Category Archives: autism

Air Quality May Affect Infants’ Brains

Reference: The ASHA Leader (a publication from the American Speech and hearing Association) February, 2013

Research demonstrates that polluted air-whether regional pollution or from local traffic sources-is associated with autism, according to a study published online in November 2012 by Archives of General Psychiatry (http://archpsyc.jamanetwork.com/journal.aspx). 

The study, conducted by University of Southern California and Children’s Hospital Los Angeles scientists, included 279 children with autism and 245 children with typical development.  The results suggest that exposure to traffic-related air pollution during pregnancy and the first year of life is associated with a more than two-fold risk of autism.  In addition, exposure to regional pollution consisting of nitrogen dioxide and small particles is also associated with autism even if the mother did not live near a busy road.

The research is the first to look at the amount of exposure to near roadway traffic pollution and to combine that with measures of regional air quality.  The study builds on previous research that examined how close participants lived to a freeway.  The researchers are now working on a study of how genes related to autism may be affected by environmental exposures to determine if certain factors make people genetically more vulnerable to particular pollutants.

Motor Experiences and Social Skills

A New Way to Think About Developement

Reference: Advance for Speech Language Pathologists and Audiologists, (Sept.19, 2011)

Early motor experiences can shape infants’ preferences for objects and faces, according to a new study.  The findings demonstrate that providing infants with “sticky mittens” to manipulate toys increases their interest in faces, suggesting advanced social development.

The study, conducted by Kennedy Krieger Institute, in Baltimore, MD, and Vanderbilt University, in Nashville, TN, supports a growing body of evidence that early motor development and self-produced motor experiences contribute to infants’ understanding of the social world around them.  Conversely, this implies that delayed or impaired motor skills, such as in autism, could negatively impact social interactions and development. 

The results provide “a new way to think about typical and atypical development,” said lead author Klaus Libertus, Phd, of the Center for Autism and Related Disorders at Kennedy Krieger.  “The mind is not independent from the body, especially during development.  As motor skills advance, other domains follow suit, indicating strong connections between seemingly unrelated domains.  Such connections have exciting implications, suggesting interventions could target the motor domain to foster social development.”

Previous research found that infants with autism spectrum disorders (ASD) show less interest in faces and social orienting.  While the new study was conducted with typically developing infants, it indicates that infants at risk for ASD or showing signs of abnormal social development may benefit from motor training as early as 3 months of age.

“This means that early motor development is very important and parents should encourage motor experiences and active exploration by their child,” said Dr. Libertus.  “Fostering motor development doesn’t have to be complex.  Any interactions or games that encourage a child to develop independent motor skills are important.”

Researchers divided 36 typically developing 3-month-olds into two groups.  One had active motor experiences, and the other had passive experiences.  Infants in the active group were given mittens affixed with strips of Velcro known as “sticky mittens”.  A brief swipe of their arm made toys covered in Velcro stick, as if they had successfully grasped the object.  Parents demonstrated this by attaching a toy to the mitten.  The toy was removed, and the infant was encouraged to reach independently for the toy again.

Infants in the passive group were fitted with aesthetically similar mittens and toys that did not have Velcro.  They were only passive observers, as parents provided stimulation by moving a toy and touching it to the inside of the infant’s palms.

After two weeks of daily training, the researchers tracked the infants’ eye movements while they watched images of faces and toys flash on a computer screen.   Infants in the passive and active groups were compared with each other and to two control groups of untrained infants comprised of non-reaching 3-month-olds and independently reaching 5-month-olds.

The active group showed more interest in faces than objects, while the passive group showed no preference.  Infants in the active group focused on faces first, suggesting strengthening of a spontaneous preference.  Their social preferences were similar to those of the 5-month-olds, indicating advanced development following training.

Individual differences in the motor activity of all the 3-month-old infants were predictive of their spontaneous orienting to faces.   Regardless of experience, the more reaching attempts infants made, the stronger their tendency to look at faces.  Thus, motor experiences seem to drive social development.

“The most surprising result is a connection between early motor experiences and the emergence of orienting toward faces,”  said Dr. Libertus.  “Logically, one would predict the opposite.  But in the light of seeing actions as serving a social purpose, it makes sense.”

A key question researchers hope to answer next is whether these early changes will translate into future gains for these children.

“Our results indicate a new direction for research on social development in infants,” said Dr. Libertus.  He and his colleagues will continue to observe the children to see if the social development benefits achieved during the current study are sustained a year later.

Grants from the National Institutes of Health provided support for the study.

Reference
Libertus, K., Needham, A. (2011). Reaching experience increases face preference in 3-month-old infants. Developmental Science, online, Sept. 9.

ADHD Links to ASD

Reference: The ASHA Leader (October 11, 1011) from the American Speech and Hearing Association

New research has identified more genes associated with attention deficit hyperactivity disorder (ADHD) and found an overlap between some of these genes and those found in other conditions such as autism spectrum disorders (ASDs).  Researchers studied the DNA of 248 unrelated patients with ADHD; 19 of 248 patients had inherited changes.  Within this group of inherited changes, researchers also found genes previously identified in conditions such as ASD; conversely they found ADHD genes in nine of the patients previously diagnosed with ASD.  The study appears in Science Translational Medicine(http://stm.sciencemag.org/content/3/95/95ra75).

Social Skills Equal Spatial Skills

Reference: The ASHA Leader (September 20, 2011)  

People who can empathize with others are also more likely to be proficient in spatial skills.  In a study, 48 adults viewed a toy building surrounded by seven faceless figures.  Participants described the visual perspective of each figure, and were assessed on measures of five traits associated with autism spectrum disorders: social skills, perseveration, attention to detail, communication, and imagination.  Overall social acumen correlated strongly with participant’s accuracy in taking the figures’ perspectives.  Visit http://psycnet.apa.org/journals/slm/37/4.

Make Your Child Laugh: The Developmental Stages of Humor

Reference: http://sos-research-blog.com

This article was posted and seemed so relevant to our very serious approach to special needs that we forget as professionals that laughter is a great way to learning.  Here is the post.

Many children with special needs have problems with friendships.  The problems can surround not understanding nonverbal communication, to not being able to identify emotions, to confusion over humor and more.  One thing we know for sure is that life without friendships and human connections is a very lonely life.

Humor is something that can bring two people together.  Laughter signifies that people are having fun and is good for a healthy relationship.  Sharing jokes and funny stories provides a connection between two people.

Children love to laugh.  But children with special needs such as autism, ADHD, Sensory Processing Disorder, and more often take things quite literally.  This results in them missing a joke or the humor in a situation.  If a child can’t share laughter with a group, then she is missing a part of the bonding that occurs and this affects the development of friendships.

Before you can work on humor with your child, you need to understand humor from a developmental perspective.  This is a general guideline and actual ages vary depending on the child.
    
    1) By six months of age, babies will laugh at behaviors that are not typical of their parents.  
         Making exaggerated faces will get a baby to laugh.
    2) A one year old baby loves the game of peek-a-boo.

At this stage, you can play peek-a-boo and other games that do not end at a predictable time, such as jack-in-the-box.  This can be played with a four or five year old child with special needs (or even older) if she has not acquired this basic level of humor.  There are many different kinds of jack-in-the-boxes, such as Sock Monkey Jack in the Box and SpongeBob Squarepants Jack-in-the-box, so you should be able to find one that will appeal to your child.

      3) Starting at age one or one and a half, children start pretend play and  will make believe that
            an object is something other than what it is or will use it in a “wrong” way.  For example,
            a child may put a sock on his hand and laugh.
       4) By age two to three as language skills develop, children enjoy giving objects the wrong 
            name.  “Bathroom” humor may also begin at this time.

For the two stages above, you can create a game to play with your child.  Take a box and fill it with familiar objects.  Pull something out and pretend it is something else.  For example, you can take a sock out of the box and say it is a hat and put it on your head.  After you take a few turns, let your child try.

        5) By age three, children enjoy playing with the sounds of words.  They may create 
             variations of common words or generate rhyming words.  Some of these children may     
              also enjoy making nonsensical sentences.

Saxton Freymann and Joost Eiffers created a set of books containing photographs of fruits and vegetables depicting emotions, vehicles, and other objects.  The pictures can help children with special needs to not only identify moods and emotions, but to also appreciate the silliness of the photographs.  The books are titled “How Are You Peeling? (Scholastic Bookshelf), “Fast Food”, and “Food Play”.

         6) Around age five, children start telling riddles or knock-knock jokes that don’t make any
               sense.

“What Do You Hear When Cows Sing?: And Other Silly Riddles (I Can Read Book 1) contains
twenty-two riddles with the use of wordplay.

         7) By age six or seven, the nonsensical part of the riddles and knock-knock jokes disappear
               and children find true riddles and knock-knock jokes very humorous.

“Good Clean Knock-Knock Jokes for Kids” contains a couple hundred jokes.

Knowing the developmental stages of humor is important.  When attempting to teach humor to a child with special needs, you need to make sure that you are teaching what is developmentally appropriate and not what is appropriate based on the child’s chronological age.  In addition to helping to develop your child’s humor, other benefits will be seen, such as improved eye contact and a fun emotional connection between you and your child.

Food Additives and Dyes: Links to Attention Problems

Reference: Learning Disabilities of America May/June 2011 Newsletter

Healthy Children Project

Article by Maureen Swanson
Healthy Children Project Coordinator

At the beginning of April, a Food and Drug Administration (FDA) advisory committee decided that there is not sufficient evidence to support a link between artificial dyes in foods and attention deficit hyperactivity disorder (ADHD).  The committee failed to recommend any ban or regulation of dye additives in food products.  They did call for more research.

There are seven primary food dyes used in the United States: Red #3, Red #40, Blue #1 & #2, Green #3 and Yellow #5 and #6.   There are two limited use dyes: Orange B used in hot dog and sausage casings, and Citrus Red 2 allowed only for coloring orange peels.  The dyes are used to make foods, candy and drinks more appealing, especially to children.  European countries already have banned some food dyes, including Blue #1 and Yellow #5 and #6.  In many cases, manufacturers now use natural colorings for food products in the European market.

According to experts at the Mayo Clinic, Yellow #5 may be more likely to cause problems with attention and behavior than other additives.  Yellow #5 is found in beverages, candy, ice cream, custards and other foods such as macaroni and cheese mixes.  The FDA requires manufacturers to label foods that contain Yellow #5 in the list of ingredients.

Many parents and teachers have their own anecdotal evidence that food dyes and preservatives seem to contribute to a child’s hyperactivity, behavior or attention problems.  LDA often takes a position that it is better to err on the side of caution when it comes to children’s health and learning.

If you want to avoid food dyes and preservatives for your family, summer is a great time to change eating and food shopping habits.  Foods to avoid include brightly colored, processed foods, which are most likely to contain one or more food dyes.  Another good rule of thumb is that if you cannot understand or pronounce the ingredients in a food product, you shouldn’t eat it.

To quote Michael Pollan, well-known author of “The Omnivore’s Dilemma” and “Food Rules”, one of the best ways to ensure a healthier diet is to “Eat Real Food.”

By real food, Pollan means fruits and vegetables, grains, dairy and meat that have not been “processed” with other ingredients into packaged foods.  In summer and early fall, farmers markets and backyard gardens make this kind of eating much easier.  If possible, load your plate with locally grown fruits and vegetables.

To have healthy, locally grown produce available year-round, one option is to can fruits and vegetables.  Another way to preserve some fruits and vegetables is to freeze them – this works well with blueberries, corn, beans, peas, rhubarb and many other fruits and vegetables.  For a “how-to” guide on freezing fresh food, see the charts at the following website: http://www.extension.umn.edu/distribution/nutrition/dj0555.html

While European governments seem more willing to take precautionary measures to protect people, especially children, from the possible harmful effects of food dyes, the FDA’s recent ruling means that in the United States, we have to take our own precautionary measures.

Landmark Study

This is an older article from Jan. 11, 2010, but I found it fascinating.  It is taken from ADVANCE for Speech-Language Pathologists and Audiologists.  I have deleted some of the content due to time restrictions, but have included the main points of the article and the implications of the study. 

This study suggests that verbal apraxia symptoms are part of a larger syndrome.  It reveals that a new syndrome in children presents with a combination of allergy, apraxia and malabsorption.  Autism spectrum disorders were variably present.

Verbal apraxia had been understood to be a neurologically-based speech disorder, although hints of other neurological soft signs had been described.  The recent study suggests the symptoms of verbal apraxia are part of a larger, multifactorial neurologic syndrome involving food allergies, gluten sensitivity and nutritional malabsorption-at least for a subgroup of children.

“While it is critical to treat verbal apraxia symptoms that often include severe delays in expressive speech production with speech therapy, we need to start asking why these kids are having these problems in the first place so we can identify mechanisms we can target to treat the cause of the symptoms,” said Claudia Morris, MD, of Children’s Hospital and Research Center in Oakland, CA.  She conducted the study in conjunction with Marilyn Agin MD, a neurodevelopmental pediatrician at Saint Vincent Medical Center in New York.  The study takes a major step toward identifying the potential mechanisms that may contribute to apraxia symptoms. 

The symptoms that the children demonstrated were a common cluster of allergy, apraxia and malabsorption, along with low muscle tone, poor coordination and sensory integration abnormalities.  The children also revealed low carnitine levels, abnormal celiac panels, gluten sensitivity and vitamin D deficiency, among others. 

The data indicate that the neurologic dysfunction represented in the syndrome overlaps the symptoms of vitamin E
deficiency.  While low vitamin E bioavailability may occur due to a variety of different causes, neurological consequences are similar, regardless of the initiating trigger.

The study suggests that vitamin E could be used as a safe nutritional intervention that may benefit some children.  Growing evidence supports the benefits of omega-3 fatty acid supplementation in a number of neurodevelopmental disorders. 

Anecdotally, children with verbal apraxia often demonstrate leaps in speech production when taking high-quality fish oil.  The addition of vitamin E to omega-3 fatty acid supplementation in this cohort of children induced benefits that exceeded expectations from just speech therapy alone, according to parental report.

“While data from a case series is by no means conclusive, the results clearly point to the need for further attention to this poorly understood disorder and a placebo-controlled study to investigate the potential role of vitamin E and omega-3 supplementation in this group of childreen,” said Dr. Morris.

Children with an apraxia diagnosis also should receive a more comprehensive metabolic evaluation than what is current practice, she pointed out.  Many nutritional deficiencies like low carnitine, zinc and vitamin D are treated easily.  If nutritional deficiencies are not addressed, children will continue to experience significant medical consequences. 

The underlying cause of these deficiences and a fat malabsorption syndrome should be determined after deficiencies are identified and treated.  In the meantime, the new study provides the essential foundation for identification.

“By identifying the early red flags of this syndrome, we have provided a way to get these kids treatment at the earliest possible moment,” she said.  “While 75 percent of the kids identified as late bloomers are just that, the rest have a true pathologic condition.  To miss it is to miss critically valuable time for early intervention.”

Children who have all these symptoms are likely to fall into the 25 percent who have a condition that needs further evaluation and treatment, Dr. Morris stated.

References:
Morris, C.R., Agin, M.C. (2009) Syndrome of allergy, apraxia, and malabsorption: Characterization of a neurodevelopmental phenotype that responds to omega 3 and vitamin e supplementation.  Alternative Therapies in Health and Medicine, 15 (4)

Atladottir, H.O., Pedersen, M.G., Thorsen, P., et al. (2009).  Association of family history of autoimmune diseases and autism spectrum disorders. Pediatrics, 124: 687-94.

Diagnosing Autism by MRI

From the ASHA Leader: (December 21, 2010)

Researchers are honing in on a diagnostic tool to identify autism spectrum disorders (ASD).  Using MRI and fMRI, researchers have identified “hot spots” where the left and right hemispheres of the brains of people with ASD do not communicate properly with one another.  Other than an increased brain size in young children with ASD, these hot spots are the only other difference researchers have found.  Visit www.physorg.com/news/2010-10-autism-mri-closer.html.