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368514-75 Researchers from Staten Island's IBR Find Predictors of Autism That Can Lead To Infant Diagnosis

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    Sep 2, 2010

       
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      RESEARCH

      Researchers from Staten Island's IBR Find Predictors of Autism That Can Lead To Infant Diagnosis


            By Stephanie Slepian xrl.in/60vu


            BR Director Dr. W. Ted Brown said the findings could lead to earlier diagnosis and intervention. file photoI

             Certain behaviors seen in infants as young as 1-month-old may be predictors of autism spectrum disorders, according to new research by scientists at the Institute for Basic Research and Developmental Disabilities, Willowbrook.
            IBR director Dr. W. Ted Brown said the findings -- published Monday in the online journal Pediatrics and set to appear in next month’s print issue -- could lead to earlier diagnosis and intervention. (See abstract below – Editor.)
             “Some of these clues will help us understand the causes of ASD and help identify children who may need earlier intervention,” he said. “The earlier the intervention, the better, is what we always say."
            The study tracked 2,196 neonatal intensive care unit graduates from Richmond University Medical Center, West Brighton, over an 11-year period. Twenty-eight of those children who were later diagnosed with ASD were matched with 112 NICU graduates who didn’t develop ASD.
            At 1 month, children with the ASD diagnosis were more likely to have asymmetrical visual tracking and arm tone deficits. By 4 months, they were more attracted to higher levels of visual stimulation, much like younger infants. Between 7 and 10 months, the children with ASD showed major declines in mental and motor performance.
            Testing detected additional deficits through age 2.
            The study’s authors said the behaviors are consistent with those associated with ASD in older children “leading us to speculate that they may be precursors to ASD."
            Dr. Brown said 25 percent of children who develop autism were one-time NICU babies. Children who develop ASD are four times more likely to be male and two weeks premature.
            The study was led by Dr. Bernard Z. Karmel, head of IBR’s Neurophysiological Department Laboratory, and was conducted by scientists in IBR’s Department of Infant Development and Pathology, in collaboration with physicians from the Department of Pediatrics at RUMC.
            The hospital and IBR - the research arm of the state Office for People With Developmental Disabilities - have a long-standing relationship to monitor the progress of NICU babies who are seen at 1 month, 3 months and six months after discharge, and then every six months until the age of 3. Testing continues once a year until they are about 8 years old.
            Still, Dr. Brown said more research is needed to determine early predictors of ASD. He is seeking to expand the study to other NICUs in the New York area.
            “There’s often no tracking until the disability develops at around 3 years or so,” he said. “There is a need for some expansion of tracking after babies leave the NICU so we can pick it up and begin early intervention."





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      • • •

      Early Medical and Behavioral Characteristics of NICU Infants Later Classified With ASD


      Published online August 2, 2010 PEDIATRICS (doi:10.1542/peds.2009-2680)
      Bernard Z. Karmel, PhD et al.

            OBJECTIVES Recent evidence suggests higher prevalence of autism spectrum disorder (ASD) in NICU graduates. This aim of this study was to identify retrospectively early behaviors found more frequently in NICU infants who went on to develop ASD.
            METHODS Twenty-eight NICU graduates who later received a diagnosis of ASD were compared with 2169 other NICU graduates recruited from 1994 to 2005. They differed in gender, gestational age, and birth cohort. These characteristics were used to draw a matched control sample (n = 112) to determine which, if any, early behaviors discriminated subsequent ASD diagnosis. Behavioral testing at targeted ages (adjusted for gestation) included the Rapid Neonatal Neurobehavioral Assessment (hospital discharge, 1 month), Arousal-Modulated Attention (hospital discharge, 1 and 4 months), and Bayley Scales of Infant Development (multiple times, 4–25 months).
            RESULTS At 1 month, children with ASD but not control children had persistent neurobehavioral abnormalities and higher incidences of asymmetric visual tracking and arm tone deficits. At 4 months, children with ASD had continued visual preference for higher amounts of stimulation than did control children, behaving more like newborns. Unlike control children, children with ASD had declining mental and motor performance by 7 to 10 months, resembling infants with severe central nervous system involvement.
            CONCLUSIONS Differences in specific behavior domains between NICU graduates who later receive a diagnosis of ASD and matched NICU control children may be identified in early infancy. Studies with this cohort may provide insights to help understand and detect early disabilities, including ASD.

      • • •

      Alberta Scientists See Alzheimer's Breakthrough
      CBC News 

      xrl.in/5zz5

            Scientists at the University of Lethbridge say they have successfully regrown adult brain cells in tests on mice, a breakthrough that could lead to treatment of neural diseases such as Alzheimer's.
            "We're pretty excited by it," said Dr. Robert Sutherland, who led the five-year project at the Canadian Centre for Behavioural Neuroscience.
            "In just the same way as people have been able to regenerate pieces of skin that have been damaged, we've been able to do that in a part of the brain," Sutherland told CBC News.
            In the study, brain cells were destroyed in mice, which were then treated with a naturally occurring growth factor and behavioural and memory exercises.
            According to Sutherland, the three-part treatment allowed the cells to regrow, and after six weeks of treatment, those mice fared just as well as those in a control group.
            "We discovered the memory disorder [in the mice] was reversed," Sutherland said. "It was gone. The memory was as good as normal."
            Dr. Simon Spanswick, one of the primary researchers involved in the project, said the implications of the cell regrowth research are vast.
            "Things like Alzheimer's disease, a number of memory diseases … dementia for example, Parkinson's disease, what we've discovered will be part of a treatment process for these disorders," he said.
            Researchers couldn't say when their research can start to be applied to humans. However, the Canadian Institute for Health Research has renewed funding for the research for another five years.

      • • •

      Autism and the Environment: Families Urge Senators to Back Research
      Experts and Parents Say Little Is Known About Environmental Links to

            By Kim Carollo And Tom Shine ABC NEWS xrl.in/60wn

            Mary and Steve Moen fought for years to get their son Max, now 10, the help he needed to deal with the behavioral and social problems he exhibited as a child with autism.
            They went for numerous evaluations and sought out some of the best specialists in the field, enduring


      Parents of autistic children and experts agree that environmental impact is a missing piece of the autism puzzle and are advocating more research.
      (Getty Images)
      sometimes year-long waits for consultations. Their persistence paid off; Max attended a special autism program to help him function better socially and control his behavior better, and now he attends a mainstream school and performs well academically, behaviorally and socially.
            Still, the underlying cause of Max's autism remains a mystery -- a situation his parents hope to change.
            Moen shared her son's story in front of the Senate Environment and Public Works Children's Health subcommittee today. The subcommittee met to get a status report on research into the links between environmental factors and developmental disorders like autism and attention-deficit hyperactivity disorder.
            "There is a genetic component, and there are likely to be some environmental issues, but no one really knows what those are, and they're probably different for different kinds of autism," said Dr. Jeffrey Brosco, professor of clinical pediatrics at the University of Miami.
            Hines said that a definitive association between environmental factors and autism could have tremendous therapeutic value.
            "If you can identify things in the environment that cause autism, you're more likely to know how to pinpoint it and treat it," she said.
            Brosco said he hopes the National Children's Study will provide a lot more insight into how the environment affects our health. The government-funded National Children's Study will follow about 100,000 pregnant women and their children and try to connect environmental factors to a variety of conditions, including autism.

            NOTE: You can view archived sessions here: xrl.in/60ws

      • • •

      TREATMENT

      Castration Drug Used as Autism Therapy

      Controversial treatment now in some medical offices.

            Bob LaMendola South Florida Sun-Sentinel xrl.in/60wh

            A Maryland medical group has started treating autistic children in South Florida with shots of a drug used for chemical castration, a therapy widely panned by mainstream experts.
            The group gives children the cancer drug Lupron to stop their bodies from making testosterone, saying the drug helps expel toxic mercury and quells aggressive or sexually explicit behavior by kids with excessive levels of the male hormone.
            A Boca Raton mother who just put her 18-year-old son on the drug said it seems to help.
            But numerous physicians, researchers and therapists insist there's no proof mercury causes autism, that Lupron removes mercury or that autistic kids have excessive testosterone. What's more, the drug carries a risk of bone damage, stunted growth and heart trouble, and can render children impotent.
            These experts contend that Lupron, costing about $5,000 a month but seldom covered by insurance, is one of many treatments that cash in on the desperation of parents trying to cope with an incurable condition for which medicine has few good answers outside of painstaking behavioral therapy.
            "Not only is there no scientific backing whatsoever for Lupron treatments, there are several major concerns for the children's health," said neurologist BethAnn McLaughlin, an adviser to the Dan Marino Foundation autism group in Weston and the mother of two developmentally disabled children.
            "These people are preying on the fears of parents. We cannot be using these children who are so vulnerable as guinea pigs in a medical experiment."
            Untested autism treatments have flourished while science struggles to explain the disorder, which disrupts the abilities to speak, concentrate, connect with people and control impulses.
            For unknown reasons, autism has been on the rise for the past few decades, with an estimated 675,000 children – about one in 100 – now having mild to severe symptoms. Scientists believe it stems from genetic defects that may only cause problems after an environmental trigger.
            A vocal subset of parents and activists blame vaccines, especially those with the mercury-based preservative thimerosal, which has been banned from virtually all as a precaution. Numerous studies have found no connection between autism and vaccines or thimerosal.
            Lupron therapy grew from the mercury camp. Baltimore researcher Dr. Mark Geier started using the drug in 2005 on the theory – disputed by mainsteam doctors – that testosterone binds mercury in the body and that many autistic kids have high levels of the hormone.
            Lupron halts production of the female hormone estrogen, which the body uses to make testosterone. The drug mainly is used to treat endometrial cancer in women and prostate cancer in men, and sometimes to chemically castrate sex offenders.
            Geier's promotional materials said he has treated hundreds of children with Lupron and has launched nine ASD Centers in eight states. In his latest, he teams with Dr. David Clayman, a Boca Raton radiologist who has an autistic teen son and is opening an ASD office beside his MRI center in Tamarac.
            Clayman said he would not comment until he treats patients with Lupron therapy for a year. Geier could not be reached for comment despite several attempts by phone. He told one parent he did not plan to comment for this story.
      + Read more: xrl.in/60wh

            EDITOR'S NOTE: Dr. Geier has previously stated that Lupron is not prescribed unless lab tests indicate an hormonal imbalance. – Editor.

      • • •



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      PEOPLE

      Caretaker Charged In Death of Woods Client

          
            By Jo Ciavaglia and Ben Finley Bucks County Courier Times xrl.in/60vs


          Stacey Strauss, 40, of Philadelphia faces charges including felony neglect of a care-dependent person in the july 24 heat-related death of Bryan Nevins, 20, a Woods Services client with severe autism. Here she walks out of district court in Penndell after being officially being arraigned Tuesday afternoon. - Steve Gengler / Staff Photo
           
            But Stacey Strauss claims that she wasn't the Woods Services employee responsible for taking care of a 20-year-old client with severe autism who died after he was left inside a hot van.
            Bryan Nevins wasn't scheduled to go on a trip with other Woods Services clients, an outing that ended with his death after he was left inside a locked and oven-hot van by a Philadelphia woman assigned to watch him, police said.
            That woman, Stacey Strauss, 40, now faces criminal charges, including felony neglect of a care-dependent person and involuntary manslaughter in the July 24 death of the 20-year-old man with severe autism.
            "It's more than a lapse of judgment," Bucks County prosecutor Robert James said Tuesday after the eight-year Woods Services employee was charged by the Bucks County District Attorney's Office. "This was a criminal failure to abide by her responsibilities. And as a result Bryan Nevins is dead . . . . This is not a tragic accident at all. She didn't do her job."
            The case marks the second time in a year that the county DA has filed criminal charges against a caretaker in a heat-related death involving a vehicle. In the first case involving a 2-year-old left in a car by a day care center director in July 2009, a jury found the caretaker not guilty on all charges including involuntary manslaughter.
            Strauss, who has no criminal record and remains suspended from her job, was held on $50,000 bail. She owns two homes in Philadelphia, one that she shares with her 21-year-old son, her attorney said.
            If convicted of the most serious charge, first-degree felony neglect, Strauss faces a maximum prison sentence of 20 years. Nevins' parents, who live in Oceanside, N.Y., have been advised of the charges filed against Strauss, said Bucks County District Attorney David Heckler.
            But Strauss' lawyer, Robert Lynch, contends Nevins' death was an accident for which many Woods Services employees share responsibility.
            "She loved those children like her own," Lynch said.
            A police affidavit in the case shows that some employees on duty were unaware that Nevins never returned from the day trip to Sesame Place in Middletown, while others knew the group returned about 12:30 p.m. Strauss, who has denied she was responsible for Nevins' care that day, also told contradictory stories of the events, according to court papers.
            The police investigation also revealed that the day he died Nevins, a six-year resident of Woods Services, was picked to replace another resident in Building 13A who was unable to go on the trip to the theme park.
            Vladimir Dubuc, a residential counselor assigned to Building 13A for the 7 a.m. to 3 p.m. shift on July 24, told police that he was initially assigned to Nevins that day; he got Nevins ready for the trip and escorted him to Building 16, where he turned him over to shift supervisor Michelle Bova about 9:45 a.m.
            That was the last time he saw Nevins on campus, he told police.
            Bova, who worked the 7 a.m. to 3 p.m. shift that day, told police that she assigned Gerald Douglas, another residential counselor, to supervise two clients who live in Building 15 on the Sesame trip, and Strauss, who was assigned to Building 13B that day, was assigned to drive the van and supervise Nevins and another client from Building 13A on the trip.
      + Read more: xrl.in/60vs

      • • •

      School, Police React to Drowning at School
      Ohio Autistic Boy Wanders from Class, Drowns at Austintown School
      xrl.in/60ux



            A 7-year-old Boardman autistic boy lost his life yesterday by drowning in an indoor pool at an Austintown school.
            Nathan Kinderdine spent the past six weeks taking part in a Summer enrichment program along with 140 other students at the Leonard Kirtz School in Austintown. Tuesday afternoon tragedy struck when the young boy, who was autistic was found face-down in a swimming pool at the school.
            "Dispatcher received a phone call in reference to a possible drowning at the school," said Det. Sgt. Raynor Holmes of the Austintown Police Department. "An officer was dispatched along with Lanes ambulance."
            Workers were unable to revive the boy. Police are now investigating what actually caused the boy to drown.
            "We're not rushing into it," Holmes said. "We're trying to find the victims whereabouts, and try and retrace where he went and where everything went from there. It's not the easiest thing to do, but that's what we have to look at."
            A timeline in the police report shows that the doors to the pool area were locked just before noon. The last adult left the pool about ten minutes later.
            About 12:35 p.m., instructors took several children into the gym. they then momentarily went into the hall to get two more children and that's when they noticed Nathan was missing.
            After a quick search, by 12:40 p.m. a custodian found the boy in the pool. Police are looking into whether there might be a problem with one of the self closing doors that lead to the pool area.
            The report states an officer fully opened a door leading from the boys' restroom into the pool 10 times. That door closed and locked, like its supposed to only once.
            Officials with Leonard Kirtz are doing everything they can to find out what happened as well.
            "We're waiting on the coroner, and Austintown Police Department report to see what they believe was the cause and the time frame involved," said Superintendent Larry Duck. "From there we'll try to look at what needs to be done to prevent this from ever happening again."
            Linda Finlay's son, 13-year-old Joshua Finlay, attended the same program as Nathan. While the Salem resident attends West Branch Middle School, autistic children are required to participate in summer programs, Finlay said.
            She said Joshua understood what happened at his school Tuesday. His reaction surprised her, she added.
            "He was really shocked," Finlay said. "He said, 'this is a really tragic thing that happened."
            Finlay said she gave her son a choice on whether to attend school today. He decided to go, she said, but left after lunch.
            Finlay said she knew something was wrong when Joshua came home with a letter from the school that stated the week would continue as scheduled, but there was an incident that involved a student in the swimming pool.
            "It's really bad," Finlay said. "I was up all night crying. I feel really bad for the parents."
            Finlay said though no decision has been made, she was thinking about sending Joshua to a different summer program next year. She said her decision has nothing to do with this incident.
            
      • • •

      Pioneer In Treatment of Autism Dies

            By Victoria Campbell, News 4 xrl.in/60va
           
            A respected and revered pioneer in the treatment of autism spectrum disorders has died. Dr. O. Ivar Lovaas passed away in California.
            Dr. Lovaas developed the practice of Applied Behavior Analysis (ABA) which helps people with autism learn to function in day-to-day society. 


      Dr. O. Ivar Lovaas.
            His work began in the 1960s and helped thousands of children with autism across the globe. ABA is evidence-based treatment that proves successful in about half of the patients treated, and can offer the chance for a more productive life.
            In Reno, Deborah Schumacher's son, Cliff, was the first child to receive treatment from Dr. Lovaas. In the early 1990's, Schumacher said she knew "something was clearly not developmentally right" with her little boy, "but i didn't know what was wrong." She learned of Dr. Lovaas's methods and classes at UCLA, and moved to southern California with Cliff when he was three years old.
            "He got 42 hours a week of one-on-one work in the beginning," she said. "That only took-- in his case-- about a year and a half and he went from being non-verbal to being able to handle first grade."
            "You have Dr. Lovaas a cheerful bouyancy and a dead seriousness about what's at stake here, and that's the life of a child," said Patrick Ghezzi, Ph.D., who uses Dr. Lovaas's treatments to help children with autism in Reno.
            "He didn't accept what a lot of other doctors and a lot of other researchers say," said Ralph Toddre of the Autism Coalition of Nevada. "[They say] there's nothing that can be done. But he wouldn't accept that.
            "He was very, very compassionate for his patients, and incredibly passionate about his work."
            Dr. Lovaas leaves a son, Eric, who continues his research and treatment. His clinics across the world also continue to help children with autism. Funeral services are pending.

      • • •

      PUBLIC HEALTH

      Scientific Explanations About Childhood Vaccine
      Safety Do Little to Quiet Parental Concerns According to New Study

      xrl.in/60gb

            AScribe Newswire - Results of a study of nearly 1,300 U.S. parents and guardians, show that while a strong majority of parents support vaccinations for their children, they continue to have concerns about vaccine safety and the potential for adverse effects.
             The study, "Communicating Effectively About Vaccines: Results of A Survey of U.S. Parents and Guardians," was conducted by the Association of State and Territorial Health Officials (ASTHO; www.astho.org). Additional findings show that current communication methods based on scientific research do not appear to be leading to more comfort with vaccines and that a child's pediatrician is the most influential source of information about vaccines, aside from the spouse or partner of the parent or guardian.
             "The fear of disease is not as prevalent as it was in the past, so convincing parents that vaccines continue to be necessary is an ongoing challenge," said ASTHO Executive Director Paul E. Jarris, MD, MBA.
             The study found that positive messages were generally rated as more convincing and believable than negative messages. The positive message that resonated most with parents was, "vaccination is one of the most important ways I can protect my child from life-threatening illness and it's the best-known protection against a number of infectious diseases."
             The negative messages that resonated most with parents were: "vaccines are unsafe due to ingredients such as thimerosal or aluminum", and "too many vaccines given too soon can harm children." Conversely, the least effective positive message is, "scientific studies do not support the concern that thimerosal causes autism."
             The study found that 16 percent of respondents had refused at least one vaccine for a child, while 13 percent had delayed receipt of a vaccine. Based on survey responses, parents who delay vaccines seem to be influenced by negative messages such as, "combination vaccines are more likely to cause adverse reactions," as evidenced by the most commonly delayed vaccines - diphtheria, tetanus, and acellular pertussis (DTaP;).
      + Read more: xrl.in/60gb

      • • •

      FINANCES

      Mass. Gov Patrick Signs Legislation
      Expanding Autism Coverage


      xrl.in/60vx



             Boston — Governor Deval Patrick has signed into law a bill that will make essential diagnostic tests, medical treatment and services for children and adults with autism spectrum disorders, including applied behavioral analysis and other critical interventions that are determined to be medically necessary, more affordable and accessible for residents of the Commonwealth. The legislation, "An Act Relative to Insurance Coverage for Autism" (HB 4935), goes into effect on Jan. 1, 2011.
            "I am proud that Massachusetts now has one of the most comprehensive autism coverage laws in the nation," said Patrick. "This bill offers needed relief for individuals and families struggling to pay for the services they need."
            "Parents have long been faced with the difficulty of getting necessary medical care for their autistic children covered by insurance companies. Studies have shown that by receiving services early, those diagnosed with an Autism Spectrum Disorder will need fewer services later in life," said Senate President Therese Murray. "This law will change existing insurance policy so that we will be able to provide early intervention care to more children with autism, teaching them to communicate and learn at an early age. The passage and signing of this legislation signals an increased understanding about autism and its treatment."
            According to the governor's office, Massachusetts has been a leader in establishing early intervention practices and other supports for people with autism. This legislation will go even further to ensure that these vital services are available for children and adults within this vulnerable community.
            The legislation signed today requires that health insurance companies provide coverage for early and intensive interventions. Under the new law, insurers may not establish any annual or lifetime service limitations on coverage for the diagnosis and treatment of Autism Spectrum Disorders that are less than that for physical conditions. Insurers may also not limit the number of visits an individual may make to an autism services provider.
            The Massachusetts Division of Health Care Finance and Policy provided an analysis for the Legislature earlier this year that identified significant financial strain facing families with children with autism. The state also reviewed evolving treatment data and concluded that the best established treatments for autism have shown substantial efficacy.
      + Read more: xrl.in/60vx




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        In This Issue:

















































      RESEARCH
      Researchers from Staten Island's IBR Find Predictors of Autism That Can Lead To Infant Diagnosis

      Early Medical and Behavioral Characteristics of NICU Infants Later Classified With ASD

      Alberta Scientists See Alzheimer's Breakthrough CBC News

      Autism and the Environment: Families Urge Senators to Back Research

      TREATMENT
      Castration Drug Used as Autism Therapy

      PEOPLE
      Caretaker Charged In Death of Woods Client

      School, Police React to Drowning at School

      Pioneer In Treatment Of Autism Dies

      PUBLIC HEALTH
      Scientific Explanations About Childhood Vaccine Safety Do Little to Quiet Parental Concerns

      FINANCES
      Mass. Gov Patrick Signs Legislation Expanding Autism Coverage




         









      DO SOMETHING ABOUT AUTISM NOW



      . . . Read, then Forward
      the Schafer Autism Report.
      $35 for 1 year - or free!
      www.sarnet.org
















      Now's the perfect time to order your free Puzzle Piece kits and launch an autism awareness campaign in your community. When we raise the funding necessary, ARI will see that important research is done, including the large-scale, independent study of vaccinated vs. unvaccinated children

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      The
      Autism Community
      Supports the
      Schafer Autism Report




      . . . Read, then Forward
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      Biomedical Treatments for Autism Spectrum Disorders

      Scientific References and Abstracts
      www.autismbiomed.com


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