“We found no evidence that maternal smoking during pregnancy increases the risk of autism spectrum disorders,” said study leader Dr. Brian Lee, an assistant professor at Drexel University and an epidemiologist at Drexel’s School of Public Health, in collaboration with researchers from Sweden’s Karolinska Institute and the University of Bristol (Bristol, UK).

“Past studies that showed an association were most likely influenced by social and demographic factors such as income and occupation that have associations with both the likelihood of smoking and with the rate of autism spectrum disorders.”

The research team studied data from national and regional Swedish registries of 3,958 children with autism spectrum disorders, along with a control group of 38,983 children without autism born during the same period.

Overall, 19.8 percent of the children with ASD were exposed to maternal smoking during pregnancy, compared to 18.4 percent of control children.

The report helps to reassure mothers who smoked during pregnancy that their behavior was not responsible for their child’s autism, Lee said, and “crosses off another suspect on the list of possible environmental risk factors for ASD.”  However, he cautioned that smoking during pregnancy is still unhealthy for mothers and has other known risks for their children.

The research is published in the Journal of Autism and Developmental Disorders.

As reported last week in our post, DSM Debate Continues, both the medical profession and general public have been stirred into a frenzy of petitions and campaigns against the proposed changes to the DSM autism criteria.  There has been widespread concern that the removal of Asperger’s disorder, and pervasive developmental disorder not otherwise specified (NOS) would leave some families no longer eligible for essential medical, social and educational services.

The APA has reassured those affected that no previously covered group will be left out in the cold. The changes would involve merging several diagnoses currently listed separately in the DSM-5 into a single umbrella category of “autism spectrum disorder.”

“The proposed criteria will lead to more accurate diagnosis and will help physicians and therapists design better treatment interventions for children who suffer from autism spectrum disorder,” said James Scully, MD, medical director of the APA, in a release.

“While final decisions are still months away, the recommendations reflect the work of dozens of the nation’s top scientific and research minds and are supported by more than a decade of intensive study analysis,” the APA states in the same release.

Neurodevelopmental Work Group member Bryan H. King, MD, believes that with the changes “we are going to be able to better characterize individuals with autism, in part because of clearer criteria that have been written to better account for people across the age span. And one could argue that this will actually make it easier for adolescents and adults, and even young children potentially, to meet criteria for diagnosis than was previously the case.”

A third public feedback period is scheduled to begin this spring.

Sophie Robert released her first documentary The Wall: Psychoanalysis put to the Test for Autism in September 2011 in France. The documentary looks at the continual abuse and dehumanization of people with autism. It explores how the French psychiatric community still maintains the disproved theory of autism being caused by the mother rather than any of the increasingly recognized neurological causes, as well as their insistence that people with autism are useless and incompetent and should be put away.

Three of the psychoanalysts interviewed in the film took legal action against Robert calling for the film to be banned.  A court hearing was held on December 8^th and the parents with autistic children started a grassroots campaign to support Sophie in France.

Supporters of Robert’s cause say the documentary is just the tip of the iceberg. The problem of autism in France is dramatic compared to most developed countries.

For instance, in France autism is often considered a “psychosis”, some even regard it as “child schizophrenia”. As a result, most children with autism are institutionalized in psychiatric units from a very young age until old age.

80% of the children with ASD don’t go to school and many don’t receive diagnosis until after the age of six.

Some parents decide to protect their children and bring them in exile to Belgium so they can receive better care and have access to schools.

The Regional Court of Lille released its verdict on Thursday Jan. 26, 2012 censoring and banning “The Wall”. Sophie Robert and her sole-proprietorship company “Océan Invisible Productions” are sentenced pay to at least 40 000 EUROS in damages and lawyers fees to the plaintiffs. They intend to appeal and support for their cause is mounting.

Lead drummer Devin Louis Miller was inspired in this move by his younger brother Timmy, who was diagnosed at age 5 with autism, Miller convinced his band-mates to donate half of the profits from their first CD. Timmy, now 10, is “doing very well, thanks to the tremendous work of doctors and scientists working on disorders across the autism spectrum,” noted the big brother, who wants to make sure others diagnosed with similar conditions get the same exceptional treatment.

“It was pretty clear almost from the time he was born that he was a developing slowly, in terms of speaking and other normal behaviors, and nobody was really shocked when they told my parents it was autism,” Devin Louis Miller said.

The surprising part, he added, was how much the doctors who took Timmy’s case understood about pervasive developmental disorders (PDD) and how much they were able to help him once the diagnosis was confirmed.

“It was amazing,” the musician said. “Once they determined that it was autism, they were really able to understand Timmy and help him. And just as importantly, they were able to explain things to my parents and help them deal with the situation.”

Recognizing the difference between mild autism, severe autism and other PDDs is vital to developing an appropriate treatment plan. Some patients diagnosed and treated at an early age have been known to “outgrow” the condition, making it even more imperative that Timmy’s autism was detected when he was relatively young.

The boy has progressed so well, according to his big brother, that he’s on target to attend a mainstream middle school for eighth grade next fall. “Timmy’s an amazing kid and he’s made great progress,” Devin Louis Miller said. “There’s no doubt that the excellent care he’s received over the past four-and-a-half-years has done wonders.”

That’s exactly what the drummer had in mind when he convinced his fellow Van Dammes to donate some of the profits from “Missing In Action” to several autism-focused charities, including the San Diego, Calif.-based Autism Research Institute and Autism Speaks, a national advocacy group with offices in New York City, Princeton, NJ, and Los Angeles, Calif.

“I just want to help,” Devin Louis Miller noted. “This is really my first chance to donate to the cause. There are a lot of other kids out there like Timmy and they need a fighting chance.”

Some other musicians that have donated to autism-focused charities are Maroon 5, Five for Fighting and Celine Dion.

The condition called Timothy syndrome, although only though to exist in 20 cases worldwide, is thought to cause autistic behavior.

This is of interest to scientists as it is a genetic condition and can be pinpointed down to a single gene defect which may give clues about the origins of autism.

One study into Timothy syndrome conducted by Neuroscientists at Stanford University School of Medicine looked at the way the nerve cells of those with Timothy syndrome developed differently from those without the syndrome.

In this study, the scientists suggest that the autism in Timothy syndrome patients is caused by a gene mutation that makes calcium channels in neuron membranes defective, interfering with how those neurons communicate and develop. The flow of calcium into neurons allows them to work, and the way that the calcium flow is regulated is a pivotal factor in how our brains function.

It is unclear to what extent the results represent what happens in most autism spectrum disorders which are not caused by Timothy syndrome.

The gaps in our understanding of the causes of psychiatric disorders such as autism have made them hard to treat. One of the biggest obstacles to research into autism and other psychiatric and neurological diseases is that scientists can’t get living brain cell samples from people with these conditions, for obvious reasons. The Stanford scientists figured out a solution to this problem, using a novel approach involving what are known as induced pluripotent stem cells, or iPS cells.

“We developed a way of taking skin cells from humans with Timothy syndrome and converting them into stem cells, then converting those stem cells into neurons,” said Ricardo Dolmetsch, PhD, associate professor of neurobiology, who led the study.

Further research will be needed to tell if this rare condition can provide clues to the origins of autism.

One investigation found that proposed revisions to the American Psychiatric Association’s definition would exclude about 75% those currently diagnosed with milder forms of autism.

The proposed revisions, which would come into effect in 2013, are likely to have big repercussions for those who would have once been eligible for services that experts say can improve an individual’s abilities to socialize, learn and ultimately live independently. The changes to DSM-5 have also sparked a broader discussion over the value of a diagnosis for behavior differences, and how to fairly allocate services at a time when resources are dwindling.

Parents are justifiably concerned that any tightening of the autistic spectrum will threaten their children’s eligibility for vital services. A campaign has therefore been launched by The Global and Regional Asperger Syndrome Partnership, Inc. to lobby the DSM-5 task force to keep a broad spectrum concept of autism.  The campaign urges those affected to contact the DSM-5 Committee to protest the newest changes.

Debate has also been rife among medical professionals.  Many divisions of the American Psychological Association have banded together to issue an open letter and petition to the DSM-5 task force and American Psychiatric Association urging that both associations should be working together on any revisions of the DSM and also publicly opposing various aspects of the proposed changes.  The letter states, “Psychologists are not only consumers and utilizers of the manual, but we are also producers of seminal research on DSM-defined disorder categories and their empirical correlates.”

The preliminary draft revisions to the current diagnostic criteria for psychiatric diagnoses are available for public review on the DSM-5 website.  Publication of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders will be in May 2013.  Despite mounting criticism the DSM-5 task force has shown no signs of amending their recommendations for changes to the definition of Autism.

“This is the second recruitment drive for an ongoing study looking to identify biomarkers, or risk-factors,” group leader Associate Professor Andrew Whitehouse says.

A/Prof Whitehouse and his group have found that autism may be linked with enlarged head circumference and prenatal exposure to increased levels of testosterone.

With one in every 100 people around the world affected by autism and the incidence increasing, researchers are working towards in utero detection and intervention that starts at birth.

“Autism is not usually picked up until a child is between two and three years of age, often when a child is not meeting language milestones,” A/Prof Whitehouse said.

“If we could detect autism much earlier, we could start intervention when the course of the brain development is much easier to alter.  We’re also hoping to provide extra training to child health nurses to help them identify warning-signs for autism at check-ups during the first year of life.”

The group will use a new ultrasound technique to image the brain of the foetus as it develops in utero.

“Previously, this imaging could only be achieved with the use of functional Magnetic Resonance Imaging, which is potentially harmful to both mother and child,” A/Prof Whitehouse says.

The researchers will compare brain development and prenatal testosterone levels of 100 “at risk” pregnancies, compromised of pregnant women with a previous autistic child and foetuses at increased genetic risk of autism, with 100 control pregnancies, where the women have had a previous child with typical development.

“If we can see differences between the groups in the level of testosterone or the trajectory of prenatal brain development, we may be able to identify these factors as biomarkers.”

“By identify biomarkers early in life, even prenatal life, we can then determine if a child is at risk of autism and do all the right things from the beginning and perhaps alter the path of brain development.”

Pregnant women who are interested in participating can contact Tammy Gibbs of the Autism Research Team at tammyg@ichr.uwa.edu.au

Some people have attributed the current increase in autism diagnoses to widened criteria for diagnosis rather than any increased incidences. Proposed changes in the definition of autism would drastically reduce the ballooning rate at which the ASDs are diagnosed and might make it harder for many people who would no longer meet the criteria to get health, educational and social services.

The definition is now being reassessed by a panel of experts selected by the American Psychiatric Association. The D.S.M., as the manual is known, is the standard reference for mental disorders, driving research, treatment and insurance decisions. Most experts expect that the new manual will narrow the criteria for autism; the question is how much.  The psychiatrists’ association has the difficult choice of deciding how to make the distinction between unusual and abnormal when defining autism.

Tens of thousands of people receive state-backed services to help offset the disorders’ disabling effects, which include sometimes severe learning and social problems, and the diagnosis is in many ways central to their lives. The proposed changes would probably exclude people with a diagnosis who were higher functioning.

Disagreement about the impact of the changes to the manual will almost certainly increase critical analysis of the finer details of the psychiatric association’s new definition. The revisions are about 90 percent complete and will be final by December, according to Dr. David J. Kupfer, a professor of psychiatry at the University of Pittsburgh and chairman of the task force making the revisions.

“This is a very significant study because it confirms that genetic factors are involved in the cause of the disorder,” said Dr. Peter Szatmari, a leading autism researcher who is the head of child psychiatry and behavioral neuroscience at McMaster University in Ontario. “But it shifts the focus to the possibility that environmental factors could also be really important.”

Little is known about the causes of autism and as recently as a few decades ago, psychiatrists thought autism was caused by a lack of maternal warmth. While it is currently thought that there are genetic explanations, there has been growing acceptance that genes do not paint the whole picture, partially because incidences of autism appear to be increasing faster than our genes can evolve.

“I think we now understand that both genetic and environmental factors have to be taken seriously,” said Dr. Joachim Hallmayer, an associate professor of psychiatry and behavioral sciences at Stanford and the lead author of the new study, which is to be published in the November issue of Archives of General Psychiatry.

Other experts have cited factors like parental age, multiple pregnancies, low birth weight and exposure to medications or maternal infection during pregnancy.

In Dr Hallmayer’s study, the largest of its kind among twins, looked at 192 pairs of identical and fraternal twins whose cases were drawn from California databases. At least one twin per pair had the classic form of autism. In many cases, the other twin also had classic autism or a milder “autism spectrum” disorder like Asperger’s syndrome.

Identical twins share 100 percent of their genes while fraternal twins share only half of their genes. So comparing autism rates in both types of twins can enable researchers to measure the importance of genes versus shared environment.

The study found autism spectrum disorders occurred in both children in 77 percent of the male identical twins and in 50 percent of the female identical twins. As expected, the rates among fraternal twins were lower: 31 percent of males and 36 percent of females.

The researchers concluded that only 38 percent of the cases could be attributed to genetic factors, compared with the 90 percent suggested by previous studies.

And more surprising still, shared environmental factors appeared to be at work in 58 percent of the cases.

There has been some critique of these findings.  “Overall, I think the authors of this study were speculating a lot and their findings go against previous data,” Max Wiznitzer, MD, associate professor of pediatrics and neurology at Case Western Reserve University in Cleveland, Ohio, and pediatric neurologist at Rainbow Babies and Children’s Hospital in Cleveland, told Medscape Medical News.

“There are wide margins of how to apply the information and the authors appear to be leaning in 1 direction when their data could have easily allowed them to go in another,” he added.

“In other words, their conclusions are exceeding what their data can support. It doesn’t support their enthusiastic interpretation of the prominence of environmental factors,” Dr. Wiznitzer asserted.

He pointed to a recent twin study by researchers from Johns Hopkins Medical Institutions.

“Their raw data looked very similar except that they had a higher concordance rate in the twins than this study shows. And they didn’t reach the conclusion that there is a significant environmental factor, which is very interesting,” said Dr. Wiznitzer.

“I don’t think they’re saying anything new. They’re just putting a spin on it. There are a lot of environmental factors out there. But I think all of us would agree that there is still a very strong genetic basis to autism that is different than heritability.”

“I think the big question is this: how do environmental factors interact with the child’s innate genetic infrastructure? Is it just that those with a specific genetic vulnerability are susceptible to the environment? That’s the discussion now,” concluded Dr. Wiznitzer.

Children with Autism were taught how to use Google SketchUp

Researchers at the University of Utah have created a program that helps kids with autism focus on building their skills and utilizing an aptitude for visual-spatial thinking, computers and other electronic media.

Cheryl Wright, associate professor of family and consumer studies, coordinated the workshops in partnership with Google’s Project Spectrum, an initiative to teach job skills to kids with autism. Steve Gross, a certified SketchUp instructor and designer for Universal Creative theme parks, leads the workshops.

Each workshop teaching the 3D modeling software SketchUp was two hours long and included hands-on training as well as time for students to share their design projects. At the end of six weeks, the participants, all boys, presented their designs to classmates at their schools and at community events.

The organizers soon found far greater benefits to these workshops than acquiring a skill set for potential employment.  The sessions facilitated social engagement among the students and their peers, parents, siblings and even grandparents.

The success of the workshops led to greater self-confidence in parents, who began to rethink what they expected of their parenting ability and began to feel more effective.

They also noticed their sons’ sincere concern about friends in the workshops – something that hadn’t happened in other social interactions. The parents and grandparents who noticed these changes began to feel optimistic that the boys would be able to develop genuine relationships with children and adults in the future.