The Autism Blog

Targeted Treatment and Autism

One of the biggest challenges parents face after receiving an autism diagnosis is what their child’s treatment plan should include.

Taking into consideration the time, money, effort, commitment, and hope parents place in any number of therapies and interventions, providers are still unable to reliably predict which treatments will be effective for which children.

This often leads parents to simultaneously employ various treatment options without any assurance that they have a good fit for their child. We’ve reported that there are current studies underway toward this end and want to share one such study with you today.

In this study of twenty young children with autism, scientists used functional magnetic resonance imaging (fMRI) to measure changes in brain activity before and after receiving sixteen weeks of Pivotal Response Treatment (PRT), a play-based, evidence-based behavioral treatment focused on development in core deficits associated with autism.

The researchers wanted to know if they could predict which children would show improvement with the PRT treatment by looking for neurobiomarkers – measurable objective characteristics in the brain. They did indeed identify a number of characteristics in brain regions associated with social information processing and social motivation that predicted the success of PRT.

This study is a step towards being able to answer the question: How do we know if a child will respond to treatment?  Having the ability to predict whether a child will respond to a particular treatment will allow for the child to receive the intervention that they will most likely respond to, which will save families resources, time, and frustration.  It also allows for treatments to be analyzed and possibly distilled down into the core features that make them successful for children, increasing a treatment’s effectiveness and usefulness to families.  

A copy of the original study can be found here.

 

Making Friends on the Playground: Social Skills Support in School- This Month’s Autism 200 Class

This month’s Autism 200 Series class  “Making Friends on the Playground: Social Skills Support in School” will be held Thursday, March 16, 2017 at Seattle Children’s Hospital in Wright Auditorium from 7 to 8:30 p.m.

These classes are designed for parents, teachers and caregivers. The topics associated with the majority of classes are applicable to all age ranges and for a wide variety of children diagnosed with autism.

Ever wonder what your child does at recess? Or with whom he/she plays? Social impairment is one of the most challenging core deficits affecting children with autism. Jill Locke Ph.D will discuss how social impairments manifest in schools, their implications with peers, and the steps educators can take to facilitate positive peer engagement. Both caregivers and educators are encouraged to attend this lecture! 

Mindful Monday – How Do You Know if You’re Being Mindful?

People sometimes ask me how to know whether they are being mindful or not. Good question! It might sound as easy as saying “if you are, you’ll know it” or “if you aren’t, you’ll know it” but I don’t think that’s always the case. Here’s my quick checklist to help you decide.

 

Do you often find yourself:

  • Thinking “I wish . . . ”, meaning you wish things were different than they are
  • “I wish I could lose 10 pounds.” or “I wish my life wasn’t so hard.” or “I wish I had a better job.”

 

  • Thinking about the past and what you might’ve done differently
  • “I should have studied something different in college.” or “I shouldn’t have wasted so much time on that project.”

 

  • Thinking about the future, with some degree of anxiety
  • “I have so much I need to do!” or “I’m worried this won’t turn out ok.”

 

  • Thinking judgmental thoughts of yourself and others
  • “Nothing looks good on me!” or “I can’t believe she wore that.”

 

  • On auto-pilot, going through the motions with reduced awareness of your experience
  • “I don’t even remember driving home.” or “I do that with my eyes closed!”

 

  • Characterizing life/your day in an “either-or” way, i.e.: all good or all bad.
  • “I had a horrible day!” or “My life is a hard one.”

 

If you answered yes to any of the above questions, you’re in good company! We live hectic lives in an increasingly complex world where information comes at us from more sources than ever before, all vying for our attention. It’s no surprise we’re not more present, more fully aware.

The Autism Blogcast with Jim and Raphe – March Edition

News Flash: The March edition of The Autism Blogcast, featuring autism experts Raphael Bernier, PhD and James Mancini, MS, CCC-SLP.

In an effort to keep you up to date on the latest news in research and community happenings, we welcome two of our favorite providers best known as Jim and Raphe, the autism news guys.

These two have too much energy to be contained in written format so our plan is to capture them in 2-5 minute videos that we’ll post the first week of each month. We welcome your questions and comments. Tell us what you think of our dynamic duo!

In this edition of the Blogcast, our reporters discuss evidence based treatments for autism and anxiety disorders, as well as helpful tips to manage anxiety in the current political climate.

 

Ask Dr. Emily – Behaviors and Co-occurring Conditions

Welcome to the February edition of Ask Dr. Emily!

We often receive questions that we want to share with all our readers. To help with this, Dr. Emily Rastall, a clinical psychologist at Seattle Children’s Autism Center, will share insights in a question and answer format. We welcome you to send us your questions and Dr. Rastall will do her best to answer them each month.

Send your questions to theautismblog@seattlechildrens.org.

Q: My 12 year grandson with autism is having trouble with portion size on everything, like how much shampoo to use, soap, using butter, mayo, just everything! He fixates on eating one thing at a time and is getting very picky about not liking foods he use to like. He is also getting very OCD. Does this go along with having autism?

A: It is not uncommon for individuals with autism spectrum disorder (ASD) to present with executive functioning challenges. That means that things like thinking ahead, planning, weighing consequences, resisting impulses, and stopping yourself when it’s time to stop, are difficult to do. Portion control is another one of those things that is processed in the executive functioning center of the brain (i.e., the frontal lobe), so it makes sense that this is something that is challenging for your grandson to do.

With regard to “OCD” symptoms, one of the diagnostic criteria for ASD involves “repetitive patterns of behavior or interest.” This can include “ritualized patterns of verbal or non-verbal behaviors” (e.g., eating foods one at a time in the same order, repeating words a specific number of times, closing every door in the house), “insistence on sameness” (e.g., needing the same green plastic cup for dinner) or “inflexible adherence to routines” (e.g., insisting that you drive home the same way every day). Often sensory sensitivities (another diagnostic criteria for ASD) play into food preferences (or lack there of) too. While many of these symptoms can mimic OCD (or obsessive compulsive disorder), much of the time these are expected behaviors to see with an ASD diagnosis. In conclusion, while OCD can occur with ASD, most individuals with ASD do not have “true” OCD.

 

Q: I have 13 year old fraternal twin boys, one was diagnosed with autism when he was 7-years-old, and the other with Tourette’s when he was 10. Now I am being told that my son with Tourette’s is showing signs of autism and my son with autism is showing signs of Tourette’s. How can this be happening at different ages and times? I need help to understand this.

A: While autism spectrum disorder (ASD) presents early in development, symptoms may not become notably impactful until later in an individual’s life. This might lead to a diagnosis that occurs later in life. Conversely, ASD symptoms that develop early in life may present as significantly impactful right away, which would lead to earlier diagnosis. With regard to Tourette’s, this can develop at different times for different children; one may develop it in elementary school while another’s symptoms may present around puberty. Tourette’s and ASD have been known to co-occur more often than would be expected by coincidence. For more information, you may be interested in the following book: Kids in the Syndrome Mix of ADHD, LD, Autism Spectrum, Tourette’s, Anxiety and More! By M Kutscher and T Attwood

 

Q: When puberty hit our 16-year-old Trey, OCD hit his high functioning autism really hard. He went from mildly medicated and in all mainstreamed classes to highly medicated (and yet unaffected) to moved into several special education classes. His anxiety has the entire family in tears at this point. We don’t know how to help him. Lights on and off, clothes on and off, food in and out, it is never ending. It doesn’t help that he is 6’6 and 400 pounds. We really need help. Any advice?

A: It is not uncommon for mental health challenges (anxiety, depression) to present with onset during puberty. I suggest you consult with your primary care provider and ask for a referral for a mental health evaluation. You will want this to occur with a psychiatric provider who has training in assessing, diagnosing, and treating obsessive compulsive disorder (OCD) and who also understands autism spectrum disorder (ASD). That provider, based on the diagnostic conclusions, will be able to provide treatment recommendations from there.