Six New Autism Research Absracts

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May 23, 2001 Search www.feat.org/search/news.asp

SCIENCE AND AUTISM

Also: * Pediatrician's Role in Diagnosis and Management of ASD Kids

* The Pediatrician's Role in the Diagnosis and Management 2

* Screening and surveillance for Autism and PDD

* Cong. Hearings Continue No Evidence MMR Vax Causes Disorder

* Autism Disorders and Brain Stem Disorders

* Prenatal, Perinatal, and Neonatal Factors in Autism

Secretin Chokes Again

Repeated Doses of Porcine Secretin in the Treatment of Autism: A

Randomized, Placebo-Controlled Trial.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11331721 & dopt=Abstract

1: Pediatrics 2001 May;107(5):E71 Books

W, Weaver L, J, Bryson S, Emelianova S, Griffiths AM,

MacKinnon B, Yim C, Wolpin J, Koren G.

Autism Research Unit, Child Development Centre.

Background and Objectives. Anecdotal reports on the efficacy of

secretin in autism raised great hopes for the treatment of children with

this disorder. Initial single-dose, randomized, controlled trials failed to

demonstrate any therapeutic effects of secretin.

The present study is the first to test the outcome of repeated doses

and to examine whether there is a subgroup of children who are more likely

to achieve positive effects.

Method. Sixty-four children with autism (ages 2-7 years; 55 boys and 9

girls) with a range of intelligence quotient and verbal ability were

randomly assigned, in a double-blind manner, to secretin or placebo groups.

Children received 2 doses of placebo or porcine secretin, 6 weeks apart.

Assessments were performed at baseline and 3 weeks after each injection

using several outcome measures.

Results. There were no group differences on formal measures of

language, cognition, or autistic symptomatology. Subgroupings based on

cognitive level, the presence or absence of diarrhea, or a his tory of

regression failed to show any significant therapeutic effects of secretin.

Conclusion. No evidence is provided for the efficacy of repeated doses

of porcine secretin in the treatment of children with autism. The possible

relationship between relief of biological symptoms and enhanced skill

performance is discussed.

PMID: 11331721 [PubMed - as supplied by publisher]

* * *

Pediatrician's Role in Diagnosis and Management of ASD Kids

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11331713 & dopt=Abstract <-- address ends here.

1: Pediatrics 2001 May;107(5):1221-1226 Books

The Pediatrician's Role in the Diagnosis and Management of Autistic

Spectrum Disorder in Children.

Primary care physicians have the opportunity, especially within the

context of the medical home, to be the first point of contact when parents

have concerns about their child's development or behavior.

The goal of this policy statement is to help the pediatrician

recognize the early symptoms of autism and participate in its diagnosis and

management. This statement and the accompanying technical report will serve

to familiarize the pediatrician with currently accepted criteria defining

the spectrum of

autism, strategies used in making a diagnosis, and conventional and

alternative interventions.

PMID: 11331713 [PubMed - as supplied by publisher]

* * *

The Pediatrician's Role in the Diagnosis and Management

of Autistic Spectrum Disorder in Children.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11331735 & dopt=Abstract

1: Pediatrics 2001 May;107(5):E85 Books

Technical Report: The Pediatrician's Role in the Diagnosis and Management

of Autistic Spectrum Disorder in Children.

Autism and its milder variants are not rare. Most pediatricians will

have he opportunity to provide a medical home for a child with autism. This

technical report serves to complement and expand on the information in the

accompanying policy statement to increase the pediatrician's fund of

knowledge and comfort level in caring for children with autism.

In so doing, it is anticipated that earlier diagnosis and referral for

appropriate intervention will be possible and that this will, in turn, have

a positive effect on long-term outcomes for children with autism and their

families.

PMID: 11331735 [PubMed - as supplied by publisher]

* * *

Screening and surveillance for Autism and PDD

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11369559 & dopt=Abstract

1: Arch Dis Child 2001 Jun;84(6):468-475 Books, LinkOut

Screening and surveillance for autism and pervasive developmental disorders.

Baird G, Charman T, A, Baron-Cohen S, Swettenham J, Wheelwright S, Drew

A.

Newcomen Centre and Bloomfield Clinic, Guy's, King's College and St '

Hospital Medical School, London, UK.

PMID: 11369559 [PubMed - as supplied by publisher]

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* * *

Cong. Autism Hearings Continue No Evidence MMR Vaccine Causes Disorder

[by Vastag in JAMA Vol. 285 No. 20, May 23/30, 2001. Only excerpt

provided. For full article, go to address below.]

http://jama.ama-assn.org/issues/v285n20/ffull/jmn0523-1.html

With no known cause and few useful treatments, autism remains an

enigma. And by many accounts, it is becoming more common. Some witnesses at

a recent congressional hearing said that recent data show an epidemic is

afoot. Others took a more cautious view. " We don't know if these higher

rates are due to different diagnostic criteria, better recognition and

reporting, study phenomena, or if they represent a true increase in rates of

autism, " said Coleen Boyle, PhD, of the Centers for Disease Control and

Prevention (CDC).

Boyle's uncertainty stems from the lack of incidence data on autism.

While reports of growing prevalence are commonincluding a 373% increase in

California from 1980 to 1994age-specific incidence rates are needed to

establish the existence of an epidemic, said epidemiologist Walter Spitzer,

MD, MPH, of McGill University in Montreal. However, incidence data are

beginning to trickle in. A recent report from Great Britain (BMJ.

2001;322:460-463), for instance, shows a sevenfold increase in age-adjusted

incidence from 1988 to 1993.

Along with this trend comes increasing research dollars. The National

Institutes of Health (NIH) reports spending $22 million on the disorder in

1997 and $52 million in 2000. The NIH hopes to increase the breadth of its

autism research program substantially over the next few years. At the CDC, a

new Center on Birth Defects and Developmental Disabilities is gearing up for

better monitoring of autism rates. Elsewhere, at the University of

California? School of Medicine, a new institute called MIND (Medical

Investigation of Neurodevelopmental Disorders) is breaking ground on a

$34-million building and an ambitious agenda to trace the roots of autism

and find diagnostic markers.

+ Full article at:

http://jama.ama-assn.org/issues/v285n20/ffull/jmn0523-1.html

* * *

Autism Disorders and Brain Stem Disorders:

a comprehensive study of 25 individuals

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11368487 & dopt=Abstract

1: Dev Med Child Neurol 2001 May;43(5):338-45 Books

Autistic spectrum disorders in Mobius sequence: a comprehensive study of 25

individuals.

Johansson M, Wentz E, Fernell E, Stromland K, MT, Gillberg C.

Department of Child and Adolescent Psychiatry, Goteborg University, Sweden.

maria.johansson@...

The prevalence of autistic disorder was analysed in 25 individuals

with Mobius sequence, a disorder with brain-stem dysfunction. The sample

consisted of 18 males and seven females (20 participants were aged 2 to 22

years, and five were aged 1, 19 and 23 months, and 55 years old).

Participants were recruited after a nationwide call and were part of a

multidisciplinary study of individuals with Mobius sequence. They were given

a meticulous neuropsychiatric examination including standardized autism

diagnostic interviews. Ten individuals had an autistic spectrum disorder.

Six of these met all diagnostic criteria for autism.

In 23 individuals cognitive development could be assessed. Eight of

those 23 patients had clear learning disability and six individuals were

functioning in the normal but subaverage range. Autistic spectrum disorder

and learning disability occurred in more than a third of the examined

patients. Considering the hospital-based nature of the sample, these

findings may be overestimates.

Nevertheless, awareness of this coexistence is important in the

diagnosis and habilitation care of children with Mobius sequence. Moreover,

the results provide further support for the notion of a subgroup of autistic

spectrum disorders being caused by first trimester brain-stem damage.

PMID: 11368487 [PubMed - in process]

* * *

Prenatal, Perinatal, and Neonatal Factors in Autism

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_ui

ds=11335784 & dopt=Abstract <-- address ends here.

1: Pediatrics 2001 Apr;107(4):E63

Prenatal, Perinatal, and Neonatal Factors in Autism, Pervasive

Developmental Disorder-Not Otherwise Specified, and the General Population.

Juul-Dam N, Townsend J, Courchesne E.

School of Medicine, University of California, San Diego.

Objectives. To examine various pre-, peri-, and neonatal factors in

autistic participants and in pervasive developmental disorder-not otherwise

specified (PDD-NOS) participants and to compare the incidence of each factor

to that of the normal population. Methods. Seventy-four participants (66

males, 8 females) were diagnosed with autism at 2.5 through 4 years of age

using the most accurate and up-to-date methods, including the Diagnostic and

Statistical Manual of Mental Disorders and the Autism Diagnostic

Interview-Revised.

At age 5, all participants were reevaluated using the Diagnostic and

Statistical Manual of Mental Disorders, the Autism Diagnostic

Interview-Revised, the Childhood Autism Rating Scale, and the Autism

Diagnostic Observation Schedule-Revised, resulting in 61 autistic and 13

PDD-NOS participants. Twenty-eight pre-, peri-, and neonatal factors were

examined in these 2 groups using both medical records and parental

interviews. Incidences were compared with those of the US population as

reported in the Report of Final Natality Statistics, 1995.

This grand scale population group was used to closely approximate

comparison to a normal, unbiased population. Results were analyzed using the

binomial probability test, with a P value of <.05, constituting a

significant difference in incidence. A Bonferroni correction was applied to

the data to adjust for the number of factors investigated.

Results.

Although most of the factors showed comparable incidences between the

index and control groups, several factors showed statistically significant

differences. Following the Bonferroni correction, the autism group was found

to have a significantly higher incidence of uterine bleeding, a lower

incidence of maternal vaginal infection, and less maternal use of

contraceptives during conception when compared with the general population.

Similarly, the PDD-NOS group showed a higher incidence of hyperbilirubinemia

when compared with the general population.

Conclusions.

The results of this study support previous findings suggesting a

consistent association of unfavorable events in pregnancy, delivery, and the

neonatal phase and the pervasive developmental disorders. However,

interpretation of the meaningfulness of these results is difficult, as the

specific complications that carried the highest risk of autism and PDD-NOS

represented various forms of pathologic processes with no presently apparent

unifying feature.

Additional studies are needed to corroborate and strengthen these

associations, as well as to determine the possibility of an underlying

unifying pathological process. This study's analysis of obstetric and

neonatal complications in combination with the use of participants diagnosed

at an early age provides some interesting concepts to consider. Perhaps

future research will confirm certain pre-, peri-, and neonatal associations

that could be used to generate a high-risk historical profile with which to

use in conjunction with currently employed diagnostic tools.

This may, in turn, help to determine the reliability of a diagnosis of

autism in younger children, leading to earlier intervention and assistance

for an improved outcome in long-term functionality and quality of life.

PMID: 11335784 [PubMed - as supplied by publisher]

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Lenny Schafer, Editor PhD Ron Sleith Kay Stammers

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