Archive for April 2016

Monthly Archive

The Autism Blogcast with Jim and Raphe-May Edition

News Flash: The May 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!

Ask Dr. Emily- Asperger’s and Screen Time Questions

Welcome to the April 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 here, on the last Friday of each month, 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 16-year-old son was diagnosed with Asperger’s when he was very young. My friends and other people have told me that “Asperger’s” is no longer the term used to describe his level of functioning. What is the correct term to use when talking about him to teachers and other parents so they understand?

A: A new version of the Diagnostic Statistics Manual-5th Edition (DSM-5) was released in 2013. The previous version of the DSM (DSM-IV-TR) described three diagnoses: Autistic disorder, Asperger’s disorder, and pervasive developmental disorder, not otherwise specified [PDD, NOS]. All three of these disorders were considered “autism spectrum disorders.” The current DSM-5 discontinued the use of the three specific diagnoses and, at present, provides only one diagnosis: Autism spectrum disorder (ASD). The way we now describe “functioning” is to qualify whether an individual presents with intellectual impairment and/or language impairment.

Many individuals historically diagnosed with Asperger’s could be described by today’s DSM-5 standards as “autism spectrum disorder without intellectual impairment and without language impairment.” Because the term “Asperger’s” was used for so long, and so many understand it well, it is not uncommon for individuals, families, and providers to continue using the term in conversation to describe presentation and/or functioning. Bottom line: Keep using the term, if it helps you communicate with educators and others, but know that there are new official terms out there.

 

Q: What is the thinking about the impact of screens on kids with autism?  I know that limiting screen time for typical kids can impact their brain and social development.  Screen time seems to be a form of comfort for my autistic teenager after a long day at school, etc…   Texting has provided a great way for her to socialize with her friends but more on her own terms.  And texting seems to be a great tool for she and I to have a difficult conversation – it seems to be less charged and conflictual that way.   Is there any research and/or guidance for the healthy way to reap these benefits without affecting brain development in a negative way?

A: This is such a great question and one that I hear often. Research tells us that screen use (i.e., T.V., video games, computer games) in typically developing children is correlated with several negative effects on development. Specifically, increased screen use in typically developing children is correlated with delays in language development, reduced social interaction, less sleep, poorer school performance, higher rates of obesity, social skills challenges, impulse control challenges, and inattention/lack of focus. Earlier start age has been correlated with language delays and executive functioning delays (like attending, planning, and resisting impulses). These results make sense, right? Time spent on media is time NOT spent interacting with and being active participants in the world and people around them.

Research regarding media use in individuals with autism spectrum disorder (ASD) tells us that children with ASD spend more time using screens on a daily basis compared to their typically developing counterparts. Bottom line, kids with ASD are getting more exposure, which puts them at potentially higher risk for experiencing the deleterious effects of media mentioned above.

Regarding recommendations, the American Academy of Pediatrics (AAP) offered their recommendations in 2011 regarding recreational screen time use. Specifically, the AAP recommends that children under age two not engage in screen time at all. Between the ages of 2 and 18, the recommendation is between 1-2 hours, with no more than two hours per day. Yes, children these days are more and more engaging in screens as a way of staying socially connected. And many kids with ASD, specifically, endorse media/screen time as their most preferred activity. Thankfully, nothing out there is saying that we cannot use screens, however, moderation is the key. Thus, setting limits, creating balance, and providing alternative activities can teach kids how to set healthy boundaries for themselves as they grow into adulthood.

 

 

Free Autism 101 Class-This Thursday

Please join us this Thursday, April 28, from 7 to 8:30 p.m. at Seattle Children’s Hospital for our free quarterly lecture, Autism 101. Autism 101 is intended for parents and families of children recently diagnosed with an autism spectrum disorder (ASD). In this free lecture, participants will learn about:

  • Up-to-date, evidence-based information regarding the core deficits of ASD
  • Variability and presentation of behaviors associated with autism
  • Prevalence and etiology (study of the cause of the disorder)
  • Treatments available
  • Resources for families

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5 Good Reasons to Participate in Autism Research

 

Research imageWhen my daughter was diagnosed at age two, I so wished there was a test that could tell us more than the fact that she met criteria for autism spectrum disorder. “Is autism in our family tree?” I wondered, thinking back to a quirky great aunt or two. “Did I do or not do something to cause this?” and “What specific treatments offer her the best chances for an optimal outcome?” were the other two questions that for years haunted me.

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Autism and the Neuroscience of Mindfulness

If you follow our feature, Mindful Monday, you know that we love sharing stories and tips on how to lessen the stress in your life. To better understand “how mindfulness works”, we went to our researchers and this is what they had to say:

Stress is a common experience among parents of all children, but life can be exceptionally challenging and stressful for parents of a child with autism. Although there are many strategies and therapeutic techniques that are designed to help parents manage stress, one strategy that has received considerable public and scientific support in recent years is mindfulness meditation, a secular form of meditation adapted from Buddhist meditation practices. Mindfulness meditation emphasizes paying attention to thoughts and feelings without judgment and allowing oneself to be present as events occur in the moment (Kabat-Zinn, 2003). Often this is done by focusing on one’s own breathing or bodily sensations without dwelling on thoughts or feelings associated with things outside of the present moment. Although mindfulness takes training and practice, scientific studies of mindfulness based stress reduction (MBSR) interventions have shown that mindfulness practice leads to decreases in parenting stress, anxiety, and depression, and improvements in sleep, well-being, and life satisfaction (Conner & White 2014; Dynkens et al., 2014).

There is a difference between MBSR, which emphasizes on the individual, and “mindful parenting”(Duncan et al., 2009). Mindful parenting in part involves applying skills of mindfulness into the parent-child interaction, including listening with full attention, nonjudgmental acceptance of self and child, emotional awareness of self and child, self-regulation in the parenting relationship, and compassion for self and child. Parents are taught to think about and respond to day-to-day situations in a mindful way. For instance, rather than involuntarily reacting out of frustration to a child who is throwing a tantrum, mindfulness training provides parents with strategies to voluntarily acknowledge and let go of automatic feelings before responding to the situation.

Of course, MBSR and mindful parenting can be difficult – mindfulness takes training and practice – but science suggests that mindfulness meditation can lead to less stress and a better sense of well-being because it changes how the brain responds to stress. Stress drastically impacts how the deep parts of our brains function and can even change the structure of brain regions. One of these brain regions, the amygdala, is well known for processing stress and guiding how the body responds. For example, the amygdala may signal other parts of the body to either increase heart rate or release hormones, and the amygdala is part of a brain system that helps us to decide between “flight or fight” in a stressful situation. When a person is under chronic stress, the size of the amygdala increases (i.e., increasing grey matter), which is unhelpful for the stress system because the amygdala becomes overly responsive to negative events.

One theory is that the neurobiological response to stress improves in a stepwise fashion, such that as mindfulness training increases, the brain begins supporting more controlled ways of thinking about and coping with stress (Zeidan, 2015; Zeidan et al., 2011). From a brain perspective, responses to stress invoke two different systems: a “hot” system that is largely automatic and involves sensory and emotional processing (for example, the amygdala), and a “cold” system that involves cognitive processing (for example, the prefrontal cortex and anterior cingulate cortex). In times of acute or chronic stress, the hot system is often overly responsive compared to the cold system. In order to reduce stress, the goal is to find a better balance between the systems by increasing cognitive control and regulation and reducing sensory and emotional processing. Mindfulness meditation appears to help some people strike that balance by focusing on observing and acknowledging the sensations and reactions of the hot system, then allowing the individual to respond in a controlled manner.

A recent study looked specifically at how different stress reduction interventions change the way the amygdala is connected to other brain regions (Taren et al., 2015). In this randomized clinical trial, adults completed a 3-day intensive training in either mindfulness practices or more general relaxation training. After the intervention, brain changes were only observed for the mindfulness group, such that there were reduced connections between the right amygdala and part of the anterior cingulate cortex that helps regulate emotion, mood, and anxiety. In other words, by using mindfulness practice, the amygdala is no longer overly responsive, but rather more appropriately responsive to stressful or negative events. In addition, the adults who were taught mindfulness techniques exhibited better stress-related health outcomes and were more likely to continue to use the techniques at home following the study.

To learn more about mindfulness training, keep a look out for The Autism Blog’s ongoing Mindful Monday series.

Lalala

Conner, C. M., & White, S. W. (2014). Stress in mothers of children with autism: Trait mindfulness as a protective factor. Research in Autism Spectrum Disorders8(6), 617-624.

Duncan, L. G., Coatsworth, J. D., & Greenberg, M. T. (2009). A model of mindful parenting: Implications for parent–child relationships and prevention research. Clinical child and family psychology review, 12(3), 255-270.

Dykens, E. M., Fisher, M. H., Taylor, J. L., Lambert, W., & Miodrag, N. (2014). Reducing distress in mothers of children with autism and other disabilities: a randomized trial. Pediatrics134(2), e454-e463.

Kabat-Zinn, J. Wherever you go, there you are: Mindfulness meditation in everyday life. 1994.

Taren, A. A., Gianaros, P. J., Greco, C. M., Lindsay, E. K., Fairgrieve, A., Brown, K. W., … & Bursley, J. K. (2015). Mindfulness meditation training alters stress-related amygdala resting state functional connectivity: a randomized controlled trial. Social cognitive and affective neuroscience, nsv066.

Zeidan, F. (2015). The Neurobiology of Mindfulness Meditation.

 

Zeidan, F., Martucci, K. T., Kraft, R. A., Gordon, N. S., McHaffie, J. G., & Coghill, R. C. (2011). Brain mechanisms supporting the modulation of pain by mindfulness meditation. The Journal of Neuroscience31(14), 5540-5548.