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Gestational Diabetes Linked To Autism Risk


Gestational Diabetes Linked To Autism Risk

Gestational Diabetes Linked To Autism Risk

A new study of more than 320,000 babies links autism to gestational diabetes.

The longitudinal study, conducted between 1995 and 2009 by researchers at Kaiser Permanente Southern California, found that children born to mothers who developed gestational diabetes before 26 weeks of pregnancy were at a 63 percent increased risk of being diagnosed with autism spectrum disorder. But after controlling for maternal age, education, ethnicity, household income, the child’s sex and the mother’s pre-existing conditions, that risk dropped to 42 percent.

While the overall rate of autism among study participants was 1 in 100 (mirroring national averages during the period of study), the rate of autism among children born to mothers with early pregnancy diabetes was 1 in 80.

Because this is a longitudinal association study, researchers were not able to establish a cause for the autism diagnosis. However, the associations were strong enough to warrant at least two health applications for expectant parents, according to study co-author Dr. Edward Curry.

For one, the study’s results emphasize the importance of early prenatal care. The women whose children were most at risk for developing autism were not women with previously diagnosed type 2 diabetes (who were already managing the condition with insulin, medication and diet). Nor were they women who got gestational diabetes after 26 weeks. Instead, the link between early gestational diabetes and an increased likelihood of autism diagnosis could mean that a fetus’ early exposure to uncontrolled high blood sugar may somehow affect brain development.

“We want to get mothers in early to make sure they’re on their vitamins, folic acid and that they check blood sugar to make sure it’s under control early on,” said Curry. “I think that’s the real takeaway message from this study.”

The second application, according to Curry, is for moms who know they were diagnosed with gestational diabetes before 26 weeks. These moms should remain extra vigilant about their baby’s developmental milestones. Are they making eye contact, babbling and pointing? Parents should also tell their child’s pediatrician about the gestational diabetes diagnosis, and ensure that pediatricians screen for autism appropriately at 12, 18 or 24 months old.

“We as pediatricians are supposed to be screening [by at least] 18 and 24 months, but it never hurts for the parents to have increased vigilance,” explained Curry. He also emphasized that his finding needs to be confirmed with more studies, as well as a few that can find out the causal link between gestational diabetes and autism, if there is one.

Dr. Annette Estes, the director of the University of Washington Autism Center, was not involved in Curry’s research but praised it for the large sample size, the length of time covered and the fact that the analysis controlled for multiple factors beyond gestational diabetes. The next step, said Estes, would be to do a prospective study, which looks forward in time by following pregnant moms, collecting data along their fetus’ growth and the child’s development. And, of course, the ultimate goal would be to figure out why there’s such a strong association between early gestational diabetes and the risk of autism diagnosis in children.

While scientists don’t know what exactly causes autism spectrum disorder, research to date suggests that a mix of genetic and environmental factors are at play. It’s known that autism tends to run in families and that having one child with autism increases the risk of subsequent siblings being diagnosed with the condition as well. Autism has also been linked in past studies to factors like air pollution, maternal obesity, periods of prenatal oxygen deprivation, exposure to pesticides and advanced parental age, according to the National Institutes of Health. The amount of preliminary research that’s out there right now can be confusing for parents and lay readers, explained Estes.

“The main factor that we are all in agreement is that genetics plays a major role in autism, but it doesn’t account for everything,” said Estes. “Once we get the genetics of autism a little more clear, then we can understand more about other risk factors; There’s going to be a number of risk factors, as we can see.”

“I think at this point, what parents can take away is that [autism research] is a science that’s in process,” she concluded.

Autism is a lifelong disorder that is characterized by lack of eye contact, communication delays, difficulty forming relationships and a preoccupation with niche subjects or objects. Other behaviors typical in people with autism include rocking one’s body, banging one’s head against a hard surface and flapping one’s hands, although the severity of the condition can vary from person to person, ranging from mild impairment to severe disability.

Nationally, the Centers for Disease Control and Prevention has determined that currently, 1 in 68 children has been diagnosed with autism spectrum disorder, and that the condition is about five times more common in boys.

Curry’s study was published online April 14 in JAMA.


Related Online Continuing Education Courses for Healthcare Professionals:

Autism: The New Spectrum of Diagnostics, Treatment & Nutrition is a 4-hour online continuing education (CE/CEU) course that describes DSM-5 diagnostic changes, assessment, intervention models, dietary modifications, nutrition considerations and other theoretical interventions.

Autism Spectrum Disorder: Evidence-Based Screening and Assessment is a 3-hour online CEU course that identifies DSM-5 diagnostic changes in the ASD diagnostic criteria, summarizes the empirically-based screening and assessment methodology in ASD and describes a comprehensive developmental approach for assessing students with ASD.

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EEG Brain Trace Can Detect Autism in Kids

A simple brain trace can help identify autism in children as young as two years old, researchers say.

EEG brain trace can detect autism in kidsA US team at Boston Children’s Hospital said that EEG traces, which record electrical brain activity using scalp electrodes, could offer a diagnostic test for this complex condition.

EEG was able to clearly distinguished children suffering with autism from others in a trial involving nearly 1,000 children.

Experts emphasise that more work is needed to confirm the BMC Medicine study results.

There are more than 500,000 autistic people in the UK.

Autism is a spectrum disorder, which means that it is not a single condition and hence affects individuals in different ways.

Generally, people with autism have trouble with social interaction and can appear locked in their own worlds.

It can be a difficult condition to diagnose and can go undetected for years.

The latest study found 33 specific EEG patterns that appeared to be linked to autism.

These patterns consistently spotted autism in children across a range of age groups, spanning from two to 12 years old.

The scientists repeated their analysis 10 times, splitting up their study group (children with a medical diagnosis of autism and children with no signs of autism) in different ways.

Around 90 percent of the time, the EEG patterns could correctly detect the children diagnosed with autism.

The team now plan to repeat their study in children with Asperger’s syndrome – one particular subset of autism.

Typically, people with Asperger’s have higher-than-average intelligence and struggle less than people with other types of autism with their speech.

Dr Frank Duffy who is leading the investigation said that the work could help determine if Asperger’s should be treated as an entirely separate condition.

And the study could also point the way to determining if younger siblings of children with autism are likely to develop the same condition themselves.

“It is a great cause of anxiety when an older sibling develops autism,” the BBC quoted Dr. Duffy as saying.

“EEG might offer a way to check for the same condition in younger siblings in advance of them having symptoms,” he added.

EEG could also be used to track what effect different autism treatments are having on the condition, he said.


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DSM Panel Holds Firm on New Autism Diagnosis

By Eric Palmer

DSM panel holds firm on new autism diagnosis, ditches 2 other revisionsA panel of psychiatrists revising the influential Diagnostic and Statistical Manual of Mental Disorders are holding firm to their streamlined diagnosis for autism but are backing off proposals for changes to some others.

How the definitions turn out in the fifth edition of the DSM when it is published next year has huge implications for the pharmaceutical industry, which has reaped huge returns from doctors turning to drugs more often for treatments. Drug treatments for autism are seen to have great potential in the market, for example, so how the manual ends up on that diagnosis is being closely monitored by the industry.

The doctors said evidence did not support creation of the diagnoses “attenuated psychosis syndrome” or “mixed anxiety depressive disorder.” The first is supposed to identify anyone at risk of developing psychosis, while the second was seen as a hybrid of anxiety and depression, reports The New York Times.

They also made some changes to the definition of depression so that people experiencing the kind of common sadness anyone might experience after an event such as a death in the family were not diagnosed with a mental condition.

Dr. David J. Kupfer, who is leading the group revising the manual, said there was a decision that some proposed diagnoses needed further study after reviews of field trials on whether different doctors would reach a diagnosis in the same way.

“Our intent for disorders that require more evidence is that they be studied further, and that people work with the criteria,” and refine them, said Kupfer who also is a professor of psychiatry at the University of Pittsburgh.

The proposed definition of autism–which eliminates related labels like Asperger’s syndrome and “pervasive developmental disorder”–has been hotly debated. In January, Yale University researchers presented evidence that about half of the people with the diagnosis who are considered high-functioning would no longer qualify under the new diagnosis and so lose certain treatment benefits. That was countered, however, this week at the association’s annual meeting when new data showed that few children would be affected by the change.
Read more: DSM panel holds firm on new autism diagnosis, ditches 2 other revisions – FiercePharma

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Top 10 Toxic Chemicals Suspected to Cause Autism and Learning Disabilities

By Stone Hearth News

Top 10 toxic chemicals suspected to cause autism and learning disabilitiesAn editorial published on April 25 in the prestigious journal Environmental Health Perspectives calls for increased research to identify possible environmental causes of autism and other neurodevelopmental disorders in America’s children and presents a list of ten target chemicals including which are considered highly likely to contribute to these conditions.

Philip Landrigan, MD, MSc, a world-renowned leader in children’s environmental health and Director of the Children’s Environmental Health Center (CEHC) at Mount Sinai School of Medicine, co-authored the editorial, entitled “A Research Strategy to Discover the Environmental Causes of Autism and Neurodevelopmental Disabilities,” along with Luca Lambertini, PhD, MPH, MSc, Assistant Professor of Preventive Medicine at Mount Sinai and Linda Birnbaum, Director of the National Institute OF Environmental Health Sciences.

The editorial was published alongside four other papers — each suggesting a link between toxic chemicals and autism.  Both the editorial and the papers originated at a conference hosted by CEHC in December 2010.

The National Academy of Sciences reports that 3 percent of all neurobehavioral disorders in children, such as autism spectrum disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD), are caused by toxic exposures in the environment and that another 25 percent are caused by interactions between environmental factors and genetics. But the precise environmental causes are not yet known. While genetic research has demonstrated that ASD and certain other neurodevelopmental disorders have a strong hereditary component, many believe that environmental causes may also play a role – and Mount Sinai is leading an effort to understand the role of these toxins in a condition that now affects between 400,000 and 600,000 of the 4 million children born in the United States each year.

“A large number of the chemicals in widest use have not undergone even minimal assessment of potential toxicity and this is of great concern,” says Dr. Landrigan. “Knowledge of environmental causes of neurodevelopmental disorders is critically important because they are potentially preventable.”

CEHC developed the list of ten chemicals found in consumer products that are suspected to contribute to autism and learning disabilities to guide a research strategy to discover potentially preventable environmental causes. The top ten chemicals are:

  1. Lead
  2. Methylmercury
  3. PCBs
  4. Organophosphate pesticides
  5. Organochlorine pesticides
  6. Endocrine disruptors
  7. Automotive exhaust
  8. Polycyclic aromatic hydrocarbons
  9. Brominated flame retardants
  10. Perfluorinated compounds

In addition to the editorial, the other four papers also call for increased research to identify the possible environmental causes of autism in America’s children. The first paper, written by a team at the University of Wisconsin – Milwaukee, found preliminary evidence linking smoking during pregnancy to Asperger’s disorder and other forms of high-functioning autism.   Two papers, written by researchers at the University of California – Davis, show that PCBs disrupt early brain development. The final paper, also by a team at UC – Davis, suggests further exploring the link between pesticide exposure and autism.



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Antidepressants May Fail to Help Some Autistic Kids


About a quarter of children with autism may be taking antidepressants that won’t help them, a new study suggests.

Antidepressants may fail to help some autistic kidsAutistic children are sometimes prescribed antidepressants to reduce repetitive behaviors, but the new findings suggest the drugs may not be as effective for this use as they seem.

Researchers at the University of Michigan analyzed results from both published and unpublished studies  (unpublished studies have been completed, but have not appeared in a scientific journal). In all studies, children with autism were randomly assigned to receive serotonin receptor inhibitors (SRIs) or a placebo for at least four weeks.

When the researchers looked at results from the published studies alone, they saw a small but real benefit to the drugs. But when the results were adjusted to take into account the role of unpublished studies, the benefit of the drugs disappeared.

The researchers said the purported benefit of taking SRIs for kids with autism could be due to publication bias, a term used to refer to the selective publication of studies with positive results — or those that show a drug works.

“This research made it clear that the effects of SRI treatment in [autism spectrum disorder] are considerably overrated because of publication bias,” the researchers write in an article published today (April 23) in the journal Pediatrics.

Finding effective treatments for autistic children will be difficult if publication bias persists, the researchers said, because it will remain unclear whether drugs are actually effective.

It’s also unclear why five of the studies went unpublished. It could be that journals would rather publish studies with positive results, or that studies with negative results tend to take a longer time to get published. The Michigan researchers were able to obtain results from only one of the unpublished studies — the researchers who worked on the other four would not provide this information when it was requested.

It is not uncommon for studies involving children to go unpublished. Another study, also published today in Pediatrics, found that, of the 3,400 clinical trials involving children that have taken place since 2000 and have been registered with the government, about 70 percent have been completed, but less than one-third have been published.

When information from studies is not made available, “trials may be unnecessarily repeated, and the information cannot be used to guide therapy,” Dr. Scott Denne, of Indiana University School of Medicine, wrote in a comment about the new Pediatrics studies.

This problem could be solved by mandating that researchers post information from their trials to the same government website that is used to document trial registration (, according to the researchers of the study on child clinical trials. Currently, registration of studies involving children and posting of results on the site is voluntary.



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Should We Really Worry About Obesity’s Link to Autism?

By Brian Fung

A new study this week linking motherhood obesity to childhood autism tells a seemingly horrible tale: pregnant women who are obese are 67 percent more likely to have a child who suffers from the disorder than her non-obese counterpart. It’s the kind of statistic that people latch on to, and dozens of stories in the media highlighted the stat.

But what can we actually make of such a figure? 67 percent sounds like a big deal. You’re well on your way to doubling your risk, it seems. But without context, it’s hard to gauge how much maternal obesity matters relative to the host of autism risk facts.

Should We Really Worry About Obesity's Link to Autism?While the 67 percent figure is “non-trivial,” according to Dr. William Eaton, a professor of mental health at Johns Hopkins University, maternal obesity isn’t exactly considered a leading risk factor. There are others that raise the risk for childhood autism by roughly the same amount, and still others that cause it to skyrocket.

For example, when a baby comes out of the womb feet-first, “a breech birth,” the child’s risk for autism increases about 63 percent. Babies with an Apgar score — an indicator, from one to ten, of a child’s relative health five minutes after birth — of less than seven are about 89 percent more likely to be autistic, Eaton said.

“There are some studies about autism which have much stronger risk factors,” Eaton added, “with hazard ratios like two or three or four,” that is to say, a 200 or 300 or even 400 percent increase in risk.

Some of these more serious risk factors are simply out of our control. A child born before 35 weeks carries two and a half times the risk for autism. Family mental history can also play a role. If someone in your family suffers from psychosis or a mood disorder, the risk for childhood autism increases two to three times.

So, maternal obesity may be a risk factor for autism, but it’s important to remember that it’s only one among many and not even the strongest link. 

And, Eaton said, separating out obesity, itself, from other linked disorders is a challenge in itself. “Just to show you how complicated things are, obese women could have a higher rate of mood disorder,” he said. “And we wouldn’t know if it was the mood disorder doing the work or the obesity.”


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Could Autism be Linked with Mothers’ Obesity During Pregnancy?

By Associated Press

Obesity during pregnancy may increase chances for having a child with autism, provocative new research suggests.

It’s among the first studies linking the two, and though it doesn’t prove obesity causes autism, the authors say their results raise public health concerns because of the high level of obesity in this country.

Study women who were obese during pregnancy were about 67 percent more likely than normal-weight women to have autistic children. They also faced double the risk of having children with other developmental delays.

On average, women face a 1 in 88 chance of having a child with autism; the results suggest that obesity during pregnancy would increase that to a 1 in 53 chance, the authors said.

The study was released online Monday in Pediatrics.

Since more than one-third of U.S. women of child-bearing age are obese, the results are potentially worrisome and add yet another incentive for maintaining a normal weight, said researcher Paula Krakowiak, a study co-author and scientist at the University of California, Davis.

Previous research has linked obesity during pregnancy with stillbirths, preterm births and some birth defects.

Dr. Daniel Coury, chief of developmental and behavioral pediatrics at Nationwide Children’s Hospital in Columbus, Ohio, said the results “raise quite a concern.”

He noted that U.S. autism rates have increased along with obesity rates and said the research suggests that may be more than a coincidence.

More research is needed to confirm the results. But if mothers’ obesity is truly related to autism, it would be only one of many contributing factors, said Coury, who was not involved in the study.

Genetics has been linked to autism, and scientists are examining whether mothers’ illnesses and use of certain medicines during pregnancy might also play a role.

The study involved about 1,000 California children, ages 2 to 5. Nearly 700 had autism or other developmental delays, and 315 did not have those problems.

Mothers were asked about their health. Medical records were available for more than half the women and confirmed their conditions. It’s not clear how mothers’ obesity might affect fetal development, but the authors offer some theories.

Obesity, generally about 35 pounds overweight, is linked with inflammation and sometimes elevated levels of blood sugar. Excess blood sugar and inflammation-related substances in a mother’s blood may reach the fetus and damage the developing brain, Krakowiak said.

The study lacks information on blood tests during pregnancy. There’s also no information on women’s diets and other habits during pregnancy that might have influenced fetal development.

There were no racial, ethnic, education or health insurance differences among mothers of autistic kids and those with unaffected children that might have influenced the results, the researchers said.

The National Institutes of Health helped pay for the study.


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