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Archive for October, 2011

Click here to read the original ASF blog post. 

Gastrointestinal (GI) problems are frequently reported among people with autism spectrum disorders (ASD). In January 2010, a multidisciplinary panel sponsored by the Autism Forum released a consensus report published in Pediatrics that reviewed the current state of knowledge and medical practice for evaluating GI disorders among individuals with ASD. The consensus report suggested that, for some individuals with ASD, exhibiting certain behaviors may be the “primary or sole symptom” of an underlying gastrointestinal problem. Included among these behaviors are aggression, self-injurious behavior, temper tantrums, and abnormalities in sleeping.

Our study used data from a population-based sample of 487 children with ASD to evaluate the feasibility of consensus panel’s recommendation that certain behaviors could help clinicians predict which children with ASD need to be evaluated for possible GI problems. We found that some behaviors were significantly associated with GI problems, but these behaviors were also very common in children with ASD who do not have medically documented GI problems. Nearly 99% of all children in the sample exhibited at least 1 of the behaviors. Therefore, as screening items, these behaviors offered very little in terms of positive predictive value for identifying GI problems.

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Association Between Behavioral Features and Gastrointestinal Problems Among Children with Autism Spectrum Disorder

http://www.springerlink.com/content/b23217521067w850/

Journal of Autism and Developmental Disorders | DOI 10.1007/s10803-011-1379-6

Matthew J. Maenner • Carrie L. Arneson • Susan E. Levy • Russell S. Kirby • Joyce S. Nicholas • Maureen S. Durkin

Copyright: Springer Science+Business Media, LLC 2011

Abstract : Recent reports suggest certain behaviors among children with autism spectrum disorders (ASD) may indicate underlying gastro-intestinal (GI) problems, and that the presence of these behaviors may help alert primary care providers to the need to evaluate a child with ASD for GI problems. The purpose of this population-based study of 487 children with ASD, including 35 (7.2%) with a medically documented history of GI problems, was to compare behavioral features of children with and without a history of GI problems. Unusual sleeping or eating habits and oppositional behavior were significantly associated with GI problems. These behaviors, however, were frequent in both children with and without GI problems, suggesting they may have limited utility in a screening capacity for GI problems.

Conclusion: Certain behaviors, including abnormalities in sleep patterns, abnormalities in mood or affect, and argumentative, oppositional, defiant or destructive behavior were described significantly more often in children with ASD who also had GI problems than in those with ASD and no history of GI problems. These features (often described as characteristics of autism) may be more common among children with autism who also have GI problems. However, because these behaviors are also frequent in children with ASD and no GI problems (nearly all children had 1 or more behaviors), they are unlikely to efficiently predict GI problems in children with ASD. Consideration of medical, biological, or physiological co-occurring conditions, genetic susceptibility, diet and nutrition, and medication use are necessary to determine whether in children with ASD both behavioral presentation and GI problems might be associated with other underlying factors.

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Yesterday the Scarsdale High School Autism Science Foundation Student Club held a Halloween-themed bake sale. The group raised awareness about autism, as well as $480 to support much needed research on what causes autism and how best to treat it. 1 in 110 individuals is now diagnosed with an autism spectrum disorder. These students are leading the way in creating a more compassionate community for individuals with autism. 

Pictured: (l-r) Jackie Sharlach, Lauren Alin, Alexandra Levine, Claire D’Silva, Adam Rolison, Rachel Kushnick and Andrea Quartner

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Earlier this week, the Institute of Medicine (IOM) at the Academy of Natural Sciences  announced the election of 65 new members from throughout the United States, in recognition of their major contributions to the advancement of the medical sciences, health care and public health.  Among those elected were ASF founding board member Dr. Paul Offit and distinguished autism researcher, Dr. Daniel H Geschwind.  Dr. Geschwind is the Gordon and Virginia MacDonald Distinguished Chair in Human Genetics and professor of neurology and psychiatry, department of neurology, University of California, Los Angeles.  He has been involved in autism research for about 10 years and focuses on gene discovery and autism therapeutics.  Last year Dr. Geschwind served as the program committee chair for the International Meeting for Autism Research.

ASF’s Jonathan Carter spoke to Dr. Geschwind about his election:

Jonathan Carter: Congratulations! How does it feel to be a member of the IOM?

Dr. Dan Geschwind: It’s very nice to get such an honor. In the end the greatest satisfaction is in the work and the deep satisfaction one attains from making scientific progress.

J: What will be your areas of focus? Can you tell us about the committees and boards that you plan to join?

G: The IOM is recognition of one’s contributions and an honor. But, because the IOM does work related to public policy and the future of medical care, election to the IOM also carries the expectation of involvement and service. The committees are done on a volunteer basis.

My participation will also be focused on neurologic and psychiatric disorders, especially neurodevelopmental disorders, and I will try to improve care and access and the quality of care for people with disorders. I would also like to get involved in the scientific issues surrounding genetics. For example, going forward in the future, possibly by next year, the cost of genomes may soon fall to $1,000. One can predict that as a clinical test, when you walk into the hospital or when you’re born, everybody will have their genome sequenced. That’s just the first step in an individual’s medical workup and personalized medicine.

Right now we can’t interpret most of the genome, but once we have large swaths of the population sequenced, we will be able to correlate genetic variation with various reactions to medicine, what therapy people should be on, especially for common diseases. And that’s an area where perhaps I can contribute as an IOM member; I know how to interpret genome data and its value – its scientific value, medical value and value for development of molecular biomarkers.

The IOM has working groups that get formed around specific issues, and I am also particularly interested in — as a doctor and a citizen — how expensive our healthcare is and how little in a relative sense our country gets for all it spends on health care. There are a lot of people with much stronger qualifications than I have in the area of health services delivery. And even though I can’t presume to have any formal expertise in that area, I definitely have an interest in it, as it represents one of the most important issues facing our society.

I assume that most of what is accomplished by the IOM is done in between the meetings, in subgroups. Having a body like the IOM where you can pull in 10 experts from a variety of disciplines to tackle important policy and scientific problems is wonderful. It’s an amazing advantage for our country to have what could be thought of as a virtual academy for problem solving.

J: What are the goals of the Geschwind Lab at UCLA?

G: There are short-term and long-term goals. There are short-term goals that have to do with gene discovery. We want to identify genes that cause and contribute to autism. We also want to understand what their mechanism is so that we can develop therapeutics. There’s enough genetic information out there now that we can start the process of developing therapy. So it’s a very exciting time.

Once you find genes, you have to figure out how they cause the disorder. Once you figure that out, you develop models for drug testing. We have been working a lot at the interface between the mechanism of the genes and how they might cause the disorder. Then, we create models that address how to develop more efficacious, hopefully, game changing drugs. So, the development of animal and cell culture models is paramount.

J: What can you tell us about the CNTNAP2 Gene?

G: What’s interesting about that gene, like several others, is that is it unlikely to be specific for autism, but certainly is a major player in ASD. Both common and rare variation in that gene increase risk for autism, so it has evidence from several different avenues that support its relevance to autism.

J: Your lab also does work on neurodegenerative diseases [like dementia]. How does that work relate to autism?

G: Working on both ends of the aging spectrum, it’s amazing how many commonalities we have found between early neurodevelopmental events and later neuro-degenerative disease. The work that we do in autism absolutely informs the work in dementia and vice versa. There are genomic and computational methods that apply to both of them and actually doing both of those things makes the laboratory a more fertile environment. It’s a wonderful opportunity to work on both neurodevelopmental and neurodegenerative disease and it makes us more effective.

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Established in 1970 by the Academy of Natural Sciences, the IOM honors professional achievements in the health sciences and serves as a national resource for independent analysis and recommendations on issues related to medicine, biomedical sciences, and health. Current members of the Institute elect new members from a slate of candidates nominated for their professional achievement.

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Dr. Bob Schultz has built the Center for Autism Research from the ground up. Dr. Schultz explains how CAR seeks to understand what causes autism and how CAR serves the community of families affected by autism. In training the next generation of scientists, Dr. Schultz also stresses the need for children to participate in studies. With higher participation rates, Dr. Schultz hopes to make diagnoses earlier in a child’s lifespan and give treatments as quickly as possible.

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Autism Science Foundation Founding Board Member Dr. Paul Offit has been elected to the Institute of Medicine (IOM) at the Academy of Natural Sciences. For three decades, Dr. Offit has been a leading researcher in the fields of virology and immunology, and a well-respected and outspoken voice on the science, safety and value of childhood vaccinations. He is also one of the most public faces of the scientific consensus that vaccines have no association with autism.

Through his advocacy, Dr. Offit has successfully cut through misinformation and helped to educate parents on the health benefits of vaccinating their children. In addition to hundreds of academic articles, he is the author of four critically-acclaimed medical narratives, including Autism’s False Prophets, which have sought to educate parents and bring scientific research back into the discussion on vaccination decisions.

“I have never met anyone who cared more about the health and well-being of children than Paul Offit” said Alison Singer, president of the Autism Science Foundation. “All of us at ASF congratulate him on this well-deserved appointment and look forward to the great work he will do as part of the IOM.”

The IOM announced the election of 65 new members from throughout the United States, in recognition of their major contributions to the advancement of the medical sciences, health care and public health. Noted autism researcher, Dr. Daniel H Geschwind, the Gordon and Virginia MacDonald Distinguished Chair in Human Genetics and professor of neurology and psychiatry, department of neurology, University of California, Los Angeles was also elected. Dr. Geschwind served as the program committee chair for the 2011 International Meeting for Autism Research.

Established in 1970 by the Academy of Natural Sciences, the IOM honors professional achievements in the health sciences and serves as a national resource for independent analysis and recommendations on issues related to medicine, biomedical sciences, and health. Current members of the Institute elect new members from a slate of candidates nominated for their professional achievement.

“It is a great pleasure to welcome these distinguished and accomplished individuals to the Institute of Medicine,” said IOM President Harvey V. Fineberg. “Each of these new members stands out as a professional whose research, knowledge, and skills have significantly advanced health and medicine, and their achievements are an inspiration. The Institute of Medicine is greatly enriched by the addition of our newly elected colleagues.”

Dr. Offit is the director of the Vaccine Education Center and chief of Infectious Diseases at The Children’s Hospital of Philadelphia. In addition, Dr. Offit holds the Maurice R. Hilleman Endowed Chair in Vaccinology and is a Professor of Pediatrics at the University of Pennsylvania School of Medicine. He serves on the board of directors of numerous organizations including the Autism Science Foundation and Every Child by Two.

During his tenure as a pediatrician specializing in infectious diseases, Dr. Offit’s work includes 25 years spent dedicated to developing RotaTeq, one of two vaccines currently used to fight rotavirus, a disease that is the leading cause of severe, dehydrating diarrhea in infants and young children. RotaTeq is recommended for universal use in infants by the Centers for Disease Control and Prevention and has the capacity to save as many as 2,000 lives per day.

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Dr. Timothy Roberts of Children’s Hospital of Philadelphia (CHOP) Center for Autism Research (CAR) is using MEG technology to measure the biological response to new medical treatments in children with autism. Eventually, he says, MEG will be used to determine which children with autism are most likely to respond to a given treatment. CHOP is participating in the ongoing arboclofen trials, sponsored by Seaside Therapeutics, for children with Fragile X and is using MEG technology as a noninvasive way to measure the biological changes in the brain that result from arboclofen intervention. Dr. Roberts also explains the value of imaging for developing new autism treatments and improving existing treatments.

 

 

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