This morning I received a press release about early results of a very large multi-site clinical trials of an early intervention program for autism. The trials are being conducted at the MIND institute (UC Davis) and the University of Washington, and here at the University of Michigan. I have not been able to get access to the article as it is not in the Dec 1 issue of Pediatrics. Hopefully I’ll get a copy later today and will post a review by Wednesday. Meanwhile here is a copy of the official press release:

Early intervention for toddlers with autism
highly effective, study finds
Significant gains seen in IQ, communication and social interaction

(Seattle, Nov. 30, 2009) – A novel early intervention program for very young children with autism – some as young as 18 months – is effective for improving IQ, language ability, and social interaction, a comprehensive new study has found. Read More

This past week, while supervising the neuropsychology rotation of our doctoral students, I asked a student to clarify on a report whether the birth weight of a patient was “below or at expectation” for his gestational age. I explained that in most cases, it is not whether the baby was born prematurely, but whether his weight was “normal” for the length of the pregnancy.  Sometimes, being premature itself is not a risk factor for specific neurodevelopmental disorders. What is important in predicting healthy development is whether the baby shows typical growth up to the day of the birth – even when the birth day is significantly before the full term date.

In the latest issue of the journal of the American Academy of Pediatrics there is a new epidemiological examination of the association between prematurity and autism that highlights the point I was making to my students. There are a number of studies that have found a link between prematurity and autism, in that premature babies are at greater risk for developing autism than full term babies. However, other studies have failed to replicate such findings. What could explain such discrepancy? One possibility is that it is not about being premature that increases the risk for autism, but instead such increased risk is due to complications and other factors associated with prematurity. If these variables have not been controlled similarly across studies then you will find studies providing conflicting results due to unknown, or uncontrolled, characteristics of the sample. Read More

I should start this new post by explaining why I’ve been mostly absent for the last month. September was an interesting and challenging month. I could say it was a perfect storm, combining the start of the academic year, preparing a new graduate seminar I had never taught before, transitioning into my new role as Assistant Professor at the University of Michigan, and rushing to get my new research laboratory functioning. Fortunately however, things are finally settling down and I can start to catch up with the child psych literature. I hope from now on I will be able to write a new post every Monday morning.

I thought it would be appropriate to start the month with some thoughts about the new Autism prevalence study that was just published in Pediatrics and which hit the news cycle this morning.

In sum, the study found that the prevalence of parent-reported rates of autism was higher than previous estimates. Specifically, they found that 1.1% of all children aged 3 to 17 had autism (1 in 91) as compared to previous estimates of approximately 1 in 150.

Does this suggest an increase in autism rates between 2003 and 2007? Maybe, in that the finding is consistent with the possibility that autism rates are increasing. However, there are a number of issues that must be taken into account, especially the methodological differences between this study and the CDC study that reported prevalence rates for 2002.

For a more detailed explanation of the CDC report from where the 1 in 150 rate comes from read my previous post on the topic: Autism rates in the USA: where did the 1 in 150 number came from? Read More

I was just reading a study that examined the proposed pathways from sleep problems in preschool children to behavioral disruption during the day. Specifically, a team from the MINDS institute at UC Davis was interested in exploring some possible reasons that could explain why sleep problems often lead to behavioral dysregulation during the day. The most obvious candidate, and the target for their study, is daytime sleepiness. It is commonly reported by parents and educators, that children that experience sleep problems at night are usually sleepy during the day, and this sleepiness may be the trigger for behavioral problems.

The authors examined 194 preschool children, including 68 kids with Autism, 57 with non-autism developmental delays, and 69 typically developing. Sleep problems were measured via parents reports but also through the use of actigraphs. These are very sensitive motion sensors that are attached to the child’s leg and are able to reliably identify when the child falls asleep or wakes up during the night. This allows the researcher to determine a number of specific sleep indicators, such as total sleep hours during the day, sleep efficiency (total hours of actual sleep while in bed), sleep latency (how long does it take the child to fall asleep), and wake after sleep duration (total minutes awake after initially falling asleep). Read More

The Journal of Autism and Developmental Disorders recently published a study examining the effectiveness of a Portable Digital Assistant (PDA) as an aid device for adolescents with autism spectrum disorders. I was surprised to read that only a couple of studies have been conducted examining the potential utility of PDAs in autism. The portability of PDAs and the ability of these devices to provide visual and auditory commands (such as video prompts), should make these devices ideal tools in the implementations of behavioral strategies that involve the presentation of prompts.

In order to evaluate the effectiveness of PDAs in autism, the authors taught 3  adolescents with ASD diagnoses to use the PDA to provide self-prompts while completing 3 cooking recipes (hamburger helper, individual sized pizza, and a ham & swiss sandwich). The 3 adolescents were selected because they met a specific inclusion criteria, which included having good fine motor skills (allowing them to manipulate the PDA), having good visual and auditory acuity, and having the cognitive skills necessary to recognize picture prompts. The adolescents were provided with a Cyrano Communication device programmed to provide picture, voice, and video prompts for each step of the cooking process. Read More