Autism Spectrum Disorders (ASD)

Autism: Just a behavioural disorder?

Think Again

This website challenges the mainstream view that autism is a just behavioural disorder.

No ASD individual should be denied a comprehensive evaluation for underlying medical issues that can be effectively treated.

Treat the child NOT the autism diagnosis!

How effective are mainstream and alternative treatments?

When my son was diagnosed, the ARI Treatment Rating was probably the best source of information I had to work with. Since 2009 we have greatly improved the effectiveness of these treatments and added many more.

 

Where do you start to help your child achieve their full potential?

If you have been told that there is no research to show that dietary modification or supplements can benefit, read the research and think again.

HOW CAN WE HELP YOUR CHILD?

Together We Can Help Your Child Achieve a Better Outcome

As a Medical Scientist, Naturopath and father of an ASD child, I know the frustration and challenges of finding the best treatment for your child. Often parents just know that it is not just ASD that is an issue. Something else may be making your child unhappy. If you don’t know what you are dealing with, then it is harder to treat your child successfully.
So can I help your child? Well no, because ultimately I know from over 20 years of personal and professional experience that it depends on your commitment and persistence to help your child. I can give you my opinion, assessment, advice and guidance. I will work with you, and within your means. However it is a long journey, and just as ASD is a spectrum, so are children’s responses. Sometimes we see immediate and amazing changes, the “wow” moments. Other times the benefits we see are slower, but they do get better.

As a parent you need to do your own research, question everything and commit to helping your child. I don’t want to be the bearer of bad news, but sometimes we need to look to the future to realise that we need to act NOW. There is no “magic potion”, it is a lot of little things done well that ultimately help. This starts with three fundamental principles that form the foundation of helping any child:

  1. dietary issues
  2. sleep disturbances
  3. gastrointestinal problems

By correcting these three fundamental issues, your child will be much happier and life is a little less stressful for you and your family. Especially if all are able to get a good night’s sleep! It also builds a good foundation for other supportive therapies like behavioural, speech, occupational therapy, etc.

My role is to diagnose the underlying issues your child may have and to support you, your family and your child. Your role is to be my eyes and ears as we embark on this journey, as I need to have a clear picture on how your child is progressing. By working together we will be able to achieve the best outcome for your child. Some parents prefer to have a few initial sessions to have their child assessed and have a health plan prepared that can guide them in helping their child. They may then review their child’s progress every few months to see how their child’s health plan may need to change. Or we decide to do some additional testing to see what other underlying issues may need to be addressed.

By correcting a child’s underlying issues, I have yet to see a child not benefit by becoming happier, calmer and ultimately benefiting more from any additional therapies. They are able to concentrate, learn and hopefully develop the skills to become independent. As a parent of an ASD child, this is what I wanted most for my child. Was it easy? No, but I made the commitment, and now he is independent and making his mark on the world. Together, we can do the same for your child.

 

Dietary Modification for ASD Children

The Gut – Why is it so important in ASD?

The Importance of Sleep

Beyond the Basics – The future direction of ASD treatment

Current Research – Selected research articles of interest

Autism is treatable!

Research is useless unless it is read, shared and implemented.

May 2017

What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis.Of children meeting criteria for ASD, the true male-to-female ratio is not 4:1, as is often assumed; rather, it is closer to 3:1. There appears to be a diagnostic gender bias, meaning that girls who meet criteria for ASD are at disproportionate risk of not receiving a clinical diagnosis.”

Employers’ perception of the costs and the benefits of hiring individuals with autism spectrum disorder in open employment in Australia. Full text. “This study examines the benefits and costs of employing adults with ASD, from the perspective of employers. Fifty-nine employers employing adults with ASD in open employment were asked to complete an online survey comparing employees with and without ASD on the basis of job similarity. The findings suggest that employing an adult with ASD provides benefits to employers and their organisations without incurring additional costs.” Highly recommend parents of teenage children to read this article to see what type of companies may employ their child. As well as ways to approach prospective employers.

Abnormal Brain Connectivity Spectrum Disorders Following Thimerosal Administration: A Prospective Longitudinal Case-Control Assessment of Medical Records in the Vaccine Safety Datalink. Full text. “Autism spectrum disorder (ASD), tic disorder (TD), and hyperkinetic syndrome of childhood (attention deficit disorder [ADD]/attention deficit hyperactivity disorder [ADHD]) are disorders recently defined as abnormal connectivity spectrum disorders (ACSDs) because they show a similar pattern of abnormal brain connectivity. This study examines whether these disorders are associated with exposure to thimerosal, a mercury (Hg)-based preservative. A hypothesis testing case-control study evaluated the Vaccine Safety Datalink for the potential dose-dependent odds ratios (ORs) for diagnoses of ASD, TD, and ADD/ADHD compared to controls, following exposure to Hg from thimerosal-containing Haemophilus influenzae type b vaccines administrated within the first 15 months of life. On a per 25 μg Hg basis, cases diagnosed with ASD, TD, or ADD/ADHD were significantly more likely than controls to have received increased Hg exposure. The results suggest that Hg exposure from thimerosal is significantly associated with the ACSDs of ASD, TD, and ADD/ADHD.”

What do Cochrane systematic reviews say about interventions for autism spectrum disorders? Full text. “This review included 17 Cochrane systematic reviews. None of them provided high-quality evidence for any autism-related outcome. Acupuncture, early intensive behavioral intervention, gluten and casein-free diets, music therapy, parent-mediated early intervention, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, clomipramine, tianeptine and selective serotonin reuptake inhibitors are pharmacological options that seem to have some benefits (this last one only for adults), but all of them are associated with high risks of important adverse events.”

Autism risk following antidepressant medication during pregnancy. “Medication with antidepressants during pregnancy does not appear to be causally associated with an increased risk of ASD in the offspring. Instead, the results suggest that the association is explained by factors related to the underlying susceptibility to psychiatric disorders. Based on these findings, the risk of ASD in the offspring should not be a consideration to withhold treatment with commonly used antidepressant drugs from pregnant women.”

“Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions.Camouflaging of autistic characteristics in social situations is hypothesised as a common social coping strategy for adults with autism spectrum conditions (ASC). Camouflaging may impact diagnosis, quality of life, and long-term outcomes, but little is known about it. This qualitative study examined camouflaging experiences in 92 adults with ASC, with questions focusing on the nature, motivations, and consequences of camouflaging. Thematic analysis was used to identify key elements of camouflaging, which informed development of a three-stage model of the camouflaging process. First, motivations for camouflaging included fitting in and increasing connections with others. Second, camouflaging itself comprised a combination of masking and compensation techniques. Third, short- and long-term consequences of camouflaging included exhaustion, challenging stereotypes, and threats to self-perception.”

Risperidone Therapy and CYP2D6 Genotype. Free book. “Risperidone is the most commonly prescribed antipsychotic medication in the US. It is an atypical (second generation) antipsychotic used in the treatment of schizophrenia, bipolar disorder, severe dementia, and irritability associated with autism. Risperidone is metabolized to the active metabolite 9-hydroxyrisperidone by the enzyme CYP2D6 and to a lesser extent by CYP3A4. Individuals who carry two inactive copies of the CYP2D6 gene are termed “poor metabolizers” and may have a decreased capacity to metabolize risperidone. These individuals may be at a higher risk of adverse effects because of increased exposure to plasma risperidone, compared to normal metabolizers, who carry two active copies of CYP2D6. Individuals who are CYP2D6 ultrarapid metabolizers (who carry more than two functional copies of CYP2D6) may have a decreased response to therapy, resulting from lower steady-state risperidone concentrations.”

Aripiprazole Therapy and CYP2D6 Genotype. Free book. “Aripiprazole is an atypical antipsychotic used in the management of schizophrenia, bipolar disorder, major depressive disorder, irritability associated with autistic disorder, and treatment of Tourette’s disorder. The metabolism and elimination of aripiprazole is mainly mediated through two enzymes, CYP2D6 and CYP3A4. Approximately 8% of Caucasians, 3–8% of Black/African Americans and up to 2% of Asians cannot metabolize CYP2D6 substrates and are classified as “poor metabolizers” (1). The FDA-approved drug label for aripiprazole states that in CYP2D6 poor metabolizers, half of the usual dose should be administered. In CYP2D6 poor metabolizers who are taking concomitant strong CYP3A4 inhibitors (e.g., itraconazole, clarithromycin), a quarter of the usual dose should be used.”

Characterization of Medication Use in a Multicenter Sample of Pediatric Inpatients with Autism Spectrum Disorder.Nearly 11% of youth with Autism Spectrum Disorder (ASD) undergo psychiatric hospitalization, and 65% are treated with psychotropic medication. Here we characterize psychotropic medication usage in subjects enrolled in the Autism Inpatient Collection. Participant psychotropic medication usage rates topped 90% at admission and discharge, though there was a decline at 2-month follow-up. Antipsychotics, ADHD medications, and sleep aids were the most commonly reported classes of medications.”

Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder.Behavioral problems were significantly improved following AT [adnotonsillectomy] in ASD children with OSA [obstructive sleep apnoea]. Early detection and treatment of children with OSA is essential to prevent behavioral problems and to support mental development.”

Efficacy of Structured Yoga Intervention for Sleep, Gastrointestinal and Behaviour Problems of ASD Children: An Exploratory Study. Full text. “According to parent’s feedback after one month of intervention most of the children improved in sleep and digestion related problems. During night children slept without any interruption for longer period compared to pre-intervention, going to bed in the night and getting up from bed in the morning not sleeping during day time were some of the improvements observed and this helped parents and other family members to have good sleep themselves during night. Some children who were snoring and breathing from mouth during sleep also stopped. Many children started taking balanced food instead of over eating every time.”

Sleep in Children with Autism Spectrum Disorder.Approximately two thirds of children with ASD have chronic insomnia, and to date, the strongest evidence on promoting sleep is for sleep education, environmental changes, behavioral interventions, and exogenous melatonin.”

Association between autism spectrum disorder and epilepsy in children.There is a significant association between ASD and epilepsy in children. The possibility of the comorbidity between ASD and epilepsy may be assessed according to the status of growth and development before the age of one year, sensory responses and behavioral competencies, and the presence or absence of epileptic seizures.”

The Gut Microbiota and Autism Spectrum Disorders. Full text. “Gastrointestinal (GI) symptoms are a common comorbidity in patients with autism spectrum disorder (ASD), but the underlying mechanisms are unknown. Many studies have shown alterations in the composition of the fecal flora and metabolic products of the gut microbiome in patients with ASD. The gut microbiota influences brain development and behaviors through the neuroendocrine, neuroimmune and autonomic nervous systems. In addition, an abnormal gut microbiota is associated with several diseases, such as inflammatory bowel disease (IBD), ASD and mood disorders. Here, we review the bidirectional interactions between the central nervous system and the gastrointestinal tract (brain-gut axis) and the role of the gut microbiota in the central nervous system (CNS) and ASD. Microbiome-mediated therapies might be a safe and effective treatment for ASD.”

Increased Serum Zonulin Levels as an Intestinal Permeability Marker in Autistic Subjects.Serum levels of zonulin, which regulates tight junctions between enterocytes and is a physiological modulator controlling intestinal permeability, in patients with autism spectrum disorders (ASDs). Serum zonulin levels were significantly higher in the patients with ASD compared with the healthy controls. There was a positive correlation between zonulin levels and Childhood Autism Rating Scale score when all subjects were assessed. This study suggests that zonulin, which regulates intestinal permeability, plays a role in the development of symptoms of ASD.”

Predictive value of selected biomarkers related to metabolism and oxidative stress in children with autism spectrum disorder.Several and reproducible studies have suggested that oxidative stress may represent one of the primary etiological mechanism of ASD that can be targeted for therapeutic intervention. Using either spectrophotometric or ELISA-colorimetric assay, levels of lipid peroxides, vitamin E, vitamin C, glutathione (GSH)/glutathione disulfide (GSSG) together with the enzymatic activity of catalase, plasma glutathione peroxidase (GPx), and blood superoxide dismutase (SOD), were measured in peripheral blood samples, as biomarkers related to oxidative stress. A remarkable increase in the area under the curve for most of the combined markers, representing both energy impaired metabolism or oxidative stress, was observed. Agents with activity against the impaired metabolic pathway associated with ASD including the metabolic defects and involved enzymes hold a promise as a novel therapy for ASD.”

Mast cells in neuroinflammation and brain disorders.It is well recognized that neuroinflammation is involved in the pathogenesis of various neurodegenerative diseases. Microglia and astrocytes are major pathogenic components within this process and known to respond to proinflammatory mediators released from immune cells such as mast cells. Mast cells reside in the brain and are an important source of inflammatory molecules. Mast cell interactions with glial cells and neurons result in the release of mediators such as cytokines, proteases and reactive oxygen species. During neuroinflammation, excessive levels of these mediators can influence neurogenesis, neurodegeneration and blood-brain barrier (BBB) permeability. Mast cells are considered first responders and are able to initiate and magnify immune responses in the brain. Their possible role in neurodegenerative disorders such as multiple sclerosis, Alzheimer’s disease and autism has gained increasing interest.

Postnatal treatment using curcumin supplements to amend the damage in VPA-induced rodent models of autism. Full text. “To summarize, this study shows evidence of the postnatal therapeutic role of curcumin in improving most of the impaired parameters in VPA (valproic acid) -induced rodent models with persistent autistic features. The mechanism of action underlying the therapeutic effects of curcumin should be investigated in the near future. Studies of the protective effects of curcumin are also recommended.”

Blood Mercury, Arsenic, Cadmium, and Lead in Children with Autism Spectrum Disorder. Environmental factors have been implicated in the etiology of autism spectrum disorder (ASD); however, the role of heavy metals has not been fully defined. This study investigated whether blood levels of mercury, arsenic, cadmium, and lead of children with ASD significantly differ from those of age- and sex-matched controls. Data showed that the children with ASD had significantly higher levels of mercury and arsenic and a lower level of cadmium. The levels of lead did not differ significantly between the groups. The results of this study are consistent with numerous previous studies, supporting an important role for heavy metal exposure, particularly mercury, in the etiology of ASD.”

Suicidality in Autistic Spectrum Disorders.Prevalence of suicide attempts varied between 7% and 47%, while suicidal ideation was reported in up to 72% of cases. Being male and having a history of self-harm and depression were cited as significant risk factors. Suicidal attempts and ideation are increased in ASD; however, the extent of the increase and the risk factors identified within this group remain under-investigated.”

Maternal experience raising girls with autism spectrum disorder: a qualitative study. Mothers reported a sense of exclusion from the neurotypical population and male-dominant ASD population and transformation in relationship. Themes identified were skepticism and delayed diagnosis, disbelief from others, lack of information about girls with ASD, higher social demands in adolescence, puberty challenges around hygiene, disappointment about physical appearance, vulnerability in relationships and worries about future functioning. The mother-daughter relationship started with an early expectation of a close and intimate relationship that then underwent a transformation, which challenged maternal competence, reshaped expectations and created a different bond between mother and daughter.”

 

April 2017

Autism, epilepsy, and synaptopathies: a not rare association.ASD are often associated with neurological conditions: the co-occurrence of epilepsy is well documented and there is also evidence of a higher prevalence of EEG abnormalities with 4-86% of individuals with ASD presenting epileptiform or not epileptiform EEG abnormalities. The presence of epilepsy in people with ASD may be determined by several structural alterations, genetic conditions, or metabolic dysfunctions, known to play a role in the emergence of both epilepsy and autism.”

Grand-maternal smoking in pregnancy and grandchild’s autistic traits and diagnosed autism. Full text. “Here we use the Avon Longitudinal Study of Parents and Children (ALSPAC) to test the hypothesis that if the mother or father (F1) had been exposed to their own mother’s (F0) smoking during pregnancy, the offspring (F2) would be at increased risk of autism. We find an association between maternal grandmother smoking in pregnancy and grand daughters having adverse scores in Social Communication and Repetitive Behaviour measures that are independently predictive of diagnosed autism. In line with this, we show an association with actual diagnosis of autism in her grandchildren. Paternal grandmothers smoking in pregnancy showed no associations.”

Brief Report: Metformin for Antipsychotic-Induced Weight Gain in Youth with Autism Spectrum Disorder.Antipsychotic treatment in youth with autism spectrum disorder (ASD) is becoming increasingly common, placing individuals at risk for antipsychotic-induced weight gain and associated complications. Metformin hydrochloride, a biguanide medication FDA-approved for treatment of type-2 diabetes in youth, may hold promise for treatment of antipsychotic-induced weight gain in youth with ASD. In this report we assess the long-term impact of metformin on antipsychotic-associated weight gain in a naturalistic sample of 53 youth with ASD. Results indicate that treatment with metformin stabilized BMI z-score over a nearly 2 year mean treatment period. Further work is indicated to determine the safety and efficacy of metformin treatment in youth with ASD, as well as predictors of response as a treatment for antipsychotic-induced weight gain.”

EEG abnormalities and long term seizure outcome in high functioning autism. Electroencephalographic abnormalities may occur in autistic spectrum disorders (ASD) even in the absence of clinical seizures. These abnormalities may vary from nonspecific changes to epileptiform abnormalities and are more common compared to the overall population. In this study we investigated the presence of EEG abnormalities in sixteen children diagnosed with high-functioning ASD. EEG recording was performed for at least 2 h and included at least 90 min of sleep activity. While none of the patients had clinical seizures, 5 patients (31.3%) were detected to have EEG abnormalities. Four of these were epileptiform (25%), and one patient developed seizure during follow-up. Our results support the fact that EEG abnormalities are observed at a higher rate also in ASD with a better functionality. The potential impact of EEG abnormalities on cognition and behavior, and the risk of epilepsy should be considered during long-term follow-up of these patients.”

Gestational vitamin D deficiency and autism spectrum disorder. Full text. “Based on a sample of 4334 children and their mothers, of whom 68 children were diagnosed with ASD, we show that gestational 25OHD deficiency is associated with a higher risk of being diagnosed with ASD. The finding from this study lends weight to the growing body of epidemiological and animal model-based research linking gestational vitamin D deficiency and altered brain development.”

Prevalence of Congenital Cytomegalovirus Infection Assessed Through Viral Genome Detection in Dried Blood Spots in Children with Autism Spectrum Disorders. Full text. “In conclusion, the prevalence of congenital CMV infection in our cohort of children with ASD was much higher than that in the general population (5% versus 0.6%), which supports an etiological association between ASD and CMV infection. Consequently, detection of CMV-DNA via DBS can be considered in the work-up of children with ASD. Given the potential prevention and treatment of CMV infection, this study could have intriguing consequences, at least for a group of patients with ASD.”

The effect of dietary supplements on clinical aspects of autism spectrum disorder: A systematic review of the literature.Types of dietary supplements evaluated in these studies included amino acids, fatty acids and vitamins/minerals. N-acetylcysteine was shown to exert a beneficial effect on symptoms of irritability. On the other hand, literature data about the efficacy of d-cycloserine and pyridoxine-magnesium supplements was controversial. No significant effect was identified for fatty acids, N,N-dimethylglycine and inositol. Literature data about ascorbic acid and methyl B12 was few, although some encouraging results were found. No serious adverse events were reported in the vast majority of the studies, while the prevalence of adverse reactions was similar between treatment and placebo groups. The use of dietary supplements in children with autism seems to be a safe practice with encouraging data about their clinical efficacy.”

Improvement in Excoriation (Skin-Picking) with use of Risperidone in a Patient with Developmental Disability. Full text. “In this case, an 11-year-old male with intellectual disability and autistic spectrum disorder, with self-injurious skin-picking, was treated with risperidone with complete resolution of skin-picking symptoms. risperidone has been approved for irritability and aggression in Autistic spectrum disorder, and may be a valuable treatment option for skin-picking in pediatric patients with developmental disabilities.”

Melatonin and circadian rhythms in autism: Case report.Among the most co-occurring conditions in autism spectrum disorders (ASD), there are sleep disorders which may exacerbate associated behavioral disorders and lead to intensification of existing autistic symptoms. Several studies investigating the use of melatonin in the treatment of sleep disorders in ASD have shown comparative efficiency in sleep with little or no side effects.”

Next Generation Sequencing Mitochondrial DNA Analysis in Autism Spectrum Disorder. Autism is a complex genetic disorder where both de-novo and inherited genetics factors play a role. Next generation sequencing approaches have been extensively used to identify rare variants associated with autism. To date, all such studies were focused on nuclear genome; thereby leaving the role of mitochondrial DNA (mtDNA) variation in autism unexplored. Our findings provide further support for the role of mitochondria in ASD and confirm that whole-exome sequencing allows for analysis of mtDNA, which sets a stage for further comprehensive genetic investigations of the role of mitochondria in autism.”

Developmental Neurotoxicity of Traffic-Related Air Pollution: Focus on Autism.Several studies suggest that young individuals may be particularly susceptible to air pollution-induced neurotoxicity and that perinatal exposure may cause or contribute to developmental disabilities and behavioral abnormalities. In particular, a number of recent studies have found associations between exposures to traffic-related air pollution and autism spectrum disorders (ASD).”

The role of oxidative stress, inflammation and acetaminophen exposure from birth to early childhood in the induction of autism. Full text. “The wide range of factors associated with the induction of autism is invariably linked with either inflammation or oxidative stress, and sometimes both. The use of acetaminophen in babies and young children may be much more strongly associated with autism than its use during pregnancy, perhaps because of well-known deficiencies in the metabolic breakdown of pharmaceuticals during early development. Thus, one explanation for the increased prevalence of autism is that increased exposure to acetaminophen, exacerbated by inflammation and oxidative stress, is neurotoxic in babies and small children. This view mandates extreme urgency in probing the long-term effects of acetaminophen use in babies and the possibility that many cases of infantile autism may actually be induced by acetaminophen exposure shortly after birth.”

Environmental factors influencing the risk of autism. Full pdf. “Autism is a developmental disability with age of onset in childhood (under 3 years old), which is characterized by definite impairments in social interactions, abnormalities in speech, and stereotyped pattern of behaviors. Due to the progress of autism in recent decades, a wide range of studies have been done to identify the etiological factors of autism. It has been found that genetic and environmental factors are both involved in autism pathogenesis. Hence, in this review article, a set of environmental factors involved in the occurrence of autism has been collected, and finally, some practical recommendations for reduction of the risk of this devastating disease in children are represented.”

Vitamin D-related genes are subjected to significant de novo mutation burdens in autism spectrum disorder.Vitamin D deficiency is a putative environmental risk factor for autism spectrum disorder (ASD). Besides, de novo mutations (DNMs) play essential roles in ASD. However, it remains unclear whether vitamin D-related genes (VDRGs) carry a strong DNM burden. We provide straightforward genetic evidences for the first time that VDRGs with a strong degree of DNM burden in ASD and DNMs of VDRGs could be involved in the mechanism underlying in ASD pathogenesis.”

The role of cholesterol metabolism and various steroid abnormalities in autism spectrum disorders: A hypothesis paper.Based on evidence from the relevant research literature, we present a hypothesis that there may be a link between cholesterol, vitamin D, and steroid hormones which subsequently impacts on the development of at least some of the “autisms” [Coleman & Gillberg]. Our hypothesis, driven by the peer reviewed literature, posits that there may be links between cholesterol metabolism, which we will refer to as “steroid metabolism” and findings of steroid abnormalities of various kinds (cortisol, testosterone, estrogens, progesterone, vitamin D) in autism spectrum disorder (ASD). Further research investigating these potential links is warranted to further our understanding of the biological mechanisms underlying ASD.”

Whose Expertise Is It? Evidence for Autistic Adults as Critical Autism Experts. Full pdf. “Autistic and non-autistic adults’ agreement with scientific knowledge about autism, how they define autism, and their endorsement of stigmatizing conceptions of autism has not previously been examined. Autistic participants exhibited more scientifically based knowledge than others. They were more likely to describe autism experientially or as a neutral difference, and more often opposed the medical model. As one autistic participant stated, “everybody is an expert bar the person with a diagnosis. That needs to change”.”

Gingival bleeding in a patient with autism spectrum disorder: A key finding leading to a diagnosis of scurvy.This case reports a patient with ASD in which gingival bleeding was the key finding that led to a diagnosis of scurvy. The literature review discusses behavioral food aversions in patients with ASD that lead to significant nutritional deficiencies, such as scurvy. Through this case report, the objective is to raise clinical awareness to consider relatively rare diseases in patients with ASD who have atypical feeding patterns.”

Vitamin-D Deficiency As a Potential Environmental Risk Factor in Multiple Sclerosis, Schizophrenia, and Autism. Full pdf. “Several studies found lower vitamin-D levels in children with autism compared to their siblings, parents, and non-family controls. Low vitamin-D levels were already present at birth in children later diagnosed with ASD but not in their healthy siblings. Subsequent research demonstrated that the vitamin-D status of mothers corresponded with their offspring’s vitamin-D status at birth. Low levels of vitamin-D during pregnancy impacted negatively on the cognitive status, early development, and ASD diagnosis.”

“We will never be normal”: The Experience of Discovering a Partner Has Autism Spectrum Disorder.Online forums and lay literature suggest that partners of individuals with Autism Spectrum Disorder (ASD) experience depression, distress, and trauma in their everyday lives, exacerbated during the time surrounding diagnosis. In this content analysis, 29 participants were provided with an online open-ended statement asking them to describe in writing their experiences of discovering that their partners had ASD during their relationships. Six themes emerged, including: facing unique challenges within relationships; insisting partners seek diagnosis; initial shock and relief; losing hope for normalcy; making accommodations within relationships; and wishing for professional support. Marriage and family therapists should help couples minimize blaming and promote self-awareness, appropriate relationship expectations, and mutual understanding.” Here is a link to a presentation given by the author of the study.

Clinical clues for autoimmunity and neuroinflammation in patients with autistic regression.The charts of 206 children with ASD and 33 diagnosed with autistic regression variant were reviewed. The incidence of febrile illness in the 6 months prior to initial parental concern was significantly higher in the children with autistic regression compared with those with ASD. The overall prevalence of familial autoimmunity was also higher in children with autistic regression compared with those with ASD. Type 1 diabetes and autoimmune thyroiditis were both more common in families with children with autistic regression.”

Transition to work: Perspectives from the autism spectrum. The aim was to gain better understanding of the experience of transition to work, barriers and also the factors that promote workplace success. Organisation support, advice from co-workers, supportive leadership, allowance of environmental modifications and presence of a consultant were identified as enablers that most facilitated success at work. Challenges included task-related difficulties, individual factors, social difficulties and distractibility, not managing work-related stress, and being perceived to be too frank.”

Autism and schizophrenia: one, two or many disorders?Autism and psychotic disorders such as schizophrenia co-occur more frequently than would be expected by chance alone. Exactly why this should be remains unclear, but a better understanding would have important implications for diagnosis, treatment and for biological explanations of both conditions.”

 

March 2017

Consensus Statement of the Indian Academy of Pediatrics on Evaluation and Management of Autism Spectrum Disorder. Full text. This reference is included to show that recommendations are slowly changing to include underlying co-morbid issues in ASD individuals. “Associated conditions with ASD could include intellectual or language impairment, known genetic conditions, catatonia, motor deficits (e.g., abnormal gait, clumsiness, toe-walking or hypotonia), macrocephaly, medical disorders (e.g., seizures, lead poisoning in children with pica); neurodevelopmental, behavioral and/ or mental health co-morbidities (e.g., hyperactivity, anxiety, depression, behavioral dysregulation), sleep problems (e.g., late onset, frequent waking, restlessness) that may affect daytime function, gastrointestinal, feeding, and nutrition problems (e.g., constipation, restricted diet), and delays in acquisition of self-help skills (e.g., toileting, dressing, hygiene).

Gastrointestinal problems: The frequency and types of gastrointestinal (GI) disorders in children with ASD are similar to those in children without ASD. These include chronic functional constipation and fecal incontinence; gastroesophageal reflux disease; chronic abdominal pain and chronic diarrhea. GI disorders in children with ASD generally should be managed in the same way as in children without an ASD.”

Complementary and alternative therapies: There is no evidence for effectiveness of these therapies and pediatricians should be able to counsel caregivers not to opt for these therapies.” Unfortunately, only one “cherry picked” reference quoted.

Still more comprehensive than Australian paediatric guidelines.

Simplifying study of fever’s dramatic relief of autistic behavior.Dramatic relief of autistic behavior by infectious fever continues to tantalize parents and practitioners, yet researchers still hesitate to study its physiology/biochemistry, fearing stress and heat of brain imaging, contagion, and fever’s complexity. Yet what could be more revealing than a common event that virtually ‘normalizes’ autistic behavior for a time? This paper proposes study of three simplified scenarios: (1) improvements appearing hours before fever, (2) return of autistic behavior soon after fever, (3) improvements persisting long after fever. Each scenario limits some risk – and some explanation – inviting triangulation of decisive factor(s) in relief and recurrence. Return of autistic behavior after fever may be most revealing. The complex mechanisms that generated fever have all abated; simpler cooling mechanisms prevail – how many plausible explanations can there be? The decisive factor in fever’s benefit is concluded to be water drawn/carried from brain myelin and astrocytes by osmolytes glutamine and taurine released from muscles and brain; the decisive factor in return of autistic behavior after fever is return of water.”

Vitamin D Deficiency in Obsessive-Compulsive Disorder Patients with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections: A Case Control Study. Full text. “Previous studies have indicated that vitamin D deficiency is common in psychiatric patients, particularly in those with neuropsychiatric disorders such as autism and schizophrenia. There has been an increasing interest in immune-related neuropsychiatric symptoms that are triggered by group A beta-hemolytic streptococcal infections. In this study, we aimed to compare the serum levels of vitamin D between obsessive-compulsive disorder (OCD) patients with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and control subjects. This study supports the hypothesis that an association between vitamin D metabolism and PANDAS-related OCD exists.”

Autoimmunity, Autoantibodies, and Autism Spectrum Disorder.It is becoming increasingly accepted that ASD is no longer defined simply as a behavioral disorder, but rather as a highly complex and heterogeneous biological disorder. Although research has focused on the identification of genetic abnormalities, emerging studies increasingly suggest that immune dysfunction is a viable risk factor contributing to the neurodevelopmental deficits observed in ASD.”

Identification of likely associations between cerebral folate deficiency and complex genetic- and metabolic pathogenesis of autism spectrum disorders by utilization of a pilot interaction modeling approach.Recently, cerebral folate deficiency (CFD) was suggested to be involved in the pathogenesis of autism spectrum disorders (ASD). However, the exact role of folate metabolism in the pathogenesis of ASD, identification of underlying pathogenic mechanisms and impaired metabolic pathways remain unexplained. Two independent interaction modules (comprising three pathways) covering enzymes encoded by ASD-related genes and folate cofactors utilizing enzymes were generated. Module 1 suggested possible interference of CFD with serine and lysine metabolism, while module 2 identified correlations with purine metabolism and inosine monophosphate production. Since our approach was primarily conceived as a proof of principle, further amendments of the presented initial model are necessary to obtain additional actionable outcomes.”

Dopamine antagonists for treatment resistance in autism spectrum disorders: review and focus on BDNF stimulators loxapine and amitriptyline.Drug development is urgently needed for individuals with autism spectrum disorders (ASD) and psychiatric comorbidity, which often presents as aggression and self-injury. At the same time, most psychiatric medications are drugs that have been repurposed following clinical observations of efficacy for a new treatment purpose. While behavioral treatments can improve core symptoms in ASD, pharmacotherapy and specifically dopamine antagonists are often prescribed for serious challenging behaviors including aggression. The classical antipsychotics received some study and are still often used in antipsychotic polypharmacy however individuals with ASD are more susceptible to the neuromotor side effects which may further impair already compromised mobility as well as cause tardive dyskinesia and neuroleptic malignant syndrome. The novel antipsychotics risperidone and aripiprazole have received most study in ASD and are FDA-approved for irritability in children over age 5 years. However individuals with ASD are more prone to weight gain, Type II diabetes and associated side effects, for which most novel antipsychotics carry a black box warning. The common practice of prescribing SSRIs that inhibit metabolism of many psychoactive drugs together with antipsychotics compounds the side effects.”

Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses. Full pdf. “According to recent evidence, up to 40-50% of variance in autism spectrum disorder (ASD) liability might be determined by environmental factors. The reviews on nutritional elements have been inconclusive about the detrimental effects of deficiency in folic acid and omega 3, but vitamin D seems to be deficient in patients with ASD. The studies on toxic elements have been largely limited by their design, but there is enough evidence for the association between some heavy metals (most important inorganic mercury and lead) and ASD that warrants further investigation. Mechanisms of the association between environmental factors and ASD are debated but might include non-causative association (including confounding), gene-related effect, oxidative stress, inflammation, hypoxia/ischemia, endocrine disruption, neurotransmitter alterations, and interference with signaling pathways.

Classical conditioning for preserving the effects of short melatonin treatment in children with delayed sleep: a pilot study. Full text. “Melatonin treatment is effective in treating sleep onset problems in children with delayed melatonin onset, but effects usually disappear when treatment is discontinued. In this pilot study, we investigated whether classical conditioning might help in preserving treatment effects of melatonin in children with sleep onset problems, with and without comorbid attention deficit hyperactivity disorder (ADHD) or autism. Melatonin treatment was effective in advancing dim light melatonin onset and reducing sleep onset problems, and positive effects were found on health and behavior problems. After stopping melatonin, sleep returned to baseline levels. We found that for children without comorbidity in the experimental group, sleep latency and sleep start delayed less in the stop week, which suggests an effect of classical conditioning. However, classical conditioning seems counterproductive in children with ADHD or autism.

Relationship between selenium, lead, and mercury in red blood cells of Saudi autistic children.Environmental contribution to ASD is due in large part to the sensitivity of the developing brain to external exposures such as lead (Pb), and mercury (Hg) as toxic heavy metals or due to a poor detoxification ability as the phenotype of this disorder. Selenium (Se) as an antioxidant element that counteracts the neurotoxicity of Hg, and Pb, presumably through the formation of nontoxic complexes. In the present study, Pb, Hg, and Se were measured in red blood cells (RBCs) of 35 children with ASD and 30 age- and gender-matched healthy control children. The obtained data demonstrates a significant elevation of Hg and Pb together with a significant decrease in the Se levels in RBCs of patients with ASD when compared to the healthy controls. The ratios of Se to both Pb and Hg were remarkably altered, being indicative of heavy metal neurotoxicity in patients with ASD. In conclusion, the present study indicates the importance of Se for prevention and/or therapy of heavy metal neurotoxicity.

Personal experiences of the Criminal Justice System by individuals with autism spectrum disorders.The processes of arrest, investigation, trial and imprisonment are often extremely difficult for individuals with autism spectrum disorders. The majority of those given a custodial sentence coped well in prison, probably due to the high levels of structure and firm frameworks in that environment. Explanation factors associated with the offences indicated that autism spectrum disorder characteristics such as misunderstandings, obsessions and idiosyncratic beliefs and/or behaviours were frequently involved, but stress was the most common explanation provided by the participants. The findings suggest limited understanding of autism spectrum disorders within the Criminal Justice System which needs to be significantly improved in order to secure their legal protection.”

Behavioral improvements in a valproic acid rat model of autism following vitamin D supplementation.The aim was to identify the effects of early vitamin D supplementation on autism-like behaviors (ASD) induced by valproic acid (VPA, an anti-convulsant and a mood stabilizer) in rats. 10 male Wistar rat pups with prenatal exposure to saline were in control group, and 20 Pups with prenatal exposure to VPA were divided into ASD-N (0.9% saline treated) and ASD-D group (vitamin D 80,000 IU/kg treated) on postnatal day 12. The repetitive behavior of the ASD-N group exhibited a negative linear relationship with serum 25(OH)D3 on PND 42. In conclusion, early vitamin D supplementation in infant rat with ASD induced by VPA significantly improved development and behavior of rats related with ASD.”

Risk of autism spectrum disorders in children born to mothers with rheumatoid arthritis: A systematic literature review.Three studies were included in the final analysis. A case-control study was unable to detect a difference in the prevalence of RA in ASD mothers versus control mothers. Another case-control study showed a statistically significant 8-fold increase in autoimmune disorders, including RA, in mothers of ASD offspring compared to controls. Forty-six percent of ASD offspring had a first-degree relative with RA compared to 26% of controls. Moreover, in a population-based cohort study, investigators observed an increased risk of ASD in children with a maternal history of RA compared to children born to unaffected mothers.”

Association of Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorders with Mean Platelet Volume and Vitamin D. Full text. “The hematological parameters of the patients, including MPV [Mean Platelet Volume], vitamin B12, and vitamin D, were assessed. There was no statistically significant difference in hematological parameters between the groups, but there were significant differences in terms of vitamin D and vitamin B12. The patient groups showed lower levels of vitamin B12 and vitamin D. In the ADHD group, there was a negative correlation between both vitamins and MPV. Both ADHD and ASDs may accompany increased risk for cardiovascular disease due to the presence of vitamin B12 and D deficiency.”

Aging and Autism Spectrum Disorder: A Naturalistic, Longitudinal Study of the Comorbidities and Behavioral and Neuropsychiatric Symptoms in Adults with ASD. Little is known about Autism Spectrum Disorder (ASD) in persons over age 50. In a retrospective, naturalistic review of 74 individuals aged 30 and older meeting DSM-5 criteria for ASD, the point prevalence of behavioral and neuropsychiatric symptoms (BNPS) declined significantly for 12 of 13 BNPS over a mean of 25 years while many other features of ASD remained stable. GI disorders (68.9%) and seizure disorders (23%) were common, and 25.7% of the sample had a BMI >30. Females were more likely to engage in screaming (p < 0.05) and oppositional behavior (p < 0.05). Current age did not have a significant effect on BNPS prevalence.”

Shorter sleep duration is associated with social impairment and comorbidities in ASD. Sleep disturbance, particularly insomnia, is common in children with autism spectrum disorders (ASD). Furthermore, disturbed sleep affects core symptoms and other related comorbidities. Severity scores for social/communication impairment and restricted and repetitive behaviors (RRB) were increased, and IQ scores were decreased, for children reported to sleep ≤420 minutes per night (lower 5th percentile) compared to children sleeping ≥660 minutes (upper 95th percentile). Our results indicate that reduced amounts of sleep are related to more severe symptoms in children with ASD.”

Acute Dystonia due to Aripiprazole Use in Two Children with Autism Spectrum Disorder in the First Five Years of Life. Full text. “It has been is speculated that aripiprazole has a protective effect for extrapyramidal side effects, movement disorders, and metabolic problems. But the increased use in children and adolescents is associated with an increase in the number of case reports related with such problems. Nevertheless, our review of the literature uncovered limited data regarding the association between acute dystonia and aripiprazole use in ASD children under five years of age is. In this paper, we present two cases of autistic spectrum disorder children with ages under 5 years that developed acute dystonia taking aripiprazole.”

Distinct Microbiome-Neuroimmune Signatures Correlate With Functional Abdominal Pain in Children With Autism Spectrum Disorder. Full text. “Our findings identify distinctive mucosal microbial signatures in ASD children with FGID [functional gastrointestinal disorders] that correlate with cytokine and tryptophan homeostasis. Future studies are needed to establish whether these disease-associated Clostridiales species confer early pathogenic signals in children with ASD and FGID.”

Tightening the Case for Gut Microbiota in Autism-Spectrum Disorder. Editorial. Full text. “The study by Luna et al in this issue of Cellular and Molecular Gastroenterology and Hepatology tightens the case for a microbial hub and serotonin and cytokine spokes in the gastrointestinal dysfunction of ASD. Compared with ASD-unaffected children, children with ASD and gastrointestinal dysfunction had increased mucosal tissue levels of select microbial taxa, mainly members of the genus Clostridium.”

The Impact of Dynamic Seating on Classroom Behavior of Students with Autism Spectrum. Full text. “The aim of this study was to compare the effectiveness of dynamic seating devices on improving a students’ in-seat and on-task behaviors and decreasing autism related behaviors within the classroom setting. This study proposes that ball seating in the classroom causes an increase of 86.7% in in-seat behaviors of ASD students. Therapy balls provide sitting and moving concurrently, which may satisfy sensory needs. As a result of normalizing arousal levels and regulating sensory inputs with rocking and bouncing on a ball, students with autism could be satisfied physiologically and would not need to engage in selfstimulatory behaviors. Furthermore, the teachers’ reports supported the use of balls and air cushions for the students in class. Accordingly, the students were calmer when compared to the use of common chairs.”

L-Methylfolate supplementation in a child with autism and methyltetrahydrofolate reductase, enzyme gene C677TT allele.Errors in folate metabolism may play a role in the pathology of autism spectrum disorders because of increased vulnerability to oxidative stress. We report a case where L-methylfolate supplementation improved symptoms of aggression and disruptive behavior in a child with autism who tested positive for the C677TT allele of the methyltetrahydrofolate reductase enzyme gene. To our knowledge, this is the first report of L-methylfolate administration in this situation. Further controlled studies of L-methylfolate in this population are warranted.”

Metabolic Dysfunction Underlying Autism Spectrum Disorder and Potential Treatment Approaches. Full text. “Recent studies have increasingly implicated mitochondrial dysfunction in ASD. The fact that mitochondria are an integral part of diverse cellular functions and are susceptible to many insults could explain how a wide range of factors can contribute to a consistent behavioral phenotype in ASD. Meanwhile, the high-fat, low-carbohydrate ketogenic diet (KD), used for nearly a century to treat medically intractable epilepsy, has been shown to enhance mitochondrial function through a multiplicity of mechanisms and affect additional molecular targets that may address symptoms and comorbidities of ASD. Here, we review the evidence for the use of metabolism-based therapies such as the KD in the treatment of ASD as well as emerging co-morbid models of epilepsy and autism.”

A late-diagnosed phenylketonuria case presenting with autism spectrum disorder in early childhood. Full text. “This case illustrates that because the majority of autism cases are idiopathic, an occasional patient with a metabolic disorder might be overlooked especially in the era of newborn screening. We also discuss the possible pathogenetic processes leading to autistic symptoms in phenylketonuria, and wish to draw attention to the possibility of cases missed in the screening program because of less than 100% coverage or insufficient food intake before blood sampling. Clinicians should keep in mind the possibility of treatable disorders in children with autism even when such disorders appear unlikely.”

Aggressive behaviors and treatable risk factors of preschool children with autism spectrum disorder.Aggressive behaviors of children with ASD were significantly associated with two treatable factors: sleep problems and ADHD symptoms. These findings have substantial clinical implications: treatment of these two risk factors may be helpful in managing aggressive behavior in children with ASD.”

The association between parents’ ratings of ASD symptoms and anxiety in a sample of high-functioning boys and adolescents with Autism Spectrum Disorder. For pre-adolescents, high levels of tension in social situations were associated with 3.5-times greater likelihood of having GAD; for adolescents, experiencing difficulty in changes in routine was associated with a 10-fold increase in risk of GAD.”

An Italian Prospective Experience on the Association Between Congenital Cytomegalovirus Infection and Autistic Spectrum Disorder.Seventy proven congenitally-infected infants, born between 2007 and 2012, were referred to our centre for CMV diagnosis and follow-up, which consisted of a consolidated protocol allowing an early evaluation of autism. We considered four children 2-year old, two of whom, at the age of 3, were diagnosed with ASD demonstrating a 2-3 fold higher prevalence (2.86%), than that in general Italian population (0.66-1.36%). Our protocol enabled us to make the earliest diagnosis and highlight the role of the virus among other causes of autism, which may be a long term sequela of congenital CMV.”

 

February 2017

Noise and autism spectrum disorder in children: An exploratory survey.Most teachers found noise control to be an important issue for students with autism and many observed children using ear defenders. In terms of managing issues related to noise, most teachers agreed that thick or soundproof walls and carpet in the classroom were the most important issues for children with ASD.”

Maternal Immunoreactivity to Herpes Simplex Virus 2 and Risk of Autism Spectrum Disorder in Male Offspring. Full text. “High levels of HSV-2 IgG antibodies in maternal midpregnancy plasma were associated with increased risk of ASD in male offspring. No association was found between ASD and the presence of IgG antibodies to Toxoplasma gondii, rubella virus, CMV, or HSV-1. In our cohort, high levels of antibodies to herpes simplex virus 2 at midpregnancy were associated with an elevated risk of autism spectrum disorder in male offspring.”

Effects of ω-3 fatty acids on stereotypical behavior and social interactions in Wistar rats prenatally exposed to lipopolysaccarides.Prenatal exposure to LPS [lipopolysaccharides] significantly increased the episodes of stereotyped movements and decreased social interaction in the offspring, after ω-3 PUFA supplementation these parameters reversed. Supplementation with ω-3 PUFA reversed animal behaviors that often are observed in autism and other mental disorders in rats prenatally exposed to LPS, and also exerted neuroprotective effects in marker levels of neuronal damage and expression of TGF-β.”

The Immune System, Cytokines, and Biomarkers in Autism Spectrum Disorder. Full text. “A diagnosis of ASD continues to be behaviorally defined. However, the body of research and accumulating evidence with respect to immune system perturbations in ASD suggest that a broader approach should be taken in order to understand biological systems as they pertain to ASD and associated behaviors. The clinical trials of immune-modulating agents, taken together with previous examples of immune system perturbations in children with ASD, suggest that cytokines are worthy of consideration as potential biomarkers of a subgroup of individuals with an ASD diagnosis and more severe behavioral outcomes.”

Salivary biomarker levels and oral health status of children with autistic spectrum disorders: a comparative study.It was observed that salivary pH and buffering capacity were lower in children with ASD than their healthy siblings, the dental caries incidence was higher in ASD children when compared to their healthy siblings and oral hygiene was fair with gingival bleeding in children with ASD.”

Independent Maternal and Fetal Genetic Effects on Mid-gestational Circulating Levels of Environmental Pollutants. Full text. “Our results support genetic control of mid-gestational biomarkers for environmental exposures by non-overlapping maternal and fetal genetic determinants, suggesting that future studies of environmental risk factors should take genetic variation into consideration. The independent influence of fetal genetics supports previous hypotheses that fetal genotypes expressed in placenta can influence maternal physiology and the transplacental transfer of organohalogens.”

Pediatric Hypovitaminosis D: Molecular Perspectives and Clinical Implications. Full text. An excellent review of the importance of adequate vitamin D in paediatrics.Vitamin D plays an important role in repairing DNA damage; thus, its deficiency would result in impaired DNA repair and higher de novo genetic mutation rates linked to an increased risk of autism. There is evidence that vitamin D influences fetal brain growth and neuronal differentiation, and there is an inverse correlation between the serum level of calcidiol concentration and autism rating scale, and a higher level of calcidiol may reduce the risk of autism. There are now speculations that problematic social behaviors in autistic children may also be linked to vitamin D deficiency and abnormal level of serotonin. Higher levels of serotonin have been linked to a gene activated by vitamin D, which in turn produces an enzyme, tryptophan hydroxylase 2 (TPH-2), that converts tryptophan to 5-hydroxytryptamine (serotonin) that leads to a higher level of serotonin production, and another gene that makes the enzyme tryptophan hydroxylase 1 (TPH-1) to be inhibited by vitamin D to halt serotonin production.”

Vitamin D and autism, what’s new?An increasing amount of evidence points to the possibility that gestational and early childhood vitamin D deficiency [25(OH)D < 40 ng/ml] cause some cases of autism. Vitamin D is metabolized into a seco-steroid hormone that regulates about 3% of the 26,000 genes in the coding human genome. It is also a neurosteroid that is active in brain development, having effects on cellular proliferation, differentiation, calcium signaling, neurotrophic and neuroprotective actions; it also appears to have an effect on neurotransmission and synaptic plasticity. Children who are, or who are destined to become, autistic have lower 25(OH)D levels at 3 months of gestation, at birth and at age 8 compared to their unaffected siblings. Two open label trials found high dose vitamin D improves the core symptoms of autism in about 75% of autistic children. A few of the improvements were remarkable.  In terms of prevention, a recent small study showed vitamin D supplementation during pregnancy (5000 IU/day) and during infancy and early childhood (1000 IU/day) significantly reduced the expected incidence of autism in mothers who already had one autistic child from 20% to 5%. Vitamin D is safe; for example, over the last 15 years, Poison Control reports there have been approximately 15,000 cases of vitamin D overdose. However only three of these 15,000 people developed clinical toxicity and no one died. Given those facts, practitioners might consider treating autism with 300 IU/kg/day, and seek to prevent autism by supplementing pregnant and lactating women (5000 IU/day) and infants and young children (150 IU/kg/day) checking 25(OH)D levels every 3 months.”

Relationship between Long Chain n-3 Polyunsaturated Fatty Acids and Autism Spectrum Disorder: Systematic Review and Meta-Analysis of Case-Control and Randomised Controlled Trials. Full text. “Omega-3 long chain polyunsaturated fatty acid supplementation (n-3 LCPUFA) for treatment of Autism Spectrum Disorder (ASD) is popular. Two meta-analyses were conducted; meta-analysis 1 compared blood levels of LCPUFA and their ratios arachidonic acid (ARA) to docosahexaenoic acid (DHA), ARA to eicosapentaenoic acid (EPA), or total n-6 to total n-3 LCPUFA in ASD to those of typically developing individuals (with no neurodevelopmental disorders). Compared with placebo, n-3 LCPUFA improved social interaction and repetitive and restricted interests and behaviours. Populations with ASD have lower n-3 LCPUFA status and n-3 LCPUFA supplementation can potentially improve some ASD symptoms. Further research with large sample size and adequate study duration is warranted to confirm the efficacy of n-3 LCPUFA.”

New evidences on the altered gut microbiota in autism spectrum disorders. Full text. “The finding that, besides the bacterial gut microbiota, also the gut mycobiota contributes to the alteration of the intestinal microbial community structure in ASDs opens the possibility for new potential intervention strategies aimed at the relief of gastrointestinal symptoms in ASDs.”

Elevated Urinary Glyphosate and Clostridia Metabolites With Altered Dopamine Metabolism in Triplets With Autistic Spectrum Disorder or Suspected Seizure Disorder: A Case Study. Full text. “The pattern of metabolites in the urine samples of the males with autism are consistent with a recent theory of autism that connects widespread glyphosate use with alteration of animal and human gastrointestinal flora. That theory is that the normally beneficial bacteria species that are sensitive to glyphosate are diminished and harmful bacteria species, such as Clostridia, that are insensitive to glyphosate, are increased following exposure to glyphosate. Excessive dopamine, caused by inhibition of dopamine-beta-hydroxylase by Clostridia metabolites, in turn, produces oxidative species that damage neuronal Krebs cycle enzymes, neuronal mitochondria, and neuronal structural elements such as the neurofibrils.”

Detection of Clostridium perfringens toxin genes in the gut microbiota of autistic children.We studied stool specimens from 33 autistic children aged 2-9 years with gastrointestinal (GI) abnormalities and 13 control children without autism and without GI symptoms. Our results indicate that autistic subjects with gastrointestinal disease harbor statistically significantly higher counts of C. perfringens in their gut compared to control children. Autistic subjects also harbor statistically significantly higher counts of beta2-toxin gene-producing C. perfringens in their gut compared to control children, and the incidence of beta2-toxin gene-producing C. perfringens is significantly higher in autistic subjects compared to control children.”

The Effect of Mitochondrial Supplements on Mitochondrial Activity in Children with Autism Spectrum Disorder. Full text. “Recent studies suggest that ASD is linked to mitochondrial dysfunction, although the exact nature of mitochondrial abnormalities in ASD appears to be complicated. For example, classic mitochondrial disease is found in 5% of children with ASD, yet up to 50% of children with ASD may have biomarkers of mitochondrial dysfunction. This study provides empirical support for common mitochondrial treatments and demonstrates that the relationship between activities of mitochondrial components might be a marker to follow in addition to absolute activities. Measurements of mitochondrial activity that can be practically repeated over time may be very useful to monitor the biochemical effects of treatments.

Thyroid dysfunction in children with autism spectrum disorder is associated with folate receptor alpha autoimmune disorder.Folate receptor α (FRα) autoantibodies (FRAAs) are prevalent in Autism Spectrum Disorder (ASD). FRAAs disrupt folate transport across the blood-brain barrier by binding to the FRα. Thyroid dysfunction is frequently found in children with ASD. The thyroid showed significant FRα expression during the early prenatal period but expression decreased significantly in later gestation and postnatal thyroid tissue. This study suggests that thyroid dysfunction in ASD may be related to the blocking FRAA. The high expression of FRα in the early fetal thyroid suggests that fetal and neonatal exposure to maternal FRAAs could affect the development of the thyroid and may contribute to the pathology in ASD.”

The Need for Objective Measures of Stress in Autism. Full text. “We believe that stress evaluation should not be subjective. Individuals with autism spectrum disorder should benefit from objective continuous measures of stress, especially knowing that almost half of individuals with autism do not have access to effective communication to express this inner stress.”

Elimination diets’ efficacy and mechanisms in attention deficit hyperactivity disorder and autism spectrum disorder. Full text. ” This review discusses an elimination diet as a treatment for attention deficit hyperactivity disorder and autism spectrum disorder, with a focus on the efficacy of the food additives exclusion diet, glutenfree/casein-free diet and oligoantigenic diet. The GFCF diet might be beneficial for children with ASD and food intolerance/allergy or underlying gastrointestinal disease. However, the evidence for the effectiveness of GFCF diets in children with ASD is weak and thus these diets cannot be generally recommended as a treatment for children with ASD. With regard to oligoantigenic diets, if applied under close supervision, these interventions could be valuable instruments to assess whether ADHD is triggered by food. Furthermore, we have observed large individual differences in terms of time that is needed for any positive effects of the diet to surface during the elimination phase. Some children appear to be ‘fastresponders’, who show a positive reaction after a few days, whereas other children are ‘slow-responders’, who show a positive reaction after a couple of weeks.” Clinically we see huge differences in behaviour in ASD and ADHD children when reactive foods are eliminated from their diet. Designing a rigorus dietary elimination study, is extremley difficult to do. Unfortunately, when such elimination diet  studies are done, those children that respond get lost when the data gets “massaged” statistically.

 

January 2017

The Experiences of Fathers Who Have Offspring with Autism Spectrum Disorder.Fathers described their experiences as a path towards acceptance, with independence and integration for their offspring being key goals. Fathers saw themselves as advocates fighting obstructive services to access appropriate care. The value placed on formal and informal support varied, although the need for personalised support was emphasised.”

Efficacy of group social skills interventions for youth with autism spectrum disorder: A systematic review and meta-analysis.Results show that overall positive aggregate effects were medium. Effects were large for self-report, medium for task-based measures, small for parent- and observer-report, and nonsignificant for teacher-report. Moderation analyses of self-report revealed the effect was wholly attributable to youth reporting that they learned about skilled social behaviors, but not that they enacted them. Social skills interventions presently appear modestly effective for youth with ASD, but may not generalize to school settings or self-reported social behavior.”

Protein-restricted diet during pregnancy after insemination alters behavioral phenotypes of the progeny.Epidemiological studies suggest that hyponutrition during the fetal period increases the risk of mental disorders such as attention deficit hyperactivity disorder and autism-spectrum disorder, which has been experimentally supported using animal models. Significant epigenetic alterations in the brains of the progenies induced by the maternal-protein restriction were observed in the present study. To our knowledge, this is first study to evaluate the effect of maternal hyponutrition on behavioral phenotypes using reproductive technology.”

Microbiota Transfer Therapy alters gut ecosystem and improves gastrointestinal and autism symptoms: an open-label study. Full text. “Several previous studies have reported abnormal gut bacteria in children with ASD. The gut microbiome-ASD connection has been tested in a mouse model of ASD, where the microbiome was mechanistically linked to abnormal metabolites and behavior. Similarly, a study of children with ASD found that oral non-absorbable antibiotic treatment improved GI and ASD symptoms, albeit temporarily. Here, a small open-label clinical trial evaluated the impact of Microbiota Transfer Therapy (MTT) on gut microbiota composition and GI and ASD symptoms of 18 ASD-diagnosed children. The Gastrointestinal Symptom Rating Scale revealed an approximately 80% reduction of GI symptoms at the end of treatment, including significant improvements in symptoms of constipation, diarrhea, indigestion, and abdominal pain. Improvements persisted 8 weeks after treatment. Similarly, clinical assessments showed that behavioral ASD symptoms improved significantly and remained improved 8 weeks after treatment ended.”

Hyperuricemia in Children and Adolescents with Autism Spectrum Disorder Treated with Risperidone: The Risk Factors for Metabolic Adverse Effects. Full text. “Hyperuricemia may play a role in metabolic adverse effect in children and adolescents with ASDs receiving the high dose and/or the long-term treatment with risperidone.”

Analysis of methionine synthase (rs1805087) gene polymorphism in autism patients in Northern Iran.It was recently shown that the genes involved in the folate/homocysteine pathway may be risk factors for autistic children. One of the genes that may be the risk factor for autism is Methionine synthase (MTR). MTR is responsible for the regeneration of methionine from homocysteine. The present study suggests that the G allele of MTR A2756G polymorphism is associated with an increased risk of autism.”

Immune dysfunction and neuroinflammation in autism spectrum disorder.It was found that that often individuals diagnosed with ASD have alterations in immune cells such as T cells, B cells, monocytes, natural killer cells, and dendritic cells. Also, many individuals diagnosed with ASD have alterations in immunoglobulins and increased autoantibodies. Finally, an important portion of individuals diagnosed with ASD has elevated peripheral cytokines and chemokines and associated neuroinflammation. In conclusion, immune dysregulation and inflammation are important components of ASD diagnosis and are key components of the diagnosis and treatment of ASD.”

Bone microarchitecture in adolescent boys with autism spectrum disorder.Bone microarchitectural parameters are impaired in ASD, with reductions in bone strength estimates (stiffness and failure load) at the ultradistal radius and distal tibia. This may result from lower physical activity and calcium intake, and decreased IGF-1 responsiveness.”

Feeding Problems and Nutrient Intake in Children with and without Autism: A Comparative Study.The majority (79%) of the parents of ASD children reported some concern regarding their feeding behavior as compared to 64% of the parents of typically developing children. ASD children consumed fewer number of food items, particularly fruits, vegetables, and proteins; had significantly lower daily intake of potassium, copper, and folate. The findings underscore the need for comprehensive assessment and empirically-supported interventions for eating problems and dietary deficiencies found in ASD children.”

ω-3 Fatty Acid Supplementation Does Not Affect Autism Spectrum Disorder in Children: A Systematic Review and Meta-Analysis.Among studies that used the Aberrant Behavior Checklist, parents’ ratings indicated significant improvement in lethargy symptoms in the ω-3 FA group compared with the placebo group (2 RCTs). Among studies that used the Behavioral Assessment System for Children, parents’ ratings indicated significant worsening of both externalizing behavior and social skills in the ω-3 FA group compared with the placebo group. One RCT reported a significant improvement in the ω-3 FA group for the daily-living component of the Vineland Adaptive Behavior Scale. Adverse effects were similar in both groups.” This review highlights the the differences in results obtained when investigating the benefit of  omega-3 oils. However, none of the studies are looking at the quality of the omega-3 oils being used. See Supplements – Buyer beware for  a discussion about the poor quality of omega- supplements on the market.

Dietary adequacy of Egyptian children with autism spectrum disorder compared to healthy developing children.The present study aimed at comparing dietary regimens and habits of normally developing apparently healthy children, without diagnosed ASD, with a pediatric population of individuals affected by autistic disorder. A total of 23.8% of children with autistic disorder vs. 11.3% in the healthy control group had a nutrient intake with features below the Recommended Dietary Allowance (RDA) of protein. Children with autistic disorder showed low dietary intake of some micronutrients; calcium (Ca), magnesium (Mg), iron (Fe), selenium (Se) and sodium (Na), also they had significantly high intake of potassium (K) and vitamin C compared to healthy controls. Serum Mg, Fe, Ca, folate and vitamin B12 in children with autistic disorder were significantly low compared with healthy children. The evidence reported in the present study should recommend screening of the nutritional status of ASD children for nutrient adequacy to reduce these deficiencies by dietary means or by administering appropriate vitamin and mineral supplements.

Pediatric Traumatic Brain Injury and Autism: Elucidating Shared Mechanisms. Full text. “Pediatric traumatic brain injury (TBI) and autism spectrum disorder (ASD) are two serious conditions that affect youth. Recent data, both preclinical and clinical, show that pediatric TBI and ASD share not only similar symptoms but also some of the same biologic mechanisms that cause these symptoms. Prominent symptoms for both disorders include gastrointestinal problems, learning difficulties, seizures, and sensory processing disruption. In this review, we highlight some of these shared mechanisms in order to discuss potential treatment options that might be applied for each condition.”

Brief Report: Mealtime Behaviors of Chinese American Children with Autism Spectrum Disorder.The top problematic mealtime behaviors reported by parents were prefers “crunchy” food (54.2%); not willing to try new foods (48%); and does not remain seated at the table until the meal is finished (46%). This study found that the majority of the Chinese-American children with ASD seldom or never were aggressive (96%) or disruptive during mealtimes (92.3%). Compared to their white counterparts, Chinese-American children with ASD showed slightly lower scores on problematic mealtime behaviors.”

Being on Your Own or Feeling Lonely? Loneliness and Other Social Variables in Youths with Autism Spectrum Disorders.Results indicated that only at an adolescent age, the ASD group reported higher levels of loneliness than the control groups. Further, the ASD group generally expressed relatively low levels of desire for social interaction, although these youths displayed a similar increase in the wish to belong during adolescence as participants in the control groups. Finally, the ASD group exhibited lower levels of social competence and social skills and higher levels of social problems and social anxiety than the control groups, and in all groups these social variables correlated in a theoretically meaningful with loneliness.”

Significant Association of Urinary Toxic Metals and Autism-Related Symptoms-A Nonlinear Statistical Analysis with Cross Validation. Full text. “Average excretion levels of several toxic metals (lead, tin, thallium, antimony) were significantly higher in the ASD group. Similarly, nonlinear methods determined a significantly stronger association between the behavioral measures and toxic metal excretion. The association was strongest for the Aberrant Behavior Checklist (including subscales on Irritability, Stereotypy, Hyperactivity, and Inappropriate Speech).”

Atypical Color Preference in Children with Autism Spectrum Disorder. Full text. “When mean rank of preference was computed in each of the ASD and TD groups with regard to each color, it was found that boys with ASD were significantly less likely than TD boys to prefer yellow and more likely than TD boys to prefer green and brown colors. These results appear to be caused by hyper-sensation characteristic of ASD, due to which boys with this disorder perceive yellow as being sensory-overloading.”

The Effects of Exercise Dose on Stereotypical Behavior in Children with Autism.While it appears high-intensity aerobic exercise may exacerbate stereotypic behaviors in children with ASD, low-to-moderate intensity exercise produces significant and large reductions in these behaviors. This provides an easily administered and cost-effective way to positively impact these individuals.”

 

December 2016

ASD and schizophrenia show distinct developmental profiles in common genetic overlap with population-based social communication difficulties.Difficulties in social communication are part of the phenotypic overlap between autism spectrum disorders (ASD) and schizophrenia. both clinical ASD and schizophrenia share some genetic influences with impairments in social communication, but reveal distinct developmental profiles in their genetic links, consistent with the onset of clinical symptoms.”

Propionic acid metabolism, ASD, and vitamin B12: is there a role for environmental nitrous oxide?A pathogenic makeover of gut microbiome to facilitate the growth of microbes capable of producing propionic acid (PPA), like Clostridia species, has been proposed as an infectious contributing etiology to the PPA model of ASD, however the reason for this pathogenic microbial overgrowth is not clear. This discussion highlights a previously identified novel environmental factor (i.e., nitrous oxide, N2O) in the etiopathogenesis of ASD and related neuropathology and posits that altered PPA metabolism in ASD may represent a key manifestation of this particular exposure.

Mathematical Modeling of the Methionine Cycle and Transsulfuration Pathway in Individuals with Autism Spectrum Disorder.Previous research has shown a connection between metabolic abnormalities in the methionine cycle and transsulfuration pathway and autism spectrum disorder. Sensitivity analysis identified the parameter describing the rate of glutamylcysteine synthesis, the rate-limiting step in glutathione production, to be particularly important in determining steady-state metabolite concentrations.”

Folic acid supplementation: what is new? Fetal, obstetric, long-term benefits and risks. Full text. “Recently, reducing the risk of autism by folic acid intake and the time of its consumption have been closely investigated. The optimal protective effect of folic acid in preventing autism is achieved when folic acid is taken preconceptionally and in early pregnancy because this is the critical period for brain development and development of neurologic pathologies.”

Fetal origins of autism spectrum disorders: the non-associated maternal factors. Full text. “There is increasing evidence that maternal exposures are involved in the pathophysiology of ASD in the developing fetus. Many genes have been postulated to be involved with the development of ASD, which can be potentiated by environmental insults. There appears to be at least one crucial time period between the first and second trimester where the associated risk of ASD development appears to be lower after this checkpoint has been reached.”

Measurement in saliva from neurotypical adults of biomarkers pertinent to autism spectrum disorders. Full text. “In summary, the data prove the concept that saliva is an appropriate body fluid in which to measure biomarkers important to autism. We found measurable levels in 74–100% of saliva samples from 12 healthy neurotypical adults on two occasions for 10 biomarkers important to autism: glutamine, glutamic acid, CD26, C4B, IFN-γ, cortisol, melatonin, testosterone, MT-2 and GSSG, but in <50% of samples for carnitine, GABA, IL-12, serotonin, cystine and rGSH.”

Can probiotics benefit children with autism spectrum disorders? Full text. “Children with autism are commonly affected by gastrointestinal problems such as abdominal pain, constipation and diarrhea. In recent years, there has been a growing interest in the use of probiotics in this population, as it hypothetically may help to improve bowel habits and the behavioral and social functioning of these individuals. The gut microbiome plays an important role in the pathophysiology of organic as well as functional gastrointestinal disorders. The present review presents a number of reported clinical, immunological and microbiome-related changes seen in children with autism compared to normally developed children. It also discusses gut inflammation, permeability concerns, and absorption abnormalities that may contribute to these problems. Most importantly, it discusses evidence, from human and animal studies, of a potential role of probiotics in the treatment of gastrointestinal symptoms in children with autism.”

Developmental Vitamin D deficiency and Autism: Putative pathogenic mechanisms. Vitamin D deficiency is emerging as a consistently reported risk factor in children. One reason for the prominence now being given to this risk factor is that it would appear to interact with several other epidemiological risk factors for autism. Vitamin D is an active neurosteroid and plays crucial neuroprotective roles in the developing brain. It has important roles in cell proliferation and differentiation, immunomodulation, regulation of neurotransmission and steroidogenesis. Animal studies have suggested that transient prenatal vitamin D deficiency is associated with altered brain development.”

Imbalance between the anti- and pro-inflammatory milieu in blood leukocytes of autistic children.  “Accumulating evidence suggests an association between immune dysfunction and autism disorders in a significant subset of children. In addition, an imbalance between pro- and anti-inflammatory pathways has been proposed to play an important role in the pathogenesis of several neurodevelopmental disorders including autism; however, the role of anti-inflammatory molecules IL-27 and CTLA-4 and pro-inflammatory cytokines IL-21 and IL-22 has not previously been explored in autistic children. Our study shows dysregulation of the immune balance in cells from autistic children as depicted by enhanced pro-inflammatory cytokines, ‘IL-21/IL-22’ and decreased anti-inflammatory molecules, ‘IL-27/CTLA-4’.”

Occupational Therapy Interventions for Adolescents With Autism Spectrum Disorder. Full text. “In this Evidence Connection article, we describe a case report of an adolescent with autism spectrum disorder. The occupational therapy assessment and treatment processes for school, home, community, and transition settings are described.”

Resveratrol suppresses neuroinflammation in the experimental paradigm of autism spectrum disorders.The major finding of the study is that resveratrol restored the core and associated symptoms of autistic phenotype by suppressing oxidative-nitrosative stress, mitochondrial dysfunction, TNF-α and MMP-9 expression in PPA induced ASD in rats. Therefore, resveratrol might serve as an adjunct potential therapeutic agent for amelioration of neurobehavioural and biochemical deficits associated with autism spectrum disorders.”

Co-occurrence of autistic and schizotypal traits and its association with emotional and psychosocial function in Chinese college students.Empirical findings suggest an overlap between autism spectrum disorders (ASD) and schizophrenia spectrum disorders (SSD). The results showed that the co-occurrence rate of autistic and schizotypal trait was 3.4% at baseline and 2.4% at one-year follow-up. The interaction between autistic traits and schizotypal traits was associated with better executive functioning and social functioning but poorer emotional expression.”

Increased Serum Levels of Tumor Necrosis Factor-Alpha, Resistin, and Visfatin in the Children with Autism Spectrum Disorders: A Case-Control Study. Full text. “Several proinflammatory and immunoinflammatory disturbances have been observed in the etiology of ASD. Serum visfatin, resistin, and TNF-α levels in children with ASD were significantly higher than that in the healthy patients …… suggesting that elevated levels of serum proinflammatory agents may be implicated in the pathophysiology of ASD.”

Caesarean section and risk of autism across gestational age: a multi-national cohort study of 5 million births.Across the five countries, emergency or planned CS is consistently associated with a modest increased risk of ASD from gestational weeks 36 to 42 when compared with vaginal delivery.”

Adults with autism spectrum disorders: a review of outcomes, social attainment, and interventions.The core social communication impairments continue into adulthood among persons with ASD, but the restrictive, repetitive patterns of behavior and activities have received less attention. Adults with ASD experience more behavioral and emotional regulation issues than their peers. In terms of social attainments, adults with ASD have a greater tendency to be overeducated for their jobs and have a lower employment rate. They are also more likely to live with their parents. Interventions make a positive impact upon social communication skills and employment.”

The potential relevance of docosahexaenoic acid and eicosapentaenoic acid to the etiopathogenesis of childhood neuropsychiatric disorders. ” The majority of studies on attention-deficit/hyperactivity disorder (ADHD) and autism found a significant decrease in DHA levels in patients versus healthy controls.”

Systematic review of the association between particulate matter exposure and autism spectrum disorders. “Particulate matter (PM) as an environmental pollutant is suspected to be associated with autism spectrum disorders. To conclude, the evidence from the studies allows us to conclude that there is an association between PM exposure and ASD whose strength varies according to the particle size studied with the association with PM2.5 and diesel PM being stronger.”

Autism genes are selectively targeted by environmental pollutants including pesticides, heavy metals, bisphenol A, phthalates and many others in food, cosmetics or household products. Full text. “Many suspect compounds identified in epidemiology, including tetrachlorodibenzodioxin, pesticides, particulate matter, benzo(a)pyrene, heavy metals, valproate, acetaminophen, SSRI’s, cocaine, bisphenol A, phthalates, polyhalogenated biphenyls, flame retardants, diesel constituents, terbutaline and oxytocin, inter alia showed a significant degree of bias towards ASG’s, as did relevant endogenous agents (retinoids, sex steroids, thyroxine, melatonin, folate, dopamine, serotonin). Numerous other suspected endocrine disruptors (over 100) selectively targeted ASG’s including paraquat, atrazine and other pesticides not yet studied in autism and many compounds used in food, cosmetics or household products, including tretinoin, soy phytoestrogens, aspartame, titanium dioxide and sodium fluoride. Further epidemiological studies and neurodevelopmental and behavioural research is warranted to determine the relevance of large number of suspect candidates whose addition to the environment, household, food and cosmetics might be fuelling the autism epidemic in a gene-dependent manner.”

Peripheral Inflammatory Markers Contributing to Comorbidities in Autism. Full text. “This study evaluates the contribution of peripheral biomarkers to comorbidities and clinical findings in autism. In conclusion, peripheral inflammatory markers might be useful as potential biomarkers to predict comorbidities in autism as well as reinforce and aid informed decision-making related to EEG findings in children with Autism spectrum disorders (ASD).”

Psychosis in autism: comparison of the features of both conditions in a dually affected cohort.Our data show there may be a specific subtype of ASD linked to comorbid psychosis. The results support findings that psychosis in people with ASD is often atypical, particularly regarding affective disturbance.”

Gastrointestinal dysfunction and autism: caution with misdiagnoses as many mysteries remain to be unraveled! Full text. “Parents should not be blamed for their child having FTT [failure to thrive] that eventually is shown to be part of ASD. They should not be involved with child protective services if their infant has FTT and the medical team involved in the infant’s care is not able to identify a cause and misses early signs of ASD or fails to tentatively consider such a diagnosis. They should not have to be extirpately exonerated later after irrevocable parental anger has developed and when the ASD diagnosis is explicily evident to all, as the fallacious faux pas of child neglect should not have been made at all.”

[Diagnostics and treatment of autism spectrum disorders in older adults: a study by experts]. Full text article in Dutch. “Empirical research into the diagnostics and treatment of older adults with autism spectrum disorders (ASD) is very limited; so far, only 17 studies have been published. Increasingly, ASD is being identified and treated within the domain of geriatric psychiatry. According to the experts, older patients with ASD, form a specific group in psychiatry. With regard to diagnosis, there was a consensus that increased attention needs to be given to age-related aspects by linking symptoms more specifically to the patient’s phase of life and to the ageing process.”

Speculations on vitamin K, VKORC1 genotype and autism.Humans vary in the gene that encodes for Vitamin K. Recent research has documented the protective effect of Vitamin K on neural cells and its role in maintaining normal neural development. Of interest, specific neural effects of Vitamin K overlap with key brain development aberrations, including those associated with autism.”

Blood-brain barrier and intestinal epithelial barrier alterations in autism spectrum disorders. Full text. “In the ASD brain, there is an altered expression of genes associated with BBB integrity coupled with increased neuroinflammation and possibly impaired gut barrier integrity.”

Assessment of suicidality in children and adolescents with diagnosis of high functioning autism spectrum disorder in a Turkish clinical sample.Consistent with the previous findings, rate of suicidality is higher in individuals with ASD. The rate of suicidal behaviors was 29% and suicide attempt was 12.7%.”

Associations of Acute and Chronic Stress Hormones with Cognitive Functions in Autism Spectrum Disorder.ASD children exhibited higher hair and salivary cortisol, which reflects chronic and acute stress hormone levels of subjects, respectively, than TD children. These results suggest that chronic stress hormone elevation may have relationships with some aspects of cognitive dysfunction in ASD subjects.”

Beneficial Effects of a Protein Rich Diet on Coping Neurotrans-mitter Levels During Ampicillin-Induced Neurotoxicity Compared to Propionic-Acid Induced Autistic Biochemical Features. Full text. “The results of the present experiments demonstrated that Amp [Ampicillin] treatment for three weeks has affected the neurotransmitter levels in brain of rats which was almost the same as that found in PA [proprionic acid] model of autism. Amp administration has previously been shown to disturb microbiome and promote the overgrowth of propionobacteria; hence can be connected with development of autism in our animal model. Amp treatment along with protein rich diet induced satisfactory improvement of neurotransmitter levels in brain tissue. The synthesis of neurotransmitters in mammalian brain responds rapidly to changes in precursor availability.”

Primary Carnitine Deficiency and Newborn Screening for Disorders of the Carnitine Cycle. Deletion of the trimethyllysine hydroxylase gene, a key gene in carnitine biosynthesis, has been associated with non-dysmorphic autism.” See also Trial of carnitine therapy in TMLHE deficiency and non-dysmorphic autism and Preventable Forms of Autism?

Are there lessons to be learned from the prevailing patterns of psychotropic drug use in patients with autism spectrum disorder? Full text editorial. “In light of limited scientific evidence on the response of the psychotropic treatments in ASD populations, the findings of the review on the prevalence and patterns of psychotropic use in ASD are very telling and underscore the gulf between limited evidence-based pharmacotherapeutic options and the substantial use of psychopharmacotherapy for managing the burden of psychopathology in ASD populations.”

Mitochondrial Dysfunction in Autism Spectrum Disorders. Full text. “Autism is classified as a psychiatric disorder which is characterised entirely by behaviours. Recent studies however, have presented evidence for systemic physiological abnormalities in ASD. The studies reviewed herein provide support to the idea of a link between mitochondrial dysfunction and the behavioural phenotype of autism.”

Dyspraxia and autistic traits in adults with and without autism spectrum conditions. Full text. “Dyspraxia is significantly more prevalent in adults with ASC compared to controls, confirming reports that motor coordination difficulties are significantly more common in this group. Interestingly, in the general population, dyspraxia was associated with significantly higher autistic traits and lower empathy. These results suggest that motor coordination skills are important for effective social skills and empathy.”

The effectiveness of an outdoor adventure programme for young children with autism spectrum disorder: a controlled study.The study included 51 participants (40 males, 11 females; age 3y 4mo-7y 4mo) enrolled in ASD special education kindergartens. Outcomes after the intervention revealed significant improvement in social-communication and different directions in the two groups in the social cognition, social motivation, and autistic mannerisms. While the group that received an outdoor adventure programme showed a tendency toward a reduction in severity, the control group showed the opposite. The outdoor adventure programme required problem-solving skills and forced the child to communicate in exciting situations. This study suggests that an outdoor adventure programme may be an effective intervention in addition to traditional treatments in young children with ASD.

 

November 2016

Gestational vitamin D deficiency and autism-related traits: the Generation R Study. Gestational vitamin D deficiency was associated with autism-related traits in a large population-based sample. Because gestational vitamin D deficiency is readily preventable with safe, cheap and accessible supplements, this candidate risk factor warrants closer scrutiny.”

Maternal Polycystic Ovary Syndrome and Risk for Attention-Deficit/Hyperactivity Disorder in the Offspring. Full text. “Maternal PCOS increased the odds of offspring ADHD by 42% after adjustment for confounders. The risk was somewhat elevated for ADHD with comorbid autism spectrum disorder.

Bone Accrual in Males with Autism Spectrum Disorder.Boys with ASD had lower spine, hip, and whole body BMD z-scores compared with controls. Although pubertal bone accrual was similar to that in controls, BMD in children with ASD remained low over a 4-year follow-up period, suggesting that low BMD is a consequence of prepubertal factors, such as low physical activity.”

Epilepsy surgery in patients with autism. Aggression and other aberrant behaviors observed in the clinical setting improved in 24 patients. According to caregivers, most patients also experienced some degree of improvement in daily social and cognitive function. Three patients had no functional or behavioral changes associated with seizure reduction, and 2 patients experienced worsening of seizures and behavioral symptoms. The reduction in aberrant behaviors observed in this series suggests that some behaviors previously attributed to autism may be associated with intractable epilepsy, and further highlights the need for systematic evaluation of the relationship between the symptoms of autism and refractory seizures.”

Rate of epilepsy in people with autism and the rate of autism in people with epilepsy are high.Examination of family members of individuals with epilepsy can also provide a likelihood of a genetic link between autism and epilepsy.”

Gut Microbiota and Autism: Key Concepts and Findings.There is an emerging body of evidence linking the intestinal microbiota with autism spectrum disorders (ASD). Studies have demonstrated differences in the composition of gut bacteria between children with ASD and controls. Certain intestinal bacteria have been observed in abundance and may be involved in the pathogenesis of ASD; including members of the Clostridium and Sutterella genus. Evidence from animal models suggest that certain microbial shifts in the gut may produce changes consistent with the clinical picture of autism, with proposed mechanisms including toxin production, aberrations in fermentation processes/products, and immunological and metabolic abnormalities.”

Can urinary indolylacroylglycine (IAG) levels be used to determine whether children with autism will benefit from dietary intervention? Read more on urinary indolyl-3-acryloylglycine here. “We found no evidence to support the hypothesis that children with ASD who suffer with bowel problems have increased levels of urinary indolyl-3-acryloylglycine in comparison to children with ASD who do not have gastrointestinal problems.”

Comparative efficacy of alpha-linolenic acid and gamma-linolenic acid to attenuate valproic acid-induced autism-like features. Valproic acid is used for treating seizures. Gamma-linolenic acid [GLA] is found in borage, blackcurrent and evening primrose oils. “It can be concluded that ALA and GLA can impart favorable protection against the VPA-induced autism-like features with GLA having pronounced effect.”

Prescription Drug Use and Polypharmacy Among Medicaid-Enrolled Adults with Autism: A Retrospective Cross-Sectional Analysis.Around 85% of adults with ASD used at least one psychotropic drug class compared with 42% of adults without ASD. Highly common psychotropics were antipsychotics (66%ASD vs 20%noASD), anticonvulsants (59%ASD vs 20%noASD), and anxiolytics/hypnotics/sedatives (21%ASD vs 11%noASD). Other than psychotropics, many adults with ASD used medical prescription drugs such as antimicrobials (47%), dermatologic agents (48%), respiratory agents (38%), gastrointestinal agents (31%), alternative medications (25%), antiparkinsonian agents (22.6%), antihyperlipidemics/statins (7.3%), and immunologics (2.0%). Rates of general (48%ASD vs 32%noASD) and psychotropic polypharmacy (19%ASD vs 6%noASD) were significantly higher in the ASD group.”

Randomized controlled trial of vitamin D supplementation in children with autism spectrum disorder.This study is a double-blinded, randomized clinical trial (RCT) that was conducted on 109 children with ASD (85 boys and 24 girls; aged 3-10 years). The aim of this study was to assess the effects of vitamin D supplementation on the core symptoms of autism in children. Supplementation of vitamin D was well tolerated by the ASD children. The daily doses used in the therapy group was 300 IU vitamin D3/kg/day, not to exceed 5,000 IU/day. The autism symptoms of the children improved significantly, following 4-month vitamin D3 supplementation, but not in the placebo group. This study demonstrates the efficacy and tolerability of high doses of vitamin D3 in children with ASD. This study is the first double-blinded RCT proving the efficacy of vitamin D3 in ASD patients. Depending on the parameters measured in the study, oral vitamin D supplementation may safely improve signs and symptoms of ASD and could be recommended for children with ASD.” There is a New Zealand study currently underway, investigating the effect of vitamin D and omega-3 supplementation in ASD.

Changes in Food Selectivity in Children with Autism Spectrum Disorder.Food selectivity is a common problem in children with autism spectrum disorder (ASD) and has an adverse impact on nutrient adequacy and family mealtimes. In this study, we assessed food selectivity in 18 children with ASD at two time points (mean age = 6.8 and 13.2 years), and examined changes in food selectivity. While food refusal improved overall, we did not observe an increase in food repertoire (number of unique foods eaten). These findings support the need for interventions early in childhood to increase variety and promote healthy eating among children with ASD.” This is why it is essential to address restricted eating habits early, they do not improve significantly as children grow older.

What Happens to Children Who Move off the Autism Spectrum? A Clinical Follow-Up Study.None of the participants met criteria for an autism diagnosis. Ninety-two percent had a lifetime diagnosis and 81% had a present psychiatric disorder based on the K-SADS. ADHD, specific phobia and Obsessive Compulsive Disorder (OCD) were the most common disorders.” Parents need to be aware that even though their children may be doing well (and may possibly lose their ASD diagnosis), they are not in the clear as they enter adulthood. Many psychiatric disorders are evident at an early age. They need to be addressed at this early age so that they are able to function well as they become mature adults.

Defining the hidden evidence in autism research. Forty per cent of rigorously designed clinical trials remain unpublished – a cross-sectional analysis.Publication bias presents a major problem in current clinical research. This study was designed to quantify publication bias in rigorously designed ASD research. The search delivered N = 30 (60%) trials were published, N = 20 (40%) remained unpublished. The majority of trials investigated drugs. The results emphasize the serious issue of publication bias. The large proportion of unpublished results precludes valuable information and has the potential to distort evidence for treatment approaches in ASD.

Omega-3 supplementation in autism spectrum disorders: A still open question? Full text. “Various attempts to suspend the omega-3 supplementation during the 22 months of follow-up failed because of significant symptom worsening (restlessness, agitation, decrease of responsiveness to teaching), which then disappeared after the resumption of the treatment. Considering anecdotal experiences, including that of our patient, and nonrandomized trials,[10],[11] the presence of a subgroup of ASD patients who are really responders to omega-3 cannot be excluded. These responders might not appear when evaluating the omega-3 effects in a sample taken as a whole.[12] Further, considering the high heterogeneity of ASD phenotypes and etiologies, it seems to be very unlikely that a given treatment produces the same results in all affected individuals.[13]

Serological screening for Celiac Disease in 382 pre-schoolers with Autism Spectrum Disorder. Full text. “Among the GI symptoms reported by parents of children with ASD and CD in our sample there were diarrhea and inappetence. The former is one of the most frequently reported GI symptoms in ASD children in several studies [5, 40] while the latter has been recently detected as one of the most common GI symptoms in a large sample of pre-schoolers with ASD [41]. Besides, half of the ASD children with CD were asymptomatic at the time of the serological screening: this prevalence could be ascribed not only to the presence of true asymptomatic forms of CD but also to the severe communication difficulties of non-verbal preschool children with ASD, making them unable to express GI and systemic symptoms suggestive of CD (e.g. recurrent abdominal pain, abdominal distension, chronic fatigue) [4, 42]. Otherwise, pre-schoolers with ASD could show their GI-related distress in alternative ways through a greater severity of problem behaviors such as irritability [43], anxiety and affective problems [44, 45], or externalizing behaviors (oppositional defiant behaviors and tantrums) [46]. These clinical data contributed to highlight the importance of a serological screening for CD in young children with ASD, even in absence of clear GI or systemic symptoms or other risk factors related to CD.”

Extremely low gestational age and very low birth weight for gestational age are risk factors for ASD in a large cohort study of 10-year-old children born at 23-27 weeks gestation. Our study confirms that low gestational age is associated with increased risk for ASD irrespective of intellectual ability, whereas severe fetal growth restriction is strongly associated with ASD without ID. Maternal report of cervical-vaginal infection is associated with increased risk of ASD with ID, and peripartum maternal fever is associated with increased risk for ID without ASD.”

Intranasal Oxytocin Enhances Connectivity in the Neural Circuitry Supporting Social Motivation and Social Perception in Children with Autism.Using functional magnetic resonance imaging, we show that OT administration in ASD increases activity in brain regions important for perceiving social-emotional information. Further, OT enhances connectivity between nodes of the brain’s reward and socioemotional processing systems, and does so preferentially for social (versus nonsocial) stimuli.”

The Prevalence and Correlates of Involvement in the Criminal Justice System Among Youth on the Autism Spectrum. By age 21, approximately 20% of youth with autism had been stopped and questioned by police and nearly 5% had been arrested. Female youth were less likely to be involved in the criminal justice system, whereas youth displaying externalizing behaviors were more likely to be involved in the criminal justice system.”

A Profile on Emergency Department Utilization in Adolescents and Young Adults with Autism Spectrum Disorders.The current study examined the rates of ED utilization between 2005 and 2013 in ASD youth 12- to 21-years-old. Adolescents with ASD accessed ED services four times as often as adolescents without ASD.”

The Relationship between Zinc Levels and Autism: A Systematic Review and Meta-analysis.There was significant statistical difference between plasma Zn concentration and autistic patients besides healthy controls. Based on sensitivity analysis, zinc supplements can be used for the nutritional therapy for autistic patients.”

[Impact of anxiety disorders on quality of life of adolescents with autism spectrum disorder without intellectual disability]. This study shows that anxiety disorders could be a risk factor for impairment of the “physical well-being” dimension of QoL [Quality of Life] in adolescents with ASD without intellectual disability.”

Integrative analysis of genetic data sets reveals a shared innate immune component in autism spectrum disorder and its co-morbidities.Our analysis reveals a novel shared innate immune component between ASD and all but three of its co-morbidities that were examined. The disease genes that overlap these two innate immunity pathways can be used to classify the cases of ASD and its co-morbidities vs. controls with at least 70 % accuracy. This finding suggests that a neuropsychiatric condition and the majority of its non-brain-related co-morbidities share a dysregulated signal that serves as not only a common genetic basis for the diseases but also as a link to environmental triggers. It also raises the possibility that treatment and/or prophylaxis used for disorders of innate immunity may be successfully used for ASD patients with immune-related phenotypes.”

Effects of acute beta-adrenergic antagonism on verbal problem solving in autism spectrum disorder and exploration of treatment response markers.Reducing noradrenergic activity may improve aspects of network processing and thus improve cognitive abilities, such as verbal problem solving, in individuals with ASD. The present pilot study explores the effects of acute administration of the beta-adrenergic antagonist propranolol on verbal problem solving in adults and adolescents with ASD. Participants solved the anagrams more quickly in the propranolol condition, as compared to the placebo condition, suggesting a potential cognitive benefit of this agent.”

Ketogenic diet and childhood neurological disorders other than epilepsy: an overview.In the last years, ketogenic diet (KD) has been experimentally utilized in various childhood neurologic disorders such as mitochondriopathies, alternating hemiplegia of childhood (AHC), brain tumors, migraine, and autism spectrum disorder (ASD). KD could improve cognitive and social skills in a subset of children with ASD.”

Neuroinflammation in Autism: Plausible Role of Maternal Inflammation, Dietary Omega 3, and Microbiota.Several genetic causes of autism spectrum disorder (ASD) have been identified. However, more recent work has highlighted that certain environmental exposures early in life may also account for some cases of autism. Imbalanced levels of essential fatty acids, and especially polyunsaturated fatty acids (PUFAs), are observed in patients with ASD and other neurodevelopmental disorders (e.g., attention deficit hyperactivity disorder (ADHD) and schizophrenia). Interestingly, PUFAs, and specifically n-3 PUFAs, are powerful immunomodulators that exert anti-inflammatory properties. These prenatal dietary and immunologic factors not only impact the fetal brain, but also affect the microbiota. Recent work suggests that the microbiota could be the missing link between environmental insults in prenatal life and future neurodevelopmental disorders. As both nutrition and inflammation can massively affect the microbiota, we discuss here how understanding the crosstalk between these three actors could provide a promising framework to better elucidate ASD etiology.”

Analysis of the Duodenal Microbiome in Autistic Individuals: Association with Carbohydrate Digestion. There was a positive correlation between the abundance of Clostridium species, and disaccharidase activity, in autistic individuals.”

Psychotropic Medication Use among Insured Children with Autism Spectrum Disorder. Nearly half (48.5 %) of children with ASD received psychotropics in the year observed; the most common classes were stimulants, alpha-agonists, or atomoxetine (30.2 %), antipsychotics (20.5 %), and antidepressants (17.8 %). The widespread use of psychotropics we observed, particularly given weak evidence supporting the effectiveness of these medications for most children with ASD, highlights challenges in ASD treatment.”

Effect of gluten free diet [GFD] on gastrointestinal and behavioral indices for children with autism spectrum disorders: a randomized clinical trial. “Of the 80 children, 53.9% had gastrointestinal abnormalities. In the GFD group, the prevalence of gastrointestinal symptoms decreased significantly after intake of GFD (40.57% vs. 17.10%) but increased insignificantly in the RD group (42.45% vs. 44.05%). GFD intervention resulted in a significant decrease in behavioral disorders (80.03±14.07 vs. 75.82±15.37) but an insignificant increase in the RD group (79.92±15.49 vs. 80.92±16.24).

The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China. This study was done in 3-6 year old children. “After adjusting for potential confounders, children with ST [Screen Time] ≥2 h/day had a significantly increased risk of having total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial problems, as well as behavioural symptoms of autism spectrum disorder.”

Autism Spectrum Disorder and Avoidant/Restrictive Food Intake Disorder. A very interesting case study. I will leave the reader to make up their own mind if parents are going about this in the right way. More importantly, common sense is telling us that nutritionally this child is starving. Compare this case to this documentary The Girl Who Never Ate.

Ketogenic diets improve behaviors associated with autism spectrum disorder in a sex-specific manner in the EL mouse.Ketogenic diet feeding improved multiple measures of sociability and reduced repetitive behavior in female mice; effects in males were more limited. Additional experiments in female mice showed that a less strict, more clinically-relevant diet formula was equally effective in improving sociability and reducing repetitive behavior. Taken together these results add to the growing number of studies suggesting that ketogenic and related diets may provide significant relief from the core symptoms of autism spectrum disorder, and suggest that in some cases there may be increased efficacy in females.”

Change in Autism Diagnoses Prior to and Following the Introduction of DSM-5. Australian study. “A significant trend-relative reduction in the number of children registered to receive autism-specific funding was evident post 2013, suggesting the more stringent DSM-5 criteria may have curbed the trend of increasing diagnoses over time.”

Autism in 2016: the need for answers.While the association between air pollutants, pesticides and other endocrine-disrupting chemicals, and risk for autism spectrum disorder is receiving increasing confirmation, the hypothesis of a real causal relation between them needs further data. The possible pathogenic mechanisms by which environmental factors can lead to autism spectrum disorder in genetically predisposed individuals were summarized, giving particular emphasis to the increasingly important role of epigenetics.”

 

October 2016

Month of Conception and Learning Disabilities: A Record-Linkage Study of 801,592 Children.Seasonal variations were specific to autistic spectrum disorder, intellectual disabilities, and learning difficulties (e.g., dyslexia) and were absent for sensory or motor/physical impairments and mental, physical, or communication problems. Seasonality accounted for 11.4% (95% confidence interval: 9.0, 13.7) of all cases. Some biologically plausible causes of this variation, such as infection and maternal vitamin D levels, are potentially amendable to intervention.”

Beneficial Effects of Co-Ultramicronized Palmitoylethanolamide/Luteolin in a Mouse Model of Autism and in a Case Report of Autism.Co-ultraPEA-LUT® treatment ameliorated social and nonsocial behaviors in valproic acid-induced autistic mice and improved clinical picture with reduction in stereotypes in a 10-year-old male child. These data suggest that ASD symptomatology may be improved by agents documented to control activation of mast cells and microglia.”

Maternal vitamin D deficiency and the risk of autism spectrum disorders: population-based study. Full text. “These findings imply gestational vitamin D substitution as a means of ASD prevention.”

Asperger syndrome in childhood – personality dimensions in adult life: temperament, character and outcome trajectories. Full text. “Three distinct temperament and character profiles emerged from the data. Those no longer meeting criteria for ASD had high reward dependence while those with a stable ASD diagnosis and psychiatric comorbidity showed elevated harm avoidance and low self-directedness and cooperativeness. Finally, those with a stable ASD and no comorbidity showed low novelty seeking and somewhat elevated harm avoidance.”

A systematic review of the association between allergic asthma and autism.Autism Spectrum Disorder and asthma could be associated conditions, as evidenced by the higher prevalence of asthma in autistic children with respect to typically developed controls.”

Infantile autism: impact of diagnosis and repercussions in family relationships. Full text. “The health professionals who report autism should better prepare the family to cope with the difficulties of this syndrome and autonomously care for the autistic child.”

No Apparent Cardiac Conduction Effects of Acute Treatment with Risperidone in Children with Autism Spectrum Disorder.Using conventional doses during acute treatment in children with ASD and serious behavioral problems, there was no difference in the mean change in QTc between risperidone and placebo.”

Cytokine Profile in Autism Spectrum Disorders in Children.The interleukin-8 (IL-8) level was significantly higher, while that of IL-10 was significantly lower in patients with childhood autism than in controls. Furthermore, the IL-8 level was significantly higher in childhood autism than in Asperger syndrome.”

Increased Risk for Substance Use-Related Problems in Autism Spectrum Disorders: A Population-Based Cohort Study.The risk of substance use-related problems was the highest among individuals with ASD and ADHD. We conclude that ASD is a risk factor for substance use-related problems.”

Treatment of Autism Spectrum Disorder in Children and Adolescents. Full text. “Risperidone and aripiprazole are currently the only medications FDA approved for symptoms associated with autism spectrum disorders, targeting the irritability often seen with this diagnosis. Children and adolescents with autism spectrum disorder appear to be more susceptible to adverse effects with medications.”

Perinatal issues for women with high functioning autism spectrum disorder.Findings suggest that women with ASD may face particular challenges during pregnancy, birthing and early mothering. These challenges evolve from perceptions of the woman about her midwives and other caregivers. If a woman perceives that her midwife is judgemental about her, then she may withdraw from the care and support she and her baby need.”

Folinic acid improves verbal communication in children with autism and language impairment: a randomized double-blind placebo-controlled trial. Full text. “In this small trial of children with non-syndromic ASD and language impairment, treatment with high-dose folinic acid for 12 weeks resulted in improvement in verbal communication as compared with placebo, particularly in those participants who were positive for FRAAs [folate receptor-α autoantibodies].”

Clinical utility of folate pathway genetic polymorphisms in the diagnosis of autism spectrum disorders.Genetic polymorphisms of the folate pathway were moderate predictors of autism risk. MTHFR C677T and hyperhomocysteinemia have been identified as risk factors for autism worldwide. Synergistic interactions between MTHFR C677T and MTRR A66G increase homocysteine.”

The role of phthalate esters in autism development: A systematic review.This review reveals evidence showing a connection between exposure to phthalates and ASD. These case control studies showed a compromised phthalate metabolite glucuronidation pathway, as a probable explanation of mechanism of the relation between phthalate exposure and ASD.”

Microbiota and neurologic diseases: potential effects of probiotics. Full text. “Overall, trials involving animal models and adults have reported encouraging results, suggesting that the administration of probiotic strains may exert some prophylactic and therapeutic effects in a wide range of neurologic conditions. Studies involving children have mainly focused on autism spectrum disorder and have shown that probiotics seem to improve neuro behavioural symptoms.”

Severe hypercalcaemia in a child secondary to use of alternative therapies. This report is an example of the importance of consulting a practitioner that is well experienced in treating ASD children.

Bone Density in Adolescents and Young Adults with Autism Spectrum Disorders.Patients with autism spectrum disorder (ASD) are at increased risk for fracture, and peri-pubertal boys with ASD have lower bone mineral density (BMD) than controls.”

Brief Report: Prevalence of Self-injurious Behaviors among Children with Autism Spectrum Disorder-A Population-Based Study.SIB prevalence averaged 27.7 % across all sites and surveillance years. Clinicians should inquire about SIB during assessments of children with ASD.”

Vitamin D Deficiency in Adult Patients with Schizophreniform and Autism Spectrum Syndromes: A One-Year Cohort Study at a German Tertiary Care Hospital. Full text. “We found very high rates of 25(OH)vitamin D deficiencies in both patient groups and have discussed whether our findings might be related to alterations in the immunological mechanisms. Irrespective of the possible pathophysiological links between vitamin D deficiency and schizophrenia or autism spectrum disorders, a more frequent measurement of vitamin D levels seems to be justified in these patient groups.”

N-acetylcysteine in the treatment of psychiatric disorders: Current status and future prospects.This study reviews the available data regarding the use of NAC in different psychiatric disorders including substance use disorders, autism, obsessive-compulsive spectrum disorders, schizophrenia, depression, bipolar disorder. Promising results were found in trials testing the use of NAC, mainly as an add-on treatment, in cannabis use disorder in young people, depression in bipolar disorder, negative symptoms in schizophrenia, and excoriation (skin-picking) disorder. Despite initial optimism, recent findings regarding NAC efficacy in autism have been disappointing.”

A Putative Blood-Based Biomarker for Autism Spectrum Disorder-Associated Ileocolitis. Gastrointestinal symptoms are common in children with autism spectrum disorder (ASD). A significant proportion of children with ASD and gastrointestinal symptoms have histologic evidence of ileocolitis (inflammation of the terminal ileum and/or colon).”

Decreasing GABA function within the medial prefrontal cortex or basolateral amygdala decreases sociability.Decreasing GABA transmission in either the medial PFC or BLA decreased sociability. Thus, changes in GABA signaling observed in conditions such as autism or schizophrenia may mediate the social withdrawal characteristic of these conditions. Moreover, they suggest that social withdrawal may be treated by drugs that potentiate GABA transmission.”

Emerging Roles for the Gut Microbiome in Autism Spectrum Disorder.The microbiome is an integral part of human physiology; recent studies show that changes in the gut microbiota can modulate gastrointestinal physiology, immune function, and even behavior. Links between particular bacteria from the indigenous gut microbiota and phenotypes relevant to ASD raise the important question of whether microbial dysbiosis plays a role in the development or presentation of ASD symptoms. Here we review reports of microbial dysbiosis in ASD.”

The Significance of the Enteric Microbiome on the Development of Childhood Disease: A Review of Prebiotic and Probiotic Therapies in Disorders of Childhood. “Certain childhood diseases have been associated with microbiome alterations, namely necrotizing enterocolitis, infantile colic, asthma, atopic disease, gastrointestinal disease, diabetes, malnutrition, mood/anxiety disorders, and autism spectrum disorders. Treatment studies suggest that probiotics are potentially protective against the development of some of these diseases.”

Genetic Evidence for Elevated Pathogenicity of Mitochondrial DNA Heteroplasmy in Autism Spectrum Disorder. Full text. “Increasing clinical and biochemical evidence implicate mitochondrial dysfunction in the pathophysiology of Autism Spectrum Disorder (ASD). Taken together, our genetic findings substantiate pathogenic mtDNA [mitochondrial DNA] mutations as a potential cause for ASD and synergize with recent work calling attention to their unique metabolic phenotypes for diagnosis and treatment of children with ASD”

Gut-to-Brain Axis in Autism Spectrum Disorders: Central Role for the Microbiome. Intestinal microbial dysbiosis, in prenatal and postnatal phases, is an important example of these environmental factors, and gastrointestinal problems including adverse reactions to foods are often reported in these children. In this review, we address the clinical and preclinical findings on the role of the intestinal microbiome in ASD and suggest possible underlying mechanisms.”

Oral health status of children and young adults with autism spectrum disorders: systematic review and meta-analysis.Prevalence of dental caries and periodontal disease in children and young adults with ASD can be considered as high, pointing to the need for oral health policies focused on these individuals.”

Screen time of infants in Sydney, Australia: a birth cohort study. Full text. “There is emerging evidence that excess screen time in children causes adverse cognitive, developmental and health outcomes. This study has shown that a large proportion of very young children residing in SWS have screen exposures for >2 hours per day. Factors contributing to excess screen time have also been identified in this study; however, a greater understanding of risk factors needs to be ascertained in order to facilitate greater public health efforts to reduce screen exposure.”

Oxytocin receptor gene variations predict neural and behavioral response to oxytocin in autism.These findings suggest biological functions of the OXTR SNP variants on autistic oxytocin responses, and implied that clinical oxytocin efficacy may be genetically predicted before its actual administration, which would contribute to establishment of future precision medicines for ASD.”

 

September 2016

The Genetic Intersection of Neurodevelopmental Disorders and Shared Medical Comorbidities – Relations that Translate from Bench to Bedside. Full text. “Syndromic Disorder genes were the largest subgroup of overlapping ASD risk genes. Since disruptions in SYN NDDs by definition affect multiple organ systems, it was not surprising that there were numerous co-occurring conditions associated with ASD genes, including GI, CANCER, IMMUNO, GU, and CARDIAC disorders. GI was composed of eight genes: CDKL5, CHD7, CNTNAP2, DHCR7, MET, NIPBL, PTEN, and TCF4. This coincides with the high prevalence of GI disturbances, over 40%, in children with ASD, and is consistent with the perspective that functional genetic variations that increase risk for ASD may also underlie ASD-associated GI dysfunctions.

Diagnostic evaluation for autism spectrum disorder: a survey of health professionals in Australia. Full text. “Despite the internationally recognised best practice guidelines for ASD diagnosis, and position statements from professional bodies, Australia does not have a national standard for ASD diagnosis.

Teaching Feminine Hygiene Skills to Young females with Autism Spectrum Disorder and Intellectual Disability. Full text. “Little applied research focuses on teaching feminine hygiene skills to females with disabilities, yet this is a common clinical concern. The current study demonstrates the use of chaining to teach two young females with autism spectrum disorder feminine hygiene skills.

Hypothesis on supine sleep, sudden infant death syndrome reduction and association with increasing autism incidence. Full text. “In conclusion, it is proposed that there may be an association between supine sleep and autism incidence increase. No other potential stressor than supine sleep is known to have been introduced globally in widely separated regions, nor one that matches the temporal patterns described here. The biological rationale proposed is that supine sleep may be a stressor, increasing gene methylation in, and disrupting needed sleep cyclicity for developing socio-emotional neural circuits.

Reduced GABA and altered somatosensory function in children with autism spectrum disorder.Our results suggest that reduced brain GABA levels could underlie altered tactile function in ASD, and that altered GABA function in ASD disrupts the link between GABA and behavior.

Sex-specific effects of docosahexaenoic acid (DHA) on the microbiome and behavior of socially-isolated mice.These results indicate that DHA alters commensal community composition and produces beneficial effects on anxiety and depressive-like behaviors in a sex-specific manner. The present study provides insight into the mechanistic role that gut microbes may play in the regulation of anxiety and depressive-like behaviors and how dietary intervention can modulate these effects.”

Unexpected improvement in core autism spectrum disorder symptoms after long-term treatment with probiotics. Full Text. “The probiotic treatment reduced the severity of abdominal symptoms as expected but an improvement in Autistic core symptoms was unexpectedly clinically evident already after few weeks from probiotic treatment start. The appropriate use of probiotics deserves further research, which hopefully will open new avenues in the fight against ASD.”

Autism spectrum disorders and bisphenol A: Is serotonin the lacking link in the chain? “Bisphenol A (BPA) is an ubiquitous xenoestrogen widely employed in a variety of consumer products including plastic and metal food and beverage containers, dental sealants and fillings, medical equipment and thermal receipts. Therefore, most people are exposed almost continuously to BPA in industrialized countries. The link between BPA and autism could be a defect of the normal in utero or perinatal serotonergic system development.”

A scoping review of what is known of the physical health of adults with autism spectrum disorder.From the findings, it can be stated with confidence that people with ASD have a high rate of comorbidity and increased risk for chronic disease.”

Use of psychotropic drugs in patients with autism spectrum disorders: a systematic review. The prevalence of psychopharmacotherapy ranged from 2.7% to 80% (median (overall): 45.7%; median (children): 41.9%; median (adults): 61.5%), with psychotropic polypharmacy occurring in 5.4-54% (median: 23.0%). Regarding drug classes, antipsychotics were most frequently used, followed by attention-deficit/hyperactivity disorder (ADHD) medication and antidepressants. Both older age and psychiatric comorbidity were associated with higher prevalences of psychopharmacotherapy and psychotropic polypharmacy.”

Effects of exposure to bisphenol A and ethinyl estradiol on the gut microbiota of parents and their offspring in a rodent model.Intestinal flora alterations were also linked to changes in various metabolic and other pathways. Thus, BPA and EE exposure may disrupt the normal gut flora, which may in turn result in systemic effects. Probiotic supplementation might be an effective means to mitigate disease-promoting effects of these chemicals.”

Experiences of Sex Education and Sexual Awareness in Young Adults with Autism Spectrum Disorder.This report suggest that mainstream sex and relationship education is not sufficient for people with ASD, specific methods and curricular are necessary to match their needs.”

Power and Autistic Traits. Full text. “Autistic traits can help people gain and sustain power, and has probably done so throughout history, says the present paper.”

Dietary interventions that reduce mTOR activity rescue autistic-like behavioral deficits in mice.The current results suggest that activated mTOR signaling pathway in the brain may be a convergent pathway in the pathogenesis of ASD bridging genetic background and environmental triggers (food allergy) and that mTOR over-activation could serve as a potential therapeutic target for the treatment of ASD.”

Gut Instincts: microbiota as a key regulator of brain development, ageing and neurodegeneration. Recently, the gut microbiota has been implicated in a variety of conditions including depression, autism, schizophrenia and Parkinson’s disease. It is plausible that such neuropsychiatric disorders might be treated in the future by targeting the microbiota either by microbiota transplantation, antibiotics or psychobiotics.”

Prevention of behavioral deficits in rats exposed to folate receptor antibodies: implication in autism.Folate receptor alpha (FRα) autoantibodies have been associated with fetal abnormalities and cerebral folate deficiency-related developmental disorders. Over 70% of the children with autism spectrum disorders (ASD) are positive for these autoantibodies and high-dose folinic acid is beneficial in treating these children.”

Mood disorders and non celiac gluten sensitivity.The association between gluten related disorders and psychiatric diseases has been firmly demonstrated. Non celiac gluten sensitivity (NCGS) is a syndrome diagnosed in patients responsive to gluten free diet after ruling out celiac disease and wheat allergy.”

Effect of the Family-based Art Therapy Program on the Social Interactions, Verbal Skills and Stereotypic Behaviors of Children with Autism Spectrum Disorders (ASD). Full text. “Applying the family- based art therapy can be effective in changing stereotypical behaviors of autistic children, because these practices are so attractive, flexible and diverse.”

Beyond the hype and hope: Critical considerations for intranasal oxytocin research in autism spectrum disorder.there remains significant potential for oxytocin to ameliorate aspects of the persistent and debilitating social impairments in individuals with ASD. Given the considerable media hype around new treatments for ASD, as well as the needs of eager families, there is an urgent need for researchers to prioritise considering such factors when conducting well-designed and controlled studies to further advance this field.”

A Systematic Review and Meta-Analysis of Multiple Airborne Pollutants and Autism Spectrum Disorder. Full text. “The strongest evidence was between prenatal exposure to particulate matter and ASD. Our research supports the need for health protective public policy to reduce exposures to harmful airborne contaminants among pregnant women and children.”

Association of Peripheral Blood Levels of Brain-Derived Neurotrophic Factor With Autism Spectrum Disorder in Children: A Systematic Review and Meta-analysis.Children with ASD have increased peripheral blood levels of BDNF, strengthening the clinical evidence of an abnormal neurotrophic factor profile in this population.”

Intestinal Dysbiosis and Yeast Isolation in Stool of Subjects with Autism Spectrum Disorders.High frequency of gastrointestinal yeast presence in ASD subjects was shown through a simple cultural approach (Candida spp. in 57.5 % of ASDs and no controls). Also GI symptoms, such as constipation and alternating bowel, did correlate (multivariate analyses) with the increased permeability to lactulose. The present data provide rationale basis to a possible specific therapeutic intervention in restoring gut homeostasis in ASDs.”

Lower maternal serum 25(OH) D in first trimester associated with higher autism risk in Chinese offspring.Lower first trimester maternal serum levels of 25(OH) D were associated with increased risk of developing autism in offspring.”

Aging with autism spectrum disorder: an emerging public health problem.the first generation of diagnosed patients with ASD is now in old age. Many such ASD patients have needed family and institutional support for their lives subsequent to childhood diagnosis. Due to aging and death of their parents and other supportive figures leading to a loss of social structures, there is no better time than now for the medical community to act.”

Does prenatal stress alter the developing connectome?Stress-related symptoms are common in women during pregnancy and are risk factors for neurobehavioral disorders ranging from autism spectrum disorder, attention deficit hyperactivity disorder, and addiction, to major depression and schizophrenia.”

Aggression in Autism Spectrum Disorder: Supporting the Entire Family. A case report. This is not a unique case that is presented. There are many similar reports, where the whole family is affected and needs understanding and support.

Longitudinal association between early atopic dermatitis and subsequent attention-deficit or autistic disorder: A population-based case-control study.toddlers who suffer from AD at the age younger than 3 years are at a higher risk of developing ADHD and ASD during later childhood. Pediatricians taking care of toddlers with AD should have knowledge of this increased risk of developing ADHD and ASD later in life, especially when children have certain comorbidities such as allergic rhinitis, allergic conjunctivitis, and asthma.”

Altered neurotransmitter metabolism in adolescents with high-functioning autism. “Multiple linear regression revealed significantly higher Glu [Glutamine]/Cr [Creatine] and lower GABA+/Glu concentrations in the HFA [high functioning autism] group compared to the controls. These results imply that imbalanced neurotransmitter levels of excitation and inhibition are associated with HFA in adolescents.”

Maternal antineuronal antibodies and risk of childhood autism spectrum disorders: A case-control study.Mothers of autistic children had significantly higher seropositivity for anti-Yo antibodies (34.7%) than control women. Some maternal antineuronal antibodies may contribute significantly to the risk of childhood autism.”

Resveratrol treatment attenuates chemokine receptor expression in the BTBR T+tf/J mouse model of autism.Emerging evidence increasingly suggests that chemokine receptors have a pivotal role in the central nervous system and are involved in the pathogenesis of numerous neuroinflammatory diseases. Resveratrol is widely used to treat neurodegenerative diseases, but its effect on autism has not been investigated. Resveratrol downregulated the chemokine receptor levels, which might provide unique targets for future therapies for autism.”

Acetaminophen Use for Fever in Children Associated with Autism Spectrum Disorder. Full text. “In summary, we have presented evidence for the association of acetaminophen use with ASD.”

Can psychiatric childhood disorders be due to inborn errors of metabolism? Full text. “Psychiatrist should be aware of inborn errors of metabolism. In the literature, most relevant articles were found concerning ASD and psychosis in combination with a metabolic disorder. This overview gives the child and adolescent psychiatrist some direction for further investigations and referral to a metabolic unit.”

Perception of Life as Stressful, Not Biological Response to Stress, is Associated with Greater Social Disability in Adults with Autism Spectrum Disorder.Results indicated that adults with ASD experienced significantly more stressful life events and perceived stress, and greater systolic blood pressure reactivity than typical community volunteers. Results also indicated that perceived stress and stressful life events were significantly associated with social disability. Interventions targeting stress management might improve social function in adults with ASD.”

Assessment of serum trace elements and electrolytes in children with childhood and atypical autism.The obtained data demonstrate that children with ASD unspecified are characterized by significantly lower Ni, Cr, and Se levels as compared to the age- and sex-matched controls. At the same time, significantly decreased serum Ni and Se concentrations were detected in patients with childhood autism. In turn, children with atypical autism were characterized by more variable serum trace element spectrum.”

Specific Medical Conditions Are Associated with Unique Behavioral Profiles in Autism Spectrum Disorders. Full text. “Autism spectrum disorder (ASD) is a heterogeneous group of disorders which occurs with numerous medical conditions. In previous research, subtyping in ASD has been based mostly on cognitive ability and ASD symptom severity. The aim of the current study was to investigate whether specific medical conditions in ASD are associated with unique behavioral profiles.”

Efficacy of atomoxetine in the treatment of attention-deficit hyperactivity disorder in patients with common comorbidities in children, adolescents and adults: a review. Full text. “Results from this review suggest that ATX [atomoxetine] is effective in the treatment of some youth and adults with ADHD and comorbid disorders, and may be a treatment option in these patients.”

Environmental Enrichment Therapy for Autism: Outcomes with Increased Access. Full text. “Environmental enrichment, delivered via an online system, therefore appears to be an effective, low-cost means of treating the symptoms of ASD.”

 

August 2016

Effectiveness of Antidepressant Medications for Symptoms of Irritability and Disruptive Behaviors in Children and Adolescents.Antidepressant medication exposure appears to have a small effect on irritability and related symptoms in youth.

Fecal Microbiota Transplantation and Its Usage in Neuropsychiatric Disorders. Full text.

Bone Density in Adolescents and Young Adults with Autism Spectrum Disorders.Patients with autism spectrum disorder (ASD) are at increased risk for fracture, and peri-pubertal boys with ASD have lower bone mineral density (BMD) than controls.”

Heart rate variability during sleep in children with autism spectrum disorder.Our findings suggest possible deficits in vagal influence to the heart during sleep, especially during REM sleep. Children with ASD may have higher sympathetic dominance during sleep but rather due to decreased vagal influence.

Perinatal Exposure to Traffic-Related Air Pollution and Autism Spectrum Disorders.Early life exposure to low levels of NOx [nitrogen oxides] and PM10 [particulate matter with diameters <10µm] from road traffic does not appear to increase the risk of ASD.

Gluten Intolerance and Neurodevelopmental Disorders: Is Nitric Oxide the Common Biomarker Linking These Conditions? Full text. “Heightened NO [nitric oxide] metabolism may help to explain the preliminary evidence suggesting a tepid connection between ADHD, ASD and CD.

Peripheral brain-derived neurotrophic factor in autism spectrum disorder: a systematic review and meta-analysis.Brain-derived neurotrophic factor (BDNF) regulates neuronal survival and growth and promotes synaptic plasticity. Subgroup analyses revealed higher BDNF levels in ASD compared with controls for both serum and plasma. This meta-analysis suggests that peripheral BDNF levels are a potential biomarker of ASD.”

Relationship Between Subtypes of Restricted and Repetitive Behaviors and Sleep Disturbance in Autism Spectrum Disorder. We examined the association of two types of restricted and repetitive behaviors, repetitive sensory motor (RSM) and insistence on sameness (IS), with sleep problems in children with autism spectrum disorder (ASD). RSM behaviors were positively associated with parent-reported sleep problems, and this relationship remained significant after controlling for anxiety symptoms. IS was not significantly associated with sleep problems.” This is always a priority in my treatment protocol for children. If they are sleeping better, their behaviour is consistently better the following day.

Increased Risk of Autism Development in Children Whose Mothers Experienced Birth Complications or Received Labor and Delivery Drugs.This study surveyed mothers of ASD and non-ASD children to determine possible effects of labor and delivery (L&D) drugs on the development of ASD. We also observed a synergistic effect between administrations of L&D drugs and experiencing a birth complication, in which both obstetrics factors occurring together increased the likelihood of the fetus developing ASD later in life. The present study shows the possible effects of L&D drugs, such as Pitocin labor-inducing and analgesic drugs, on children and ASD.”

Altered plasma levels of chemokines in autism and their association with social behaviors. Chemokines are immune molcules involved in the inflammatory response. “Chemokines have been implicated in the etiology and pathogenesis of ASD. The current study investigated the plasma levels of seven chemokines (RANTES, Eotaxin, MIP-1 α, MIP-1 β, MCP-1, IP-10, and MIG) in 42 young autistic patients and 35 age-matched typically developing (TD) children. Among these seven chemokines, MIP-1α, MIP-1β and IP-10 levels were found to be associated with social behaviors in all the participants. Moreover, MIP-1α and IP-10 were found to be independent predictors of social behaviors. The results of our study support the hypothesis that altered chemokine levels are involved in the pathophysiology of ASD and they indicate that chemokines plasma levels could be potential biomarkers for ASD.

Polycystic ovary syndrome and psychiatric disorders: Co-morbidity and heritability in a nationwide Swedish cohort.Following adjustment for comorbid psychiatric disorders, women with PCOS were still at a significantly increased risk for bulimia, schizophrenia, bipolar disorder, depressive and anxiety disorders, personality disorders, with the highest AORs [adjusted odds ratios] for ASD and tics.

Neurological, Metabolic, and Psychiatric Adverse Events in Children and Adolescents Treated With Aripiprazole. The main reported adverse effects in the non-PS [psychotic disorder] group were chronic insomnia, Parkinsonism, behavioral changes psychoses, and weight gain, whereas the adverse effects in the PS group was predominantly anxiety, convulsions, and neuroleptic malignant syndrome. Although aripiprazole is considered safe and well tolerated in children and adolescents, severe adverse events as neuroleptic malignant syndrome, extreme insomnia, and suicidal behavior has been reported to health authorities.

Prenatal, perinatal and postnatal factors associated with autism spectrum disorder. Full text. “The present survey confirms the high prevalence of prenatal, perinatal and postnatal factors in children with ASD and suggests the intervention of some of these factors (acute fetal distress and difficult labor, among others), as determinant variables for the genesis of ASD.

Prenatal Inflammation, Infections and Mental Disorders.Evidence for the effect of prenatal exposure to maternal infection on risk for mental disorders [schizophrenia spectrum disorders, autism spectrum disorders, attention-deficit hyperactivity disorder, anorexia nervosa, and mood disorders] exists for several different infections, suggesting that common factors occurring in infections (e.g. elevated cytokine levels and fever), rather than the infectious agent itself, might be the underlying factor in increasing the risk for mental disorders.

Environmental risk factors for autism spectrum disorders.Air pollution, organic toxicants, seasonal factors, psychological stress, migration, birth order, and nutrition may have a close relationship with the incidence of ASD.

The Role of the Immune System in Autism Spectrum Disorder.During gestation, prenatal insults including maternal infection and subsequent immunological activation may increase the risk of autism in the child. Similarly, the presence of maternally derived anti-brain autoantibodies found in approximately 20% of mothers whose children are at risk for developing autism has defined an additional subphenotype of ASD.

Stress, anxiety, and depression among parents of children with autism spectrum disorder in Oman: a case-control study. Full text. “This study corroborates with other studies carried out in other populations that caring for children impacts the mental health status of caregivers.

Hormone disorder and vitamin deficiency in attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs).Our study results highlight the importance of supplementation of vitamins B12 and D in the ASD and ADHD patients.

Polychlorinated Biphenyl and Organochlorine Pesticide Concentrations in Maternal Mid-Pregnancy Serum Samples: Association with Autism Spectrum Disorder and Intellectual Disability.Our results suggest higher levels of some organochlorine compounds during pregnancy are associated with ASD and ID.”

Oxytocin efficacy is modulated by dosage and oxytocin receptor genotype in young adults with high-functioning autism: a 24-week randomized clinical trial.These results suggest that efficacy of long-term oxytocin administration in young men with high-functioning ASD depends on the oxytocin dosage and genetic background of the oxytocin receptor, which contributes to the effectiveness of oxytocin treatment of ASD.”

Parent Perceptions of Sexual Education Needs for Their Children With Autism.All parents in this study found that some level of sexual education was necessary and important and that all children had been introduced to sexual information but in varying degrees. Topic preferences included those that would increase the recognition of healthy relationships, provide a measure of self-protection, and ameliorate undesirable consequences of sexual activity.

Metformin for Treatment of Overweight Induced by Atypical Antipsychotic Medication in Young People With Autism Spectrum Disorder: A Randomized Clinical Trial.Metformin reduced BMI scores from baseline to week 16 significantly more than placebo. Statistically significant improvements were also noted in secondary body composition measures and but not in metabolic variables. Overall, metformin was well tolerated. Five participants in the metformin group discontinued treatment owing to adverse events (agitation, 4; sedation, 1). Participants receiving metformin vs placebo experienced gastrointestinal adverse events during a significantly higher percentage of treatment days.

The maternal effect in infantile autism: elevated DNA damage degree in patients and their mothers.Oxidative stress is assumed to play a key role in the pathogenesis of infantile autism. It is known that oxidative stress has a prominent genotoxic effect, which is realized through inducing single and double strand breaks of the nuclear DNA. We evaluated the degree of DNA damage in patients with infantile autism and their mothers using DNA comet assay.  [DNA comet assay results] were considerably higher in the sample of autistic children, than in age-matching healthy controls. Interestingly, these parameters were also elevated in healthy mothers of autistic children, with no difference from the values in the group of autistic children. The control group of healthy women of reproductive age, who had no children with autism, differed by the DNA comet tail moment from the group of mothers of autistic children, but did not differ significantly from the control group of healthy children. The results suggest that there are genotoxic factors in mentally healthy mothers of autistic children, which can determine the pathological process in the foeti via environmental “maternal effect” during gestation.

Brief Report: Prevalence of Self-injurious Behaviors among Children with Autism Spectrum Disorder-A Population-Based Study.Self-injurious behaviors (SIB) have been reported in more than 30 % of children with an autism spectrum disorder (ASD) in clinic-based studies.

Sexuality in High-Functioning Autism: A Systematic Review and Meta-analysis. Exhibiting higher levels of sexual understanding, females with HFA were subject to more adverse sexual experiences than males with HFA and neurotypical counterparts. Males reported greater desire for, and engagement in both solitary and dyadic sexual contact.

The role of phthalate esters in autism development: A systematic review. This review reveals evidence showing a connection between exposure to phthalates and ASD.”

Oxytocin and Autism Spectrum Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. “7 out of the 11 studies that examined social cognition reported improvements. Additionally, one out of the 4 studies on restricted, repetitive behaviors, reported improvements following oxytocin administration.”

A preliminary investigation on the relationship between gut microbiota and gene expressions in peripheral mononuclear cells of infants with autism spectrum disorders. Our results strongly suggested that altered gut microbiota in infants resulted from ASD development and was associated with systemic immunity dysregulation, especially chronic inflammation.

Shank3 Is Part of a Zinc-Sensitive Signaling System That Regulates Excitatory Synaptic Strength.Shank3 is a postsynaptic protein associated with neurodevelopmental disorders such as autism and schizophrenia. In this study, we show that Shank3 is a key component of a zinc-sensitive signaling system that regulates excitatory synaptic transmission. Intriguingly, an autism-associated mutation in Shank3 partially impairs this signaling system. Therefore, perturbation of zinc homeostasis may impair, not only synaptic functionality and plasticity, but also may lead to cognitive and behavioral abnormalities seen in patients with psychiatric disorders.

Autism Spectrum Disorders and Metabolic Complications of Obesity.In children with ASD, mood stabilizers, antipsychotics, antiepileptic drugs, and selective serotonin reuptake inhibitors were associated with obesity.

Respite Care and Stress Among Caregivers of Children With Autism Spectrum Disorder: An Integrative Review.While most studies found that respite care was associated with lower stress [in carers], several found that respite care was associated with higher stress.

 

July 2016

Parenting stress as an indirect pathway to mental health concerns among mothers of children with autism spectrum disorder.Autism spectrum disorder symptom severity was positively related to both parenting stress and maternal psychopathology symptoms.

Histamine regulation of microglia: gene-environment interaction in the regulation of central nervous system inflammation.Microglia mediate neuroinflammation and regulate brain development and homeostasis. Microglial abnormalities are implicated in a range of neuropsychiatric pathology, including Tourette syndrome (TS) and autism.

Aggression in autism spectrum disorder: presentation and treatment options.Aggression is associated with negative outcomes for children with ASD and their caregivers, including decreased quality of life, increased stress levels, and reduced availability of educational and social support.” Yet again there is no mention in this article of the possibility of underlying pain or discomfort as a cause of aggression.

Mothers of Children with Autism have Different Rates of Cancer According to the Presence of Intellectual Disability in Their Child.Mothers of children with autism without ID had increased risk of cancer, which may relate to common genetic pathways.

Aripiprazole for the treatment of irritability and aggression in children and adolescents affected by autism spectrum disorders.consideration should be given to the potential causes of irritability and aggression, such as coexisting medical conditions and environmental factors including inappropriate intervention of parents and teachers.

Weight Gain Effects of Second-Generation Antipsychotic Treatment in Autism Spectrum Disorder.Treatment with risperidone, aripiprazole, and olanzapine resulted in statistically significant increase in BMI

Altered urinary porphyrins and mercury exposure as biomarkers for autism severity in Egyptian children with autism spectrum disorder.Results showed that children with ASD had significantly higher levels of Hg [mercury], Pb [lead], ……. compared to healthy controls and healthy siblings of the ASD children. Mothers of ASD children showed a higher percentage of dental amalgam restorations compared to the mothers of healthy controls suggesting that high Hg levels in children with ASD may relate to the increased exposure to Hg from maternal dental amalgam during pregnancy and lactation.

A Meta-Analytic Review of the Efficacy of Physical Exercise Interventions on Cognition in Individuals with Autism Spectrum Disorder and ADHD. The results revealed an overall small to medium effect of exercise on cognition, supporting the efficacy of exercise interventions in enhancing certain aspects of cognitive performance in individuals with ASD and/or ADHD.

Treatment of Severe Self-Injurious Behavior in Autism Spectrum Disorder by Neuromodulation. “An increasing number of case reports and series document the safe and effective use of electroconvulsive therapy (ECT) in children, adolescents, and young adults with autism spectrum disorder who engage in severe, intractable, repetitive self-injurious behavior (SIB) without environmental or operant function.”

Response to Electroconvulsive Therapy in Patients With Autism Spectrum Disorder and Intractable Challenging Behaviors Associated With Symptoms of Catatonia. “Electroconvulsive therapy could be a potentially beneficial intervention in patients with ASD and severe challenging behaviors associated with catatonic symptoms including agitated or excited forms of catatonia.”

Feeding behavior and dietary intake of male children and adolescents with Autism Spectrum Disorder: a case-control study. “ASD patients consumed in average more calories than controls, had a limited food repertoire, high prevalence of children with inadequate calcium, sodium, iron vitamin B5, folate, and vitamin C intake.”

The Therapeutic Effects of Camel Milk: A Systematic Review of Animal and Human Trials. “Identified studies highlighted treatment with camel milk of diseases, including diabetes, autism, cancer, various infections, heavy metal toxicity, colitis, and alcohol-induced toxicity. Although most studies using both the human and animal model do show a clinical benefit with an intervention and camel milk, limitations of these studies must be taken into consideration before widespread use.”

Vitamin A deficiency and xerophthalmia in children of a developed country. “Fifty-two of the 146 children had VAD [vitamin A deficiency]; their average age was 8.4 years (range 11 days to 18 years old). In this Australian cohort, the most common pre-existing medical conditions in those children whose vitamin A status was investigated were cystic fibrosis, gastro-oesophageal reflux disease, micronutrient deficiency and short gut syndrome. The most common medical conditions affecting children with measured VAD in this cohort include autism, coeliac disease and cystic fibrosis. A significant association was found between VAD and anaemia and serum iron levels. Of the 146 children, 28 had ophthalmology review, of whom 13 had VAD.”

The relationship between mercury and autism: A comprehensive review and discussion. This review found 91 studies that examine the potential relationship between mercury and ASD from 1999 to February 2016. Of these studies, the vast majority (74%) suggest that mercury is a risk factor for ASD, revealing both direct and indirect effects. The preponderance of the evidence indicates that mercury exposure is causal and/or contributory in ASD.

 

June 2016

The positive association between elevated blood lead levels and brain-specific autoantibodies in autistic children from low lead-polluted areas. In children with autism spectrum disorder (ASD), it has been documented increased levels of brain-specific autoantibodies. Furthermore, lead (Pb) has been identified as one of the main neurotoxicants acting as environmental triggers for ASD as it induces neuroinflammation and autoimmunity.

Relationship between adipic acid concentration and the core symptoms of autism spectrum disorders.Overall, no increase in the concentration of adipic acid in children with ASDs compared to TD children, however when considering vitamin B supplementation in ASD there were significantly increased level of urinary adipic acid in children with an ASD not taking vitamin B supplementation compared to supplemented children or to TD children. Interestingly, the increase in adipic acid concentration was significantly and indirectly correlated with the severity of the deficit in socialization and communication skills in children with an ASD.Dr Bernard Rimland pioneered the use of vitamin B6 and magnesium in autism. There have been various reports of vitamin B6 and magnesium improving verbal skills, non-verbal skills, and social interaction skills in ASD individuals. This study suggests that urinary adipic acid may be a marker to identify a subgroup of ASD individuals that may benefit from vitamin B6 supplementation. The level of adipic acid can be measured in a urinary Organic Acid Test.

Sibling Experiences: Living with Young Persons with Autism Spectrum Disorders.Like other young people, those with autism spectrum disorder (ASD) have an impact on siblings in both positive and negative ways.

Gut to brain interaction in Autism Spectrum Disorders: a randomized controlled trial on the role of probiotics on clinical, biochemical and neurophysiological parameters. Full text. Here are details of a clinical trial recruiting ASD patients. The aim of the study is to look at GI disturbances in ASD individuals, the link to gut dysbiosis, and how probiotic treatment may affect a number of biomarkers and core symptoms of ASD. “One of the possible outcome of this study is the identification of a subgroup of children with ASD and GI symptoms that could represent a particular endophenotype of ASD characterized by an abnormal gut microflora. We expect that these children, after a probiotic treatment, could show changes in GI symptomatology and in related blood, urinary and fecal biomarkers through their effects in restoring the balance of intestinal microflora, and in attenuating immunological abnormalities. Moreover, we expect that the treatment with probiotics in individuals with ASD and GI symptoms may produce also more significant improvement in autistic symptoms, in behavioral profiles, in adaptive functioning and in cognitive and linguistic development in comparison with individuals with ASD and GI symptoms treated with placebo.

Risperidone-induced priapism in an autistic child: a case report. Full text. Priapism is a prolonged erection of the penis.  “Clinicians who prescribe risperidone should be aware of the possibility of this rare complication in their patients. Information about this possible side effect and instructions regarding appropriate response should be made available to caregivers of those in the at-risk group of young patients.”

Dietary Patterns of Children with Autism Spectrum Disorder: A Study Based in Egypt. Full text. “Tailoring a specially designed balanced diet with appropriate micronutrient supplementation may ameliorate the severity of autism symptoms and related abnormal behaviours.”

Feeding Disorders in Children with Autism Spectrum Disorders Are Associated with Eosinophilic Esophagitis.Feeding disorders in children with ASD should not be assumed to be solely behavioral and an esophagogastroduodenoscopy should be performed to evaluate for EoE [Eosinophilic Esophagitis].

Out of School and Into Distress: Families of Young Adults with Intellectual and Developmental Disabilities in Transition.Parents reported significantly higher levels of distress after their child transitioned out of school. Employed parents and parents of a child with an autism spectrum disorder are at increased risk for distress.

An Introduction to the Psychopharmacology of Children and Adolescents With Autism Spectrum Disorder.There are currently no FDA-approved medications to treat the core symptoms of ASD. Consequently, all medications, besides risperidone and aripiprazole for severe irritability, are considered off-label. Additionally, due to reduced levels of effectiveness and higher rates of side effects, more typical medications such as antidepressants and stimulants should be used with caution.

Parenting stress among parents of children with Neurodevelopmental Disorders.Another interesting finding was that IQ level or emotional and behavioral problems are associated with the higher levels of parenting stress.

Effect of gluten free diet on gastrointestinal and behavioral indices for children with autism spectrum disorders: a randomized clinical trial.Of the 80 children, 53.9% had gastrointestinal abnormalities. In the GFD [gluten free diet] group, the prevalence of gastrointestinal symptoms decreased significantly after intake of GFD but increased insignificantly in the RD [regular diet] group. GFD intervention resulted in a significant decrease in behavioral disorders but an insignificant increase in the RD group.

Maternal Infection during Pregnancy and Risk of Autism Spectrum Disorders: A Systematic Review and Meta-analysis.These findings indicate that maternal infection during pregnancy increases the risk of ASD in offspring. Possible mechanisms may include direct effects of pathogens and, more indirectly, the effects of inflammatory responses on the developing brain.

Prenatal exposure to the organophosphate insecticide chlorpyrifos enhances brain oxidative stress and prostaglandin E2 synthesis in a mouse model of idiopathic autism. Full text. “Organophosphate insecticides, among which chlorpyrifos (CPF), are widely diffused environmental toxicants associated with neurobehavioral deficits and increased risk of ASD occurrence in children. The results further support the hypothesis that oxidative stress might be the link between environmental neurotoxicants such as CPF and ASD.

Autism spectrum disorder prevalence and associations with air concentrations of lead, mercury, and arsenic.ambient metal concentrations were negatively associated with ASD prevalence. After adjusting for confounding factors, tracts with air concentrations of lead in the highest quartile had significantly higher ASD prevalence than tracts with lead concentrations in the lowest quartile.

Opioid peptides and gastrointestinal symptoms in autism spectrum disorders. Full text. “oxidative stress in individuals with ASD may be a consequence of metabolic sulfur deficiency, abnormal gut bacteria growth, and increased intestinal permeability, thus suggesting a possible correlation between gastrointestinal abnormalities and symptoms of ASD. Although the evidence to support opioid-free diets (gluten-free, casein-free) is limited and weak, dietary restrictions should only be introduced after gastrointestinal symptoms have appeared or intolerance or allergy to these foods has been diagnosed.

Autism and epilepsy: A population-based nationwide cohort study. Individuals with epilepsy are at increased risk of ASD, especially if epilepsy appears in childhood. Further, ASD is more common in the siblings and offspring of individuals with epilepsy, suggesting shared etiology.

Autism-specific maternal anti-fetal brain autoantibodies are associated with metabolic conditions.In this exploratory study, mothers whose children had severe ASD and who experienced diabetes were more likely to have anti-fetal brain autoantibodies 2-5 years later.

Experiences of emergency department care from the perspective of families in which a child has autism spectrum disorder.Care for children with autism spectrum disorder (ASD) in the emergency department (ED) is increasingly recognized as difficult.

A randomised, double blind, placebo-controlled trial of a fixed dose of N-acetyl cysteine in children with autistic disorder. There are now two published pilot studies suggesting efficacy, particularly in symptoms of irritability. “This was a placebo-controlled, randomised clinical trial of 500 mg/day oral N-acetyl cysteine over 6 months. This study failed to demonstrate any benefit of adjunctive N-acetyl cysteine in treating autistic disorder.

Psychophysiological Associations with Gastrointestinal Symptomatology in Autism Spectrum Disorder.Heart rate variability, a measure of parasympathetic modulation of cardiac activity, was found to be positively associated with lower gastrointestinal tract symptomatology at baseline. This relationship was particularly strong for participants with co-occurring diagnoses of anxiety disorder and for those with a history of regressive ASD or loss of previously acquired skills. Clinicians should be aware that gastrointestinal problems, anxiety, and autonomic dysfunction may cluster in children with ASD and should be addressed in a multidisciplinary treatment plan.” I continuously say that ASD children should have a comprehensive evaluation for underlying co-morbidities rather than practicing “lazy medicine” and writing out a script for a psychoactive drug.

Identification and Treatment of Pathophysiological Comorbidities of Autism Spectrum Disorder to Achieve Optimal Outcomes. Full text. Excellent review. “In this paper we review some of the pathophysiological abnormalities associated with ASD and their potential associated treatments. Overall, there is evidence for some children with ASD being affected by seizure and epilepsy, neurotransmitter dysfunction, sleep disorders, metabolic abnormalities, including abnormalities in folate, cobalamin, tetrahydrobiopterin, carnitine, redox and mitochondrial metabolism, and immune and gastrointestinal disorders.

Improvement in Symptoms of Autism Spectrum Disorder in Children With the Use of Gastrin-Releasing Peptide: An Open Trial. Full text. “Evidence has suggested a link between gastrin-releasing peptide (GRP) and neuropsychiatric disturbances. Recent preclinical studies have raisedthe hypothesis that some ASD symptoms, such as socialinteraction deficits and reduced interest in bonding, maybe caused by a lack of GRP action at some early point indevelopment. Gastrin-releasing peptide was safe and well tolerated by most subjects and may be effective for core symptoms of autism.

Vitamin D and omega-3 fatty acid supplements in children with autism spectrum disorder: a study protocol for a factorial randomised, double-blind, placebo-controlled trial. Full text of  study protocol. “There is strong mechanistic evidence to suggest that vitamin D and omega-3 long chain polyunsaturated fatty acids (n-3 LCPUFAs), specifically docosahexaenoic acid (DHA), have the potential to significantly improve the symptoms of autism spectrum disorder (ASD).

Efficacy of Folic Acid Supplementation in Autistic Children Participating in Structured Teaching: An Open-Label Trial. Full text. “The results illustrated folic acid intervention improved autism symptoms towards sociability, cognitive verbal/preverbal, receptive language, and affective expression and communication. These results unravel that children with ASD—or, at the very least, a subset of children with ASD—could benefit from this simple and safe nutritional supplementation.

The effect of epilepsy on autistic symptom severity assessed by the social responsiveness scale in children with autism spectrum disorder. Full text. “ASD participants with epilepsy were significantly more impaired than ASD participants on some measures of social functioning such as social awareness and social communication.

Atopic diseases and inflammation of the brain in the pathogenesis of autism spectrum disorders. Full text. “Recent epidemiological studies have shown a strong statistical correlation between risk for ASD and either maternal or infantile atopic diseases, such as asthma, eczema, food allergies and food intolerance, all of which involve activation of mast cells (MCs). Serum IL-6 and TNF may define an ASD subgroup that benefits most from treatment with the natural flavonoid luteolin.

Acetaminophen use in pregnancy and neurodevelopment: attention function and autism spectrum symptoms. Full text. “Prenatal acetaminophen exposure was associated with a greater number of autism spectrum symptoms in males and showed adverse effects on attention-related outcomes for both genders. These associations seem to be dependent on the frequency of exposure.

Bedtime Electronic Media Use and Sleep in Children with Autism Spectrum Disorder.Overall, these findings indicate that incorporating television and video games into the bedtime routine is associated with sleep onset difficulties among children with ASD. Exposure to violent media before bed is also associated with poor sleep.

Truths, Myths and Needs of Special Diets: Attention-Deficit/Hyperactivity Disorder, Autism, Non-Celiac Gluten Sensitivity, and Vegetarianism. Full Text.

Psychoactive pharmaceuticals at environmental concentrations induce in vitro gene expression associated with neurological disorders. Full text. “We found that psychoactive pharmaceuticals altered the gene expression of neuronal systems in vitro at environmental concentrations. These altered gene expressions are associated with potential neurological disorders by playing a key role in the formation, growth and regulation of neurons.

 

May 2016

Safety of Selective Serotonin Reuptake Inhibitors in Pregnancy: A Review of Current Evidence.Exposure to SSRIs in pregnancy has been associated with miscarriage, premature delivery, neonatal complications, birth defects-specifically cardiac defects-and, more recently, neurodevelopmental disorders in childhood, specifically autism spectrum disorders. It is important that every pregnant woman being treated with an SSRI (or considering such treatment) carefully weighs the risks of treatment against the risk of untreated depression for both herself and her child.

Brain GABA levels across psychiatric disorders: A systematic literature review and meta-analysis of 1 H-MRS studies.In conclusion, this meta-analysis provided evidence for lower brain GABA levels in ASD……. compared with healthy controls.”

Risk of Psychiatric and Neurodevelopmental Disorders Among Siblings of Probands With Autism Spectrum Disorders.Autism spectrum disorders were also associated with schizophrenia spectrum disorders, affective disorders, anxiety disorders, and other neurotic and personality disorders among siblings.

Chemicals, Nutrition, and Autism Spectrum Disorder: A Mini-Review. Full text. “Several chemical exposures such as air pollution (e.g., particular matter 2.5), pesticides, bisphenol A, phthalates, mercury, and nutrition deficiency such as folic acid, vitamin D, or fatty acid may possibly be associated with an increased risk of ASD, whereas other traditional risk factors such as smoking/tobacco, alcohol, or polychlorinated biphenyls are less likely to be associated with ASD.

Genome-wide association study of serum coenzyme Q10 levels identifies susceptibility loci linked to neuronal diseases.In summary, this study demonstrates that serum CoQ10 levels are associated with common genetic loci that are linked to neuronal diseases [like Alzheimer disease, autism, and schizophrenia].

The landscape of DNA methylation amid a perfect storm of autism aetiologies.The dynamic developmental landscape of DNA methylation is vulnerable to numerous genetic and environmental insults: therefore, understanding pathways that are central to this ‘perfect storm’ will be crucial to improving the diagnosis and treatment of ASD.

Persistence of self-injurious behaviour in autism spectrum disorder over 3 years: a prospective cohort study of risk markers.Behavioural correlates of being non-verbal, having lower ability and higher levels of overactivity, impulsivity and repetitive behaviour, were associated with self-injury..” Sad that 3 years of research was done on 67 ASD individuals with self-injury but no evaluation for PAIN as the driver for the self-injury.

DNA methylation: a mechanism linking environmental chemical exposures to risk of autism spectrum disorders?..we describe epidemiological and experimental evidence implicating altered DNA methylation as a potential mechanism by which environmental chemicals confer risk for ASD..

Association between autism symptoms and family functioning in children with attention-deficit/hyperactivity disorder: a community-based study...the association between ASD symptoms and most family functioning measures was accounted forby child internalising and externalising disorders, ADHD severity, and socioeconomic status; however, ASD symptoms appear to be independently associated with poorer FQoL [family quality of life] in children with ADHD.”

A Comparison Between Caregiver-Reported Anxiety and Other Emotional and Behavioral Difficulties in Children and Adolescents with Autism Spectrum Disorders Attending Specialist or Mainstream Schools.Increasing numbers of students with Autism Spectrum Disorder (ASD) are attending mainstream schools. Nonetheless, concerns about their emotional well-being and mental health in these settings have also been raised. Students with ASD attending mainstream schools experienced higher levels of social anxiety symptoms compared to their specialist school counterparts.

Mean serum-level of common organic pollutants is predictive of behavioral severity in children with autism spectrum disorders.The ASD cohort displayed greater quantitative variance of analyte concentrations than controls, suggesting a wide range of detoxification functioning in the ASD cohort. This study supports the hypothesis that environmental exposure to organic pollutants may play a significant role in the behavioral presentation of autism.

CSF concentrations of 5-methyltetrahydrofolate in a cohort of young children with autism. this study examined CSF 5-methyltetrahydrofolate (5-MTHF) concentrations in a group of young children with autism.” “CSF 5-MTHF levels vary significantly over time in an unpredictable fashion and do not show a significant relationship to typical clinical features of autism. Reduced CSF 5-MTHF levels are a nonspecific finding in autism.”

SnapShot: Microglia in Disease.dysregulation of microglia contributes to the pathology of neurodevelopmental disorders such as autism spectrum disorders; neurodegenerative disorders such as Alzheimer’s disease; and schizophrenia

Associations between cytokines, endocrine stress response, and gastrointestinal symptoms in autism spectrum disorder.The relationship between cortisol response to stress and GI functioning was greater for children who had a history of regressive autism.

Epigenetic Effect of Environmental Factors on Autism Spectrum Disorders. Full text. “findings support the idea that the phenotypes of ASDs caused by epigenetic dysregulation are reversible and thus treatable.

Correlation between Nutrition and Symptoms: Nutritional Survey of Children with Autism Spectrum Disorder in Chongqing, China.These results suggest that reduced macronutrient intakes, severe feeding behavior issues, constipation, and vitamin A deficiency are quite common among children with ASD. Further, a low serum vitamin A level may be a risk factor for symptoms of ASD.

Mass spectrometric evaluation of neurotransmitter levels in IMR 32 cell line in response to Ayurvedic medicines.Herbal medicines given as part of ayurvedic medicine increased the neurotransmitter levels ……… these ayurvedic medicines when prescribed to children with ASD might alleviate the abnormal behavioral symptoms by maintaining neurotransmitter homeostasis.” Herbal medicine can be very useful in the treatment of ASD children.

A comparative consecutive case series of 20 children with a diagnosis of ADHD receiving homeopathic treatment, compared with 10 children receiving usual care.In this small consecutive sample the intervention was associated with improvements in criminality, anger and children with a concomitant diagnosis of Autism Spectrum Disorder ASD.”

Risperidone-Induced Acute Respiratory Distress in an Adolescent with Autism. No abstract available. However it is a reminder that pharmaceutical medications can have serious side effects.

A sexually dichotomous, autistic-like phenotype is induced by Group B Streptococcus maternofetal immune activation...these data show for the first time that gestational exposure to GBS plays an important role in the generation of neurodevelopmental abnormalities reminiscent of human autism spectrum disorders (ASD). These results provide new evidence in favor of the role of a common and modifiable infectious/inflammatory environmental factor in human ASD pathophysiology.

Gut microbiome and psyche: paradigm shift in the concept of brain-gut axis. [German]”a faulty composition of the gut microbiota in childhood influences the maturation of the central nervous system and thus may favor the development of mental disorders such as autism, depression, or other.

Cataract secondary to self-inflicted blunt trauma in children with autism spectrum disorder.We report 3 cases of bilateral cataract secondary to self-inflicted blunt eye trauma in children with autism spectrum disorder (ASD). All 3 children hit their foreheads, orbits, or globes repeatedly for long periods of time and developed cataracts.” This case report is so sad in that NO ONE investigated WHY these three children were self-injuring themselves. The most common reason is underlying PAIN.

Population-Based Prevalence of Intellectual Disability and Autism Spectrum Disorders in Western Australia: A Comparison With Previous Estimates.prevalence of intellectual disability (ID) and/or autism spectrum disorders (ASDs) in Western Australia (WA).A cohort of children born from 1983 to 2010 in WA with an ID and/or ASD…The prevalence of ID has risen in WA over the last 10 years with most of this increase due to mild or moderate ID. Whilst the prevalence of ASD has also increased over this time this does not fully explain the observed increase. Aboriginal children are at a 2.5-fold risk of ID but are less likely to be accessing disability services.

The missing voices of Indigenous Australians with autism in research.The purpose of this Letter to the Editor is to raise awareness among those who read Autism about the limited amount of peer-reviewed literature on Aboriginal and Torres Strait Islander Australians living on the autism spectrum. This letter summarises the results of our search on Pubmed and Google Scholar for peer-reviewed literature on this subject. It then concludes by explaining why more research should be conducted on Aboriginal and Torres Strait Islander Australians living on the autism spectrum.

Effects of Atomoxetine in Individuals with Attention-Deficit/Hyperactivity Disorder and Low-Functioning Autism Spectrum Disorder.ATX [atomoxetine] appears to be safe and effective for social withdrawal and ADHD symptoms in children with ASD and ID.” Out of 37 patients 16 (43,2%) were considered responders, 5 (13.5%) stopped medication due to either increased motor activity and talkativeness, irritability, temper outbursts, or increased blood pressure. This is only within 12 weeks. Long-term side effects?  Better outcomes can be achieved with dietary modification or targeted supplements, with minimal side effects.

Use of complementary and alternative medicine in children and adolescents with autism spectrum disorder: A systematic review.Approximately half of children and adolescents with autism spectrum disorder use complementary and alternative medicine. Doctors should be aware of this and should discuss complementary and alternative medicine use with patients and their carers, especially as the evidence is mixed and some complementary and alternative medicine treatments are potentially harmful.” It is unfortunate that complimentary medicines that have been shown to be effective are reported as “potentially harmful”, yet pharmacological medications like atomexatine in the study above are reported as appearing to be “safe and effective”.

Preschool to School in Autism: Neuropsychiatric Problems 8 Years After Diagnosis at 3 Years of Age.More than 90 % of children with a preschool diagnosis of ASD have remaining neuropsychiatric problems at 11, despite early intervention.

Omega-3 and Omega-6 Polyunsaturated Fatty Acid Levels and Correlations with Symptoms in Children with Attention Deficit Hyperactivity Disorder, Autistic Spectrum Disorder and Typically Developing Controls. Full text. “Children with ADHD and ASD had low levels of EPA, DHA and AA and high ratio of n-6/n-3 PUFAs and these correlated significantly with symptoms.” Research on omega-3 supplements show inconsistent results. Unfortunately no one actually tests the quality of omega-3 supplements used in the majority of studies. The few studies done on omega-3 supplements have shown that most are of very poor quality.

Asperger syndrome in males over two decades: Quality of life in relation to diagnostic stability and psychiatric comorbidity.The subsample that no longer fulfilled an autism spectrum disorder had full-time jobs or studies (10/11), independent living (100%), and reported having two or more friends (100%). In the stable autism spectrum disorder group, 41% had full-time job or studies, 51% lived independently, and 33% reported two or more friends, and a significant minority had specialized employments, lived with support from the government, or had no friends.

Curcumin in depressive disorders: an overview of potential mechanisms, preclinical and clinical findings.Despite the limited number of reports, preclinical models investigated the potential role for curcumin in anxiety, bipolar disorder, post-traumatic stress disorder and autism spectrum disorders.

Feelings of loss and grief in parents of children diagnosed with autism spectrum disorder (ASD).The core category that explained the feelings of these parents was unexpected child loss, associated with shock, negation, fear, guilt, anger, and/or sadness.

Correctional Management and Treatment of Autism Spectrum Disorder.Currently, there is no universal training on ASD for CJS [criminal justice system] professionals, nor are there service standards for individuals with ASD during incarceration, to support their community re-entry and reduce recidivism.

Antipsychotic Use Trends in Youth With Autism Spectrum Disorder and/or Intellectual Disability: A Meta-Analysis.1 in 6 youth with ASD received antipsychotics. Both proportions increased in later years; however, clinical reasons and outcomes of antipsychotic use in ASD/ID require further study.

Practices and outcomes of self-treatment with helminths based on physicians’ observations.The results strongly support previous indications that helminth therapy can effectively treat a wide range of allergies, autoimmune conditions and neuropsychiatric disorders, such as major depression and anxiety disorders. Approximately 57% of the self-treating patients observed by physicians in the study had autism. Physicians reported that the majority of patients with autism and inflammation-associated co-morbidities responded favourably to therapy with either of the two most popular organisms currently used by self-treaters, Hymenolepis diminuta and Trichuris suis. However, approximately 1% of paediatric patients experienced severe gastrointestinal pains with the use of H. diminuta, although the symptoms were resolved with an anti-helminthic drug.

Neuropathological Mechanisms of Seizures in Autism Spectrum Disorder. Full text. “This manuscript reviews biological abnormalities shared by autism spectrum disorder (ASD) and epilepsy. Two neuropathological findings are shared by ASD and epilepsy: abnormalities in minicolumn architecture and γ-aminobutyric acid (GABA) neurotransmission. Mineral deficiencies can cause glutamate and GABA neurotransmission abnormalities and heavy metals can cause mitochondrial dysfunction which disrupts GABA metabolism.

Iodine Deficiency and Hypothyroidism From Voluntary Diet Restrictions in the US: Case Reports.Recent trends among specific populations of children in the United States include adopting food restrictions, such casein-free and gluten-free diets. We present here 2 cases of iodine deficiency resulting from severe food restriction and associated primary hypothyroidism. ” Iodine status should be assessed in all children regardless of diet as iodine deficiency is prevalent in children and pregnant women in Australia.”

 

April 2016

Calcium and Vitamin D Supplement Prescribing Practices among Providers Caring for Children with Autism Spectrum Disorders: Are We Addressing Bone Health? Full text. “Twenty-four percent of children in the GFCF group had a documented 25(OH)D level compared to none in the non-GFCF group. The data highlight a gap in calcium and vitamin D supplement prescribing practices among providers caring for children with ASD as well as a gap in the practice of checking 25(OH)D levels.

Regulation of prefrontal cortex myelination by the microbiota.In summary, we believe we demonstrate for the first time that the microbiome is necessary for appropriate and dynamic regulation of myelin-related genes with clear implications for cortical myelination at an ultrastructural level.”

Targeted Nutritional and Behavioral Feeding Intervention for a Child with Autism Spectrum Disorder. Full text. “this study is the first of its kind highlighting the importance of a multidisciplinary approach to address pediatric feeding problems. Additionally, nutritional, medical, and oral motor assessments are critical components of a feeding program

The impacts of physical activity intervention on physical and cognitive outcomes in children with autism spectrum disorder.The findings provide supporting evidence that physical activity interventions involving table tennis training may be a viable therapeutic option for treating children with autism spectrum disorder.

Evaluation of whole blood zinc and copper levels in children with autism spectrum disorder.   Zinc (Zn) and copper (Cu) are important trace elements for cognitive development and normal neurological functioning. The results of the present study may be indicative of Zn deficiency in ASD children. Taking into account Zn-mediated up-regulation of metallothionein (MT) gene expression, these findings suggest a possible alteration in the functioning of the neuroprotective MT system.

 Associations between joint attention and language in autism spectrum disorder and typical development: A systematic review and meta-regression analysis.Joint attention may be more tightly tied to language in children with ASD as compared to TD [typically developing] children……… children with ASD who exhibit deficits in joint attention develop language contingent upon their joint attention abilities.

The prevalence of symptoms of attention-deficit/hyperactivity disorder in parents of children with autism spectrum disorder.Symptoms of ADHD were present in 10.4% of the mothers of children with a diagnosis of ASD and in 11.3% of the fathers.

Lost at Sea in Search of a Diagnosis: A Case of Unexplained Bleeding.Here, we present a 17-year-old male with autism spectrum disorder and a diet severely deficient in ascorbic acid due to textural aversion and food preferences. He presented with recurrent arthritis, hemarthrosis, bruising, and anemia. His vitamin C level was low, and his symptoms improved promptly after treatment with ascorbic acid.

Bread and Other Edible Agents of Mental Disease. Full text. “Perhaps because gastroenterology, immunology, toxicology, and the nutrition and agricultural sciences are outside of their competence and responsibility, psychologists and psychiatrists typically fail to appreciate the impact that food can have on their patients’ condition.

The basis for folinic acid treatment in neuro-psychiatric disorders...despite normal systemic levels, folate transport to the brain is impaired in the so-called cerebral folate deficiency (CFD) syndromes presenting as developmental and psychiatric disorders. These include infantile-onset CFD syndrome, infantile autism with or without neurologic deficits..” “Infantile CFD syndrome and autism with neurological deficits tend to be characterized by elevated Folate receptor alpha [FRα] antibody titers and low CSF MTHF.” “..therapeutic regimens using high dose folinic acid, corticosteroids and milk-free diet is presented which has proven to be beneficial in providing adequate folate to the brain and decreasing the FRα autoantibody titer in those positive for the antibody.” For more on Cerebral Folate Deficiency click here.

Analysing change in music therapy interactions of children with communication difficulties. Full text. “Music therapy has been found to improve communicative behaviours and joint attention in children with autism…

Autism, mitochondria and polybrominated diphenyl ether exposure.In this review, we propose that PBDE, and possibly other environmental exposures, during child development can induce or compound mitochondrial dysfunction, which in conjunction with a dysregulated antioxidant response, increase a child’s susceptibility of autism.

Sulforaphane treatment of young men with Autism Spectrum Disorder.Sulforaphane, a phytochemical derived from a number of cruciferous vegetables, most notably broccoli sprouts, has metabolic effects that in some ways resemble that of fever. This review paper discusses this “fever effect” and the intracellular effects of sulforaphane as well as the results of our recent clinical trial of sulforaphane in young adults with autism.” For more on sulforaphane click here.

Oxidative Stress and Nitric Oxide in Autism Spectrum Disorder and Other Neuropsychiatric Disorders.The etiology of autism spectrum disorder (ASD) remains unclear; however, the toxic environmental exposure to oxidative stress has been suggested to play an important role in its pathogenesis.

The Potential of Nasal Oxytocin Administration for Remediation of Autism Spectrum Disorders.Administration of oxytocin has been proposed as a treatment for the core symptoms of autism spectrum disorder (ASD), including social-communicative deficit.

Effects of yokusankan, a Japanese kampo medicine, for symptoms associated autism spectrum disorder.Yokukansan (YKS), a traditional Japanese medicine, is composed of seven kinds of dried herbs. It is widely prescribed in clinical situation for treating psychiatric disorders by acting on mainly glutamatergic and serotonergic nervous system. In this review, we introduce the ameliorative effects of YKS on ASDs including pervasive developmental disorder not otherwise specified (PDD-NOS) and Asperger’s disorder in the open-label studies, suggesting that YKS is effective and well tolerated for the treatment of severe irritability/agitation and hyperactivity/noncompliance in subjects with ASD.

Biomarker-guided Strategy for Treatment of Autism Spectrum Disorder (ASD).We outline herein, several ASD-associated basic physiological pathways that can be regulated by the small molecule phytochemical sulforaphane, as an example of a druggable small molecule target for which much in vitro, pre-clinical, and clinical evidence already exists.

Plasma Oxytocin in Children with Autism and Its Correlations with Behavioral Parameters in Children and Parents.Oxytocin (OT) has been implicated to play an important role in autism spectrum disorders (ASD) etiology. Our results support the hypothesis of OT deficiency in autism. The “paradoxical” associations of OT levels and social skills in children with autism indicate disturbances at various levels of OT system.

Service Needs Across the Lifespan for Individuals with Autism.Adults with ASD were less likely to be receiving multiple types of services, and more likely to have a need for services. These findings demonstrate that adults with ASD have more and different needs for services.

Serum levels of SOD and risk of autism spectrum disorder: A case-control study.This study examined the clinical significance of serum superoxide dismutase (SOD) level, a marker of oxidative stress, in children with autism spectrum disorder.” “Levels of SOD increased with decreasing severity of ASD ….decreased serum SOD levels could be implicated in the pathophysiology and progression of autism.

Case 2: Persistent skin discolouration in a child with autism spectrum disorder. Full text. A 3-year old ASD boy described as a “picky eater” presented with orange discolouration of his entire body. He drank 1.36 litres per day of a commercial fruit juice. The diagnosis was hypercarotenemia (elevated serum beta-carotene). Of note was his overall carbohydrate intake of 158 grams per day from juice (130 grams per day is recommended for children).

A Pilot Study for Understanding the Perceptions of Australian General Practitioners Regarding Psychopharmacology for Children With Autism Spectrum Disorders.GPs reported a lack of experience of these medications, and would often prescribe only under the supervision of specialists. GPs with greater confidence and involvement with children of ASDs prescribed more medications; whereas GP reporting more concerns with regard to medications prescribed less.

Therapeutic potency of bee pollen against biochemical autistic features induced through acute and sub-acute neurotoxicity of orally administered propionic acid.Propionic acid (PA), as a metabolic product of gut microbiota and as a commonly used food additive, has been reported to mediate the effects of autism. Bee pollen was effective in ameliorating the neurotoxic effect of PA.

Vitamin D and Autism Spectrum Disorder: A Literature Review.…serum 25(OH)D level during pregnancy or childhood-we found growing evidence for a relationship between vitamin D and ASD.

What Happened to Paul? Manifestation of Abnormal Pain Response for Individuals With Autism Spectrum Disorder.This article concludes by arguing that professionals across all domains of health care need to begin to see behavior as communicative for those with ASD. This is particularly true of changes in behavior, which can be significant indicators of health care problems rather than something to be dismissed as another manifestation of the condition.

The Relationship Between Pain, Self-Injury, and Other Problem Behaviors in Young Children With Autism and Other Developmental Disabilities. Research has suggested that individuals who engage in self-injurious behavior may have enhanced expressions of pain ……These results continue to support that individuals with self-injury may have enhanced expressions of pain.”

Urinary 3-(3-Hydroxyphenyl)-3-hydroxypropionic Acid, 3-Hydroxyphenylacetic Acid, and 3-Hydroxyhippuric Acid Are Elevated in Children with Autism Spectrum Disorders. Full text. “Recent studies have shown that some abnormal aromatic metabolites in autism patients are presumably derived from overgrown Clostridium species in gut, which may be used for diagnostic purposes.” This metabolite is included in the Organic Acid Test.

Weight Gain and Metabolic Consequences of Risperidone in Young Children With Autism Spectrum Disorder.Rapid weight gain with risperidone treatment may promote the cascade of biochemical indices associated with insulin resistance and metabolic syndrome. Appetite, weight, waist circumference, liver function tests, blood lipids, and glucose warrant monitoring.

Minocycline as Adjunctive Treatment to Risperidone in Children with Autistic Disorder: A Randomized, Double-Blind Placebo-Controlled Trial.Forty-six children with diagnosis of autistic disorder …… participated in a randomized controlled trial and underwent 10 weeks of treatment with either minocycline (50 mg twice per day) or placebo in addition to risperidone titrated up to 2 mg/day (based on bodyweight). By week 10, 21 (91.3%) patients in the minocycline group and 15 (65.5%) patients in the placebo group achieved at least partial response. Minocycline seems to be a safe and effective adjuvant in management of patients with autistic disorder.” So this seems to be safe and effective, but dietary intervention is not proven and “dangerous”!

Comparison of nutritional status between children with autism spectrum disorder and typically developing children in the Mediterranean Region (Valencia, Spain).Autism spectrum disorder group failed to meet dietary recommendations for thiamin, riboflavin, vitamin C, or calcium. Risk of inadequate intake of fiber, vitamin E, and sodium was lower in children with autism spectrum disorder than typically developing children.

 

March 2016

Medical Therapy for Inappropriate Sexual Behaviors in a Teen With Autism Spectrum Disorder.

Realizing a diagnosis of autism spectrum disorder as an adult.

Case 3: Regression in an adolescent with autism spectrum disorder. Full text.

Mental Health in Children Born Extremely Preterm Without Severe Neurodevelopmental Disabilities.

Potency of pre-post treatment of coenzyme Q10 and melatonin supplement in ameliorating the impaired fatty acid profile in rodent model of autism. Full text. “Melatonin and coenzyme Q were effective in restoring normal level of most of the impaired fatty acids in PA-intoxicated rats which could help suggest both as supplements to ameliorate the autistic features induced in rat pups.”

Sensory cognitive abnormalities of pain in autism spectrum disorder: a case-control study. Full text.

Association of methylenetetrahydrofolate reductase (MTHFR) gene C677T polymprphism with autism: evidence of genetic susceptibility. “present meta-analysis strongly suggested a significant association of the MTHFR C677T polymorphism with autism.”

Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives. Full text. “The high success rate and safety in the short term reported for recurrent Clostridium difficile infection has elevated FMT as an emerging treatment for a wide range of disorders, including Parkinson’s disease, fibromyalgia, chronic fatigue syndrome, ……and autism.”

Autism and sleep disorders. Full text. Improvement in sleep can make a significant improvement to the quality of life for the ASD individual and their family.

The microbiota-gut-brain axis and its potential therapeutic role in autism spectrum disorder. “Research continues to show that the gut in autistic children is a promising area of treatment. Parents treating their children’s gut issues are seeing some amazing improvements in their children. The US, Canadian and UK Paediatricians have guidelines recommending that all ASD children should have a comprehensive gastrointestinal assessment. Unfortunately, Australian Paediatricians have not adopted similar guidelines.”

Aging and autism spectrum disorder: Evidence from the broad autism phenotype.

Gender Dependent Evaluation of Autism like Behavior in Mice Exposed to Prenatal Zinc Deficiency.

Epilepsy and Autism. “Epilepsy and autistic spectrum disorder frequently coexist in the same individual. Electroencephalogram (EEG) epileptiform activity is also present at a substantially higher rate in children with autism than normally developing children.”

Plasma phthalate and bisphenol a levels and oxidant-antioxidant status in autistic children. “Phthalates and bisphenol A (BPA) are endocrine disruting chemicals (EDCs) that are suggested to exert neurotoxic effects. Plasma BPA levels of children with PDD-NOS were significantly higher than both classic autistic children and controls.”

People with autism ‘die younger’, warns charity. 

Neuro-inflammatory mechanisms in developmental disorders associated with Intellectual Disability and Autism Spectrum Disorder: a neuro-immune perspective. “These results may reflect an inappropriate immune response to environmental factors, such as infectious or toxic exposure. The role of microglia as sensors of pre- and post-natal environmental stimuli and its involvement in the regulation of synaptic connectivity, maturation of brain circuitry and neurogenesis has recently emerged.

Alzheimer’s disease and Autistic Spectrum Disorder: Is there any Association? “Modern technology resulting in genetically modified crops and increase in gadgets emitting electromagnetic frequencies have resulted in enhanced risks for neurological dysfunctions and disorders like ASD and AD. Subsequent advances in the psychological, pharmacological, biochemical and nutritional aspects of the disorders have resulted in the development of newer therapeutic approaches.”

Fidgety movements – tiny in appearance, but huge in impact.

Association of current phthalate exposure with neurobehavioral development in a national sample. “…increased phthalate exposure exhibited supralinear associations with social, thought and attention problems in children aged 6-11 years, who showed greater vulnerability to phthalate exposure.”

Multiple inflammasome complexes are activated in autistic spectrum disorders. “…intestinal fatty acid binding protein (IFABP), an index of altered GI permeability, was significantly increased in serum of ASD”

Metals and Neurodegeneration. Full text. “Epidemiological and clinical studies have shown a strong correlation between aberrant metal exposure and a number of neurological diseases, including Alzheimer’s disease, amyotrophic lateral sclerosis, autism spectrum disorders ….”

The Association between Adult Participation and the Engagement of Preschoolers with ASD. Full text.

Plasma amino acid profile in autism spectrum disorder (ASD). Full text. “We found significant differences in levels of ammonium, phosphoethanolamine, histidine, homocysteine, carnosine, methionine, cystathionine, cystine, threonine, 3-methyl histidine and phenylalanine/tyrosine ratio between patient and control groups. Both vitamin B12 and D were significantly lower in the ASD group compared to controls.” Autism is treatable.    The evidence continues to accumulate that there are biochemical and nutritional abnormalities in these individuals.

Perioperative and Anesthesia Guidelines for Children with Autism: A Nationwide Survey from Sweden.

Exposure to Folate Receptor Alpha Antibodies during Gestation and Weaning Leads to Severe Behavioral Deficits in Rats: A Pilot Study. Full text. “Folate deficiency and folate receptor alpha autoantibodies (FRα-AuAb) have been associated with pregnancy-related complications and neurodevelopmental disorders.”

Blocking and Binding Folate Receptor Alpha Autoantibodies Identify Novel Autism Spectrum Disorder Subgroups. Full text. “Folate receptor α (FRα) autoantibodies (FRAAs) are prevalent in autism spectrum disorder (ASD). They disrupt the transportation of folate across the blood-brain barrier by binding to the FRα. Children with ASD and FRAAs have been reported to respond well to treatment with a form of folate known as folinic acid, suggesting that they may be an important ASD subgroup to identify and treat.” This study and the study above indicate that there is a subgroup of children that benefit significantly with the active form of folate.

Perinatal exposure to lead (Pb) promotes Tau phosphorylation in the rat brain in a GSK-3β and CDK5 dependent manner: Relevance to neurological disorders. Although this is an animal study it does confirm that lead “in whole blood below 10μg/dL, considered safe for humans”, can lead to neurological disorders such as Alzheimer’s, Parkinson’s diseases as well as autism.

Outcome for Children Receiving the Early Start Denver Model Before and After 48 Months.

Increased Release of Mercury from Dental Amalgam Fillings due to Maternal Exposure to Electromagnetic Fields as a Possible Mechanism for the High Rates of Autism in the Offspring: Introducing a Hypothesis. “There are some evidence indicating that perinatal exposure to mercury is significantly associated with an increased risk of developmental disorders such as autism spectrum disorders (ASD) and attention-deficit hyperactivity disorder (ADHD)…..exposure to MRI or microwave radiation emitted by common mobile phones can lead to increased release of mercury from dental amalgam fillings…..our findings can lead us to this conclusion that maternal exposure to electromagnetic fields in mothers with dental amalgam fillings may cause elevated levels of mercury and trigger the increase in autism rates.”

The impact of caring for an adult with intellectual disability and psychiatric comorbidity on carer stress and psychological distress. “Carers of people with ID and comorbid psychopathology were found to have significantly higher levels of stress and psychological distress than carers of people with ID alone. Autism was found to be the only significant predictor of both stress and psychological distress among measures of psychopathology.”

Stress and Parents of Children with Autism: A Review of Literature. “The daily challenges of caring for the child are endless and effect all aspects of the child’s care as well as the parent’s mental health and ability to manage the needs of the child and family.”

Complementary and Alternative Medicine in Autism: The Question of Omega-3. In this article, we address the role of omega-3 in the treatment of ASD, reviewing the relevant literature highlighted by searches of PubMed from 1949 to the present. According to the criteria of evidence-based medicine (ie, randomized clinical trials), the data do not support the effectiveness of omega-3 treatment in children with ASD. However, based on anecdotal experiences and on nonrandomized trials, we cannot exclude that there might be a subset of people with ASD who do respond to this type of approach.

 

February 2016

Dysregulated Breastfeeding Behaviors in Children Later Diagnosed With Autism.

Relevance of Neuroinflammation and Encephalitis in Autism. Full text.

Oxytocin for Male Subjects with Autism Spectrum Disorder and Comorbid Intellectual Disabilities: A Randomized Pilot Study. Full text.

Managing Children With Autism Spectrum Disorders in Emergency Departments.

Supplementation of Korean Red Ginseng improves behavior deviations in animal models of autism. Full text.

Prevalence and Correlates of Elopement in a Nationally Representative Sample of Children with Developmental Disabilities in the United States. Full text.

Comorbidity of Atopic Disorders with Autism Spectrum Disorder and Attention Deficit/Hyperactivity Disorder.

Psychogenic nonepileptic seizures as a manifestation of psychological distress associated with undiagnosed autism spectrum disorder. Full text.

Parent and health care provider perspectives related to disclosure of autism spectrum disorder in pediatric emergency departments.

Maternal experience of Lego Therapy in families with children with autism spectrum conditions: What is the impact on family relationships?

Iodine in autism spectrum disorders.

The effect of ketogenic diet in an animal model of autism induced by prenatal exposure to valproic acid.

Factors Mediating Dysphoric Moods and Help Seeking Behaviour Among Australian Parents of Children with Autism.

Psychiatric Co-occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with Autism Spectrum Disorder.

Language comprehension and brain function in individuals with an optimal outcome from autism.

Environmental exposure to metals, neurodevelopment, and psychosis.

Facing the Unknown: Intolerance of Uncertainty in Children with Autism Spectrum Disorder.

Rates of Autism Spectrum Disorder Diagnosis Under the DSM-5 Criteria Compared to DSM-IV-TR Criteria in a Hospital-Based Clinic.

Oxytocin in the socioemotional brain: implications for psychiatric disorders.

Does Rubella Cause Autism: A 2015 Reappraisal?

A Non-inflammatory Role for Microglia in Autism Spectrum Disorders.

Psychostimulants: Concerns over Long-Term Adverse Side Effects.

Low-level lead exposure and autistic behaviors in school-age children.

Randomized, Placebo-Controlled Trial of Methyl B12 for Children with Autism.

Improvement of autism spectrum disorder symptoms in three children by using gastrin-releasing peptide.

Obesity and associated factors in youth with an autism spectrum disorder.

Early Characteristics of Children with ASD Who Demonstrate Optimal Progress Between Age Two and Four.

Abnormal Pressure Pain, Touch Sensitivity, Proprioception, and Manual Dexterity in Children with Autism Spectrum Disorders. Full text.

Listening to Parents: A Qualitative Look at the Dental and Oral Care Experiences of Children with Autism Spectrum Disorder.

Centrally acting non-narcotic antitussives prevent hyperactivity in mice: Involvement of GIRK channels.

Serum Ferritin, Weight Gain, Disruptive Behavior, and Extrapyramidal Symptoms in Risperidone-Treated Youth.

Exploratory Study of Childbearing Experiences of Women With Asperger Syndrome.

Research advances in the role of vitamin D in autism spectrum disorders.

Medical and Behavioral Correlates of Depression History in Children and Adolescents With Autism Spectrum Disorder.

Assessment and Treatment of Anxiety in Youth With Autism Spectrum Disorders. “Anxiety is one of the most prevalent co-occurring symptoms in youth with autism spectrum disorder (ASD).”

Pharmacologic Treatment of Severe Irritability and Problem Behaviors in Autism: A Systematic Review and Meta-analysis.

Health Care Transition Services for Youth With Autism Spectrum Disorders: Perspectives of Caregivers. “The receipt of transition services was low overall, with rates for individual services ranging from 3% to 33%.” “Regression analyses showed depression to be the only variable significantly associated with service receipt.”

Toward Practice Advancement in Emergency Care for Children With Autism Spectrum Disorder.

Sleep Difficulties and Medications in Children With Autism Spectrum Disorders: A Registry Study. “Medications for sleep were prescribed in 46% of 4- to 10-year-olds given a sleep diagnosis. The most common medication used for sleep was melatonin followed by α-agonists, with a variety of other medications taken for sleep (anticonvulsants, antidepressants, atypical antipsychotics, and benzodiazepines). Children taking medications for sleep had worse daytime behavior and pediatric quality of life than children not taking sleep medications.”

Fit for School: The Samurai School Program.

Frontal networks in adults with autism spectrum disorder. Full text.

Evaluation of Intestinal Function in Children with Autism and Gastrointestinal Symptoms.

Perioperative considerations in children with autism spectrum disorder.

The metabolic basis for developmental disorders due to defective folate transport. Clinically I have been using high dose 5-methyltetrahydrofolate in ASD children with some very good results.

Use of acetaminophen (paracetamol) during pregnancy and the risk of autism spectrum disorder in the offspring.

 

January 2016

Parent Perceptions of Care Received by Children With an Autism Spectrum Disorder.

Use of Antipsychotic Medications for Nonpsychotic Children: Risks and Implications for Mental Health Services.

Risk factors in autism: Thinking outside the brain.

Interleukin-18 modulation in autism spectrum disorders. Full text.

Commentary: Structural and functional features of central nervous system lymphatic vessels. Full text.

Template to Perpetrate: An Update on Violence in Autism Spectrum Disorder.

The levels of blood mercury and inflammatory-related neuropeptides in the serum are correlated in children with autism spectrum disorder.

Otitis Media and Related Complications Among Children with Autism Spectrum Disorders.

Low oxytocin and melatonin levels and their possible role in the diagnosis and prognosis in Iraqi autistic children.

Abnormal fatty acids in Canadian children with autism. More research showing deficiencies in beneficial omega-3 fatty acids in ASD children. Parents have been giving omega-3 oils to ADHD and ASD children for years. Yet the message is still slow to filter through to the general community.

Gastrointestinal symptoms and behavioral problems in preschoolers with Autism Spectrum Disorder. Yet another study linking gastrointestinal (GI) issues with behavioural issues (“anxiety problems, somatic complaints, externalizing and total problems”) in ASD children. Parents need to take their ASD child’s GI symptoms seriously and have them treated properly.

Gut microbiota in autism and mood disorders. Full text. The evidence is conclusive that there is an ASD and gut microbiota connection. Hence why many parents are working so hard on their childrens diet to help create a balanced microbiota in their childen’s gut.

Hoarding in Youth with Autism Spectrum Disorders and Anxiety: Incidence, Clinical Correlates, and Behavioral Treatment Response.

Gender dysphoria and autism spectrum disorder: A narrative review.

Effects of propranolol on conversational reciprocity in autism spectrum disorder: a pilot, double-blind, single-dose psychopharmacological challenge study.

A systematic review and meta-analysis of the long-term overall outcome of autism spectrum disorders in adolescence and adulthood. This study shows an estimated 19.7% of ASD adolescents and adults had a good long-term outcome, 31.1% a fair outcome, and 47.7% a poor outcome. Parents need to keep these statistics in mind. The orthodox medical advice given for over 20 years is a recipe for setting children up for long-term failure. Parents need to be proactive when children are younger and consider biomedical treatments at an early age.

Autism and Overcoming Job Barriers: Comparing Job-Related Barriers and Possible Solutions in and outside of Autism-Specific Employment. Full text.

Nutritional and Therapeutic Characteristics of Camel Milk in Children: A Systematic Review.

Nutritional and Metabolic Biomarkers in Autism Spectrum Disorders: An Exploratory Study. Another study validating what biomed parents have been doing for years to address their ASD child’s underlying issues.

Maladaptive Behavior and Gastrointestinal Disorders in Children with Autism Spectrum Disorder. Full text. This study only found significant gastrointestinal issues in severe maladaptive behaviour.

Integrative Approaches to Caring for Children with Autism.

Clinical improvement following vitamin D3 supplementation in Autism Spectrum Disorder.

Adolescent boys with autism spectrum disorder growing up: follow-up of self-reported sexual experience.

How Sensory Experiences Affect Adolescents with an Autistic Spectrum Condition within the Classroom.

Type 2 Diabetes Mellitus in Youth Exposed to Antipsychotics: A Systematic Review and Meta-analysis. Full text.

From Autism to Eating Disorders and More: The Role of Oxytocin in Neuropsychiatric Disorders. Full text.

From molecules to neural morphology: understanding neuroinflammation in autism spectrum condition. Full text.

The Effects of Rhythm and Robotic Interventions on the Imitation/Praxis, Interpersonal Synchrony, and Motor Performance of Children with Autism Spectrum Disorder (ASD): A Pilot Randomized Controlled Trial. Full text.

Autism in Toddlers Born Very Preterm.

An investigation of the ‘female camouflage effect’ in autism using a computerized ADOS-2 and a test of sex/gender differences. Full text.

Management of Sleep Disorders in Children With Neurodevelopmental Disorders: A Review.

Decreased Brain Levels of Vitamin B12 in Aging, Autism and Schizophrenia. Full text.

An update on the comorbidity of ASD and ADHD: A focus on clinical management.

Mitochondrial response to the BCKDK-deficiency: Some clues to understand the positive dietary response in this form of autism. Mitochondrial dysfunction can be picked up by the urinary markers in the Organic Acid Test.

Sleep and Behavioral Problems in Children with Autism Spectrum Disorder. Sleep problems were significantly associated with physical aggression, irritability, inattention, and hyperactivity.

The opioid effects of gluten exorphins: asymptomatic celiac disease. The opioid theory in ASD is considered unsubstantiated. However gluten exorphins have resurfaced as having a role in coeliac disease.

Elevated plasma levels of glutamate in children with autism spectrum disorders.

Autism traits: The importance of “co-morbid” problems for impairment and contact with services. Data from the Bergen Child Study.

The relationship between tics, OC, ADHD and autism symptoms: A cross- disorder symptom analysis in Gilles de la Tourette syndrome patients and family-members.

The two fold role of oxytocin in social developmental disorders: A cause and a remedy? Article discusses recent evidence suggesting a link between oxytocin labor induction and developmental social impairments such as autism spectrum disorders (ASD).

 

December 2015

The plausibility of maternal toxicant exposure and nutritional status as contributing factors to the risk of autism spectrum disorders.

Locus ceruleus neurons in people with autism contain no histochemically-detectable mercury.

Assessing early implementation of state autism insurance mandates.

Therapeutic and Ethical Dilemma of Puberty and Menstruation Problems in an Intellectually Disabled (Autistic) Female: a Case Report.

Neurological disorders and celiac disease.

How does environmental enrichment reduce repetitive motor behaviors? Neuronal activation and dendritic morphology in the indirect basal ganglia pathway of a mouse model.

Therapeutic Targets for Neurodevelopmental Disorders Emerging from Animal Models with Perinatal Immune Activation. Full text.

Maternal polycystic ovary syndrome and the risk of autism spectrum disorders in the offspring: a population-based nationwide study in Sweden.

Evaluation of Asperger Syndrome in Youth Presenting to a Gender Dysphoria Clinic.

Perinatal Phosphatidylcholine Supplementation and Early Childhood Behavior Problems: Evidence for CHRNA7 Moderation. This is a very interesting study. If there is a family history of autism, supplementation with phosphatidylcholine may be warranted.

Use and Perceived Effectiveness of Complementary and Alternative Medicine to Treat and Manage the Symptoms of Autism in Children: A Survey of Parents in a Community Population. Anectdotal evidence continues to confirm that Complementary and Alternative Medicine (CAM) is beneficil in dealing with the health and behavioural issues in ASD children. These are most effective while they are still young and building the foundation for their future years.

Hair Heavy Metal and Essential Trace Element Concentration in Children With Autism Spectrum Disorder. This helps validate why chelation therapy has been reported, via the ARI parent survey, to be beneficial for up to 73% of ASD children.

Alexithymia in Adolescents with Autism Spectrum Disorder: Its Relationship to Internalising Difficulties, Sensory Modulation and Social Cognition.

Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children.

A reply to Wang T, Shan L, Du L, Feng J, Xu Z, Staal WG, Jia F. Serum concentration of 25-hydroxyvitamin D in autism spectrum disorder: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry. 2015; doi: 10.1007/s00787-015-0786-1.

Behavioral phenotypes of autism spectrum disorder patients and their parents.

The very low birth weight infant microbiome and childhood health. Unfortunately I was not able to gain access to the full article, however the following is a full text article on the subject: The Human Neonatal Gut Microbiome: A brief review.

Zn/Cu Levels in the Field of Autism Disorders: A Systematic Review and Meta-analysis. Full text. Measuring zinc and copper levels in ASD children has been one of the most basic tests that is performed by biomedical practitioners treating ASD children. Although this study refers to Zn/Cu ratios, more typically they are expressed as Cu/Zn ratios. Again parents should take note that the research is validating what the biomedical community has been doing for years.

Epigenetic effects of casein-derived opioid peptides in SH-SY5Y human neuroblastoma cells. Full text. Opioid peptides (casein) again are being implicated as causative factors in gastrointestinal dysfunction and neurological conditions. Although this is a “test-tube” study, it does add to the growing evidence that a casein free diet may benefit a sub-group of ASD chidren.

DUF1220 copy number is associated with schizophrenia risk and severity: implications for understanding autism and schizophrenia as related diseases.

Sleep problems are more frequent and associated with problematic behaviors in preschoolers with autism spectrum disorder.

Testosterone in relation to behavioral problems in pre-pubertal boys with autism spectrum disorders. Full text.

Driving Simulator Performance in Novice Drivers with Autism Spectrum Disorder: The Role of Executive Functions and Basic Motor Skills.

A clinicomicrobiological study to evaluate the efficacy of manual and powered toothbrushes among autistic patients.

Maternal use of acetaminophen during pregnancy and risk of autism spectrum disorders in childhood: A Danish national birth cohort study.

Poor Brain Growth in Extremely Preterm Neonates Long Before the Onset of Autism Spectrum Disorder Symptoms.

Atypical sympathetic arousal in children with autism spectrum disorder and its association with anxiety symptomatology.

An Autistic Endophenotype and Testosterone Are Involved in an Atypical Decline in Selective Attention and Visuospatial Processing in Middle-Aged Women. Full text.

On the Role of Glutamate in Presynaptic Development: Possible Contributions of Presynaptic NMDA Receptors. Full text.

Targeting Glia with N-Acetylcysteine Modulates Brain Glutamate and Behaviors Relevant to Neurodevelopmental Disorders in C57BL/6J Mice. Full text.

[Nutritional Therapy for Children and Adolescents with Autism Spectrum Disorders: What is the Evidence?] [Article in German]. Unfortunate that article is not available as full text. It would be useful to see which articles were included in the review. Often there is “cherry picking” of articles to reach a certain conclusion. The research published clearly shows that there is a subgroup of children that improve considerably on a gluten and casein free diet.

Fathers’ Experience With Autism Spectrum Disorder: Nursing Implications.

Dietary docosahexaenoic acid alleviates autistic-like behaviors resulting from maternal immune activation in mice.

Beneficial action of resveratrol: How and why?

Reduced GABAergic Action in the Autistic Brain. Full text.

New Therapeutic Options for Autism Spectrum Disorder: Experimental Evidences. Full text.

Is Oxytocin Application for Autism Spectrum Disorder Evidence-Based? Full text.

The psychophysiological impact of childhood autism spectrum disorder on siblings.

Developmental Neurotoxicity of Inhaled Ambient Ultrafine Particle Air Pollution: Parallels with Neuropathological and Behavioral Features of Autism and Other Neurodevelopmental Disorders.

Increased ω-3 polyunsaturated fatty acid/arachidonic acid ratios and upregulation of signaling mediator in individuals with autism spectrum disorders.

November 2015

Relationship Between Self-Reported Health and Stress in Mothers of Children with Autism Spectrum Disorders.

Obesity and Autism.

Premature mortality in autism spectrum disorder.

Acetylcysteine for treatment of autism spectrum disorder symptoms.

Identifying the lost generation of adults with autism spectrum conditions.

Potential role of organochlorine pesticides in the pathogenesis of neurodevelopmental, neurodegenerative, and neurobehavioral disorders: A review.

Effects of therapeutic horse riding on gait cycle parameters and some aspects of behavior of children with autism.

Minocycline ameliorates prenatal valproic acid induced autistic behaviour, biochemistry and blood brain barrier impairments in rats.

Obsessive-Compulsive Disorder and Autism Spectrum Disorders: Longitudinal and Offspring Risk. Full pdf

Autism: Pathophysiology and promising herbal remedies.

Prescription Use among Children with Autism Spectrum Disorders in Northern New England: Intensity and Small Area Variation.

Role of oats in celiac disease. Full pdf

A Comparison of PECS and iPad to Teach Requesting to Pre-schoolers with Autistic Spectrum Disorders.

Neurotoxic syndrome induced by clomipramine plus risperidone in a patient with autistic spectrum disorder: serotonin or neuroleptic malignant syndrome? Full pdf

Autism Characteristics in Older Adults with Depressive Disorders.

The Effect of Karate Techniques Training on Communication Deficit of Children with Autism Spectrum Disorders.

Behavioral Benefits of Camel Milk in Subjects with Autism Spectrum Disorder. Full pdf

The effect of sung speech on socio-communicative responsiveness in children with autism spectrum disorders.

Nutritional Status of Individuals with Autism Spectrum Disorders: Do We Know Enough?

Sodium Butyrate attenuates social behavior deficits and modifies the transcription of inhibitory/excitatory genes in the frontal cortex of an autism model.

Brief Report: Scurvy as a Manifestation of Food Selectivity in Children with Autism.

Management of mental ill health in people with autism spectrum disorder.

Impact of repeated vaccination on vaccine effectiveness against influenza A(H3N2) and B during 8 seasons. Full pdf

Cerebro-cerebellar circuits in autism spectrum disorder. Full pdf

Autism spectrum disorders and neuropathology of the cerebellum. Full pdf

Multifocal atrial tachycardia caused by risperidone.

Gluten Sensitivity. Full pdf. Highly recommended reading. Gluten can cause a wide range of systemic issues from gastrointestinal and immune to neurological. Again the link between gluten and ASD is discussed. Anecdotal accounts from parents that a gluten free diet is beneficial for their ASD child continue to be reported. The medical community is beginning to agree that a gluten free trial is worth considering and is no longer considered dangerous.

Detection of gluten immunogenic peptides in the urine of patients with coeliac disease reveals transgressions in the gluten-free diet and incomplete mucosal healing. This would be an excellent test to check that children were not consuming any hidden gluten while on a gluten free diet.

The plausibility of maternal toxicant exposure and nutritional status as contributing factors to the risk of autism spectrum disorders.

October 2015

Nutritional Impact of a Gluten-Free Casein-Free Diet in Children with Autism Spectrum Disorder.

Evaluation of Classroom Active Engagement in Elementary Students with Autism Spectrum Disorder.

Oxytocin and vasopressin: linking pituitary neuropeptides and their receptors to social neurocircuits.

The Impact of Neuroimmune Alterations in Autism Spectrum Disorder.

Xerophthalmia and vitamin A deficiency in an autistic child with a restricted diet.

Mitochondrial enzyme dysfunction in autism spectrum disorders; a novel biomarker revealed from buccal swab analysis.

Neonatal brain abnormalities associated with autism spectrum disorder in children born very preterm.

Microbiota-Gut-Brain Axis: Yeast Species Isolated from Stool Samples of Children with Suspected or Diagnosed Autism Spectrum Disorders and In Vitro Susceptibility Against Nystatin and Fluconazole.

The Costs and Benefits of Employing an Adult with Autism Spectrum Disorder: A Systematic Review.

Increased Serum Phthalates (MEHP, DEHP) and Bisphenol A Concentrations in Children With Autism Spectrum Disorder: The Role of Endocrine Disruptors in Autism Etiopathogenesis.

Prevalence of School Bullying Among Youth with Autism Spectrum Disorders: A Systematic Review and Meta-Analysis.

Factors Associated with Stress Among Parents of Children with Autism.

Assessment of sleep problems and related risk factors observed in Turkish children with Autism spectrum disorders.

Viewpoints on Factors for Successful Employment for Adults with Autism Spectrum Disorder.

Acid glycosaminoglycan (aGAG) excretion is increased in children with autism spectrum disorder, and it can be controlled by diet.

Association between Prenatal Environmental Factors and Child Autism: A Case Control Study in Tianjin, China.

Multiple Antipsychotic Medication Use in Autism Spectrum Disorder.

The mental health of individuals referred for assessment of autism spectrum disorder in adulthood: A clinic report.

Brief Report: Burden of Care in Mothers of Children with Autism Spectrum Disorder or Intellectual Disability.

Epigenetics in Clinical Practice: Characterizing Patient and Provider Experiences with MTHFR Polymorphisms and Methylfolate.

Enjoyment, Barriers, and Beliefs About Physical Activity in Adolescents With and Without Autism Spectrum Disorder.

Beneficial Effects of Palmitoylethanolamide on Expressive Language, Cognition, and Behaviors in Autism: A Report of Two Cases.

Respite Care for Single Mothers of Children with Autism Spectrum Disorders.

Altered kynurenine pathway metabolism in autism: Implication for immune-induced glutamatergic activity.

The effect of oxytocin nasal spray on social interaction deficits observed in young children with autism: a randomized clinical crossover trial.

A trial of an iPad™ intervention targeting social communication skills in children with autism.

Motivation for everyday social participation in cognitively able individuals with autism spectrum disorder.

Violent Fantasies in Young Men With Autism Spectrum Disorders: Dangerous or Miserable Misfits? Duty to Protect Whom?

Anxiety in high-functioning autism: A pilot study of experience sampling using a mobile platform.

Serum concentration of 25-hydroxyvitamin D in autism spectrum disorder: a systematic review and meta-analysis.

Subclinical autism spectrum symptoms in pediatric obsessive-compulsive disorder.

Do Children with Autism Overutilize the Emergency Department? Examining Visit Urgency and Subsequent Hospital Admissions.

Methodological approach to brain derived neurotrophic factor in children with autism spectrum disorder.

[Frequency of overweight and obesity in children and adolescents with autism and attention deficit/hyperactivity disorder].

September 2015

The Gluten-Free/Casein-Free Diet: A Double-Blind Challenge Trial in Children with Autism.

Evaluating Function-Based Social Stories™ With Children With Autism.

Clinical and neural effects of six-week administration of oxytocin on core symptoms of autism.

Impact of aerobic exercise on sleep and motor skills in children with autism spectrum disorders – a pilot study.

Prevalence and Predictors of Complementary and Alternative Medicine Use in a Large Insured Sample of Children with Autism Spectrum Disorders.

Maternal Anti-Fetal Brain IgG Autoantibodies and Autism Spectrum Disorder: Current Knowledge and its Implications for Potential Therapeutics.

Oxytocin enhances attentional bias for neutral and positive expression faces in individuals with higher autistic traits.

An epigenetic basis for autism spectrum disorder risk and oral contraceptive use.

Health Conditions and Functional Status in Adults with Autism: A Cross-Sectional Evaluation.

Impact of aerobic exercise on sleep and motor skills in children with autism spectrum disorders – a pilot study.

Music therapy: An effective approach in improving social skills of children with autism.

Psychosocial Functioning and Life Satisfaction in Adults With Autism Spectrum Disorder Without Intellectual Impairment.

Neuropsychopharmacotherapeutic efficacy of curcumin in experimental paradigm of autism spectrum disorders.

Insomnia in childhood and adolescence: clinical aspects, diagnosis, and therapeutic approach.

Risk Factors for Depression in Children and Adolescents with High Functioning Autism Spectrum Disorders.

Children with autism spectrum disorders, who improved with a luteolin-containing dietary formulation, show reduced serum levels of TNF and IL-6.

Gluten-free and casein-free diets in the therapy of autism.

Comparison of Fecal Microbiota in Children with Autism Spectrum Disorders and Neurotypical Siblings in the Simons Simplex Collection.

Autism spectrum disorder symptoms in children with ADHD: A community-based study.

August 2015 July 2015

Gluten and casein supplementation does not increase symptoms in children with autism spectrum disorder.

Developmental neurotoxic effects of two pesticides: Behavior and neuroprotein studies on endosulfan and cypermethrin.

Influence of sleep disorders on the behavior of individuals with autism spectrum disorder.

Abnormal transsulfuration metabolism and reduced antioxidant capacity in Chinese children with autism spectrum disorders.

Substance-use disorder in high-functioning autism: clinical and neurocognitive insights from two case reports.

Psychiatric Symptoms in Youth with a History of Autism and Optimal Outcome.

Maternal Chemical and Drug Intolerances: Potential Risk Factors for Autism and Attention Deficit Hyperactivity Disorder (ADHD).

Children with Autism Spectrum Disorder and Patterns of Participation in Daily Physical and Play Activities.

Early-onset anorexia nervosa in girls with Asperger syndrome.

Decreased levels of serum oxytocin in pediatric patients with Attention Deficit/Hyperactivity Disorder.

Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis.

Oxytocin in General Anxiety and Social Fear: A Translational Approach.

Mealtime behaviors associated with consumption of unfamiliar foods by young children with autism spectrum disorder.

Violations of Personal Space in Young People with Autism Spectrum Disorders and Williams Syndrome: Insights from the Social Responsiveness Scale.

Brain “fog,” inflammation and obesity: key aspects of neuropsychiatric disorders improved by luteolin.

Immune mediators in the brain and peripheral tissues in autism spectrum disorder.

Substance use disorder in Asperger syndrome: An investigation into the development and maintenance of substance use disorder by individuals with a diagnosis of Asperger syndrome.

Prenatal exposure to common environmental factors affects brain lipids and increases risk of developing Autism Spectrum Disorders.

Prevalence of Inflammatory Bowel Disease Among Patients with Autism Spectrum Disorders.

Lipopolysaccharide Exposure Induces Maternal Hypozincemia, and Prenatal Zinc Treatment Prevents Autistic-Like Behaviors and Disturbances in the Striatal Dopaminergic and mTOR Systems of Offspring.

Autism spectrum disorder prevalence and proximity to industrial facilities releasing arsenic, lead or mercury.

Breast Milk Protects Against Gastrointestinal Symptoms in Infants at High Risk for Autism During Early Development.

June 2015

Enteric short-chain fatty acids: microbial messengers of metabolism, mitochondria, and mind: implications in autism spectrum disorders.

Hyperhomocysteinemia: Impact on Neurodegenerative Diseases.

Vitamin/Mineral Supplements for Children and Adults with Autism.

Sleep in Autism Spectrum Disorders.

Gut-Microbiota-Brain Axisand Its Effect on Neuropsychiatric Disorders With Suspected Immune Dysregulation.

Potential Etiologic Factors of Microbiome Disruption in Autism.

Gut-Microbiota-Brain Axis and Its Effect on Neuropsychiatric Disorders With Suspected Immune Dysregulation.

Association of maternal report of infant and toddler gastrointestinal symptoms with autism: evidence from a prospective birth cohort.

Dietary Supplementation in Children with Autism Spectrum Disorders: Common, Insufficient, and Excessive. This study deserves a comment. The children selected were from the Autism Speaks Autism Treatment Network the majority of which were on a modified diet or supplements. In my opinion, it is positive that these children were consuming similar amounts of micronutrients as children without ASD. Unfortunately, the study did not identify or compare the nutrient levels of children with self restricted diets and no supplementation (the majority of children). Nor was any blood work done to assess nutrient levels in the body. Nutrient requirement is determined by genetics, digestion and the absorption ability of the individual. Biomedical doctors that are measuring blood levels of nutrients in ASD children frequently see low zinc, vitamin A, folate and vitamin D despite supplementation, indicating the need to supplement at higher doses to get body levels optimal due to higher demand or an underlying gastrointestinal issue that needs to be corrected.

Environmental Enrichment as a Therapy for Autism: A Clinical Trial Replication and Extension.

Dietary glycemic index modulates the behavioral and biochemical abnormalities associated with autism spectrum disorder.

Melatonin Treatment in Children with Developmental Disabilities.

Autism Spectrum Disorder and Amplified Pain.

Complementary and Alternative Therapies for Autism Spectrum Disorder.

Increased homocysteine levels correlate with the communication deficit in children with autism spectrum disorder.

Sleep Disturbances and Associated Factors in Chinese Children with Autism Spectrum Disorder: A Retrospective and Cross-Sectional Study.

Sleep in Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder.

Selected vitamin D metabolic gene variants and risk for autism spectrum disorder in the CHARGE Study.

The Role of Epigenetic Change in Autism Spectrum Disorders.

Sex and gender differences in autism spectrum disorder: summarizing evidence gaps and identifying emerging areas of priority.

Effect of intranasal oxytocin administration on psychiatric symptoms: A meta-analysis of placebo-controlled studies.

Treatment Resistant Epilepsy in Autism Spectrum Disorder: Increased Risk for Females.

Ineffective degradation of immunogenic gluten epitopes by currently available digestive enzyme supplements.

Fermented foods, neuroticism, and social anxiety: An interaction model.

Melatonin in Children with Autism Spectrum Disorders: How Does the Evidence Fit Together?

May 2015

 

MINDD International Forum 2015 – a summary of selected presentations

 

INTERESTED IN A SPEAKER ON ASD RELATED TOPICS?

John is a regular speaker at the Biomedical Parent Support Group that meets monthly in Balwyn. He has also presented at the Amaze conference in Melbourne. He is available to speak to your parent support group, school, organisation or event on a wide range of topics. Topics include:

  • His personal journey to help his ASD son overcome underlying medical issues and help him become independent
  • What every parent should consider with a diagnosis of a child with ASD
  • Behaviours that indicate your child has underlying medical issues that need to be addressed
  • Gastrointestinal issues – chronic constipation or loose stools
  • Dietary intervention, can it make a difference?
  • Sleep issues in ASD
  • Personal clinic experience – case studies of ASD children
  • Puberty and sexuality in ASD