https://www.newsweek.com/dual-approach-autism-opinion-1818062
https://www.newsweek.com/dual-approach-autism-opinion-1818062
https://www.newsweek.com/dual-approach-autism-opinion-1818062
Dispel notion that any medical intervention is inherently harmful
https://www.newsweek.com/dual-approach-autism-opinion-1818062
Diagnostic Overshadowing Issue in Autism
Dual Approach for Autism
My article in Newsweek
https://www.newsweek.com/dual-approach-autism-opinion-1818062
Finding the actual cause
https://www.washingtonpost.com/wellness/2023/06/01/schizophrenia-autoimmune-lupus-psychiatry/
YES. I believe there are parallels for autism. There is probably some other physiological stuff going on that is causing all the SIB, meltdown and even struggles with talking ability which fluctuate on a day to day basis - all stuff which what makes or breaks your inclusion in society and gatekeeps opportunities. I bet after a few decades when I am a very old man, i will find out that what I had was some INFLAMMATORY PROCESS that and treatable as a baby itself and I could have had a better quality of life instead of struggles, exclusion and rejections at every step.
New research suggests that a subset of patients with psychiatric conditions such as schizophrenia may actually have autoimmune disease that attacks the brain
Markx and his colleagues discovered that although April’s illness was clinically indistinguishable from schizophrenia, she also had lupus, an underlying and treatable autoimmune condition that was attacking her brain.
... a complex autoimmune disorder where the immune system turns on its own body, producing many antibodies that attack the skin, joints, kidneys or other organs. But April’s symptoms weren’t typical, and there were no obvious external signs of the disease; the lupus appeared to only be affecting her brain.
After months of targeted treatments — and more than two decades trapped in her mind — April woke up.
ERGO: underlying autoimmune and inflammatory processes may be more common in patients with a variety of psychiatric syndromes than previously believed.
undergone many courses of treatment — antipsychotics, mood stabilizers and electroconvulsive therapy — all to no avail.
Discussion on Epilepsy in Autism
https://brainfoundation.org/empowering-voices-epilepsy-in-autism/
on 6/2/23.
Registration https://us06web.zoom.us/webinar/register/WN_Y_T4XhL8SqazIsqfkg4AjA#/registration
Catatonia
Catatonia can manifest in different ways in autistics, including mutism (inability to speak), echolalia (repeating words or phrases), stereotypic movements (repetitive movements), posturing (assuming and maintaining unusual body positions), and stupor (a state of unresponsiveness).
Rihar et al 2023
Autism and GI Issues
April 18 is Regressive Autism Day
Regressive autism / late-onset autism /acquired autism, is where a child develops typically in early childhood meeting all developmental milestones, but then experiences a loss of previously acquired skills, at around 1.5 years to 4 years. Estimates of regressive autism range from 30 - 44% of kids who get diagnosed with autism in childhood. (1,2,3)
This loss/regression is especially evident in the areas of social communication and interaction; such as loss of interest in social interaction, loss of eye contact, loss of spoken language, loss of motor skills and the development of repetitive behaviors.
For instance, I met all my developmental milestones till 1.5 years, including the ability to able to speak short phrases. I was the happy social butterfly at my first birthday party; I interacted with everyone at the party. I pointed to the distant bird sitting on a tree and engaged in joint attention activities.
But after my regression at 16-18 months, I lost a majority of the previous skills. By age 2, I lost the ability to talk, the ability to make eye contact, the ability to point, the ability to do a pincer grasp and the ability to hold a spoon. I no longer recognized even my parents. I hid under the table, walked on tiptoe, endlessly spun the wheels on my tricycle and lined up every toy in the house. I was in a confused and dazed state and cried most of the time in daycare. I fussed for eating and sleeping.
DEJA VU!! - Regressive Autism is like Alzheimers in toddlerhood itself where you forget even your family, instead of in old age. Something must have happened to cause this memory loss and this functioning loss. I can understand why parents of young children find this heartbreaking; they suddenly become strangers for own children.
The Autism - Parkinson's Connection
The Autism Alzheimers Connection.
Alzeheimers and Oxidative Stress was the topic of study at my cell neuroscience course.
Increasingly research is showing a link between Autism and Alzheimer's though they had been considered distinct neurological disorders in the past.
April 13 is Autism Adolescence Day
Recognizing the transitions that come with adolescence in autism, along with the current inadequacy of needed supports, care and services. Translatable solutions are needed now.
- Social Isolation/Loneliness, Social Difficulties, fewer friendships/social contacts, lesser time spent on social activities (1,2,3)
- Mental health, suicide ideation and NSSI
- Bullying and victimization
- Navigating educational system & workplace due to social and communication difficulties
- Seizure onset 15% (compared to 0.5 - 1% in general population) (4).
- Higher prevalence of atypical or non-convulsive seizures in autistic teens compared to non-autistic (5).
- Increased prevalence of epilepsy in autistic teens (11.4%) compared to 0.5% in general population (6).
- Sleep disturbance at 50-80%- insomnia, nightmares, and irregular sleep-wake cycles (7).
- Sensory sensitivities at 88% (non-autistic teens 58%) (8).
- GI symptoms in autistic kids compared to non-autistic kids. In a 2014 study (9) figures are 43.5% compared to 18.1%. In a 2010 study (10), figures are 46-85% compared to 9-10%). Which means the prevalence is higher in autistic teens as well. 'Autistic teenagers at increased risk for anxiety, depression, and other mental health conditions.
- Co-occuring condition in 70% of autistics - anxiety disorders 41%, ADHD 31% & mood disorders 16% (11).
- Nuero-inflammatory markers in autistic teens
- Obesity 22.4% (general population 15.6%) (14)
- Asthma 22.2% (general population 12.8%) (15)
- Allergies 23.9% (general population 18.4%) (16)
Maffei et al 2023: Oromotor skills in Autism
Based on review of research published between 1994 and 2022 on oromotor functioning in autistic individuals,
- Oromotor functioning plays a foundational role in spoken communication and feeding.
- 81% of included 107 studies report a significant oromotor challenges related to speech production, nonspeech oromotor skills, or feeding
- Studies used various methods to investigate oromotor functioning in autistics
- Behavioral measures - tasks such as tongue protrusion, lip closure, and oral diadochokinesis.
- Parent report measures - questionnaires and interviews.
- Medical record review - examining medical records for information on feeding / swallowing difficulties.
- Neuroimaging techniques - fMRI & MEG.
- The findings suggest that oromotor challenges are common in autistics, but more research is needed to better understand the nature / extent and their impact on communication and feeding.
- numerous inclusion and exclusion criteria, which may have excluded relevant studies eg: non-English publications, pre 1994 studies etc
- wide variation in studies re sample characteristics, behaviors analyzed, and research methodology, which makes it difficult to draw definitive conclusions.
- did not include a meta-analysis, which would have allowed for a quantitative synthesis of the findings across studies.
Autism and Movement Disorders
- A 2013 study found that autistic children had difficulties with motor planning and control, particularly in tasks that required them to plan and execute a sequence of movements.
- A 2011 study autistic children had more severe motor impairments also had more severe social communication deficits.
- A 2010 study looked found autistics had poorer motor coordination and control (as well as more difficulty with tasks that required fine motor skills, such as writing and drawing) ; compared to non-autistic controls (3).
- A 2003 study looked at prevalence and found autistics were more likely to have motor coordination difficulties than non-autistics, suggesting a potential link between autism and movement disorders.(4)
- A 2000 study found autistic children with autism had deficits in both motor control and executive function (compared to non-autistic controls), suggesting that the two may be related (5).
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.
One concerning side effect is memory impairment. So 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.
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.