Vestibular, Proprioception in Autism

Lay summary:  Go to any Occupational Therapist and you are bound to hear the words vestibular and proprioception, sensory diet at least a few times.  

Why is this important: Understanding the role of sensory processing difficulties and the sensory systems involved (such as vestibular, proprioception, and somatosensory body mapping) can be helpful in developing effective interventions and support strategies for autistics.

EMPATHY

Towards a more Humane Society.  Contemplating one line each day on it. #MentalHealth. This month is Empathy 


Empathy 
-Hari Srinivasan

Empathy doesn't just change the world, it changes us.
Empathy is the antidote to judgment.
Empathy is the fuel that powers kindness.
Empathy creates the space for true connection to happen.
Empathy is the ability to hear the unspoken and see the unseen.
Empathy is a muscle that grows stronger with use.
Empathy is not a feeling, it's a choice to listen with an open heart.
Empathy is not just a trait, it's a way of life.
Empathy is the foundation of all meaningful relationships.
Empathy is the art of putting yourself in someone else's shoes.
Empathy is a powerful tool that allows us to connect with others on a deeper level.
Empathy is the magic that turns strangers into friends.
Empathy is the ability to understand without judgment.
Empathy is the bridge that closes the gap between us and them.
Empathy is the light that shines in the darkness of misunderstanding.
Empathy is the heart's way of saying, 'I see you, I hear you, and I feel you'.
Empathy is the key to unlocking the door to compassion.
Empathy is the lens through which we see the world with a different perspective.
Empathy is the art of caring for someone else's feelings as if they were your own.
Empathy is the oxygen that breathes life into relationships.
Empathy is the secret ingredient that makes kindness so powerful.
Empathy is the currency of connection.
Empathy is the glue that holds us together in times of difficulty.
Empathy is not just a feeling, it's an action that can change lives.
Empathy is the foundation of true understanding and acceptance.
Empathy is the art of listening with your heart.
Empathy is the superpower that allows us to connect with people from all walks of life.
Empathy is the gift of truly seeing and being seen by others.
Empathy is the art of seeing with the heart and feeling with the soul.

See posts for other months. 
Jan [JOY] Feb [EQUANIMITY] March [EMPATHY] April [KINDNESS]

Propananol

Propanaol has come up in lectures in my Cell Neuroscience course this sem. Of personal interest to me, as its use has become prevalent in the autism population. My last set of docs at Stanford said they preferred its use as it has less side effects compared to other drugs.  I have mixed feelings about it effectiveness in my case but I've heard its helping a number of other autistics.

The use of Propranolol (brand names - Inderal, Hemangeol, & InnoPran XL) in autism is actually off-label as some research has suggested that propranolol may be helpful with anxiety, social withdrawal and repetitive behaviors. More research is needed to fully understand its effectiveness in autism.

Some common side effects of propranolol include fatigue, dizziness, cold hands and feet, slow heartbeat, and trouble sleeping. More serious side effects include wheezing, depression, and liver problems.

One concerning side effect is memory impairmentSo I have to wonder about its long term impact as we age, as many autistics are on it for many years and years. Are we looking at short term gains and compromising our long term health compounding health issues that already accompany old age. 

Empathy is the antidote to judgement

Towards a more Humane Society. Contemplation, one line a day. This month Empathy


 

ASA Press Release




 I get quoted in this press release.




The Autism Society of America is taking direct action at a national level on multiple priority issues that impact Autistic individuals. In particular, the organization is highlighting the importance of passing legislation that provides additional funding for home and community-based services (HCBS) and addressing employment disparities. This includes the Better Care Better Jobs Act and the HCBS Access Act.

“The current system of supports and services are set up such that there can be a sudden stop in services for the most absurd of reasons. Such policies need to change,” states Hari Srinivasan, an Autistic student at Vanderbilt, and member of the Autism Society’s Council of Autistic Advisors. “I find myself in this strange situation where the PhD stipend makes me ineligible for SSI, which in turn is linked to all state-funded disability supports and disability health insurance that I have relied on all my life. My significant Autism challenges and required supports, did not magically go away in graduate school. It is like a financial penalty on the disabled person to want to aspire for higher education and the pursuit of the American Dream.”

I want to relate this back to what the late Judy Heumann said in her 2019 interview with me for the Daily Cal [post on unedited longer interview], [Daily Cal article]

"There is currently a huge legislative disincentive for people with more significant disabilities who depend on services — such as Medi-Cal health insurance, Social Security and personal attendant services — from being productively employed. She does not want to hear stories similar to that of her friend who had to turn down a job she was well qualified for because of the fear of losing these crucial services. She would also like to see legislative policy changes so that employers see disability as just another diversity category." - Daily Cal 11/26/19




Empathy is the fuel that powers kindness

Towards a more Humane Society. Contemplation, one line a day. This month Empathy




 

Benzodiazepines and Barbiturates



Benzodiazepines

In class today, we studied pharmacology of GABA-A receptors, specifically Benzodiazepine's. Of personal interest as I've been on lorazepam (fast acting for agitation, mood swings) and clonazepam (longer lasting). Unfortunately the body develops a tolerance and these don't work anymore.

Nashville next stop in Senseless School Shootings

This time a young white 28 year old female ex-student, walked into an elementary school with assault weapons and just shot 6 people, 3 staff and 3 kids aged 8-9. What a horrible tragedy.   

Why is the US the ONLY country in the world where young kids are getting shot in their own schools every few months? That too with assault weapons. 

This does not make sense. I wonder at the need to even own assault weapons when you live in a city. A gun makes remote sense maybe if you were living in the midst of the woods with a grizzly bear or packs or wolves on the loose. 

Just last week our professor had mentioned how suicide rates dramatically increased amongst women who's partner/boyfriend owned a gun. Why is there such an obsessive need to hand out guns to just about anyone so easily in this country. 

Vanderbilt University Medical Center, located just 4 miles from the school was where all the children were sent - already dead on arrival. How does a hospital emotionally prep for "emergencies" like this?

https://www.npr.org/sections/health-shots/2023/03/31/1167375561/nashville-school-shooting-vanderbilt-hospital


Empathy creates the space for true connection to happen

Towards a more Humane Society. Contemplation, one line a day. This month Empathy


 

Brain Blast

 Every spring, the Vanderbilt Brain Institute puts on Brain Blast event at Nashville Public Library for high schoolers and younger children, with various booths educating children on the wonders of the brain in fun and creative ways. Oh and the screen in the background was showing various images, including some things about autism and neurodiversity. 

Happy 150th Birthday, Vanderbilt

Vandy turned 150. Happy Birthday

Slow Burn

Usually you get to see the Cal-Stanford rivalry during the Big Game every year!

Stanford-Burn in the Night Agent series... Too funny, 


Larkin: "I thought I could read my way to Stanford."

Sutherland: "...you went to Stanford?"

Larkin: "No. Those bastards rejected me. I went to a community college then transferred to Berkeley. When I started my company I hired a bunch of Stanford grads to grab me coffee."

 

Empathy is the ability to hear the unspoken and see the unseen

Towards a more Humane Society. Contemplation, one line a day. This month Empathy


 

CRH-PVN Neuron and Stress Controllability Presentation

I survived it. 
OMG. lot of work went into this intense presentation the last couple of weeks with my classmate James. 
And right after our 50 min presentation, we were given feedback from the 3 TAs (Patrick, Matt & Elena) and by the Prof Teru Nakagawa and Prof Christine Konradi. Other students are literally sent out of the room, so that we could be given individual feedback from the grading team. I got to go first then James. 


Presenting with passion, nerves not intact,
Paper on CRH-PVN neurons stacked.
The audience watched, with eyes on me,
My words and slides, a neuroscience spree



Wind Advisory, Thunderstorm and Tornado Watch

Wind Advisory and Tornado Watch. Tornado missed us but crazy thunderstorm at night, pounding rain and blinding flashes of lightning. 

Thunderstorm brewing, lightning striking 
Electric sky bolts, bit frightening 
Nature's fury, quite enlightening 
Powerful energy, never tiring


The weather is absurd

The weather is truly absurd,
Can't decide. That's the Word!
Snow flurries on Saturday
Spring equinox the next day. 
Two days later, summer hot 
80 F? seriously, what have we got?
Now its pouring rain again
The weather is going insane

Empathy is a muscle that grows stronger with use

Towards a more Humane Society. Contemplation, one line a day. This month Empathy


 

This time last year

 This time last year, I was holding up the Tower of Pisa. LOL. 

Italian Vacation during spring break

Do you know that PhD students don't get spring break like the undergrads. We sure could use that break for sure. Its been a crazy semester. 



I was holding up the Tower of Pisa

With a tilt and a twist, like Galileo's wrist

Galileo throwing objects from the top

Law of falling bodies nonstop. 


Hyperpolarized Neurons on Strike

Working on my friday neuroscience presentation which is draining all my learning neurons. 

My neurons in a state of overloaded hyperpolarization.
Off on unplanned mental vacation.
Won't depolarize, they're stuck in their ways.
Action potential needed anon.
Neurons need to call off strike. 



Empathy is the key to unlocking the door to someone's heart

Towards a more Humane Society. Contemplation, one line a day. This month Empathy


 

1:36 is the new ratio

The CDC just announced that the new dx ratio is 1:36 [Read article]

To give you perspective, back when I was dx in childhood it was around 1:151, when I started undergrad it had come to 1:88. Just during my undergrad, the numbers progressed from 1:64 to 1:54 and by the end of my undergrad, it was 1:44.

And
  • (But of course). Autism is reported to occur in all racial, ethnic, and socioeconomic groups. [Read article]
  • About 1:6 (17%) children aged 3–17 years were diagnosed with a Dev Disability (autism, AHHD, blindness & CP) [Read summary]
  • ASD is more than 4 times more common among boys than among girls. [Read article]

The new ratio simply can't be just due to increased dx capabilities or awareness or more adults being dx. What else is going on? We need to be investigating this. 

From https://www.cdc.gov/ncbddd/autism/data.html
 

Requesting Accommodations

At the Frist Center for Autism & Innovation and Mentra webinar. 

Below are my responses to two questions
What are the most important accommodations to ask for during your time as a student?
Is there a best practice for navigating disability services within institutions, that can often make it hard for neurodivergent people?


Empathy is not just a trait, its a way of life.

Towards a more Humane Society. Contemplation, one line a day. This month Empathy


 

Neurexins and Autism

Neurexins had come up in my Cell Neuroscience course this semester. Connection to Autism. But of course!!


Neurexins are a family of proteins that play important roles in synaptic function. They are involved in the formation, maintenance, and plasticity of synapses, which are the junctions between neurons that allow them to communicate with each other. Mutations in neurexin genes have been linked to a number of neurodevelopmental disabilities, including autism.

A few reasons why neurexin genes might be associated with autism.
  • disrupt in function of synapses (& communication between neurons), which could contribute to the autistic social and communication challenges
  • disruption in brain development as neurexin genes expressed early in brain development, and play important roles in the formation of neural circuits.
  • impact on function of other genes as they interact with a number of other proteins.
More research is needed to understand the exact mechanisms by which mutations in neurexin genes mutations contribute to autism.

Empathy is the art of putting yourself in someone else's shoes

Towards a more Humane Society. Contemplation, one line a day. This month Empathy


 

Severe Weather Nashville - Winter Edition

Nashville sure has a lot of severe weather alerts. This is the running tab for Winter (Dec 21 - Mar 20). 

Empathy is the magic that turns strangers into friends

Contemplation, one line a day.Towards a more humane society, an empathic society. 

 

March Snowfall, a Climate Change Call

Snow flurries gently fall
Mercury dips to a 27F crawl.
Bits of fluff dance and sway
Cherry blossoms on a spring day
I watch from my window, in awe of this display.

Calendar March, the weather all wrong
Days should be bright and long
Unexpected snowfall, sign of larger exchange?
World upended by climate change

CRH who?

Neuroscience humor. Studying CRH-PVN neurons and stress this week. 

Knock knock.
Who's there? 
CRH. 
CRH who? 
CRH releasing PVN, causing stress to you!

Stress v Anxiety in Autism - what's the difference.



First a lighthearted take

Stress is when you're stuck in traffic and late for an important meeting, while anxiety is when you're stuck in traffic and your brain starts to imagine all the worst-case scenarios that could happen at the meeting. They both make you feel like you're about to lose your mind, but with anxiety, you have to deal with the added bonus of your own overactive imagination!

Before you speak, ask yourself

Before you speak, ask yourself: 
Is it kind?
Is it necessary?
Does it improve the silence?

-Sri Sathya Sai Baba

Empathy is the ability to understand without judgement

Contemplation, one line a day.Towards a more humane society, an empathic society. 

 

Frustration

Nothing seems to go my way
Stuck in this rut, I cannot escape

Remembering Judy @DREDF

Last year, I had been invited to join the DREDF board, my response to joining was a resounding YES. 

At the first board meeting on Aug 12,2022, it was the late Judy Heumann who nominated me to the board and the motion was seconded by Christina Mills. The board voted unanimously to have me join the board. 

Thinking of you Judy, as we head into the next board meeting without you today. You were there at start of DREDF to make it a reality and later on its board, and we will miss your presence. 

Testing Neural Knowledge

Sharpen your mind, it's time for a quiz
Neuroscience is the topic, don't you miss 
Clear those distractions, focus your wit 
Perk up and prepare, let's get on with it

Getting mentally ready for the tough Neuroscience quiz on Fridays.

Empathy is the bridge that closes the gap between us and them

Contemplation, one line a day.Towards a more humane society, an empathic society. 

 

The Three T's

My classmate James and I met with Prof Christine Konradi to discuss our presentation strategy for the paper on the CRH-PVN neuron for our neuroscience class next friday.

"You start out by you telling them what you're going to tell them, then tell them, and then you tell them what you told them," was her starting advice.

She was referring to the Three T's approach - Tell Them, Tell Them, Tell Them -  a strategy for organizing a speech or presentation into three parts:
  • introduction where you preview what you will discuss
  • the body of content /message
  • Conclusion where you summarize what you covered.
The idea is to make your message clear and memorable by emphasizing the key points multiple times.

Next week we'll be learning about mood disorders, the HPA axis, which the CRH neurons are part of. 

Each week, we have a different professor teaching the class in an area that's their specialty. Next week its with Professor Konradi who also picks the paper that we present. 

 I asked what had motivated her to pick this paper. She said, we were learning about mood disorders this week and the HPA axis  which the CRH neurons were part of. So not only is this topic related to what we have been learning for the week but also it is relevant for us in neuroscience because the kind of tools and methods used are very state of the art.  

So fingers crossed we do a good job. It's a lot of work putting a presentation together. and i've noticed my other classmates looking absolutely worn out during their presentation week. 


The politics of studying the brain

I learned a little bit about the politics of research during a conversation with a professor, for instance researching the dopaminergic system belongs to people studying strictly study movement disorders. 

Which is a real pity really. I have wondered why that is not looked at in the context of autism. Its like the two are never considered together for autism. But disabilities like autism have so many areas involved. Like challenges in movement, is such a critical piece for autistics like me, and worth investigating. How else will we get to solutions.  

Autistic Cre v Autism Mouse Models



Autistic Cre mice and autism mouse models are both animal models used to study autism. Both  have their own strengths and limitations and can complement each other in understanding the complex etiology of autism. However, there are some key differences between the two.

Autistic Cre mice are genetically modified mice that express mutations or deletions of specific genes that have been associated with human autism. These mice are created by introducing a Cre recombinase gene under the control of a promoter specific to the gene of interest. The Cre recombinase then catalyzes the recombination of loxP sites, leading to the deletion or mutation of the targeted gene.

On the other hand, autism mouse models are created through a variety of methods, including genetic manipulation, exposure to environmental toxins, or maternal infection during pregnancy. These models aim to replicate some of the behavioral and neurobiological features of autism in humans, such as impaired social interaction and communication, repetitive behaviors, and altered brain development and function.

One of the main differences between the two is the level of specificity in targeting autism-related genes. Autistic Cre mice allow researchers to study the effects of specific gene mutations or deletions on behavior and brain function, whereas autism mouse models often involve a broader range of genetic or environmental factors that may contribute to the development of autism.

Additionally, autistic Cre mice are often used to study the cellular and molecular mechanisms underlying autism, such as changes in synaptic function or neurotransmitter signaling, whereas autism mouse models may focus more on behavioral and phenotypic characteristics of the disorder.


Autistic Cre

 (Understanding Cre rats for my upcoming presentation, and why not learn which ones are used in autism space while I am at it)




First, what is a Cre-rat?

Empathy is the light that shines in the darkness of misunderstanding

Contemplation, one line a day.Towards a more humane society, an empathic society. 

 

In limbo

Stuck in endless hesitation,
Mind and body trapped in ambivalence's sensation.

Can't move forward, can't step back,
Caught in a loop of indecision, what do I lack?

Fruit Fly Connectome

Lay Summary: Scientists have now mapped all the neural connections/pathways of a fruit fly (connectome). Why is this important? Fruit fly model is used in autism research, so this advance potentially helps autism research. 

https://www.science.org/doi/10.1126/science.add9330

ITAKOM

Some nice comments about my talk "Redefine The Table" at the @ITAKOM conference

And again, the solution is system change. Individual approaches for the people who need it more, which means centering the most disenfranchised ND people... This benefits everyone.

Empathy is the oxygen that breathes life into relationships

Contemplation, one line a day.Towards a more humane society, an empathic society. 

 

Principles of Neural Science

This time last year, I had met with Prof Carissa Cascio during my Vanderbilt campus visit, and she had shown her copy of the Kendal textbook that awaited me in the program. Well certainly got to experience this textbook first hand this semester. 






OCD

My mind is spinning round and round
Compelled to do what can't be found
Repetitive acts, a daily grind
OCD consumes, hard to unwind.

Powerful urge, the need is great
To ease the mind, to alleviate
Thoughts plague, won't go away
OCD controls, no matter what I say

Constant struggle, day by day
To keep those obsessive compulsive behaviors at bay

Can’t give in
….Must break the spin
Embracing HOPE
as a new day begins. 




Monday Blues

It's only Monday morn, already feel worn out.
Week ahead seems like an endless bout

POM 101

I completed the Protection of Minors Training this morning. 

Why is this important - while a majority of students are not-minors,  universities do cross path with thousands of children each year with all the programs they run., ~50K kids/year at Vandy, per the training. 

Apparently 1:10 kids get abused (median age 9) but only 38% disclose and 90% perpetrators are known to the child. Types of abuse include physical, sexual, neglect and emotional. 

When it comes to abuse, most just focus on the physical or sexual parts. I want to address childhood "abuse" in the context of disabled kids who are also subject to endless rounds of emotional abuse and neglect all through childhood. It's terribly unreported, not even acknowledged, and we carry lifelong emotional scars well into adulthood. 

Here is a small example: Throughout my special education years in elementary I was moved around multiple classrooms, sometimes are many as 4 in the course of one school year. How is that not emotional abuse by teachers who openly did not want me in their classrooms and resentful of my presence. How does that make a small child feel. How it is that the very people we are supposed to trust to nurture and support us (the 98% of folks we are surrounded by), end up as the perpetuators of lifelong emotional trauma for us. 





Empathy is the glue that holds us together in times of difficulty

Contemplation, one line a day.Towards a more humane society, an empathic society. 

 

Stepping Stones to Bliss

Do not despair when adversities confront you or exult when success blesses you.

Any adversity is a stepping-stone to eternal bliss.

- Sri Satya Sai Baba

Haas Scholars Cohort

 This day last year. Hanging with my Haas Scholars Cohort @UC Berkeleu

Empathy is not just a feeling, its an action that can change lives

Contemplation, one line a day.Towards a more humane society, an empathic society. 

 

A Highly Sensitive Person

A Highly Sensitive Person (HSP) 

"Sensitivity is a heightened 'ability to .... to one’s environment'"
"I often complain about sounds, smells, or tastes that don’t seem to bother those around me..

Does that sound like Deja vu for the sensory overstimulated autistic?  
Read more in this Greater Good Science Center article.

Bayes Squad

 The Bayes Squad

A Probability Party with Formula Fellows


Bayes Theorem BT: Alright folks, let's get this Bayesian statistics party started! I'm Bayes Theorem, and I'm the king of the castle around here.

Prior Probability PA(A): Whoa, whoa, whoa. Slow down there, Bayes. You may be the main formula, but I'm the one who sets the foundation. I'm Prior Probability, and I establish the probability of events before any data is collected.

Likelihood P(A): And I'm Likelihood, the star of the show. I calculate the probability of evidence given the hypothesis.

Eastern Rosebud

Eastern Rosebud
campus at start of spring

 

Serenity is the compassion that comes with forgiveness.


 


Empathy is the foundation of true understanding and acceptance

Contemplation, one line a day.Towards a more humane society, an empathic society. 

 

If you don't demand, you are not going to get it.

Remembering the late Judy Heumann

 

Buch et al, 2023 Autism Subgroups

 


Key takeaways  

  • The identification of three autism subgroups based on genetic and brain connectivity differences. 
    • 1. increased expression of genes involved in immune system function and synaptic signaling, as well as increased connectivity between the default mode network and the visual network. 
    • 2. decreased expression of genes involved in synaptic signaling and increased connectivity between the default mode network and the somatomotor network. 
    • 3. increased expression of genes involved in mitochondrial function and decreased connectivity between the DMN and the somatomotor network. 
  • The suggestion that key genes associated with each subgroup may lead to distinct autism-related behavioral phenotypes via interactions with atypical functional brain connectivity patterns.
  • Distinct biological subtypes of autism may require different treatment approaches.

Methods

combo of network-based analysis and text mining to identify hub genes associated with each subgroup and to analyze the frequency of certain keywords in abstracts related to these genes. The goal was to understand how these genes and their associated behavioral phenotypes may be related to atypical brain connectivity patterns in each subgroup.

Limitations of study
  • Small sample size
  • data from post-mortem brain tissue, which may not fully capture the living brain complexity.
  • Focus only on genetic and brain connectivity differences, not look at other factors. Also not look at environmental factors. 
  • No controls (ie: are these subgroups present in non-autistic controls)
  • Sex differences not looked at. 
Questions that arise
  • How to use subgroups to develop more personalized treatments for each subgroup
  • How can these findings be used to inform not just childhood dx but also how to help the growing number of adult autistics.
  • Are there other factors beyond genetics and brain connectivity that may contribute to the development of these subgroups?
  • What are the ethical implications of using genetic and brain connectivity data to identify subgroups.

Empathy is the art of listening with your heart

Contemplation, one line a day.Towards a more humane society, an empathic society. 

 

Refusing to accept and making a fuss

Remembering the late Judy Heumann




 

Neurotransmitters go Knock Knock

Knock knock. Who's there? 

Glutamate. Glutamate who? Glutamate to meet you!

GABA. GABA who? GABA nice day today, isn't it?

Dopamine. Dopamine who? Do-pa-mine if I tell you a joke?

Serotonin. Serotonin who? Serotoninly you didn't forget about me!

Empathy is a powerful tool that allows us to connect with others on a deeper level

Contemplation, one line a day.Towards a more humane society, an empathic society.