What in the World is Going On, March Edition

Yale researchers and their colleagues reported in the February issue of Journal of the American Academy of Child & Adolescent Psychiatry that children with autism spectrum disorders who also have serious behavioral problems responded better to medication combined with training for their parents than to treatment with medication alone. Lawrence Scahill, professor at Yale University School of Nursing and the Child Study Center, completed a federally funded multi-site trial on 124 children ages 4 to 13 with autism spectrum disorders at three U.S. sites including Yale, Ohio State University, and Indiana University. In addition to autism spectrum disorders, children in the study had serious behavioral problems, including multiple and prolonged tantrums, aggression, and/or self-injurious behavior on a daily basis.

Some children received medication alone for six months or medication plus a structured training program for their parents for six months.Parent training included regular visits to the clinic to teach parents how to respond to behavior problems to help children adapt to daily living situations. The medication used in the study was risperidone. It’s not surprising that combined treatment was superior to medication alone in reducing the serious behavioral problems.

Scahill stated, “In the current report, we show that combination treatment was better than medication alone on measures of adaptive behavior. We note that both groups—medication alone and combined treatment group—demonstrated improvement in functional communication and social interaction. But the combined group showed greater improvement on several measures of everyday adaptive functioning.”

The Autism Research Institute published a great bulletin in February focusing on issues that concern adults with autism. Check out what is going on throughout the USA here.

The University of Alberta has launched a study looking at how teens with an autism spectrum disorder (ASD) use media and factors associated with their media use. Theywill also look at parents’ thoughts about their teen’s use of media and will follow up for a year to see the influences of media use on the teen’s development.Research shows that teens with an autism spectrum disorder (ASD) spend a large amount of time watching TV, playing computer or video games, and using the Internet. Parents struggle with management of media use.

Last month, the
Supreme Court ruled that Canadians with mental disabilities have the same right to testify in court as everyone else. This should have happened back in 1985 when the equality provision of the Charter of Rights took effect. It states “Every individual is equal before and under the law and has the right to the equal protection and equal benefit of the law without discrimination and, in particular, without discrimination based on race, national or ethnic origin, colour, religion, sex, age, or mental or physical disability.”

An older law, The Canada Evidence Act passed in 1893, imposed restrictions on litigants with mental disabilities. Anyone charged with a criminal offence had the right to challenge the competency of the accuser. The presiding judge would then examine the plaintiff to determine whether he or she understood the obligation to tell the truth. Those who failed this test would be denied the right to testify. To prevent individuals with mental disabilities from testifying because they cannot explain the nature of the obligation to tell the truth “is to exclude reliable and relevant evidence and make it impossible to bring to justice those charged with crimes against the mentally disabled,” said Chief Justice Beverley McLachlin. To read more about the case that changed this precedent, click here.

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), due out in 2013, has sparked an on-going debate on the changes to the autism diagnosis. The new DSM-5 suggests folding Asperger syndrome — along with pervasive developmental disorder — not otherwise specified (PDD-NOS) — into a new category of autism spectrum disorder. The idea behind this change is “to acknowledge the widespread consensus that Asperger syndrome is part of the autism spectrum, to clean up a currently hard-to-implement and contradictory diagnostic schema, and to do away with distinctions that are made idiosyncratically and unreliably across different diagnostic centers and clinicians.”Parents fear these changes may affect funding and supports for their child. People with Asperger Syndrome fear losing a label that has become part of their identity and culture.

Francesca Happe published one of the most compelling articles in favour of the proposed changes. Some of her points include the range of autism – whether there are “meaningful differences between Asperger syndrome and high-functioning autism, loosely used to describe individuals with good current language and IQ in the average range despite earlier delays” and clinical confusion, “The Asperger diagnosis is distinguished from autism by a lack of language and cognitive delay. However, language and cognitive delay are not diagnostic criteria for autism. So, to fail to meet criteria for autism, a person with Asperger syndrome must not show the communication impairments specified for autism. Since these include “marked impairment in the ability to initiate or sustain a conversation,” most — if not all — people with Asperger syndrome do meet diagnostic criteria for autism.”

Happe does say, “The intention of the DSM-5 is not to blur important boundaries among groups, but to ensure that individuals are described in terms of their specific pattern of needs, rather than fitting them into narrow categories that they do not really match.” She brings up some valid points in her article and backs what she says. I have not come across better arguments than Happe’sin support the proposed changes.

Researchers at the Washington University School of Medicine in St. Louis believe autism itself seems to be responsible for the problems children with the disorder have in developing motor skills such as running, throwing a ball and learning to write, according to a new study. Previously, it wasn’t clear whether these motor skill difficulties ran in families or were linked to autism. Test results from this study test results showed that 83 percent of the children with an autism spectrum disorder were below average in motor skills, while their siblings without the disorder generally scored in the normal range, according to the study released online in advance of publication in an upcoming print issue of the journal Autism.

Identical twins had similar scores. Non-twin siblings who each had autism had similar scores. But scores were markedly different in sibling pairs in which one child had autism and the other did not, the researchers found. To read more, click here.

Puberty is a time of great change both physically and emotionally. A great new book for girls, The Girls’ Guide to Growing Up, is written for girls beginning this new phase of their lives. This appealing and easy-to-follow guide for girls with intellectual disabilities is an introduction to the physical and emotional changes they’ll encounter during puberty. Written at a third-grade reading level for preteens or young teenaged girls to read by themselves or with a parent, it’s filled with age-appropriate facts, realistic illustrations and photos, icons, and a Q&A. The author is a sex educator who specializes in working with people with intellectual disabilities.

Sleeping difficulties continue to be one of the top concerns for parents of children on the autism spectrum. This new book, Sleep Difficulties and Autism Spectrum Disorders: A Guide for Parents and Professionalsis a comprehensive guide to the management of sleep problems, introduces all the proven remedies, and focuses on the problems commonly found in ASDs and related conditions. The author discusses sleep in depth, including how we currently define and understand it. The full spectrum of sleep disorders is explained alongside the range of possible treatment approaches. The book also examines why some sleep problems are more common among people with an ASD than others, how sleep problems evolve over time, what can be done to treat them and the likely benefits from different treatments.

Autism News Science out of the UK is a solid site for scientific information on autism. Left Brain/Right Brain first came into existence in 2003. Over the years it has changed its basic form a few times, but its core content and interest has always been autism and the news, science – and bad science – associated with it. They have a good team of regular bloggers and invite guest bloggers to submit articles as well.

These are the highlights of what in the world is going on in autism for March 2012.

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