Autism Science Foundation Weekly Science Report

The racial and ethnic disparities in the diagnosis of ASD has always been unacceptable, but it’s been hard to figure out. This week, researchers published their findings from a close look at 500 African American families with ASD to understand what the barriers were to a timely diagnosis. The results are not surprising, but they are also alarming. Some of these families may benefit from telehealth in the future. Telehealth is not perfect, but it turning out to be helpful. For example, it may be beneficial in treating insomnia in people with ASD. Delivering cognitive behavioral therapy online resulted in improvements in sleep in adolescents with ASD. It isn’t a panacea, but it seems to be more helpful than people gave it credit for before the pandemic.

https://pubmed.ncbi.nlm.nih.gov/32839243/

https://pubmed.ncbi.nlm.nih.gov/32838539/

There are many many potential factors that influence a diagnosis of ASD that have been underexplored, and recreational drugs are one of them. Of course it would never explain all the cases of ASD, not one singular thing does, but does cannabis consumption during pregnancy lead to an increased probability of having a child with ASD? As it turns out, yes, a small increase, meaning it isn’t the only thing causing ASD but: JUST SAY NO if you are pregnant. On the other end of the spectrum is aggression, a completely horrible feature of some people with ASD. About 30% of people who are aggressive and have an ASD diagnosis are not responsive to any medications or therapies, which is horrifying. Researchers in Canada and Brazil have studied the brains of this group, with what is called “refractory aggression” to try to get to the mechanism.

https://pubmed.ncbi.nlm.nih.gov/32778828/

https://pubmed.ncbi.nlm.nih.gov/32762791/

This week the ASF Podcast explores two ways to better understand the environmental influences in ASD diagnosis: 1. through potential cost savings of avoided cases of ASD due to reduced air pollution and 2. by studying pre-conception exposures going back as far as the grandparents exposure. These two concepts do not prove any one thing, including one environmental factor, causes ASD, however, using these approaches may improve understanding of ASD and allow for legislation that improves many health outcomes in children. Below are the two references:

https://pubmed.ncbi.nlm.nih.gov/32749866/

https://pubmed.ncbi.nlm.nih.gov/32704384/

Biological features of ASD can be seen long before behavioral impairments in children are seen. Researchers are now studying the activity of the brain at 3 months in infants that go on to develop autism and those that do not. There are distinct features in the brain seen in a 3 month old that goes on to develop ASD. In addition, excessive brain activity resulting in seizures can increase the probability of a later ASD diagnosis in infants with a rare genetic disorder called Tuberous Sclerosis. This podcast will explain how connectivity and activity in a 3 month old can influence a later diagnosis. What we don’t know more about is those intervening months, and what can be done to mitigate symptoms.

https://www.sciencedirect.com/science/article/abs/pii/S2451902220301403?via%3Dihub

https://onlinelibrary.wiley.com/doi/epdf/10.1002/acn3.51128

It’s been about 6 months since the COVID-19 pandemic began in the United States, longer in Asia and some parts of Europe. While scientists still don’t know the direct effects of COVID-19 in pregnant women on later development of their children, they do know about ASD following other neuroinflammatory responses. These include things like the flu, UTI’s, herpes, and other things that cause inflammation and immune disruption. This podcast reviews the evidence so far in humans and animals, with the goal of helping people understand that the threat is real, and that wearing a mask is not a mark that you do not have the freedom to do so. It is a reflection that you understand that the world is victim of a pandemic, and you want to protect others from getting sick.

https://reader.elsevier.com/reader/sd/pii/S0149763419302088?token=6A507B42E4214202ED738386D6C119F334516249286DFE65CDE1B73A0859F430F8C0600C592A04FF500B31454175C08A

https://www.ncbi.nlm.nih.gov/pubmed/31824351

The words “induced pluripotent stem cell” refer to a group of cells that are gathered from a person with a disorder, like autism, then changed or “induced” from a skin cell into an embryonic “stem” cell, and can be then made into baby brain cells, or baby heart cells or baby bone cells. This makes them “pluripotent”. This tool has been used in neurodevelopment disorders to help illustrate when the wiring of the brain starts to go off course. Things start to happen very early after conception and one of the only ways to study these things is by using either embryonic cells or these induced embryonic “stem cells”. The latter is more cost effective and more precise. This technology has an incredibly high potential in understanding autism, but it may never be used as a treatment. Nevertheless, knowing how and when brain development deviates is essential for understanding people with ASD.

https://link.springer.com/content/pdf/10.1007%2F978-3-030-45493-7.pdf

You have spoken, and scientists have listened, to surveys that have asked how you are doing, what your family needs, what is working and what has not worked. Telehealth gets mixed reviews, and kids are suffering from everything from anxiety to OCD. Other results of these surveys are covered in this week’s ASF podcast. Please continue to answer these requests for feedback, because the future of autism interventions, assessments and services depends on them.

https://pubmed.ncbi.nlm.nih.gov/32515992/

https://pubmed.ncbi.nlm.nih.gov/32503172/

https://pubmed.ncbi.nlm.nih.gov/32445682/

Racial and ethnic disparities in autism care is not new, the lower age of diagnosis and lack of care for these families have been reported for years. While they have always been unacceptable, in light of recent events, it’s time to reconsider what scientists should be doing about them. A systematic review identifies what is going on with regards to access to interventions and their efficacy. Another study successfully collaborates Part C Early Intervention providers to reach families of color to improve screening. And finally, researchers not even focused on autism provide a perspective on how far and wide this problem reaches. Autism Science Foundation maintains their commitment to working together with other organizations to eradicate these disparities once and for all.

http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=32238530

https://doi.org/10.1007/s10803-020-04429-z

A fresh take on an existing topic: why there are more boys diagnosed with ASD than girls. Even from a few months old, girls are different than boys, and they show subtle differences in toddlerhood. But at the time of diagnosis, they score the same on standardized instruments of ASD used to categorize someone as having ASD or not. This means it isn’t about the measures. It could be cultural factors, it could be a protective effect, but there needs to be a better understanding of these differences across the lifespan to help everyone with ASD, especially females.

https://www.cell.com/current-biology/retrieve/pii/S096098222030419X?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS096098222030419X%3Fshowall%3Dtrue

https://doi.org/10.1007/s10803-020-04526-z

https://doi.org/10.1111/jcpp.13242

Unfortunately, families hear more about what does work to help families with ASD rather than what does not work. But through the course of decades of research, scientific projects and hours of families participation, there is a better picture of what treatments are, and are not, helpful. This week’s podcast will review what drugs have shown to not be effective so far in treating restrictive and repetitive behaviors and also provides an update on umbilical cord blood stem cell transfusions on social communication behaviors.

https://www.jpeds.com/article/S0022-3476(20)30334-6/pdf

https://jaacap.org/article/S0890-8567(20)30265-3/pdf