Happy Tamil New Year

Puthandu /Tamil New Year is believed to be the day God Brahma, began his creation. It falls on the first day of the Tamil month of Chithirai (~Apr 13-15). Tamil calendar was created during the Chola dynasty in the 9th century CE.

Mango Pachadi, is the speciality food of the day, symbolizing the different flavors of life, including sweetness, sourness, bitterness, and tanginess.

Schwartzman 2023: suicidal behaviors in autistic adolescents

No surprise that suicide ideation and NSSI is higher in autistics!

Key Takeaways

• Early adolescent autistics (total sample 239, 138 autistic) at higher risk for suicidal ideation and NSSI (non suicidal self-injurious behaviors) compared to non-autistics.
• 20% autistics reported suicide ideation on self-report questionnaires but not to a study psychiatrist (via the Columbia Suicide Severity Rating Scale)
• No sex based differences seen. 

Questions that arise after reading. 

• What are the underlying factors that contribute to the higher risk of suicidal thoughts / behaviors and NSSI in autistic early adolescents? 
• How can clinicians improve their ability to detect these behaviors given the discrepancies between self-report and clinician-rated measures? 
• What interventions or treatments are effective in reducing the risk of these behaviors in autistic youth? 
• How can parents, caregivers, and educators better support autistic youth who may be at risk ? 
• What are the long-term outcomes for autistic youth with suicidal thoughts/behaviors and NSSI?

References
Schwartzman JM, Muscatello R, Corbett BA. Assessing Suicidal Thoughts and Behaviors and Nonsuicidal Self-Injury in Autistic and Non-Autistic Early Adolescents Using the Columbia Suicide Severity Rating Scale. Journal of Autism and Developmental Disorders 53.2 (2023): 559-570. doi:10.1177/136236132311621. PMID 30938385

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. 

April 13 is Autism Adolescence Day

Because being a teenager isn't hard enough already

Compared to Neurotypical Teens, Autistic teens face greater challenges in 

Social Front. 

• 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

Health Issues. 

• 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)

MAST - The Maastricht Acute Stress Test

[concepts in Sensorimotor Research] 

The Maastricht Acute Stress Test (MAST) is a research laboratory procedure that is used to induce stress in research participants. It is used to study the effects of stress on a variety of physiological and psychological processes, including heart rate, blood pressure, cortisol levels, anxiety, and depression. The MAST combines elements from two of the most common experimental paradigms measuring stress, the Trier Social Stress Test (TSST) and the Cold Pressor Test (CPT).

The Test: 
There is a 5-minute preparation phase, during which the participant is seated in a comfortable chair and is given instructions about the task. The participant is then asked to put their right hand into a bowl of ice water for 60-90 seconds. In between each hand immersion trial, the participant is asked to complete a series of mental arithmetic problems. The participant is given negative feedback if they make a mistake or take too long to answer a question.

The test takes approximately 20 minutes to complete. During the procedure, the participant's heart rate, BP, and salivary cortisol levels are measured. The participant is also asked to rate their subjective feelings of stress on a scale of 1 to 10.

Benefits

• It is a simple and easy-to-use procedure.
• It is non-invasive and does not pose any risk to participants.
• It is effective at inducing stress in participants.
• It can be used to measure a variety of stress-related outcomes.

Limitations

• Laboratory-based procedures may not be representative of real-world stress.
• It can be stressful for participants and may not be suitable for everyone. (will autistics even agree to do this?)
• It is not a diagnostic tool and cannot be used to diagnose any medical conditions.

https://www.frontiersin.org/articles/10.3389/fpsyg.2017.00567/full

One small act of kindness can create a ripple effect that can change the world.

HEW sit-in continues - Disabled vow long fight

Daily Cal Headlines ... April 11, 1977: 

"HEW sit-in continues - Disabled vow long fight." 

from Day 6 of the nearly month-long sit-in.

highlights:

CeCe Weeks said: "It's the first militant thing we've ever done. There is a new political movement throughout the land. We're going to stay till we're dragged out."

Although HEW Secretary Califano said he would sign the revised regulations, Kitty Conetalks about how those are inadequate and called upon President Carter to sign the original regs immediately as he had promised he would do.

State Director of the Department Of Rehabilitation Ed Roberts (former CIL Director) said "We've got to keep up the pressure."

Demonstrators Mary Jane Owen and then-CIL Deputy Director Judith Heumann had gone on a hunger strike.

Donations were pouring in from "such politically dissimilar groups as the Black Panthers and Safeway stores, McDonald's and the United Farm Workers. 'We couldn't do this without the support from outside," Cone said. 'We're really excited by the community's response.'"

"We're basically happy and strong," Weeks said. "There's more energy here all the time," she said.

------

That was indeed a time. The attached photo is a scan from a book of about 100 Daily Cal front pages: "The Daily Californian's Best of Berkeley 1960-1980, publ by the Independent Berkeley Student Publishing Company, 1980.

—

Daily Cal photo caption:

“The nearly 100 protesting disabled staged a sit-in [to demand the passage of the long-delayed Regulations implementing section 504 of the 1973 Rehabilitation Act] at San Francisco’s HEW Office.”

Section 504, the first disability civil rights act, Required nondiscrimination of people with disabilities by end of the end by any entity receiving federal funds.

These Regulations became the model for the Americans with Disabilities Act 13 years later, which prohibited discrimination against people with disabilities in virtually all areas of public life.

Media Mention

Media Mention On twitter. 

Thank you for the kind words. 

I hope I do indeed get to "redefine" autism research

 

No Eye Contact. No problem.

No Eye Contact?

No Problem!

Sunglasses are your personal Eye Contact Filter. 

#AutismHumor #AutismSolutions

Media Mention

Thank you. A Honor.

 

Kindness is the gift that keeps on giving

Serenity is the wisdom that comes with knowing what we can and cannot control.

 

McGlade et al 2023: Effectiveness of Early Intervention Therapies

My take: If early childhood therapy was so "effective", then the thousands of kids who have had massive amounts of therapy all through childhood (starting with early intervention) would have "RECOVERED" may times over. Why are my challenges still significant - ie: all that therapy did not make a dent. Currently there is no such thing as gold-standard childhood therapy. Most autism therapy is hit-or-miss, at any age. Its just $$$$ spent on trial and error. Lots of careers and promotions. 

Recently there was a twitter post pointing out that since were were no readily available "statistics" (referring to it as a "cool autism fact")  showing numbers of the more significantly impacted adult autistics meant that numbers of this group must be overstated. Others in the thread  questioned if adult autistics who did not not speak, even existed, since that autistic posting had learned to speak at age 3. This an irresponsible statement and an erasure of the huge number of non-speaking or minimal verbal adults who need to be part of the autism solutions. 

Onto the paper. 

=======

Key Takeaways from paper. 

• Limited evidence  to recommend very early interventions for infants and toddlers with autism.
• Limited impact of early intervention for at-risk infants/toddlers (by age 3. 
• No significant treatment effects for autism symptoms, cognitive outcomes, receptive/expressive language. Even neurocognitive outcomes (EEG and eye tracking) were inconsistent. 

• Gold-standard early intervention is yet to be developed.  Future treatment will need to include novel and individualized intervention targets alongside the targeting of parental responsiveness.

Questions that arise. 

• What are the implications of these findings for clinical practice and policy related to early intervention for autism?
• What are the long-term outcomes of very early interventions for infants and toddlers with autism beyond age 3 years?
• What are the ethical considerations related to intervening in infants and toddlers at increased likelihood of autism dx, and how can these be addressed in future research and practice?

McGlade, A., Whittingham, K., Barfoot, J., Taylor, L., & Boyd, R. N. (2023). Efficacy of very early interventions on neurodevelopmental outcomes for infants and toddlers at increased likelihood of or diagnosed with autism: A systematic review and meta-analysis. Autism Research, 16(4), 698-710. https://doi.org/10.1002/aur.2924

Disabled People are not ADA People.

lavantconsulting

: 

 People with disabilities are not “Americans with Disabilities Act people” or “Americans with Disabilities Act Guests.” The ADA is a law that increases equity for disabled people, not a label of any individuals. Referring to people with disabilities in this way is disrespectful and never appropriate.