Maternal Immune Activation and Autism

A new study published this month by the American Association of the Advancement of Science indicates that immune cells “may have a direct role in causing behaviors linked to autism.” The study abstract noted that previous research has already shown “viral infection during pregnancy has been correlated with increased frequency of autism spectrum disorder in offspring.”

For this study, researchers at New York University Langone studied a subset of T-helper lymphocyte cells called TH17 and the production of cytokine interleukin-17a (IL-17a). The study in mice mimicked a viral invasion and showed using genetic mutants and blocking antibodies that TH17 and IL-17a caused maternal immune activation (MIA) behavior abnormalities in mice offspring. Additionally, the study demonstrated that “blocking the action of TH17 and IL-17a completely restored normal structure and functioning” in the mice offspring brains. The study’s authors suggest that the “therapeutic targeting of TH17 cells in susceptible pregnant mothers may reduce the likelihood of bearing children with inflammation-induced” autism spectrum disorder behaviors.

Sources:  http://science.sciencemag.org/content/early/2016/01/27/science.aad0314

https://www.rt.com/news/330705-autism-disorder-treatment-cells/

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Sulcal Pit as a Genetic Marker for Autism

Scientists in France have identified a genetic marker for autism that they found in a “less deep fold of Broca’s area” — an area of the brain that specializes in language and communication. The scientists at the Institut de Neurosciences de la Timone, located in Marseille, focused on this “new geometric marker called the sulcal pit.” The sulcal pit is the “deepest point of the sulcus in the cerebral cortex from which points all the folds on the brain’s surface develop.”

Using MRI scans, the scientists analyzed the sulcal pits of 102 young boys aged 2-10 according to three groups:  Autism spectrum disorder, pervasive developmental disorder not otherwise specified and “normal developing” children. Comparing the three groups, the depth of the sulcal pit in the brain was less in the autism spectrum disorder group than in the other two groups. The scientists also noted in the autistic children that the deeper the sulcal pits were, the more “impaired the language production” was in the children.

Additionally, the study disproved a previously held belief that brain “cortical folding was complete at birth.” The French scientists noted that some of the brains’ “superficial folding continued to deepen with age in both the autistic and other children.”

Source:  http://www.sciencedaily.com/releases/2016/01/160113101121.htm including journal reference Brun Lucile, Auzias Guillaume, Viellard Marine, Villeneuve Nathalie, Girard Nadine, Poinso François, Da Fonseca David, Christine Deruelle. Localized misfolding within Broca’s area as a distinctive feature of autistic disorderBiological Psychiatry: Cognitive Neuroscience and Neuroimaging, 2015; DOI: 10.1016/j.bpsc.2015.11.003 published 12 January 2016.

Robot Helps Children with Autism Learn Social Skills

Milo, is a two foot-tall humanoid robot that uses facial expressions and children’s voices to demonstrate appropriate social behavior in order to help kids with autism learn social skills. The robot was developed by Robokind and the children’s voices were developed by Acapela Group to help autistic kids engage with the robot in order to teach them the meaning of emotions and facial expressions.

Milo uses the Robots4Autism’s research-based curriculum to teach elementary and middle school-aged kids about acting appropriately in social situations and demonstrating empathy while encouraging more self-motivation in the kids. “Recent research has shown that children working with a therapist and Milo are engaged 70-80% of the time compared to just 3-10% of the time without the robot.”

Robots4Autism’s curriculum for kids with autism is available in Android and iOS. Some of the benefits of the curriculum are noted to be “observable increases in eye contact, body language and friendliness, intrinsically motivates children to learn and documents and records sessions for later inclusion and review in IEPs.” You can find out more about Milo and the Robots4Autism curriculum at the robokindrobots’ website.

Sources: http://www.robokindrobots.com/robots4autism-home/

http://autism.einnews.com/article/301938397/dmzHv36mfCmo2GXc

Autism and Abnormal Blood Vessels in the Brain

Researchers recently published a study in the Journal of Autism and Developmental Disorders called “Persistent Angiogenesis in the Autism Brain: An Immunocytochemical Study of Postmortem Cortex, Brainstem and Cerebellum.” The study found that the brains of those with autism have “unstable blood vessels disrupting proper delivery of blood to the brain.” “Typical” brain blood vessels are stable.

The researchers conducted the study by looking microscopically at post-mortem age-matched normal brains and autistic brains. The researchers did not know which brains had had an autism diagnosis and which brains did not thus eliminating bias in their observations. The study found formation of new blood vessels (angiogenesis) in the brains from individuals who had had an autism diagnosis; no such angiogenesis was noted in the normal brains. The areas of the brain affected were the “superior temporal cortex (primary auditory cortex), fusiform cortex (face recognition center), pons/midbrain and cerebellum.” Specifically, the researchers found increased levels of the proteins nestin and CD34 which are markers of angiogenesis. Importantly, the study findings found that the angiogenesis was not the kind that caused the sprouting of new vessels but instead of splitting, thus causing continuous fluctuations in blood circulation.

Sources:  http://www.nyu.edu/about/news-publications/news/2015/12/16/scientists-find-new-vessel-for-detecting-autism.html

http://link.springer.com/article/10.1007/s10803-015-2672-6?no-access=true

Autism and SwiftKey Symbols Visual Keyboard App

SwiftKey this week launched a new Android App called SwiftKey Symbols, a visual symbol type of keyboard instead of the traditional QWERTY keyboard. The image keyboard is designed to help those with communication and learning difficulties such as non-verbal kids with autism communicate more effectively with family, friends and teachers. The app is currently in beta version on the SwiftKey Greenhouse page where users can test apps and provide feedback before the final version is launched.

This visual symbol app keyboard lets users construct sentences by picking out symbols according to categories or using the “prediction bar.” What makes the app really special for autistic kids and others with communication difficulties is the app “learns from each individual’s behavior to show relevant images;” therefore, each individual’s SwiftKey Symbols app will be unique. An additional function of the app is that it remembers what symbols have been used at what time of the day and day of the week in order to improve its prediction capability. Users can also add their own image symbols and categories.

SwiftKey was started by co-founders Jon Reynolds (CEO) and Dr. Ben Medlock (CTO) in 2008. The first SwiftKey keyboard app launched in London in 2010. The company has offices in London, San Francisco and Seoul as well as representatives in India and China.

Sources: http://gadgets.ndtv.com and https://swiftkey.com/en/greenhouse

Apps that Help Kids with Autism

A non-profit, Common Sense Graphite, has come up with what they think are the best apps for working with kids on the autism spectrum. Here is a categorized partial list based on highest rating:

Emotions:

  • Daniel Tiger’s Grr-ific Feelings: Singing and role-playing conversations based on emotions. Covers not only words but facial expressions and body language.
  • Touch and Learn Emotions: Helps kids identify feelings such as excitement, sadness or anger. One drawback of the app is some of the images could identify more than one emotion which could be confusing.
  • Breathing Bubbles: Name “joys and anxieties” by creating sentences and putting them into bubbles, then “releasing worries” and “embracing joys.”
  • IF…The Emotional IQ game: An adventure game that “promotes wise decision-making and respect for others.”
  • Mood Meter—Building your Emotional Intelligence: Kids “explore a grid of emotions to describe their current mood.” It is expected for users to create much of their own text and images as built-in images and text are “limited.”

Language and Communication:

  • Proloquo2Go: Tool to help kids with speech difficulties communicate better. App needs to be customized to reflect kids’ current abilities and goals. Note: Cost is $220.
  • Language Builder Deluxe: Audio and visual tool to learn language. Kids must have interaction with an adult to evaluate their sentences as there is no feedback. Note: Cost is $10.
  • QuestionIt: Basic approach to teaching “question words and concepts” to kids experiencing language delays.

Social Skills:

  • The Social Express II: Interactive lessons “help students to cope with real life situations.” Free to download but subscription required.
  • Social Stories: Help for kids to write social stories such as “School Day,” “Home Day,” and “On the Bus.” Note: Cost is $7.
  • Conversation Builder: “Themed scripts” help kids to practice “successful social exchanges” including turn-taking, initiation and staying on topic. Note: Cost is $20

Summary: There are numerous apps that can help kids on the autism spectrum with emotions, communication, social skills and schedules (not included in this article). Cost is free to a few dollars unless otherwise noted. All the apps are available on Apple products (at least iPad) but only a few are available on Android. Most of the apps cover at least 4 grade levels—usually more.

Sources: Graphite.org and autism.einnews.com

Aberrant Sniffing and Autism

As published on Cell.com on July 20 of this year, researchers tested the sniff response in 36 children, 18 with autism spectrum disorder and 18 without, to see if the sniff response in children with autism is different than the neurotypical. To measure the sniff response, the researchers built a “computer-controlled air-dilution olfactometer equipped with a custom-designed double-barreled pediatric nasal cannula that allowed [the researchers] to simultaneously deliver odors and measure nasal airflow.” This instrument was used to measure the sniff response to “pleasant (rose or shampoo) and unpleasant (sour milk or rotten fish) odors.” The procedure took 10 minutes and consisted of 20 different smells (10 of each type) while the children watched a cartoon. The four parameters measured to quantify the sniff response were “sniff volume, peak airflow rate, mean airflow rate, and duration.” Note, the sniff response was not done in relation to any verbal cues or task.

Results of the study showed that children without autism spectrum disorder took “larger sniffs” for pleasant odors versus unpleasant odors. There was no difference in the sniffs between pleasant and unpleasant smells in the autism group. The researchers also found that the greater aberrant sniffing (non-adjustment of the sniff based on the properties of the odor), the more severe the autism. The difference in the two groups persisted even with “equal reported odor perception” (children identified equally between the two groups whether smell was supposed to be pleasant or unpleasant).

I would caution on extrapolating too much from the study regarding aberrant sniffing as the sample size is small. Also, from personal experience, the intensity of the smell, irrespective of whether the particular smell is deemed “pleasant” or “unpleasant” makes a big difference as to how I (who am on the autism spectrum) react to the smell. For example, I cannot stand intense perfume smells that emanate from a person or a cleaning product regardless of whether the actual smell is something pleasant like a flower.

Source: http://www.cell.com/current-biology/fulltext/S0960-9822%2815%2900651-X

CHD8 Gene and Autism

Dozens of genes have been found to be correlated with autism. However, according to James P. Noonan, an associate professor of genetics, ecology and evolutionary biology at the Kavli Institute for Neuroscience at Yale University, one of these genes, CHD8, has been found to be a “master regulator in the developing human brain” and to “control the expression of many other genes.” The function of CHD8 is thought to be to regulate gene expression by “modifying the way DNA interacts with histones, proteins present in the nucleus of every cell that wind long strands of DNA.” People who have “a loss-of-function mutation in this gene, which inactivates the corresponding protein, are very likely to have an autism diagnosis.” Noonan’s study was published in March in the journal Nature Communications.

In the study, Noonan and his fellow researchers looked at developing brains of people and mice as well as neuronal stem cells. They found that CHD8 bound to thousands of sites in the brains of the humans and mice as well as the stem cells. Next, they reviewed previous genetic studies and found that “autism-associated genes were more likely to be targeted by CHD8 than expected by chance.” Finally, they looked at whether CHD8 had a regulatory effect on these genes associated with autism. The researchers looked to accomplish this goal by “reducing the expression of the CHD8 gene in cultured human neuronal stem cells and explored what, if any, gene expression levels changed.” The result of this reduced gene expression was the impaired regulation of many of the targeted genes but “autism risk genes were most strongly affected.” Mr. Noonan believes that as a result of this type of research, answers to what “biological pathways and developmental processes that are affected in autism” will be developed.

Source: News.Yale.edu March 10, 2015

Brain Anatomy Differences in Autism

The Medical Research Council UK Autism Imaging Multicentre Study which was comprised of the Institute of Psychiatry at Kings College in London, the Autism Research Centre at the University of Cambridge and the Autism Research Group at the University of Oxford analyzed the brains of males with autism versus male controls using quantitative magnetic resonance imaging. The study was comprised of 89 men with autism spectrum disorder (mean age 26 and “full-scale IQ 110”) and 89 “male control participants” (mean age 28 and “full-scale IQ 113”). The differences in the two groups were identified statistically through “partial least squares analysis.”

The results of the study showed significant brain anatomy differences between the two groups although the adults with autism spectrum disorder did not “differ significantly from the controls in overall brain volume.” Study individuals with autism did have “significantly increased gray matter volume in the anterior temporal and dorsolateral prefrontal regions and significant reductions in the occipital and medial parietal regions as compared with controls.” The importance of these regional differences in neuroanatomy is that there was a “significant correlation between these differences and the severity of specific autistic symptoms.” Additional differences between those with autism spectrum disorder and the male controls were that those with autism had “spatially distributed reductions in white matter volume.”

In summary, quantitative MRI showed that although the overall brain volume of those with autism spectrum disorder and the controls (commonly referred to as the neurotypical) is not significantly different, there are significant brain anatomy differences in gray matter volume as well as white matter volume in those with autism spectrum disorder compared to the neurotypical; and further, the regional differences correlated with autistic symptom severity.

Source: Journal of the Archives of General Psychiatry; Jan. 2, 2012; copyrighted by the American Medical Association as detailed on the Nuffield Department of Clinical Neurosciences Medical Sciences Division of University of Oxford website: http://www.ndcn.ox.ac.uk/publications/343223.

Autism and Mealtime

So I have been reading a lot of blog posts about neurotypical parents and their struggles with their autistic child or children at mealtime. If your family has an enjoyable mealtime where everyone is ready to join hands and sing Kumbaya, then this article is not for you. On the other hand, if mealtime at your house is more like hell on earth, and you go to bed at night craving Valium, then read on.

Psychologists and all sorts of pro-family professionals like to extol the virtues of family mealtime. It’s the part of the day when everyone in the family gets together to compare notes and agendas about the day, and check-in as it were. Additionally, as if contending with society’s norms wasn’t enough, you probably have relatives and friends who are quick to remind you of the importance of “3 squares a day,” “eating everything on your plate because there are starving Africans,” “mealtime is synonymous with family time” etc. etc. ad nauseam.

But, how about we look at mealtime from the perspective of an autistic person. I have been on the autism spectrum for over fifty years and I raised a daughter on the autism spectrum so I would like to share some observations. I don’t purport to know what it is like for every autistic person, but I can give some perspective to the neurotypical out there. As the vast majority of autistic children have some type of sensory issue, let’s look at what mealtime may be like from the viewpoint of one with sensory issues.

  • Light:  Is it bright in your kitchen or dining room at mealtime? Most people don’t eat in the dark unless the power is out, so chances are there is a fair amount of light emanating from light bulbs at dinner as well as sunlight during the day.  Does your child act up when in the presence of fluorescent light, bright sunlight or just a well-lit room?
  • Noise: Is it quiet like a library at your breakfast or dinner table? Or is there a lot of talking, bustling about, moving of chairs etc.?
  • People: Does your child get antsy/agitated when around more than 1 person at a time? Does your child prefer a lot of alone time? How does/he she react with a group of people around a table?
  • Textures/Taste: Does your child only like certain textures of food?  Certain colors of food?  If there is more than one item on the plate, does he get agitated if the food touches or starts running together? Does unfamiliar food send your child into a meltdown?
  • Smell: Does your child have a heightened sense of smell? Do certain smells agitate him? How about a variety of smells all at once?

Is it any wonder your child does not do well at mealtime or refuses to eat?

When I raised my daughter, she and I were the only ones in the home and as I mentioned, we both are on the autism spectrum. The family meal concept (breakfast, lunch, dinner) went out the window early. You probably noticed your autistic child only likes a few foods (little sarcasm there). We on the autism spectrum will eat the same foods most of the time, if you let us, until we either get tired of the food (which can take a VERY long time) or we have something else put in front of us that looks more interesting. I have eaten peanut butter sandwiches for lunch (or sometimes for dinner) pretty much every day for the last fifty years. Really. My daughter and I when she was growing up, rarely liked the same foods at the same time or wanted to eat at the same time of the day. I could have forced us to have mealtime, but it seemed counterproductive. Yes, we did eat a meal together on occasion outside of the home at a restaurant or at a relative or friend’s house. I do advocate having a “group meal” once in a while to teach your child about the neurotypical world, but forcing your autistic child into 2 or 3 family meals around a table per day is going to put you into an early grave. By the way, my daughter and I are healthy adults (from a nutritional standpoint—anxiety issues are another story).

Do yourself and your nervous system, not to mention the poor overloaded nervous system of your child on the autism spectrum, a favor, and try to give your child small amounts of no more than 1 or 2 foods at a time. Combine that with an eating environment that is one to one and surrounded by low light, low sound and low disruption. Inotherwords, have eating take place in an environment as soothing as possible. Experiment and see what different foods your child may like. Above all, don’t give up. Just because your child does not like the food now, doesn’t mean he won’t want to try it 3 months from now or a year from now.

Do NOT battle with your child over eating. Battling over food turns eating into an anxiety-producing activity which can lead to life-long eating problems and even eating disorders. Introduce new foods slowly and don’t expect miracles overnight. Eventually, try giving foods from different food groups at intervals during the entire waking day to maintain nutrition. Resist the temptation to believe “my child only likes …” and repeatedly just give him that food. You are not doing him any favors.