Is your autistic child Complex or Essential? Research by the Autism Centre at the Children’s Hospital Columbia, Missouri is suggesting that there are two distinct forms of autism.
Children with Complex Autism make up about 20% of the autistic population. They tend to have lower IQs, more physical and brain abnormalities including microcephaly, and are just as likely to be boys as girls. Essential Autism is male dominated, seven boys to every one girl, and sufferers tend to have less seizures plus a higher IQ. An important difference between Complex and Essential is that Complex is not hereditary where as Essential can be.
If this distinction between the two type is valid then it could have some important implications for finding the causes and best treatments. As Complex Autism is non-hereditary and is high in congenital defects it points to a environment or external factor during pregnancy being the cause. Where as Essential Autism might be purely caused by genetics or an external factor such as mercury or a combination of both (see Blood Test for Autism?).
On the treatment side, the symptoms and type of autism can predict a successful treatment. Successful being defined as an IQ greater than 70 and having verbal ability at eight years old or greater.
||% Chance Of Successful Treatment
Study Full Text [PDF]: Essential Versus Complex Autism: Definition of Fundamental Prognostic Subtypes
Featured on last night’s Inside Out progam was The Sound Learning Centre. The centre provides a range of light and sound therapies and I have been assessed and received light treatment from them.
In a ten minute segment, the program followed Harry Phillips and his mother Carrie as Harry received treatment for his aspergers syndrome. Harry, about ten years old, was a clever and articulate child but suffered from symptoms common in aspergers such as clumsiness, very fussy eating habits and sensitive hearing. Carrie commented that she couldn’t hoover when he was in the house because of the pain the noise caused him.
The Auditory Integration Training (AIT) was demonstrated to the TV show’s frontman by Pauline Allen who runs the cente and we were treated to a snatch of Fleetwood Mac (from the Rumours album I think) played through the equipment. The treatment works by dropping out certain frequencies and switching ears so it sounds like you are listening to a distant radio station on a hot summer night. The music fading and returning as the signals bounce and distort around the upper atmosphere.
Helen Woods, a highly autistic child, and her mother were also featured. They had received the treatment a year ago and Mrs Woods was delighted with it, commetting “after five days [of treatment] we were able to go in to cafe without Helen screaming, running around and knocking chairs over“. She also commented that Helen had started making more speech like sounds and could begin to communicate but Mrs Woods emphasized that this wasn’t a cure for autism.
The progam returned to Harry and his mother at the end of his AIT treatment. When Carrie was asked had the treatment worked “Absolutely” was the answer. The presenter asked how could be sure that this wasn’t just Harry progressing as he got older? Carrie’s response was the speed of the change is too quick. Harry had been using the hoover yet ten days ago the sound of the Hoover was painful to him. He also seemed more coordinated.
This was an extremely good feature on The Sound Learning Centre with very balanced BBC reporting. A relief after the distortions of ‘The Dyslexia Myth‘. It was a shame they did not feature the assessment stage of the treatment as it is extensive and would of made the process look more creditable. Overall the program did a good job demonstrating the speed and effectiveness of the treatment whilst highlighting the weakness of the science behind it.
The Sound Learning Centre is based in Palmer’s Green, north London, UK. They will be having an open house on the 20th October 2005.
See also: Hyperacusis, Light & Sound Sensitivity Effects Readers, The Senses of Autism,
BBC: Inside Out investigates how sound therapy may be helping some autistic children live with their condition
You can test your Autistic Spectrum Quotient . It a simple multiple choice questionnaire so its not going to diagnose autism but indicate if you have certain autistic traits. Developed by Cambridge’s Autism Research Centre they found the average, normal adult’s score was about 16 and that most people diagnosed as autistic scored over 30. When I took it I scored 25 so definitely more autistic than the average person which supports the hypothesis that dyslexia and mild autism overlap to some degree.
The study used to validate the test has some interesting bit in it: “Among the [normal population], males scored slightly but significantly higher than women … The students in Cambridge University did not differ from the randomly selected control group, but scientists (including mathematicians) scored significantly higher than both humanities and social sciences students, confirming an earlier study that autistic conditions are associated with scientific skills. Within the sciences, mathematicians scored highest“.
Before taking the test is is worth stressing: “[it] is not diagnostic [test], but may serve as a useful instrument in identifying the extent of autistic traits shown by an adult of normal intelligence. A score of 32+ appears to be a useful cut-off for distinguishing individuals who have clinically significant levels of autistic traits. Such a high score on the AQ however does not mean an individual has Aspergers or High Functioning Autism“
The Autism Spectrum Quotient (AQ) : Evidence from Asperger Syndrome/High Functioning Autism, Males and Females, Scientists and Mathematicians [PDF]
“BBC television will feature The Sound Learning Centre on its ‘Inside Out’ regional current affairs programme, to be broadcast by BBC ONE (London region) on Monday evening 19 September from 7.30 till 8.00pm. Viewers outside the London Region can see this programme on SKY channel 944 [NTL 926]. The programme will follow clients from first contact with the Centre, during 10 days of Sound and Light treatment, right through to the final day of treatment and includes interviews with the children, their parents and Pauline Allen, the principal of The Sound Learning Centre“.
The Sound Learning Centre provides a range of visual and audio based treatments for a dyslexia, ADHD, autism and other developmental problems. Read my account my assessment and light therapy treatment and watch the show. It will be an interesting contrast to the ‘The Dyslexia Myth‘.
This one hit the news back in May (BBC coverage) but somehow I missed it at the time.
A study run by the US Centers for Disease Control (CDC) looked at 698 autistic children born in Denmark. They found that autism was associated with breech presentation, a low Apgar score , a gestational age at birth of less than 35 weeks and parental psychiatric history of schizophrenia-like psychosis or affective disorder. Analyses showed no statistically significant association between risk of autism and weight for gestational age, parity, number of antenatal visits, parental age, or socioeconomic status.
Full Text: Risk Factors for Autism: Perinatal Factors, Parental Psychiatric History, and Socioeconomic Status
See also: Premature Babies Have High Chance of Learning Disabilites
The Independent on Sunday ran an article The Secret Life of Babies on how our understanding of very young babies is improving. The latest evidence is suggesting that babies are a lot more aware of their emotions than previously thought. The secret to these breakthroughs is cheap brain scanning technology that lets us see into a babies thought patterns for the first time.
This has exciting possibilities in detecting autism and other developmental problems. By the time autism is diagnosed, normally between two or three years, the child is already a long way behind developmentally. If children with autism can be detected a few months after birth using brain scans, then treatment can begin sooner. This assumes that you are born with autism and it isn’t caused by vaccines, mercury or other outside forces.
See also: Autism Tests
Early diagnosis of autism is vital as the earlier treatment begins the more effective it is. (See Predicting Autism in Infants at 12 Months). Now a Florida, USA, based team is proposing they can predict Auspergers and Autism as early as six months.
I picked this up from a HOI News article though the original paper was published in 2002. The paper, Reflexes Gone Astray in Autistism in Infants [PDF], was published in Early Indicators of Autistic Spectrum Disorders and Related Challenges [PDF], the 2002 issue of the Journal of Developmental and Learning Disorders . In 2004, the same team published Eshkol–Wachman movement notation in diagnosis: The early detection of Asperger’s syndrome .
The 2002 paper looks at the role primitive and postural reflexes play in early development particularly on a ‘Tilt Test’ which examines how an infant moves their head when their body is tilt by 45 degrees. The researchers acquired videos of infants who had at a later stage been diagnosed as autistic. They examined the autistic children’s movement in the video and compared it to ‘healthy’ children. This an effective way of spotting indicative behavior but the research paper doesn’t give any statistical analysis. e.g. did all autistic children behave in this way and did none of the ‘normal’ children exhibit the behavior? The paper also makes no mention of the work by Sally Goddard and Peter Blythe at the INPP. Their work has shown that primitive reflexes have a significant role in learning difficulties of all sorts including dyslexia, ADHD / ADD, dyspraxia and autism. Sally Goddard’s book Reflexes, Learning and Behaviour covers the ’tilt test’ when discussing the Labyrinthine and Oculo Headrighting reflexes.
Any research into early detection of autism and the role reflexes play in development is important. However this work is very light on detail and over simplifies the problem. The ’tilt test’ is a useful diagnostic tool but in itself is not a predictor of autism.
New research by the University of Arkansas points to the possibility of a blood test to detect autism. The study by Dr James (Metabolic biomarkers of increased oxidative stress and impaired methylation capacity in children with autism) points to autistic children having a impaired capacity for methylation, which has many functions in the human body including dealing with heavy metals, including mercury. Specifically, 80 per cent of autistic children in the study had notably low levels of active glutathione. A reduction of glutathione can wreak damage on the brain, gastro-intestinal tract and immune system. Heavy metals also reach higher levels more quickly in children with low glutathione. The build-up may act as an environmental trigger, turning on latent autism-causing genes. The Arkansas team has also found that the genes controlling glutathione metabolism are more likely to be disrupted in autistic children than in healthy ones.
Source: Times Online Science Notebook
See Also: Mercury & Autism; Ethyl Mercury Versus Methyl Mercury
Autism is a very individualistic problem which requires finding the right approach for the individual. It is also very important to treat it early so months spent on a treatment that isn’t suitable can be costly in more ways than one.
An article on Medical News Today looks at a study designed to identify children who are most likely to benefit from a treatment programme called Pivotal Response Training (PRT). Researchers looked at children who had either responded very well to the treatment or had responded very poorly. They built up profiles of those children and used them to predict which of a new group of children would respond and which would not. This was a double-blind study so neither the patients or the PRT trainers knew what the study was about to avoid the children accidentally receiving different treatment. After five weeks those predicted as not responding hadn’t shown any sign of improvement and the treatment was stopped for them. For those benefiting from the therapy the treatment was continued. Importantly, one of the non-responding children started a different treatment programme and made significant progress. This demonstrates the important fact that the screening process did not just identify those who could not be treated by any method.