Showing posts with label autism spectrum disorders. Show all posts
Showing posts with label autism spectrum disorders. Show all posts

Wednesday, November 5, 2014

Very Low Birth Weight Infants, Social Interventions: Two New Studies on Autism Spectrum Disorders

By: Lewis First, MD, MS; Editor-in-Chief 

Child with autism spectrum disorder.
Photo by KOMU News via Flickr
There is not a general pediatric peer-reviewed journal that has not published multiple studies on autism-spectrum disorders (ASDs) and ours is no exception. This month, we further our knowledge of ASDs by publishing two fascinating studies on this developmental abnormality.

The first by Pyhälä et al. (doi: 10.1542/peds. 2014-1097) compared slightly more than 1,000 adults born in Helsinki at very low birth weight (less than 1,500 grams) with term-born adults for ASD traits based on various developmental test batteries.

The results are well worth your attention and indicate that if children are born very low birth weight (VLBW) there is a higher risk of ASD traits as adults, especially in regard to social interactions. Although the authors note that faster growth in weight, height and head circumference from birth to term seemed to reduce this risk, suggesting that targeted interventions to aggressively grow a VLBW infant may play a role in improving an infant’s neurodevelopment as well. Just the fact that the authors have followed a cohort of VLBW infants into adulthood and tracked their developmental skills make this an interesting study to reflect upon.

A second study by Wetherby et al. (doi: 10.1542/peds.2014-0757) randomized toddlers with ASDs to receive either a parent-implemented social intervention at home or a group early social interaction program in a clinic, both designed in either case to help parents better communicate with their children in everyday activities. In this case, the results of this trial had a clear winner—the individual early social interaction program.

To find out what the program consisted of and whether it can be adapted by ASD families in your practice, review the findings in this study. Given that doing so will not require large amounts of professional time nor overwhelming amounts of parental time makes this a must-read if you care for children with ASDs.

Related Reading:

Tuesday, July 15, 2014

Covering the Topic of Weighted Blankets & Sleep in Autistic Children

By: Lewis First, MD, MS; Editor-in-Chief 

Photo by Yogendra Joshi via Flickr (cropped)
Sleep problems in children with autism spectrum disorders (ASD) have been identified and well-studied in prior articles published in Pediatrics. Of course, parents have sought solutions to these sleep problems, and one of those solutions readily offered online via the Internet is the use of weighted blankets to allegedly provide a better quality of sleep.

Yet studies on the effectiveness of weighted blankets compared to regular ones have been limited until this week when Gingras et al. (doi: 10.1542/peds.2013-4285) offer us a randomized placebo-controlled phase three trial of weighted blankets in 67 children with ASD between 5 and 16 years of age.

If you are a fan of using weighted blankets to improve sleep in autistic children (and a number of children and parents are), you will find the results of this study surprising and perhaps disappointing.

Are your patients with ASD using weighted blankets? Do they tell you they work? Would you still recommend one after reading this study? Share your thoughts with us via response to this blog, an eLetter or on Facebook and Twitter.

Related Reading: 

Monday, April 28, 2014

GI Symptoms and Autism: A Meta-Analysis Worth Digesting

Photo by Hey Paul Studios via Flickr
Patients with an autism spectrum disorder (ASD) often complain of gastrointestinal (GI) symptoms, or so it appears, yet just what are those symptoms, how common are they, and are they part of an underlying common pathophysiologic mechanism that links ASD with a gastrointestinal problem?

McElhanon et al. (doi: 10.1542/peds. 2013-3995) have performed a thorough meta-analysis of studies involving GI symptoms and children with ASD. The results may confirm your suspicions. They may also leave you wanting more in regard to specific GI disorders responsible for those symptoms, whether the symptoms are the result of an ASD, and how they can happen pathophysiologically. If anything, this study will show an increased prevalence of GI symptoms—and hopefully lead to even better studies to further define the causal nature of these symptoms in ASD patients.

What’s your opinion on GI symptoms in your ASD patients? Do you see them more often that you might expect? Are there some symptoms more common than others (e.g. abdominal pain)? It would be great if you did a gut check on this topic and share your thoughts via a response to this blog, an eLetter, or through Facebook or Twitter.

Related Reading:

Wednesday, April 9, 2014

Does Parental Obesity Influence the Risk of a Child Developing an Autism Spectrum Disorder?

Most of us have probably not considered the role of increased parental BMI in being associated with an increased risk of autism spectrum disorder (ASD)—and yet Suren et al. (doi: 10.1542/peds. 2013-3664) certainly did in designing their research hypothesis for a study we are releasing this week.

Photo by Cade Martin, via the CDC
Using a sample of almost 93,000 children from a Norwegian data base used in the Norwegian Mother
and Child (prospective) Cohort Study, the authors looked at maternal pre-pregnancy and paternal BMI and the subsequent risk of a child developing an ASD.

While the study cannot claim any kind of causality, the association is a curious one that the authors speculate upon in their discussion, which makes this study fascinating to read and think about.

Let us know if you agree by responding to this blog in the comments section below, by sharing your thoughts via an eLetter on our journal’s website or through Facebook or Twitter.

Related Reading:

Monday, December 23, 2013

Validating an Improved Checklist for Screening Low-Risk Toddlers for Autism

Public Domain Photo via Wikimedia Commons
For many years, one of the most valid and reliable screening tools we have for the detection of a child with an autism spectrum disorder has been the Modified Checklist for Autism in Toddlers (M-CHAT). Recently however, a new version, the Modified Checklist for Autism in Toddlers, Revised with Follow-up (M-CHAT R/F) was instituted to detect autism spectrum disorder (ASD) in children sooner and hopefully without too many false positives.

Fortunately, the revised version does appear to be quite valid in its earlier identification of children with either ASD or another type of developmental delay—at least according to data shared in a study by Robins et al. (doi: 10.1542/peds.2013-1813) that we are early releasing this week.

Are you using this checklist at 18 months and following up with it at 24 months? If so, has it helped you make a diagnosis of an ASD sooner so appropriate early intervention can be instituted? Let us know by leaving a comment below or sharing your thoughts via Facebook or Twitter, or submitting an eLetter on our website.

Related Readings:

Tuesday, October 22, 2013

Psychotropic Drug Use in Children with Autism Spectrum Disorders: How Often Does It Occur?

Photo by Brandon Giesbrecht via Flickr
While the evidence for the benefits of psychotropic medications for children with autism spectrum disorders (ASD) is not particularly strong, we are all aware that children are being placed on these medications with the hope of improving their symptoms. Yet how commonly does this occur?

Spencer et al. (doi: 10.1542/peds.2012-3774) look into this question through a retrospective observational study based on medical and pharmaceutical claims data linked to children with ASD enrolled in a health plan from 2001 to 2009. The prevalence of the use of psychotropic drugs (and not just one per patient, but even instances of two or more classes of drugs being used in one child) is eye opening—especially given the lack of strong evidence for their efficacy and the risk of side effects and adverse events. If ever there were a need to at least establish guidelines for better use of these medications in pediatric patients with ASD, this article should prompt such efforts. Read the study for yourself and see what I mean.