Maffei et al 2023: Oromotor skills in Autism
Based on review of research published between 1994 and 2022 on oromotor functioning in autistic individuals,
key takeaways:
Maffei MF, Chenausky KV, Gill SV, Tager-Flusberg H, Green JR. Oromotor skills in autism spectrum disorder: A scoping review. Autism Res. 2023 Apr 3. doi: 10.1002/aur.2923. Epub ahead of print. PMID: 37010327.
- 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.
Some limitations of this paper include
- 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.
Anxiety in ASD
Went for a guest lecture by Dr. Trenesha Hill, Asst Prof at U Nebraska Medical Center.
What caught my attention was atypical/autistic anxiety (vs non-autistic-anxiety) as being related to core characters of Autism. Especially the suggestion that hypersensitivity (ie: sensory differences) was a main factor distinguishing autistic-anxiety from non-autistic anxiety. Totally worth investigating the sensory aspect which I wish this study had done.
A kind word can change someones entire day
Towards a more Humane Society. Contemplating a different emotion and writing one line each day on it. #MentalHealth. This month on KINDNESS
46th anniversary of 504 sit-in
46 years ago, Apr 5, 1977 was the start of the longest sit-in in US history.
"Without 504 — there might well be no Americans with Disabilities Act, that finally brought us up to parity with federal civil rights laws covering gender and race."
https://dredf.org/504-sit-in-20th-anniversary/short-history-of-the-504-sit-in/
https://dredf.org/504-sit-in-20th-anniversary/short-history-of-the-504-sit-in/
Hold opposed ideas in the mind at the same time
Where do the behavior autistics go?
In this month of autism acceptance and autism belonging, I want to point to a very concerning issue.
When your disability is TOO VISIBLE, you are made INVISIBLE by society, warehoused somewhere where you can be out of sight and out of mind of society.
This is the plight of many adult autistic peer friends that I know. The adult autism world of inclusion and belonging, only wants the good patients. Special education had never wanted "behavior kids - the ones with meltdowns, aggression and SIBs", so will just house them in some classroom or NPS, ready to spit them out at age 22 at which point their legal obligation ends under IDEA.
I truly believe that there is a biological basis to all this SIB, aggression and other behaviors. There also seems to be confusion that such behaviors are seen only to those with low IQ or lesser speaking ability or whether you have access to communication. I know an equal number of autistics, considered "moderate" or "high" in childhood who reach exactly the same place by early/late teen-hood; tossed between psychiatric facilities or stuck at home with their families. Most are heavily medicated with pharma cocktails that don't seem to work at all for autistic physiology.
The adult autism world does not want these "behavior autistics" either. Adult Day Programs (ironically meant for autistics) don't want them, even Group Homes for autistics want only the 'well-behaved' and easily manageable ones.
Let me give you an example of 2 peers that I know - one sits in the corner all day and is regarded as a model student by that Adult Day Program. The other peer is at home with his aging parents as no day program will take him - "too much behaviors." And he is just one of the many dozens I personally know and grew up with in this scenario.
Behavior therapy agencies will tell the family that that autistic is "not a good fit" for their program. If behavior therapy agencies don't want to help with behavior, then why is the word "behavior" in their name at all. Autism professionals too will find PC alternatives that essentially say "not a good fit" for the autism they don't want to work with.
Autism Clinics at major hospitals too, end at age 18. Did the autism and behaviors magic away in adulthood.
Essentially the entire autism professional space is rending such autistics even more invisible.
And doing such a fantastic job of it that the other autistics (invisible disabilities/neurodiverse) don't know or believe our existence.
In a recent twitter post an adult autistic pointed to lack of numbers of such adults as evidence that they don't exist - and since she herself had started to talk at only at age 3 after therapy; it must mean that ALL autistics must have regained speaking ability and inclusion sometime in childhood.
Are you really surprised at this. When you are out of sight is out of mind of society; it also means nothing need be done to help. And it merits some societal attention only when it makes it to the news in a dramatic fashion such as in the article below which will be lost in the in the quicksand of short public memory.
And did I mention, it is incredibly hard to even find support staff as there are enough "easier" adult-autistics clients job market. So staff don't want these autistics either; everyone wants the easy button.
There is only waitlists or rejection at every turn.
Where are the services and supports for these adult autistics? What is the long term outcome? What is the plan?
It does not have to be like this. I truly believe that there is a biological basis to all this SIB, aggression and other behaviors. Where is the biomedical research that looks for answers as to what's going on at a physiological level so that we can work on targeted solutions. Given that traditional pharma is not working, when are we going to get targeted interventions and pharma that actually work with autistic physiology?
How can there be inclusion and belonging for these autistics unless we find solutions to some prior steps first?
Why is this not seen as an urgent need in autism research?
And to the growing numbers of Neurodiverse community out there, the action I request of you is - Include everyone, including the marginalized autistics. Help find solutions to these issues so that every autistic can be part of the dream of Inclusion and Belonging.
Autism and Movement Disorders
There has been research exploring the link between autism and movement disorders, particularly with regards to motor coordination and control. Some examples
- 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).
The Point: This is an area of need for answers and translatable solutions
Health Care Considerations
April is Autism Solutions Month.
Some Healthcare Considerations
Autistic and other high-support disabled people often need full sedation to access procedures like regular dental care, yet such procedures are rarely covered by insurance—which means people aren't getting the care they need, says @HariSri108.
Another medical care consideration from @HariSri108 is that often autistic people cannot tolerate the sight of medical implements like syringes. Providers can take simple steps like covering implements with towels until they are actually used.
Subscribe to:
Posts (Atom)