensive costs of therapy necessary to help these remarkable children succeed. They need local, State, and federal governments who are understanding and willing to create this environment to help them succeed. They need ordinary people like you and me to be willing to accept them for who they are, and willing to help when it's needed, and give them space when they need it.

Tonight, many cities around the world will switch their white lighting around their buildings to blue. It will look pretty, and many people will feel they have done their duty. Much like wearing pink for Breast Cancer Awareness Month, green for Saint Patrick's Day, etc. Some will buy ribbons, stickers, buttons, or magnets to display their support for this one day for autism awareness. Tweets, walls, and other social media posts will be dripping with support and awareness messages. It's great, because the news is getting out there.

But it's not enough to wear blue, use blue lightbulbs, or buy a ribbon. While we take this day to focus on autism, we need to focus on helping those with autism get the education they need in the best environment, get jobs, be productive, and feel comfortable in society. Autism isn't a one day thing, ask any parent with a child on the spectrum. It's an every minute thing, because you are "on" every minute of every day. Autism is on every minute of every day.

So, today, please show your support for those with autism, and continue that support tomorrow, the next day, and so on. Children with autism are very special children, and deserve to be seen as children, not a diagnosis.

March 13, 2013

Autism Contingent Shock Therapy: Therapy or Torture?

I was disgusted to read in Forbes of a treatment center that uses electroshock therapy, known as "contingent shock" in the United States today as a form of therapy. The founder of this treatment center, a follower of B. F. Skinner (a famous behaviorist) has been using negative reinforcement techniques for years to try and resolve behavior problems with children who have developmental disabilities or mental illness.

While electroconvulsive therapy has been used for years in the treatment of people with mental disorders or depression, it's a therapy done when the patient is anesthesia and usually only as a last resort as it remains controversial. Contingent shock therapy, on the other hand, is given to someone while they are conscious, aware, and performing undesirable behaviors.

The therapy is based on the work of B. F. Skinner's "Skinner Box" he developed during his research time at Harvard in the 1930's which placed lab rats in a box with an floor that could be charged with electricity anytime the rodent did a behavior that was undesirable. Slowly, the rodent would learn not to do the behavior, and therefore not get shocked.

Since the early 1900's, when autism was first used to describe a range of psychological conditions, it had a stigma associated with mental illness. In 1911, Eugen Bleuler first used the term to refer to a group of symptoms of schizophrenia. In the 1940's, researchers in the US used the term to describe children with emotional or social problems, often called pediatric schizophrenia. And because of this, as of the 1960's, doctors had a direct link between autism and schizophrenia in their minds.

So during the 1960's and 1970's, research into autism treatments focused on medications like LSD and negative (punishment) behavior change techniques like electric shocks, pinching, spanking, and even breaking vials of ammonia under the nose. Contingent shock, which is a shock administered after an undesirable behavior has begun or happened, is a direct decedent of this practice.

What's interesting is research exists out there to suggest that any gains using these methods are temporary, and not permanent. In 1968 Todd Risley found in his research that there is no permanent gain in behavior when people receive these electric shocks. This was back in 1968 with the research was fresh, the technique in vogue, and the results were quickly ascertained. Lichstein and Schreibman found in 1976 that while the techniques seemed to work, it was often very traumatic for the clinician (often more so) than the patient.

The technique remains controversial, particularly since the U.N. has now declared the therapy as practiced by the Judge Rotenberg Center is torture as outlined in the U.N. Convention against Torture. Why? Because the voltage used in the personal devices administering the electric shock can and does leave a mark that can last for days.

So, the question remains, should this method of treatment be allowed, given the current application and research? Has any other research been done? And even if the research suggests electrocuting someone to modify behavior works, should it be used in this day and age when spanking is strongly discouraged?

I've seen a couple more recent articles, one by the founder of the Judge Rotenberg Center, and one other, that extolled the virtues of contingent shock therapy. But I can't get past the image presented in the book, The Alliance where whole masses were controlled using electric shocks embedded in the brain. It's an extreme jump I admit, but it's still the image that comes to my mind.

March 8, 2013

Auti-Sim: Providing Insight to Autism World

Article first published as Auti-Sim: Providing Insight to Autism World on Technorati.

Auti-Sim showing a child with autism in full meltdown.  The screams you don't hear, are deafening.

As a parent, you want to understand your children. You want to comprehend what is going through their minds, and how to reach them. As a parent of a child with autism you have to try that much more to understand why going into a supermarket means dealing with meltdowns, and walking in crowded parks means lots of pressure. At times, you are so bewildered that you just throw up your hands and sigh.

In order to help alleviate that frustration, A new "game" has been developed to help people see the world from the eyes of a child with autism. Called Auti-Sim, it features you, a child with autism, in a playground full of children.

The premise is simple, try to engage with the kids (walk up to them) while they are playing. The reality is somewhat complicated: the noise is too much to bear and your vision becomes blurred and pixelated. Now, I don't honestly believe that children with autism have blurry vision in social situations, but it's a visual illustration of how the world around them changes when not in a comfortable situation.

It quickly becomes clear that staying on the outside of the action, along the edges of the playground, is the "safest" place to be. Things are clearer there, less unbearable in noise and vision. In a word, being antisocial makes you feel more comfortable.

After playing with the controls, hearing the screams, and realizing that the more time I spend trying to tough it out the longer it takes to calm down, I think I gained a little insight into the world that my boys currently live. For those looking to gain such an insight, I would definitely recommend this game.

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