In the Virginia (US) legislature (which I sometimes call the “House of Burgess” for fun), efforts to mandate coverage of intensive behavioral therapy (AKA “ABA,” “discrete-trial training,” etc.) by insurance policies gained a little momentum 16 February when Senate Bill 464 passed by a nearly 2-to-1, bi-partisan margin. Earlier this legislative session, one similar bill (HB 303) was rejected by a narrow vote (4-to-4) in the committee on Commerce and Labor of the Virginia House but another (HB 34) may still be alive (I’m too uniformed about legislative processes to know).
Janie Shelton and colleagues at the University of Califonia at Davis reported that women over 40 years of age who give birth have an increased risk of the child having Autism. By studying a large sample of births, the researchers were able to disentangle the relative contributions of maternal and paternal age to the likelihood of having a child with Autism.
I want to note that readers should understand that the GMC investigation, though very important, did not expressly examine the scientific basis of Dr. Wakefield’s case. The findings discuss whether he was qualified to do the work and followed procedures in seeking approval for it. The scientific strength of the findings from the study in question have been examined extensively by well-qualified researchers and found wanting, though (see, for example, Hornig et al., 2008).
In Pediatrics Dr. Timothy Buie and colleagues published a paper providing evidence-based recommendations for pediatricians who evaluate and treat gastrointestinal problems in patients with Autism. The authors, who represent many important scientific groups concerned with allergies, gastrointestinal disorders, nutrition, and similar problems, concluded that children with Autism and related disorders should be assessed and, as approriate, given medical care just as would individuals without Autism. The team encouraged pediatricians to develop and employ “evidence-based algorithms for the assessment of abdominal pain, constipation, chronic diarrhea, and gastroesophageal reflux disease (GERD).” Continue reading ‘Science, gastro-intestinal problems, diets, and Autism’
Writing in Molecular Psychiatry, L. Palmieri of the Laboratory of Biochemistry and Molecular Biology, Department of Pharmaco-Biology, University of Bari (Bari, IT) and colleagues reported the results of a small-n study of levels of metabolic transporters in the brain tissue of individuals with and without Autism. They compared the contents of samples from the brains of individuals with Autism and individual without Autism (matched on the bases of sex, age, and time after death that the samples were obtained). They found aspartate-glutamate carrier activity was increased by excessive calcium levels in brains of the Autistic individuals. Continue reading ‘Excessive levels of calcium mark brains of individuals with Autism’
Thanks to a comment by reader DrFoo (AKA ‘Rollen’), I was alerted to an interesting study about variation in the rates of Autism in different ethnic populations. The news releases say that the incidence of Autism among Hispanics is lower than it is among non-Hispanic white peers.
These news releases refer to a study entitled “Explaining Low Rates of Autism Among Hispanic Schoolchildren in Texas” by Raymond Palmer and colleagues. Here’s the abstract:
In data from the Texas Educational Agency and the Health Resources and Services Administration, we found fewer autism diagnoses in school districts with higher percentages of Hispanic children. Our results are consistent with previous reports of autism rates 2 to 3 times as high among non-Hispanic Whites as among Hispanics. Socioeconomic factors failed to explain lower autism prevalence among Hispanic schoolchildren in Texas. These findings raise questions: Is autism underdiagnosed among Hispanics? Are there protective factors associated with Hispanic ethnicity?
I’ve not had time to examine the issue closely, but I have a few links:
A new study from the US Center for Disease Control (CDC) puts the prevalence of Autism Spectrum Disorders (ASD) at 0.9% (one in every 110) of 8-year-old children. Writing in Morbidity and Mortality Weekly Report, Catherine Rice of the CDC’s National Center on Birth Defects and Developmental Disabilities reported the results of her study 18 December.
In what is called a surveillance study, Ms. Rice examined educational and medical records of children age 8 in 2006, because that age appears to be a peak age for prevalence of ASD. Research teams from sites that participate in the Autism and Developmental Disabilities Monitoring (ADDM) Network monitor public health records. Ms. Rice’s report aggregated the data from 10 sites. Continue reading ‘New prevalence study of ASD’
Twelve key children’s services for community services boards
specialized children’s emergency services;
crisis stabilization;
evaluations for Comprehensive Services Act services;
psychiatric/medication;
office-based mental health therapy;
office-based substance abuse therapy;
mental health case management;
intellectual disabilities case management;
substance abuse case management;
home-based behavioral treatment and support for families;
school-based day treatment; and
local residential services.
Right here in my home commonwealth of Virginia last week, Mira Signe, Vicki Hardy-Murrell, John Morgan, and Margaret Nimmo Crowe explained why it is important that government and private organizations attend to and address issues in children’s mental health. By explaining that Virginia has inadequate services and that one in every five children or youths experience mental health problems at some time during their lives, they made the point that that there is a tremendous need for public focus on these issues. This was the kick-off event for the Campaign for Children’s Mental Health.
The Campaign for Children’s Mental Health is a 3-year sustained effort to make mental health services more available and accessible to Virginia children in need. It will strongly endorse Governor-elect McDonnell’s call for system improvements; urge the General Assembly and state and local government to work collaboratively with the administration to address system deficiencies; and conduct a high-profile three-year advocacy and education drive to build public and political support for improved mental health services for children.
Only about one in 20 of Virginia’s children have access to the key services listed in the accompanying box. So, four out of five children who need these services do not have access to them.
No, Virginia, this is not an acceptable way to treat our children. Let’s do better.
Down load the press release (source of the excerpt quoted here).
I’m going a little afield here, as this is not about children or youth. Still, I thought it might be interesting to a reader or two. Using images of the brains of adults with Autism and other adults without Autism, Michael Lombardo and colleagues examined activity in two parts of the individuals brains considered to be involved in thinking about oneself or about others. They found that the individuals with Autism showed differences from their not-Autistic matches in the area of the brain (cingulate cortex) that is active during social interactions and bonding.
All of the participants who had Autism diagnoses (N=29) were pretty high functioning. They were, on average, 26 years old, their average full-scale IQ was almost 116, and on the ADI-R social, communication, and repetitive scales their average (SD) ratings were 17.87 (4.73), 14.83 (3.58), and 5.78 (2.71) respectively. Continue reading ‘Self- and other-referents in Autism’
The story of James Delorey is, sadly, an instructive one. For those who have children, the possibility of a daughter or son being lost is a frightful concern. For those whose children have disabilities and are even more vulnerable than other children, having a missing child must be even more frightful.
James Delorey, a boy with Autism, was lost for many hours in the woods near the neighborhood of his home. Harold Doherty, the father of a child from the same Canadian province, chronicled the story on Facing Autism in New Brunswick. Here are references to his posts:
In “Autism: A journey of recovery” on the “American Morning” section of the Web site of CNN, reporter Kiran Chetry relates the story of Jake Exkorn and his family. Jake’s remarkable story is one of great losses in competence as a toddler, followed by persistent, intensive therapy during his childhood and substantial progress.
Trine Tsouderos and Patricia Callahan, the Chicago Tribune reporters who have provided exemplary examinations of unsupported therapies for Autism, continued their series of stories on the topic with a piece entitled “Autism: Kids Put At Risk” in the Los Angeles Times. In this briefer (though still well-researched) article they devote most of the coverage to examining the physicians who prescribe chelation, hyperbaric oxygen therapy, anti-testorsterone drugs, mega-doses of vitamins, and many other unproven regimens and other doctors who have serious doubts about the consequences, including the safety, of such therapies.
EBD Blog provides news and commentary about Emotional and Behavioral Disorders in children and youths. These problems have sometimes been called "emotional disturbance" or even "serious emotional disturbance." Whatever they are called, these problems are real, painful, and important. They often affect other people as well as having deleterious effects on school, social relations, and other aspects of the individuals' lives.
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