Thursday, January 31, 2008

Accelerated head growth can predict autism before behavioral symptoms start

Children with autism have normal-size heads at birth but develop accelerated head growth between six and nine months of age, a period that precedes the onset of many behaviors that enable physicians to diagnose the developmental disorder, according to new research from the University of Washington’s Autism Center.

The study also indicates that this aberrant growth is present in children who have the early onset form of autism as well as those later diagnosed with the regression type of the disorder, according to Sara Webb, who led the research.

“We know there are a number of risk factors for autism, and if we can pinpoint them we have better ways of identifying children at risk so we can get them into prevention or monitoring,” said Webb, a UW research assistant professor of psychiatry and behavioral sciences.

“This abnormal or accelerated rate of head circumference growth is a biological marker for autism. It occurs before the onset of behavioral symptoms at 12 months of age such as a child’s failure to respond to their name, a preoccupation with certain objects, not pointing to things, a lack of interest in other people and the absence of babbling.

“By itself, head growth is not an indicator of autism,” she said, “because kids are going to be getting bigger and development is so variable. However, if you notice it and some of these other symptoms, it is a red flag to seek evaluation.”

She said is it important understand that the data used in this study were based on three measurements made during the first three years of life, not from single point in time. To do this, the researchers obtained the medical records of 28 boys who had been diagnosed with autism spectrum disorder between the ages of 3 and 4 at the UW Autism Center and eight boys with developmental delay. All of the boys were participating in a larger longitudinal study.

Infant head measurements are typically done on a regular basis by pediatricians through the first 18 months of life, but are not reliably done after that. Head circumference is calculated from the brow, or ridge above the eyes, around to the bony bump on the back of the skull and back around to the brow. Three measurements, including at birth, were required to chart the growth of each child and compare it with the range of normal development.

Webb said in most cases parents would have a difficult time detecting abnormal growth because there is a range of normal head sizes. Approximately 20 percent of children with autism have abnormally large head sizes, or what is called macrocephaly.

“Some of the children in our study started with a very small head size and later their growth accelerated. What we are looking for is disproportionate growth in children compared to the rest of their body. In this study nearly 60 percent of the autistic children had accelerated growth but only six of the children met the criteria for macrocephaly.”

Webb said she sees this information being used by pediatricians to screen children and refer them earlier rather than later for evaluation and intervention before other symptoms develop. The UW researchers plan to further explore the implications of abnormal head size as part of a larger autism prevention study of 200 infants at high risk for the disorder that has just started.

These youngsters have older siblings already diagnosed with autism and have a one in five chance of developing the disorder, which has a strong genetic component. The typical risk for autism is now believed to be one in 150.

Earlier research at the UW Autism Center by its founding director Geraldine Dawson showed that accelerated head growth in children with autism slows down in the second year of life and this deceleration coincides with a with a period of worsening symptoms of autism.

###

The National Institute of Child Health and Human Development and the National Institute of Mental Health funded the research. The study was published in the Journal of Child Neurology. Co-authors of the new paper are Dawson, Theresa Nalty, Jeff Munson and Catherine Brock, who are all affiliated with the center, and Robert Abbott, a professor of educational psychology.
For more information, contact Webb at (800) 994-9701 or sjwebb@u.washington.edu

Saturday, January 12, 2008

Genetic link to autism may explain speech problems

London, Jan 12: Scientists have found a genetic link to autism that may explain why affected children can take months or even years longer to speak, a study says.

Variants in this gene could help to diagnose the condition and, in the long run, provide valuable insights into how to develop more effective treatments, the study said. ''Autism is a developmental brain disorder that impairs basic behaviours needed for social interactions, such as eye contact and speech, and includes other symptoms, such as repetitive, obsessive behaviours,'' said Prof Aravinda Chakravarti of the Johns Hopkins University School of Medicine, who conducted one of the studies. ''The symptoms sometimes cause profound disability, and they persist throughout life. Treatments may relieve some symptoms, but no treatment is fully effective in treating the core social deficits. Although the cause of autism is not yet clear, studies of twins have shown that genes play a major role,'' the Daily Telegraph quoted him as saying.

Intriguingly the variants identified mostly affect boys, especially when inherited from mothers. However, they are present in more than one third of the population, underlining how many genes contribute to the disorder and inheriting these gene variants does not mean that a boy will inevitably develop autism but will be more vulnerable to language-related problems, the research informed.The gene is most active in brain regions involved with thought and language, which suggests why affected children can have speech delayed, and the link with the developmental disorder is convincing because it has been confirmed by three teams of scientists.

The American Journal of Human Genetics published findings of a team led by Prof Daniel Geschwind at the University of California, Los Angeles, along with one by Prof Aravinda Chakravarti and Prof Dan Arking from the Johns Hopkins University School of Medicine, Baltimore, and a team at Yale led by Prof Matthew State.Confirmation by three groups, using different methods, suggested that several variants in the gene, called contactin-associated protein-like 2 (CNTNAP2), may play a key role in the development of autism. The gene makes a protein that enables brain cells to communicate with each other through chemical signals and appears to play a role in brain cell development. ''This gene not only may predispose children to autism,'' said Prof Geschwind, who searched for the gene in 500 affected families, ''but we think that it also may influence the development of brain structures involved in language, providing a tangible link between genes, the brain and behaviour.''

The UCLA team examined CNTNAP2's presence in early brain tissue and discovered that the gene was most active in developing brain structures involved in language and thought, especially the frontal lobe. ''Finding genes is a first step in trying to better understand the disorder, and that many genes are likely to contribute,'' Prof Geschwind said.The Hopkins team studied almost 1,500 affected children and found that children with autism were about 20 per cent more likely to have inherited the one gene variant from their mothers than from their fathers. ''For males, individuals who get the version of the gene linked with autism from mom have around 36 per cent increase in risk related to someone with no risk versions of the gene, and if the male child get the riskier version from both mom and dad, the risk increased by about 59 per cent,'' Prof Arking said.''Autism is highly heritable. Identifying the genes involved is crucial to our ability to map out the pathology of this isolating and sometimes terribly disabling disease, which currently has no cure,'' the director of the US National Institute of Mental Health, Dr Thomas Insel said.

Friday, January 11, 2008

MIND Institute gets $15 million to study Autism

A researcher at the UC Davis MIND Institute has received a $15.3 million grant from the National Institutes of Health to test the effect of intensive intervention on toddlers with autism.

Sally Rogers, a leading researcher on autism treatment, will use play- and relationship-based approaches to see if intervention earlier than 24 months of age is effective in reducing -- or circumventing altogether -- the language and social problems associated with the serious developmental disorder.

She will be joined in the five-year study by researchers at the University of Washington and University of Michigan.

Researchers will also attempt to identify the behavioral factors that help predict whether or not a child will respond well to treatment.

"There is very little published about the effectiveness of any intervention model for children in treatment earlier than two," Rogers said in a press statement.

Grandmother believes MMR vaccine brought on grandson's autism

By Kevin Canessa Jr.Observer Editor

Debbie Wertalik is confident about a lot of things in her life. Perhaps the most stark and surreal notion she’s confident in surrounds a time in her young grandson Tyler’s life.

It was about six years ago. He was just 1 year old at the time. And it forever changed the way she looks at vaccine shots.“I was talking to an expert who suggested we go back to look at videos of Tyler from his first birthday,” she said. “So we looked at the video. He was running very well for a 1 year old. Then, we looked at a video from around Easter that same year. He was playing and having a good time. Next, we looked at a video from the June after that Easter. We had gone down the shore and he was going on rides.“Tyler was totally different. He had a blank stare on his face. He wasn’t the same grandson of just a couple of weeks earlier.”Wertalik says a month before she went down the shore with Tyler, her daughter Debbie, and other members of the family, her grandson got his first dose of the MMR vaccine — against measles, mumps and rubella.That one vaccine, she’s completely sure, triggered something in Tyler that had previously been unknown to her and the family: autism.It wouldn’t be until three or so years later that Wertalik and the family learned Tyler was an autistic child. Yet looking back, she believes the vaccine, which contained Mercury in it as a preservative, triggered the autism.“I firmly believe there is a predisposition in certain children for autism,” she said. “But in Tyler’s early years, there were absolutely no signs. Then, we looked at the videos. It couldn’t be clearer. At first, we couldn’t understand how it was possible. But then we realized there was an overload of Mercury. It was an obvious catalyst.”

A few years after Debbie’s daughter Tara had Tyler, she had another child, Bella. Like her brother, Bella, too, had a predisposition to being autistic. But there was one thing all involved were certain of this time around — there was no way on earth Bella was getting an MMR vaccine.“If she had gotten the shot, we might have lost her,” Debbie said. “That was the critical factor. There was no way it was going to happen.”Wertalik has, for years, been the director of an autism support group called Putting the Pieces Together. You’ve likely seen photos from her events in this newspapers — and press releases for the group’s athletic wing, the Special Angels. In a real way, she’s the greatest advocate in our readership area on autism-related issues. So it should come as no shock that she’s not overly thrilled with a recent decision by the state Health Commission to mandate flu shots — in addition to other vaccines — for school-age children.She says she’s tried, with no response, to speak directly with Gov. Jon S. Corzine, about this and other issues. The governor’s office has told her that even though Corzine is “her governor, he is not going to take” her phone calls.“He allows this proposal to be introduced, and it will cost a lot of money,” she said. “Yet he won’t talk about it. It’s infuriating.”Like Debbie, perhaps the nation’s most noted autism spokeswoman is Deirdre Imus, the wife of radio host Don Imus.Last week, when word of the flu-shot mandate came down, Mrs. Imus took to the airwaves and lambasted the governor numerous times — and she announced his office’s telephone number, encouraging outraged listeners to call him.“I spoke with Gov. Corzine, and he pledged he’d do what he could to make sure this didn’t happened,” Mrs. Imus said on the air. “And now this? Are you kidding me? What is he thinking? These shots contain Mercury and I don’t care what dissenting expert says — Mercury causes autism. This is just outrageous.”Wertalik and Mrs. Imus’ outrage stems from another simple notion, one the pharmaceutical companies don’t want the public to know apparently: that is, that the vaccines, whether for the flu, MMR or other diseases, can be packaged, singularly, without using Mercury as a preservative.It would cost more to obtain the doses — and it would cost the companies more because the doses have a shorter shelf life and have to be individually prepared.

Still, it is possible. Yet it’s not happening.“There are families fighting this who don’t realize the shots can be obtained without the harmful elements,” Wertalik said. “They can split up the dosages preservative free.”What’s worse, she says, is that even if a child is harmed by Mercury-laden immunizations, parents and families have little recourse.“In a homeland security bill a couple of years ago, they used what they call an ‘Omnibus Bill,’ where they take an issue that would never get passed otherwise, and package them into other bills to get them through,” she said. “In this case, a homeland security bill that Congress passed mandated the drug companies can’t be sued if there’s a bad reaction to vaccines containing Mercury and other harmful materials. It’s just senseless.”The specific bill she references could not be verified.Still, Wertalik advises new parents to be very careful about what vaccines they get for their children.“It may seem like you’re being a pain, but parents should definitely ask to look at the labels on the bottles of the vaccines,” she said. “While I’m in no position to recommend what any other parent should do, I do believe parents need to use strong judgment. In other words, if there are harmful materials in the bottles, back away. Wait until they’re older if you have to. I just say that if you’re dealing with an infant — no way they should be getting this much Mercury in their tiny bodies. They’re just not prepared and ready to be able to handle it.”What others are sayingIn addition to Wertalik, we also asked a sampling of local residents what they thought of the mandatory shots.

Here’s a sampling of what we found.

June Radamski lives in Belleville. She says she doesn’t like the mandatory flu-shot idea.“When I first heard of this, I was mortified,” she said. “I have two young children not in school yet. But there is no way I am allowing them to get flu shots before they go into pre-K. If it means I claim religious reasons to avoid it, that’s what I guess I’ll have to do.”Robert Spangler, of North Arlington, is on the same page as Radamski.“I don’t have kids, but even I don’t feel comfortable getting flu shots,” Spangler said. “Injecting Mercury into a human body — think of what I just said — would it make any sense to put any amount of a harmful substance into your body needlessly?”Raul Salazar, of Kearny, also agrees with Radamski and Spangler — to an extent.“I wouldn’t mind doing it for my kids if the shots didn’t have any substances in them,” Salazar said. “But I don’t think they’re mak ing them without.”Meanwhile, Sarah J. Attanasio, of Nutley, says she thinks the Mercury amounts are too small to be concerned.“From what I’ve heard, the Mercury has not too much danger,” Attanasio said. “I’d take the risk if I had kids. Thankfully, right now I don’t.”Miguel Reynoso, of Belleville, agrees.“I know my mother gets a flu shot every year, and it seems like they have worked. No flu for her,” Reynoso said. “So I don’t see why my sons can’t get the shots. No harm, no foul, right?”

Wertalik and Mrs. Imus’ outrage stems from another simple notion, one the pharmaceutical companies don’t want the public to know apparently: that is, that the vaccines, whether for the flu, MMR or other diseases, can be packaged, singularly, without using Mercury as a preservative.It would cost more to obtain the doses — and it would cost the companies more because the doses have a shorter shelf life and have to be individually prepared.Still, it is possible. Yet it’s not happening.“There are families fighting this who don’t realize the shots can be obtained without the harmful elements,” Wertalik said. “They can split up the dosages preservative free.”What’s worse, she says, is that even if a child is harmed by Mercury-laden immunizations, parents and families have little recourse.“In a homeland security bill a couple of years ago, they used what they call an ‘Omnibus Bill,’ where they take an issue that would never get passed otherwise, and package them into other bills to get them through,” she said. “In this case, a homeland security bill that Congress passed mandated the drug companies can’t be sued if there’s a bad reaction to vaccines containing Mercury and other harmful materials. It’s just senseless.”

The specific bill she references could not be verified.Still, Wertalik advises new parents to be very careful about what vaccines they get for their children.“It may seem like you’re being a pain, but parents should definitely ask to look at the labels on the bottles of the vaccines,” she said. “While I’m in no position to recommend what any other parent should do, I do believe parents need to use strong judgment. In other words, if there are harmful materials in the bottles, back away. Wait until they’re older if you have to. I just say that if you’re dealing with an infant — no way they should be getting this much Mercury in their tiny bodies. They’re just not prepared and ready to be able to handle it.”

What others are saying

In addition to Wertalik, we also asked a sampling of local residents what they thought of the mandatory shots. Here’s a sampling of what we found.June Radamski lives in Belleville. She says she doesn’t like the mandatory flu-shot idea.“When I first heard of this, I was mortified,” she said. “I have two young children not in school yet. But there is no way I am allowing them to get flu shots before they go into pre-K. If it means I claim religious reasons to avoid it, that’s what I guess I’ll have to do.”Robert Spangler, of North Arlington, is on the same page as Radamski.“I don’t have kids, but even I don’t feel comfortable getting flu shots,” Spangler said.

“Injecting Mercury into a human body — think of what I just said — would it make any sense to put any amount of a harmful substance into your body needlessly?”Raul Salazar, of Kearny, also agrees with Radamski and Spangler — to an extent.“I wouldn’t mind doing it for my kids if the shots didn’t have any substances in them,” Salazar said. “But I don’t think they’re mak ing them without.”Meanwhile, Sarah J. Attanasio, of Nutley, says she thinks the Mercury amounts are too small to be concerned.“From what I’ve heard, the Mercury has not too much danger,” Attanasio said. “I’d take the risk if I had kids. Thankfully, right now I don’t.”Miguel Reynoso, of Belleville, agrees.“I know my mother gets a flu shot every year, and it seems like they have worked. No flu for her,” Reynoso said. “So I don’t see why my sons can’t get the shots. No harm, no foul, right?”

Growing Adult Autism Population Focuses on Higher Education


PITTSBURGH, Nov. 29 /PRNewswire/ -- As early detection and treatments improve, a growing number of young adults with High-Functioning Autism and Asperger's Syndrome are considering higher education.

While some colleges scramble to meet the needs of an aging population with autism, others have turned to third-party programs, such as Achieving in Higher Education with Autism and Developmental Disabilities (AHEADD), to enhance their level of support. Originally developed in collaboration with Carnegie Mellon University's department of Equal Opportunity Services, AHEADD provides mentoring and personal advocacy services for students with Asperger's Syndrome, Attention Deficit Disorder, High-Functioning Autism, and Non-Verbal Learning Disorder. The program is quickly expanding to higher-education environments in the District of Columbia, New York, Pennsylvania, Texas, and Virginia.

For students on the Autism Spectrum, programs such as AHEADD greatly influence their college application decisions. "These students are often served really well in the K-12 public school system, and then they're cut off," says Carolyn Komich Hare, AHEADD's founder and director. "College poses a whole new set of communication, organization, and social challenges, and it is important to have a plan in place to make the transition as seamless as possible. I have students who apply to colleges in Pittsburgh just because of the level of support they can receive here."

As accommodations improve, students, as well as their universities, are feeling the effects. One hundred percent of college students who participated in AHEADD for one semester improved their GPA by at least .5, and sometimes by as much as two, points. Ninety percent of students who were on academic probation were able to successfully continue their college careers with the program's support. "The Asperger's population is much bigger than we think it is," says Larry Powell, manager of Disability Resources at Carnegie Mellon University. "If we could put together systems that would adequately support these students, word would get around and more students would disclose it and would come."

University of Washington Launches First Autism Prevention Study

Autism researchers at the University of Washington will take the initial step in attempting to prevent the developmental disorder when they launch an $11.3 million study this week.

The UW's Autism Center has begun looking for 200 Seattle-area infants, 6 months old or younger, who have an older sibling diagnosed with autism. They will be part of the first study designed to prevent autism symptoms from developing in children who are at high risk for the disorder. While the latest research shows that autism affects as many as one in every 150 newborns in the United States, about one of every 20 infants who have an older sibling with autism will develop the disorder.

"This is the first trial to attempt to intervene and treat infants who are at risk for autism at the earliest time that symptoms are present," said Annette Estes, associate director of the UW Autism Center and research assistant professor of psychiatry and behavior science, who will head clinical assessment component of the new study. "Other research has shown that the earlier the intervention the better the outcome in treating children with autism. One of our goals is to be able to identify autism as early as possible before obvious symptoms show up so we can intervene while the connections in a child's brain are still plastic. "At the same time we will be trying to identify early risk factors for autism, something we could do if we had genetic markers. Right now we can't reliably identify autism until about 24 months of age. We will be looking at genetics, neurobiology and a number of early behavioral measures to predict which children will develop autism," she said.

Infants selected to participate in the prevention study will be given a preliminary assessment and then will be divided into two groups. Half of the infants will be monitored by specialists and referred for community treatment. The other infants and their mothers will participate in an intervention at the UW Autism Center that promotes first relationships. Mothers will be trained to engage their infants in eye contact and each mother and child will be videotaped interacting once a week for nine weeks. All of the children in both groups will be evaluated when they are 12 months old.

Those in the UW treatment group then will participate in an early intensive intervention program. At 24 months, the children will be re-evaluated to see if the intervention reduces the symptoms of autism. The research is funded by the National Institute of Child Health and Development, which recently named the UW Autism Center one of six new Autism Centers of Excellence. The new grant also will enable UW scientists to continue work unraveling other aspects of autism, including searching for genes related to autism susceptibility, brain imaging, linguistic and social responses to speech in autism, and risk and protective factors associated with autism in children with the disorder and in their family members.

Basic Facts on Autism

Autism is a brain disorder that is associated with a range of developmental problems, mainly in communication and social interaction. The first signs of this disorder typically appear before age 3. Although treatment has improved greatly in the past few decades, autism cannot be cured. It persists throughout life.

It's estimated that three to six of every 1,000 children have autism. A recent increase in the number of autism cases in the United States may be the result of improved diagnosis and changes in diagnostic criteria.

The disorder occurs three to four times more often in boys than in girls. The severity of symptoms is variable. Some children with autism will grow up able to live independently, while others may always need supportive living and working environments.

The cause of autism isn't clear, and there's no cure. But intensive, early treatment can make a difference.

Signs and symptoms

In general, children with autism have problems in three crucial areas of development — social skills, language and behavior. The most severe autism is marked by a complete inability to communicate or interact with other people.

Because the symptoms of autism vary widely, two children with the same diagnosis may act quite differently and have strikingly different skills.

If your child has autism, he or she may develop normally for the first few months — or years — of life and then later become less responsive to other people, including you. You may recognize the following signs in the areas of social skills, language and behavior:

Social skills

Fails to respond to his or her name
Has poor eye contact
Appears not to hear you at times
Resists cuddling and holding
Appears unaware of others' feelings
Seems to prefer playing alone — retreats into his or her "own world"

Language

Starts talking later than other children
Loses previously acquired ability to say words or sentences
Does not make eye contact when making requests
Speaks with an abnormal tone or rhythm — may use a singsong voice or robot-like speech
Can't start a conversation or keep one going
May repeat words or phrases verbatim, but doesn't understand how to use them

Behavior

Performs repetitive movements, such as rocking, spinning or hand-flapping
Develops specific routines or rituals
Becomes disturbed at the slightest change in routines or rituals
Moves constantly
May be fascinated by parts of an object, such as the spinning wheels of a toy car
May be unusually sensitive to light, sound and touch

Young children with autism also have a hard time sharing experiences with others. When someone reads to them, for example, they're unlikely to point at pictures in the book. This early-developing social skill is crucial to later language and social development.

As they mature, some children with autism become more engaged with others and show less marked disturbances in behavior. Some, usually those with the least severe impairments, eventually may lead normal or near-normal lives. Others, however, continue to have severe impairments in language or social skills, and the adolescent years can mean a worsening of behavior problems.

The majority of children with autism are slow to acquire new knowledge or skills. However, some children with autism have normal to high intelligence. These children learn quickly yet have trouble communicating, applying what they know in everyday life and adjusting in social situations. An extremely small number of children with autism are "autistic savants" and have exceptional skills in a specific area, such as art or math.

Causes

Autism has no single, identifiable cause. The disorder seems to be related to abnormalities in several regions of the brain. Researchers have identified a number of gene defects associated with autism.

Families with one autistic child have a one in 20 chance of having a second child with the disorder. In some cases, relatives of autistic children show mild impairments in social and communication skills or engage in repetitive behaviors.

Children with symptoms of autism have a higher than normal risk of also having:

Fragile X syndrome, which causes mental retardation
Tuberous sclerosis, in which tumors grow in the brain
Tourette's syndrome
Epilepsy

Some people believe autism is caused by vaccines — particularly the measles-mumps-rubella vaccine (MMR), as well as vaccines containing thimerosal, a preservative that contains a very small amount of mercury. But extensive studies have shown no link between vaccines and autism.

When to seek medical advice

Babies develop at their own pace, and many don't follow exact timelines found in some parenting books. But children with autism usually show some signs of delayed development by 18 months.

If you suspect that your child may have autism, discuss your concerns with your doctor. The earlier treatment begins, the more effective it will be.

Your doctor may recommend further evaluation if your child:

Doesn't babble or coo by 12 months
Doesn't gesture — such as point or wave — by 12 months
Doesn't say single words by 16 months
Doesn't say two-word phrases by 24 months
Loses previously acquired language or social skills at any age

Screening and diagnosis

Your child's doctor will look for signs of developmental delays at regular checkups. If your child shows some signs of autism, you may be referred to a specialist in treating children with autism. This specialist, working with a team of professionals, can perform a formal evaluation for the disorder.

Because autism varies widely in severity and manifestations, making a diagnosis may be difficult. There isn't a medical test to pinpoint the disorder. Instead, a formal evaluation consists of observing your child and talking to you about how your child's social skills, language skills and behavior have developed and changed over time. To help reach a diagnosis, your child may undergo a number of developmental tests covering speech, language and psychological issues.

Although the signs of autism often appear by 18 months, the diagnosis sometimes isn't made until age 2 or 3, when there may be more obvious delays in language development. Early diagnosis is important because early intervention — preferably before age 3 — seems to be associated with the best chance for significant improvement.

Treatment

There's no cure for autism, and there's no "one-size-fits-all" treatment. In fact, the range of home-based and school-based treatments and interventions for autism can be overwhelming. Your doctor can help identify resources in your area that may work for your child. Treatment options may include:

Behavioral and communication therapies. Many programs have been developed to address the range of social, language and behavioral difficulties associated with autism. Some programs focus on reducing problem behaviors and teaching new skills. Other programs focus on teaching children how to act in social situations or how to communicate better with other people.
Drug therapies. Right now, there are no medications that directly improve the core signs of autism. But some medications can help control symptoms. Stimulants can help with hyperactivity, while antipsychotic drugs sometimes will control repetitive and aggressive behaviors.

Complementary approaches. Some parents choose to supplement educational and medical intervention with complementary therapies, such as art therapy, music therapy, special diets, vitamin and mineral supplements, and sensory integration — which focuses on reducing a child's hypersensitivity to touch or sound. However, there is no scientific proof that these therapies work. It's important to talk with your child's doctor before trying any treatment.
Children with autism often respond well to highly structured education programs. Successful programs often include a team of specialists and a variety of activities to improve social skills, communication and behavior.

A child won't "outgrow" autism. But he or she can learn to function within the confines of the disorder, especially if treatment begins early. Preschool children who receive intensive, individualized behavioral interventions show good progress.

Coping skills

Raising a child with autism can be physically exhausting and emotionally draining. These ideas may help:

Find a team of trusted professionals. You'll need to make important decisions about your child's education and treatment. Find a team of teachers and therapists who can help evaluate the options in your area and explain the federal regulations regarding children with disabilities. Make sure this team includes a case manager or service coordinator, who can help access financial services and government programs.

Take time for yourself and other family members. Caring for a child with autism can be a round-the-clock job that puts stress on your marriage and your whole family. To avoid burnout, take time out to relax, exercise or enjoy your favorite activities. Try to schedule one-on-one time with your other children and plan date nights with your spouse — even if it's just watching a movie together after the children go to bed.

Seek out other families of autistic children. Other families struggling with the challenges of autism can be a source of useful advice. Many communities have support groups for parents and siblings of children with autism.

Autism linked to higher testosterone level

London - Powerful evidence has emerged that may soon lead scientists to discover the causes of autism which, in one form or another, now affects about one in every 100 children in Britain.Scientists have found that raised levels of the sex hormone testosterone in the womb of pregnant women is a significant risk factor in whether a child develops autistic characteristics.

The researchers emphasised that although they cannot prove testosterone exposure in the womb causes autism, they strongly believe it may be the smoking gun that eventually leads to the source of the brain disorder. Professor Simon Baron Cohen of Cambridge University said 235 healthy children whose mothers had amniocentesis - a womb test during pregnancy - were closely monitored for eight years and tested for autistic-like behaviour at regular intervals during their development.

The scientists found that high levels of testosterone in the amniotic fluid of the womb were significantly correlated with autistic-like behaviour, such as whether the child tends to be more unsociable or less empathetic than normal."It's a significant correlation and it's a correlation that remains significant after you have controlled for a whole set of other factors," Professor Baron Cohen told the British Association's Science Festival at York University.Previous work on animals has suggested that testosterone in the womb may affect the early development of the brain, which in humans might lead to the sort of extreme behaviour typical of autistic spectrum disorder, including Asperger's syndrome."What we knew before this study was that foetal testosterone was showing a correlation with social development at earlier points in childhood," the scientist went on. "But we hadn't been able to look at so-called autistic traits before, so in that respect this is something new."

The idea that foetal testosterone actually plays a causal role in autism is just a hypothesis. So there is no evidence from any lab in the world that this is actually a causal factor, but this research is certainly consistent with that hypothesis."Professor Baron Cohen has pioneered the "extreme male brain" theory to explain that autism and its related disorders may be a manifestation of being at the end of a wide spectrum of behaviours seen typically in little boys rather than little girls.Autistic characteristics for instance includes a fascination with numbers and systems - such as collecting cards - rather than conversational play with other children, which typifies the sort of behaviour seen more commonly in small girls."Children with autism seemed to have an exaggeration of the typical male profile because they have a very strong interest in systems, like numbers, but have difficulties with empathy," Professor Baron Cohen added.

Cases of autism - or more accurately autistic spectrum disorder - have increased dramatically over the past 30 years. But this is almost certainly due to better diagnosis and a broadening of the definition to cover other conditions, rather than a real increase.

Coping with the Reality of Autism

By Janna Farley

Of all the things to worry about with the birth of a child, Misty McGaugh never gave autism a second thought."As a mom, you worry about if your baby will have 10 fingers and 10 toes," the 29-year-old Sioux Falls mom says. "Never did I worry about if my daughter would have autism."But then she caught a special about autism on "The View" last spring. The more McGaugh listened to experts talk about the developmental disability, the more she recognized the signs to watch for in her daughter, Makenna.

"As I watched the show and they were going through the signs to look for, I was in awe," McGaugh says. "I was thinking, 'This is my daughter.' " Of most concern: The then-newly minted 2-year-old was talking but stopped - often one of the biggest warning signs that leads to an autism spectrum disorder diagnosis.After talking with her physician at Makenna's regular well-baby checkup, the McGaughs were referred to the Birth to 3 Connections program. One month later, it was official: Makenna had autism.

Today, Makenna has speech therapy twice a week and occupational therapy once a week. When she turns 3 next month, Makenna will start going to the early childhood program at Hayward Elementary and will be in a classroom of other autistic kids. She's still not verbal, but she's learning sign language, and she will engage her parents in play. "Therapy has really done wonders for her," McGaugh says. "She can tell you 'more' and 'mine' with sign language. She grabs your finger and drags you over to what she wants."McGaugh's story is not unique.Autism, the complex developmental disability that affects the normal functioning of the brain and impacts development in social interaction and communication skills, is the most common of the Pervasive Developmental Disorders, affecting an estimated 1 in 150 births, according to the Centers for Disease Control and Prevention. Roughly translated, this means as many as 1.5 million Americans today are believed to have some form of autism. It's four times more likely to occur in boys, but girls are not immune.

And this number is on the rise. In the Sioux Falls School District, for example, there are 112 students who have been diagnosed with autism, says Deb Muilenburg-Wilson, director of special services for the district. Twelve years ago, there were only eight.Why autism is on the rise is a cause for much debate. Some think there's a link between autism and vaccinations. Others credit doctors and specialists for simply getting better at identifying the disorder. Still others argue that parents just want a label to slap on behavioral issues.
Support for the child

Whatever the reason, an increase in the prevalence of autism has changed how parents, schools and specialists deal with the spectrum disorder and its varying degrees.A diagnosis of autism is life-altering, says Brittany Schmidt, director of the Autism Spectrum Disorders Program at Sanford School of Medicine of the University of South Dakota's Center for Disabilities. "There are no two ways about it," she says. "Autism is ... lifelong. I haven't met a family who wouldn't want it to be different."

Services available depend on the individual child's needs, as well as age, Schmidt says, and the availability of information and resources for autism has grown exponentially in the past decade. For kids younger than 3, there's the Birth to 3 Connections program. After that, the local school district takes over. The agencies provide information, training, evaluation services, consultations and family support groups for consumers.The earlier a diagnosis can be made, the better, in terms of getting assistance, Schmidt says. That also will help when it comes to integrating an autistic child into the classroom. "The earlier we can intervene, the better chance those youth will have in being successful with their learning," Muilenburg-Wilson says.Specialized early childhood classrooms, like the one Makenna McGaugh will attend, offer a much more structured, scheduled learning environment with a bigger focus on communication than regular early childhood classrooms - usually with fewer students, Muilenburg-Wilson says.

There are four of these classrooms in the district, says DeeAnn Konrad, community relations supervisor for the district. But it's not a one-size-fits-all educational approach. "Autism has a full continuum of abilities and needs within it. Each child presents very uniquely," she says. "As educators, we have to look at each child one at a time and plan each program around their needs. Many of those youth can be successful in classes. Others need more support."The district has invested in training to help teachers understand the strategies that will reach autistic students, Muilenburg-Wilson says. "We as a district have some staff who are specifically trained in autism so they can be leaders in training other staff. We've had to develop some specialized evaluation teams around autism."

In parents' shoes

Communication between teachers and parents is even more critical when it comes to autism. "For all children's learnings, it's important to have close communication between home and school," Muilenburg-Wilson says. "For children with autism, many of the strategies and individual skills need to happen across the environment, so it's important to have an increase in communication, so the children can carry over the skills they're learning to all environments."

The goal is to mainstream students whenever possible.Emotionally, autism can take its toll on parents.

"When families come into our clinic, we try really hard to be cognizant of where they are in the acceptance process or the discovery process," Schmidt says. "Some families have their head around the word 'autism.' Even though it's scary and not what they had in mind for their child's future, they're accepting of it. Other families who come in are either in denial or they just don't want it to be so."Even though the public is more aware of autism, there still is a stigma, says Stephanie Ollerich, whose 5-year-old daughter is autistic. "Nathalie will have a fit in the middle of a grocery store, and I will have parents look at me like, 'Why can't you control your child?' It's happened to me so many times, it doesn't phase me."Support groups help. Ollerich has been involved with a group of parents since her daughter was diagnosed. They still get together at least once a month.

"I really have to remind myself every day that she didn't ask to be this way," Ollerich says. "She didn't ask to have tantrums, to not understand. It's not her fault. It's difficult. So you learn patience. You learn to have lots of patience. It's my job not to just be a mother, but to be a teacher."McGaugh still is learning to navigate autism.

"I still have my good days and bad days. There's a neighbor girl who's six months younger than Makenna, and she'll come over and talk to me. That breaks my heart sometimes. My husband has a hard time accepting that she might never talk."But Makenna is such a happy, happy kid. Someday, my daughter may say something to me. If she does, she does. If she doesn't, she doesn't."

Mercury Vaccine Link Disproven

CHICAGO (Reuters) - A new study provides more proof that childhood vaccines with mercury as a preservative -- no longer on the market -- did not cause autism, researchers reported on Monday.

The findings came from a look at children diagnosed with autism in California from 1995 to 2007. It found that the number of autism cases continued to rise through that period even though the preservative thimerosal -- nearly half of which is made of ethylmercury -- was removed from most vaccines in 2001.

The data "do not show any recent decrease in autism in California despite the exclusion of more than trace levels of thimerosal from nearly all childhood vaccines (and) do not support the hypothesis that that exposure (to it) during childhood is a primary cause of autism," the study concluded.

Some earlier studies had linked mercury to autism, theorizing that as more and more children were being vaccinated against more health threats, it could explain increases in autism.

But a 2004 report from the U.S. Institute of Medicine said a review of existing studies did not appear to back the mercury-autism theory.

What causes autism remains a mystery. Some experts have said the increased number of cases is due at least in part to more awareness, an expanded definition, education and other factors.

People with autism spectrum disorders suffer in varying degrees from limited social interactions, lack of verbal and nonverbal communication and other abilities. As many as 1.5 million people in the United States have some form of autism, which is generally diagnosed beyond the age of 2, after most vaccinations have occurred.

"Although our analysis ... shows an increase in autism in California despite the removal of thimerosal from most vaccines, we support the continued quest for the timely discovery of modifiable risk factors for autism and related conditions," said the report from Dr. Robert Schechter and Judith Grether of the California Department of Public Health.
The report was published in the Archives of General Psychiatry.

In an editorial in the same publication commenting on the findings, Dr. Eric Fombonne of Montreal Children's Hospital, said that despite this study and earlier ones, beliefs persist among the general population that autism is related to mercury-preserved vaccines or to the triple measles-mumps-rubella vaccine specifically.

But, he said, parents of autistic children "should be reassured that autism in their child did not occur through immunizations."

"Their autistic children, and their siblings, should be normally vaccinated, and as there is no evidence of mercury poisoning in autism, they should avoid ineffective and dangerous 'treatments' such as chelation therapy ..." he added.

(Reporting by Michael Conlon; Editing by Doina Chiacu)

Study Shows Gene May Raise Autism Risk

A rare genetic flaw that occurs spontaneously near or during conception may sharply increase the risk that a child will develop autism, researchers reported Wednesday.

The new study, released online by the New England Journal of Medicine, is based on the most comprehensive DNA scan ever performed of families with autistic children. Experts said it illustrated both the promise and the challenges inherent in the search for genetic explanations of the disorder.

Although the researchers found strong evidence that the genetic alteration could cause autism, they said it turned up in less than 1 percent of about 1,500 children with the disorder.

The finding is not likely to improve diagnosis or treatment for most children struggling with autism or related problems anytime soon, experts said, but it points to a specific chunk of DNA where some developmental problems could originate. Up to one in 150 children born in the United States show some evidence of the social and learning difficulties that characterize autism, and scientists understand very little about how or why those problems develop.

“This is a fantastic study, in that it points us toward a path, gives us an idea of where to look,” said Thomas Lehner, chief of the genomics research branch at the National Institute of Mental Health, who was not involved in the research. “However, it also shows we have a long way to go to understand what is a very complex disorder.”

The study involved more than a dozen researchers from several institutions, most associated with the Autism Consortium, a nonprofit research organization in Boston. The investigators analyzed DNA from 751 families with autistic children and found that five of the youngsters had a region on Chromosome 16 that had been deleted. Further analysis, in 512 children with autism at Children’s Hospital Boston, and a group of 299 Icelandic people, turned up eight more such cases.

The rate of the chromosome alteration in a group of normally developing people was one in 10,000. “The analysis tells us that this is a very strong risk factor for autism, increasing the risk by ten- to a hundred-fold,” said the study’s senior author, Mark J. Daly, an assistant professor of medicine at Harvard and Massachusetts General Hospital.

The rarity of chromosome alteration in people without developmental problems, Dr. Daly said, suggests that natural selection has worked against it — most likely because its effects on development can be disabling.

In the past year, several research groups have linked spontaneous alterations in this or nearby areas on Chromosome 16 to a variety of developmental problems, including autism. It will take more research to determine which precise alterations lead to autism or other neurological problems, they say.

“We want to be careful that we understand these alterations before assuming that any one of them caused a child’s problem,” said Lisa G. Shaffer, who is chief executive of Signature Genomic Laboratories in Spokane, Wash. “Because if it’s not the cause, we need to keep searching; the child may have a problem that’s treatable.”

Rare Gene Connected to Autism

A rare genetic variation dramatically raises the risk of developing autism, a large study showed, opening new research targets for better understanding the disorder and for treating it.

Research into the causes of autism has focused on genetic causes because so many families have multiple children with the disorder. Thus far, only about 10 percent of autism cases have a known genetic cause. Boston-area researchers estimate the gene glitch they've identified accounts for another 1 percent of cases.

They found a segment of a chromosome which has genes linked to brain development and various developmental disorders was either missing or duplicated far more often in autistic people. The defect was inherited in some cases, but more often the result of a random genetic accident.

The results from the Autism Consortium study, released online Wednesday by the New England Journal of Medicine, confirm those of smaller studies by U.S. and Canadian research groups in the past year. The consortium verified its findings by checking two other DNA databases.

"They really did nail it," said Dr. Andrew Zimmerman, director of the Kennedy Krieger Institute's Center for Autism & Related Disorders in Baltimore, who was not involved in the research.

He predicted children newly diagnosed with autism or other developmental disorders now will be tested for this defect on chromosome 16 and that studies of many more DNA samples may reveal other autism-related gene variations.

Already, the findings are starting to be used to give some parents long-sought answers to burning questions: What caused autism in their child and how likely is it that any future children also would have autism, long known to run in families?

"We've provided very compelling evidence that this particular small stretch of the genome provides an important clue to the biological roots of autism," said lead researcher Mark J. Daly, an assistant genetics professor at Harvard Medical School and an investigator for the consortium, which includes researchers from 14 Boston-area universities and medical centers.

When the biological pathways involved are figured out, scientists can try to design drugs to target chemicals in the brain to treat autism, said Geraldine Dawson, chief science officer of the advocacy group Autism Speaks.

"I think chromosome 16 is now going to be a hotbed for autism research," said Thomas Lehner, head of the genomic research branch at the National Institute of Mental Health. "It gives us a very important lead."

Another study researcher, Dr. David Miller of Children's Hospital Boston, said the chromosome 16 variations increased the risk of autism a hundredfold. But he said the disorder must be due to a combination of genetic variations since there were cases of people who had the defect but didn't have autism.

Autism, a complex, poorly understood disorder, is characterized by repetitive behaviors and poor social interaction and communication skills. Research has mainly centered on genetic causes, and on whether it could be caused by the mercury-based preservative once used in childhood vaccines, which has been repeatedly discounted.

The number of children diagnosed with autism has risen in recent years to as many as one in 150 American children, but experts are unsure whether its prevalence really is increasing or the trend is due to a broader definition of autism.

For their study, consortium researchers scanned all 46 chromosomes from DNA samples from 1,441 children with autism or related disorders. They also scanned DNA from most of their parents and 2,800 other people, none known to have autism.

The researchers found a 25-gene segment of chromosome 16 was missing in five children with autism; none of their parents had the deletion. That shows that in some cases the genetic glitch is not inherited from the parents, but instead due to a random accident while an egg or sperm is being formed.

Another seven autistic children had a chromosome 16 duplication, but all but one had parents with the same duplication.

The researchers confirmed their findings by looking at DNA databases from Children's Hospital Boston and Iceland. The same defect was found in 1 percent of those with autism or related disorders. It was found in just seven of about 19,000 Iceland samples from people without the disorder.