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Autism Spectrum Disorder

Measles: Once Eradicated, Back Again

Vaccination has remained controversial.

The scientific facts illustrate vaccines do not cause autism. In addition, it is inaccurate to think of autism as a single disorder. Autism is rather a spectrum of disorders characterized by different symptoms and their severity. So why do these controversies persist despite the United States Court of Federal Claims’ ruling on three cases that no evidence currently supports a correlation between vaccines and autism spectrum disorders? Individuals who choose to vaccinate, and not to vaccinate (read: anti-vaxxers) have both entered the debate with contention. This heated debate stems from anti-vaccine activists such as Andrew Wakefield; a physician barred from practicing medicine for allegations of scientific misconduct following a failure to replicate or confirm his findings of a correlation between the measles, mumps and rubella (MMR) vaccine and autism. In fact, the former practicing physician directed the anti-vaccine propaganda film Vaxxed: From Cover-Up to Catastrophe. Conspiracy theories interest me but after reviewing the research there comes a time to conclude these unsound controversies – especially when they risk harming others. This is one of those times.

Precautions taken to prevent debate from growing include removing thimerosal from vaccines administered to children. Anti-vaxxers have argued that thimerosal, a mercury-containing preservative, cause autism. Public health officials have dismissed these claims, stating there is a lack of evidence suggesting thimerosal is implicated in the development of autism, still thimerosal has been removed from vaccines in hope of persuading people to vaccinate their children. The heated debate continues along with an increase in reported frequency of measles, a disease once eradicated from America.

Measles is a highly infectious airborne disease spreading rapidly through simple interactions such as coughing or sneezing. Once contracted there is no cure, supportive care can however reduce mortality. America was declared free of circulating measles with approximately 900 recorded cases from 2001 to 2011. In 2014, the Centers for Disease Control (CDC) issued a statement suggesting endemic measles, rubella, and congenital rubella syndrome (CRS) has not returned to the United States apart from some reported cases of measles due to unvaccinated tourists infecting others around them.

In 2014, the anti-vaccination movement began to pick up again. By 2015, from January to April 159 cases of measles were reported by the CDC; 48% unvaccinated and 38% unsure whether they were vaccinated. Measles resulted in pneumonia and subsequently the death of one woman that year, the first fatality from measles in roughly a decade. In 2018, there were 273 reported cases of measles. Recently, from January to February an outbreak resulted in at least 58 confirmed incidents of measles in Clark County, Washington, where there is a higher rate of vaccination exemptions. In fact, 1 in 4 kindergartners have not received vaccinations. The Washington State governor has declared a state of emergency. The cause of the outbreak tied to parents electing not to vaccinate their children.

Outbreaks of measles are still occurring following its eradication from our country. While this may be a heated debate for some, it is life and death for others. Vaccine-preventable diseases still exist around the world and in America, despite their low prevalence. The only disease eradicated completely is currently smallpox. Polio, while close to eradication still exists. With the decision to not vaccinate increasing in number so will the incidence of vaccine-preventable disease. However, viruses move quicker than parents’ ability to decide: what started out as 10 or 50 infected people can become hundreds and thousands.

References

Aleccia, J. (2015, July 03). Undetected measles led to death of Clallam County woman in her 20s. Retrieved from https://www.seattletimes.com/seattle-news/health/undetected-measles-led-to-womans-death/

Ball, L. K., Ball, R., & Pratt, R. D. (2001). An assessment of thimerosal use in childhood vaccines. Pediatrics, 107(5), 1147-1154.

Clemmons, N. S., Gastanaduy, P. A., Fiebelkorn, A. P., Redd, S. B., & Wallace, G. S. (2015). Measles—United States, January 4–April 2, 2015. MMWR. Morbidity and mortality weekly report, 64(14), 373.

Fiebelkorn, A. P., Redd, S. B., Gastañaduy, P. A., Clemmons, N., Rota, P. A., Rota, J. S., … & Wallace, G. S. (2015). A comparison of postelimination measles epidemiology in the United States, 2009–2014 versus 2001–2008. Journal of the Pediatric Infectious Diseases Society, 6(1), 40-48.

Gastañaduy, P. A., Redd, S. B., Fiebelkorn, A. P., Rota, J. S., Rota, P. A., Bellini, W. J., … & Wallace, G. S. (2014). Measles—United States, January 1–May 23, 2014. MMWR. Morbidity and mortality weekly report, 63(22), 496.

Godlee, F., Smith, J., & Marcovitch, H. (2011). Wakefield’s article linking MMR vaccine and autism was fraudulent.

Johnson, K. (2019, February 8). The measles outbreak continues to be an emergency in Washington state. Retrieved from https://www.post-gazette.com/news/health/2019/02/07/outbreak-measles-cases-Clark-County-Washington-state-vaccination-emergency/stories/201902010163

Novella, S. (2016). The anti-vaccination movement. Skeptical Inquirer, 31, 26-31.

Offit, P. A., & Jew, R. K. (2003). Addressing parents’ concerns: do vaccines contain harmful preservatives, adjuvants, additives, or residuals?. Pediatrics, 112(6), 1394-1397.

Schuchat, A. (2015). Measles in our time: the US experience. Future virology, 10(7), 809-812.

Sudfeld, C. R., Navar, A. M., & Halsey, N. A. (2010). Effectiveness of measles vaccination and vitamin A treatment. International journal of epidemiology, 39(suppl_1), i48-i55.

Sugarman, S. D. (2007). Cases in vaccine court—legal battles over vaccines and autism. New England Journal of Medicine, 357(13), 1275-1277.

UNICEF. (1996). Vaccines bring 7 diseases under control. Retrieved from https://www.unicef.org/pon96/hevaccin.htm

Volkmar, F. R., State, M., & Klin, A. (2009). Autism and autism spectrum disorders: diagnostic issues for the coming decade. Journal of Child Psychology and Psychiatry, 50(1‐2), 108-115.

Wakefield, A. (2016). Vaxxed: from Cover‐Up to Catastrophe. Burbank, CA.: Cinema Libre Studio.

Woodard, T. (2019, January 10). Measles, still present after all these years! Retrieved from https://www.akpeds.com/pediatric-peeps/2019/1

Categories
Autism Spectrum Disorder

“Atypical”—Suggestions to Paint a More Comprehensive Picture of Autism Spectrum Disorder

The new Netflix Original—“Atypical” features Sam, a high school senior navigating love and life with Autism Spectrum Disorder.  Autism Spectrum Disorder (ASD) is characterized by, “deficits in social communication and social interaction” (American Psychiatric Association 2013).  It’s no surprise that it adds challenges to the already tricky landscape of a high school social life.  The series does a great job of asserting the point that Sam wants to experience relationships with others, he just might not know how to go about obtaining them. Netflix and Rabia Rashid, the creator and executive producer of the show, had the best of intentions in creating a protagonist with ASD.  Rashid conveys this in her interview with vulture.com when asked about her inspiration for creating a show with a protagonist on the spectrum.  “I was very aware that more people were being diagnosed with autism, and it was interesting to me that a whole generation of kids were growing up knowing that they were on the spectrum and wanting independence” (2017).  It is clear that she wanted to give a voice and representation to group of people who are marginalized in the media, unfortunately, the execution missed the mark in a few areas.  

The Mighty and The Huffington Post explores the show’s shortcomings by interviewing individuals living with Autism Spectrum disorder within their articles, “People in the Autism Community Review ‘Atypical’, Netflix’s Original Series About Autism” and “My Autistic Opinion: Atypical is a Stereotypical Representation of Autism”.  While the general consensus from those interviewed in the articles by The Mighty and The Huffington Post was approval for a number of the show’s qualities, they agreed it left some room for improvement.  As someone who does not experience Autism Spectrum disorder, my initial thoughts on the show were an overwhelming approval for what I thought was a championing voice for the community.  Although, after reading the opinions of people who are actually on the spectrum, I realize that “Atypical” is a far from perfect representation of ASD, despite good intentions.

A common criticism mentioned by several of the individuals was that Sam was a “caricature of autism” which perpetuated many of the harmful stereotypes of the disorder (Staff 2017).  One woman with ASD, Haley Moss, described her feelings on how these stereotypes might have a larger impact on public opinion in the article from The Mighty.  She states, “[the show] hurts us by falsely portraying us as creepy, insensitive, and just really awkward” ( Moss 2017).  Stereotypes in the media like these do truly have an impact on the perceptions of neurotypical people that may not be properly informed on the subject.  It is also very important to keep in mind that not everyone who experiences ASD faces the same challenges, so by using such broad stereotypes, it ultimately reduces the collective experience into a “caricature”.   As Moss points out, “Atypical” could have avoided mistakes like these if a person with Autism Spectrum Disorder was consulted during the production.  Another improvement that could have been implemented was the choice of an actor who has been diagnosed with Autism Spectrum Disorder (Staff, 2017). This decision would have allowed someone in the community to breathe more genuine and authentic qualities into Sam’s character in a nonstereotypical manner.

As with many real-life instances, Sam is often unfairly the source of humor in the show deriving from his perceived lack of insight on social cues and overall communication with others.    Moss is especially worried that the jokes in the show paint Sam as, “…inherently selfish and inconsiderate…” (Moss 2017).  This depiction is not representative of individuals on the spectrum in any way and may lead to further stigmatization.  “Atypical” may benefit the community by deriving humor elsewhere which does not capitalize on Sam’s attempt to connect with people.  This aspect of the show’s shortcomings are particularly harmful in that often times, people with ASD may have difficulty understanding others humor due to a deficit in comprehending social contexts (American Psychiatric Association 2013) .  Therefore, to use Sam as the source of humor in a show that attempts to humanize him is particularly ineffective and damaging.    

All of this is not to say that “Atypical” completely missed the mark.  It is so important to produce narratives surrounding Autism Spectrum Disorder because it is an important step in creating a more understanding atmosphere.  By showing the world this perspective it might inspire empathy and acceptance in others which might have otherwise gone ignored or right out scrutinized. “Atypical” is on the right track, the execution simply needs a few adjustments.

References:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Arlington, VA: American Psychiatric Publishing.

Fernandez, M. E. (2017, August 15). Atypical Creator Robia Rashid on Autism: ‘I Had to Do a Lot of Real Learning’. Retrieved September 24, 2017, from http://www.vulture.com/2017/08/atypical-showrunner-robia-rashid-interview.html

Moss, H. (2017, August 11). My Autistic Opinion: Atypical is a Stereotypical Representation of Autism. Retrieved September 17, 2017, from http://www.huffingtonpost.com/entry/my-autistic-opinion-atypical-is-a-stereotypical- representation_us_598e2e04e4b0ed1f464c0abd

Staff, T. M., Daughter, M. &., Savely, C., Reynolds, B., Flood, T., & Burgess, M. (2017, August 1). People in Autism Community Review ‘Atypical,’ Netflix’s Original Series About Autism. Retrieved September 17, 2017, from https://themighty.com/2017/08/atypical-autism-netflix-review/

 

Categories
Autism Spectrum Disorder

Now Boarding: How Airlines Are Accommodating Those with Autism

Air travel is arguably the most stressful form of travel. From crowded security checkpoints to the constant rotation of delays and cancellations, air travel can present unique challenges for any traveler. Such difficulties can be magnified for those with autism due to the sensory and communicative symptoms related to the disorder. While an airport environment can be incredibly overwhelming for a person with autism, airlines are beginning to recognize and respond to the needs of their travelers with neurological disorders.

The Arc, a Washington D.C. organization which assists those with developmental and intellectual disabilities, coordinates Wings for Autism, a program geared toward helping families of autistic children become familiar with airports and air travel. The program runs as a type of rehearsal; families come to the airport and participate in standard airline procedures such as going through security checks, waiting in the gate area and getting onto a plane. The program does not require any airline commitments or flight tickets.

The program offers the unique opportunity to foresee how a child with autism may react to air travel, giving the family a chance to adjust accordingly. Wings for Autism also serves as an educational tool for airlines. TSA employees are able to spend additional time with children with developmental disabilities and practice their interaction. At the events, TSA officers ask the families for insight on how to best accommodate the needs of children with autism or other intellectual and developmental disorders.

Since 2011, 44 airports have participated in the program, totaling more than 75 individual Wings for Autism events.

Sarah Bal, public relations director for The Arc, emphasized that the program’s primary goal is to acclimate children across the autism spectrum to the airport environment. This includes sounds, procedures, and the general commotion which often comes with air travel. According to Bal, the program has helped over 2,000 families since launching six years ago at the Charles River Center in Needham, Massachusetts (Netto, 2017).

Wings for Autism is an important and useful tool in assuring that air travel for those with autism is as painless as possible. In addition to such interactive programs, airlines are stepping up in other ways to assure comfort and convenience for their travelers dealing with neurological disorders.

In April 2016, Delta Air Lines unveiled a calming room at Hartsfield-Jackson Atlanta International Airport. The room, which was created to ease the airport experience for children with autism and other disorders, features a mini ball pit, tactile activity panel, and a bubbling water sculpture (Baskas, 2017).

A similar quiet room was recently opened at Myrtle Beach International Airport in South Carolina, and the first airport sensory room in Europe launched in March at Ireland’s Shannon Airport. The latter’s accommodations include color changing LED lights, a wheel projector, and an undulated wavy wall.

The combination of Wings for Autism and sensory rooms in airports allows families affected by autism to ease themselves into air travel. The stresses related to air travel are often unpredictable, but these airline accommodations allow the chance to best prepare and deal with the inconveniences that may arise during a trip. Businesses and establishments have a responsibility to accommodate all people to the best of their ability, including those with disabilities, and hopefully, more airlines and airports across the world continue to introduce new ways of assisting their customers.

References:

Baskas, H. (2017, April 12). Friendlier Skies: Airlines Are Making Travel Easier for People with Autism. Retrieved April 26, 2017, from http://www.nbcnews.com/business/travel/friendlier-skies-airlines-are-making-travel-easier-people-autism-n745711

Netto, J. (2017, April 19). Preparing to fly with kids with autism. Retrieved April 26, 2017, from http://www.cnn.com/2017/04/19/health/autism-kids-flying/

Categories
Autism Spectrum Disorder

Could Stem Cells Lead to an Autism Breakthrough?

Duke University recently conducted a first-of-its-kind study that sought to determine whether a transfusion of umbilical cord blood containing rare stem cells could help treat autism. The study included 25 children diagnosed with autism and the results were optimistic; two-thirds of the children, ranging from ages 2 to 6, reported improvements.

The safety trial began over a year and a half ago, which found that umbilical cord blood was not only safe, but 70% of the 25 participants had behavioral advances as described by their parents and tracked by the Duke researchers. The children traveled to Duke three times over the course of a year, and each visit included a series of evaluations including MRIs, EEGs, and autism assessments. The children received the umbilical cord blood infusion on the first visit. Each child received 1 to 2 billion cells, given through an IV in their arms or legs. The subsequent visits occurred six months and one year after the infusion.

Dr. Joanne Kurtzberg and Dr. Geraldine Dawson spearheaded the study. Kurtzberg, head of the Robertson Clinical and Translational Cell Therapy Program, and Dawson, director of the Duke Center for Autism and Brain Development, each saw the intense need for advancements in autism treatments.

Kurtzberg has been studying for years the effects of umbilical cord blood treatments on several disorders, including inherited metabolic disorders and cerebral palsy. In children with cerebral palsy who also exhibited autistic tendencies, their symptoms of autism improved with the treatments. The improvements among children with cerebral palsy gave Kurtzberg the idea to test cord blood specifically for autism.

While both doctors were encouraged by the results of the initial study, they cautioned that plenty of additional research is necessary in order to definitively state whether or not umbilical cord blood treatments improve autism symptoms. Dawson noted the study did not have a comparison group, which she stated is “very important in establishing whether a treatment is actually effective” (Drash & Sanjay, 2017).

Next up is a definitive trial — a double-blind, placebo-controlled trial involving 165 children with autism, ranging in age from 2 to 8. During this secondary phase, the children will receive either their initial umbilical cord blood infusion during their first visit to Duke, or a placebo. A battery of tests, including brain monitoring, will follow.

After six months, the children will receive a second infusion with whatever preparation they did not receive the first time. Known as a crossover trial, subjects receive both a treatment and the placebo, but in a different order. The order of the infusion is not known and researchers say it would be practically impossible to find participants if their parents knew that their children might not receive an infusion.

If this second phase of research shows that umbilical cord blood is effective in improving autism symptoms, primarily social behaviors, Dawson said the finding would be “game-changing”. Again, before any optimism can be confirmed, Kurtzberg reiterated, “we don’t want to mislead people and claim it’s working before we have definitive proof” (Drash & Sanjay, 2017).

And while such definitive proof is still up-in-the-air, these studies should, at the very least, spark hope for the future of autism research. When dealing with research concerning any disorder that lacks a known cause or cure, it is vital to remember that there may be several dead-ends before progress is actually made. Although the Duke study is extremely preliminary, it demonstrates the constant push for more knowledge surrounding autism spectrum disorder. It is this type of research that one day may uncover a breakthrough that could alter the lives of millions of people affected by autism.

References:

Drash, Wayne, and Sanjay Gupta, Dr. “Stem cells offer hope for autism.” CNN. Cable News Network, 05 Apr. 2017. Web. 09 Apr. 2017.

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Autism Spectrum Disorder

The Importance of Representing Autism on “Sesame Street”

Whenever a popular, long-running television show announces a major casting change, it sparks conversation. Whether an audience-favorite is departing, or a buzzworthy addition is being made, viewers keenly follow every casting shakeup. Recently, a television show, nearing its 50th anniversary and over 150 Emmys to its name, got the whole world talking. That show was “Sesame Street”.

“Sesame Street” is set to add Julia, a 4-year-old muppet with autism, to its cast. The announcement reiterates the commitment to a larger educational effort by the nonprofit organization that produces “Sesame Street”, Sesame Workshop. The announcement came with a series of YouTube videos which provided glimpses of the character’s personality and interests. In one video, Julia demonstrates her love of singing by performing “Sunny Days” with fellow cast member Abby Cadabby. Julia will officially join the cast in April.

“Sesame Street” first introduced Julia in a digital storybook in October 2015. At the time, Jeanette Betancourt, Sesame Workshop’s vice president of outreach and educational practices, openly acknowledged the importance of the character. “We wanted to demonstrate some of the characteristics of autism in a positive way,” Betancourt said, adding that breaking down some of the “myths and misconceptions” around the disorder were a priority (Dell’Antonia, 2017).

The addition of Julia to “Sesame Street” brings up the importance of representation in the entertainment industry. Julia is not only the first new muppet to join the cast in nearly a decade, she is also the first muppet to have autism. The inclusion of an autistic muppet gives representation to the millions of children with autism spectrum disorder (ASD) around the world. For the first time, autistic “Sesame Street” viewers will be able to see more of themselves in a character, an incredibly significant development.

For children with ASD, Julia will provide the opportunity to represent their ideals, struggles, and interests. For children not familiar with the disorder, Julia serves as an excellent educational opportunity. By viewing a muppet with ASD on “Sesame Street”, these children will see that while Julia has autism, they can still relate to her. The exposure to a television character that is different than those around her will hopefully demonstrate to children that when they encounter a peer like Julia, they should embrace her as they would anyone else.

It is crucial that children learn to be welcoming and understanding of others who live with ASD or other disorders. One of the most common struggles those diagnosed with ASD experience are the difficulties of picking up social cues, presenting a unique challenge for children beginning to interact with peers for the first time. A 2012 study focused on bullying and children with ASD found that 63% of children diagnosed with the disorder had been bullied. Such a statistic supports the opinion that more education is needed in order to promote acceptance among young people.

That is why the announcement of Julia joining “Sesame Street” is a commendable act. By providing young children the opportunity to watch a character that has autism, “Sesame Street” is living up to its reputation as a leading educational program. Exposure is the introductory step in helping children understand that not everyone looks, sounds, or acts as they do. The more exposure to autism, even through a television program, allows young people the chance to form a better understanding of the disorder.

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Autism Spectrum Disorder

Conspirator-In-Chief: Trump’s Dangerous Views on Autism

Conspiracy theorist: a person who holds a theory that explains an event or situation as the result of a secret plan by usually powerful people or groups (“Conspiracy Theorist,” n.d.).

President Donald Trump is a conspiracy theorist. Throughout his short political career, he has routinely demonstrated a blatant disregard for easily obtainable facts, in exchange for wild explanations and inflammatory ideas. This past January, as Trump prepared to embark on his first term in office, a troubling development occurred at his New York City compound Trump Tower. A meeting with Robert F. Kennedy Jr., a well-known vaccine skeptic, reignited interest in previous statements made by Trump regarding vaccinations and autism.

It is important to note that Trump’s alarming beliefs toward vaccinations were clear long before he sought public office. He first floated the theory that vaccinations are linked to autism during a 2007 interview with Palm Beach Politics stating, “My theory, and I study it because I have young children, my theory is the shots. We’re giving these massive injections at one time, and I really think it does something to the children” (Hafenbrack, 2007). Trump cited no evidence at the time of the interview to support his theory.

Trump continued to hold the belief that there was a link between vaccinations and autism, clearly demonstrated by several tweets sent between 2012 and 2014. None of the tweets provided any scientific support to his statements.

In September 2015, during a Republican presidential debate, Trump again insinuated his disproven belief. There, Trump stated that while he supports vaccines, he wanted “smaller doses over a longer period of time”. He cited no evidence supporting the notion that altering current Centers for Disease Control and Prevention-recommended immunization schedules would have an effect on the rate of autism diagnoses.

During a fundraiser in August 2016, Trump reportedly expressed his skeptical views on vaccinations. Several anti-vaccine advocates, including Andrew Wakefield, who authored the controversial and retracted 1998 study published in The Lancet suggesting a link between autism and the MMR vaccine, attended the donor event. Trump also reportedly received a copy of Wakefield’s anti-vaccination propaganda film Vaxxed: From Cover-Up to Catastrophe at the event.

That brings us to the meeting with RFK Jr. on January 10th; Kennedy emerged from a meeting with the then-President-elect and told the throng of reporters present that he was asked to chair a new commission on vaccine safety. Several hours later, Trump officials countered Kennedy’s statement by stating the President-elect was only considering such a commission, and that no final decisions had been made.  

While speaking with reporters, Kennedy said, “President-elect Trump has some doubts about the current vaccine policies, and he has questions about it” (Phillip et al., 2017). The Trump Administration has made no further comments related to autism since the meeting.

The creation of such a commission would directly contrast the widely established views of the medical community. Through numerous extensive studies, no link has ever been found between vaccines and autism.

In most cases, it would be a stunning development for a president to be so out of touch with modern medicine. For President Trump, however, it is not only unsurprising, but also predictable that the 45th President of the United States would subscribe to such a roundly debunked theory. Throughout the 2016 campaign, Trump continuously touted conspiracy theories and outright lies.

Donald Trump rose to political prominence by pushing the so-called “birther movement”, the idea that former president Barack Obama was not born in the United States. There has never been any evidence produced that suggests Barack Obama was not born in the U.S.

During a campaign rally in November 2015, Trump stated he witnessed thousands of people in Jersey City, New Jersey cheering during the September 11th terrorist attacks. There is no evidence or other witnesses to support this statement.

After the second presidential debate in October 2016, Trump suggested his Democratic opponent Hillary Clinton took performance-enhancing drugs. No evidence was provided.

During the final presidential debate, Trump denied to acknowledge that 17 federal intelligence agencies agreed that Russian hackers were attempting to influence the presidential election stating, “our country has no idea”. Twelve days earlier, the Department of Homeland Security said otherwise.

Trump has asserted that numerous organizations and elections have been rigged against him. From the Emmy’s to the Iowa caucus, if Trump does not win, someone or something must be working against him.

Upon losing the popular vote to Clinton, Trump called into question the validity of the very election that put him in office. While providing no evidence, Trump stated numerous times that upwards of three million people voted illegally. Clinton won the popular vote by nearly the same amount.

Trump stated his inaugural crowd included 1-1.5 million people. The photographic evidence contrasts that estimate.

Most recently, Trump tweeted that Barack Obama ordered a wiretap of Trump Tower during the election. This assertion has since been denied by several government agencies, including the FBI and the Department of Justice.

With these lies and conspiracy theories in mind, it should come as no surprise that President Trump advocates for the discredited theory that there is a link between vaccines and autism. While President Trump claims to support vaccinations, his continual assertion that they cause autism negates that sentiment. You cannot claim to support vaccinations while promoting a baseless theory that they cause a neurological disorder.

Trump almost certainly does not think of the influence his words now hold, as an argument could be made that his own personal beliefs could have a strong impact on his supporters. While what President Trump says regarding vaccinations and autism does not change the facts, it does matter. In a time where alternative facts and fake news have altered the perceptions of some, the words of a president are still significant.

As president, Donald Trump is now in charge of the Centers for Disease Control and Prevention as well as the National Institutes of Health. His personal beliefs are directly at-odds with these institutes, and their ability to protect public health depends on federal funding. President Trump is the most powerful man in the world, and his belief in conspiracy theories holds a weight now that it certainly did not before.

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Autism Spectrum Disorder

What the Brain May Be Telling Us About Autism

Although there continues to be countless questions related to the cause of autism spectrum disorders (ASD), it is undisputed that rates of ASD are higher in males than females. In fact, males are nearly five times more likely to be diagnosed with ASD than females.

Some scientists believe that characteristics of the brain that vary between the sexes may explain the differential appearance of ASD. One primary difference between male and female brains is the thickness of the cortex — the outer layer of the cerebrum that plays a vital role in consciousness. Male brains tend to have a thinner cortex compared to female brains, leading Christine Ecker, a neuroscience professor at Goethe University in Frankfurt, Germany, to begin a new study that examined cortical thickness to determine whether brain anatomy differences were connected to a higher probability of autism in males.

The study, published in JAMA Psychiatry, consisted of Ecker and her co-authors examining brain MRIs of 98 adults with ASD (49 male, 49 female) and 98 adults without the disorder (51 male, 47 female), and comparing the cortical thickness. The research found that the thinner the cortex, regardless of gender, the more likely the person was to have ASD. In women, those with thinner, more “male-like” cortical thickness readings were about three times more likely to have ASD than women with thickness readings expected of unaffected women (Park, 2017).

Ecker’s primary takeaway from the study is the prospect that a thicker cortex in women might provide a defense against developing autism. Understanding the role that cortex thickness plays in developing autism could guide researchers towards more anatomy-specific factors that cause autism, and potentially offer clues about how to treat its symptoms.

In the conclusion of the study, the authors stress that  “In addition to genetic and environmental factors, normative sex-related phenotypic diversity should thus be taken into account when determining an individual’s probability of ASD” (Ecker et al., 2017).  It remains unclear whether a thinner cortex is a direct cause of autism, or simply a symptom of the disorder and thus the normal variations in thickness between male and female brains should be considered.

Looking forward, Ecker hopes to expand on her research to include investigating the potential functional changes the varying thicknesses have on male and female brains to determine if they can be connected to ASD. Ecker also hopes to track the variations in cortex measurements over the lifespans, to see if the male and female differences remain from infancy throughout adolescence or whether they arise later in life.

The release of the study highlights the need for continued research in an effort to determine the cause of ASD. With 1 in 68 children diagnosed today, autism is one of the fastest-growing developmental disorders in the United States with 1 in 42 boys being diagnosed with ASD, a statistic that is the central basis of this new study. Determining why more males are affected by autism than females is an important aspect of autism diagnosis, which may lead to groundbreaking findings on the main cause of the disorder.

References:

Ecker, C., Andrews, D. S., & Gudbrandsen, C. M. (2017). Association Between the Probability of Autism Spectrum Disorder and Normative Sex-Related Phenotypic    Diversity in Brain Structure. JAMA Psychiatry. Retrieved February 12, 2017, from https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2601066?utm_source%20=Silverchair_Information_Systems&utm_campaign=FTM_02062017&utm_conte%20nt=news_releases&cmp=1&utm_medium=email

Park, A. (2017, February 8). Why Autism Affects Boys More than Girls. Retrieved February 12, 2017, from http://time.com/4663196/autism-spectrum-disorder-gender/

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Autism Spectrum Disorder

Vaccination and Autism: The Case for the Flu Vaccine

As fall shifts into winter and temperatures continue to drop, we all anticipate the return of falling snow, cozy sweaters, steaming hot chocolate, and the flu. Yes, the flu, unfortunately, rears its ugly head amongst the charming trademarks of the changing seasons. Caused by the influenza virus, the flu can ruin the holidays by producing a variety of uncomfortable symptoms including cough, fever, body aches, and a sore throat. Since millions of Americans are infected each year, the flu has become one of the most commonly vaccinated illnesses; a new vaccine is produced annually to fight the most prevalent strains of the virus.

While the Centers of Disease Control and Prevention (CDC) recommends everyone six months and older receive a flu vaccine, there have been questions regarding the risks it may pose to pregnant women and their unborn children. As flu season kicks into high gear, a new  study published by JAMA Pediatrics aims to “investigate the association between influenza infection and vaccination during pregnancy and [Autism Spectrum Disorder] risk.

The study examined the health records of children born at Kaiser Permanente facilities in Northern California between 2000 and 2010. Of the more than 196,000 records reviewed, 3,101 children (1.6%) had been diagnosed with autism through June 2015. Among the mothers of the 3,101 children, only 1% had the flu while pregnant, and approximately 23% had received a flu vaccination during their pregnancy (Shute).

The study did not find a correlation between having the flu while pregnant and an increased risk for autism in children. While the study did find a slightly increased risk of autism in the case of mothers who had a flu shot during their first trimester of pregnancy, the number is negligible (Seaman, 2016). In fact, the researchers believe the finding could be due to chance, given the small number of children in that group.

Lisa Croen, senior author of the study and a senior research scientist for Kaiser Permanente, hopes the study will provide reassurance to prospective mothers with lingering doubts about whether the flu or flu vaccine increases the chance for autism. “The way we feel people should interpret this is that there is really not any increased risk for autism,” Croen said upon the study’s release, adding, “and we’re recommending no changes in the vaccine policy” (Shute).

Despite this, Croen also acknowledges that there should be further research regarding the potential link between flu vaccinations and the risk for autism, with a focus on maternal immune responses during pregnancy.

The CDC recommends the annual influenza vaccine as the best line of defense against the illness, and currently recommends that pregnant women receive a vaccination. Contracting the flu while pregnant can pose several risks, including premature birth and low birth weight for the baby. A flu vaccination would not only significantly reduce a mother’s risk of contracting the flu, but it would also protect a newborn during the first few months of life.

The discussion of vaccinations and potential links to autism has become increasingly controversial in recent years. The Humanology Project recently explored the myth linking the MMR vaccine and autism, with the general consensus that vaccines do not cause, or increase the risk of, autism. Much of that sentiment applies to the discussion of the influenza vaccine and autism as well, as the CDC and obstetric and pediatric medical societies ardently maintain that it is completely safe for expecting mothers to receive the vaccine.

The vast majority of medical research is clear: vaccinations are essential to keeping our society healthy, and the benefits of vaccines greatly outweigh the potential risks associated with them. Since pregnancy causes changes in the immune system, heart, and lungs that leave expecting mothers at greater risk for infections and illness, it is imperative they talk to their doctor about the importance of the influenza vaccine.

References:

Seaman, A. (2016, November 28). Flu – or flu vaccine – in pregnancy not tied to autism in kids. Retrieved November 29, 2016, from http://www.reuters.com/article/us-health-flu-pregnancy-autism-    idUSKBN13N2E0?utm_source=34553&utm_medium=partner

Shute, N. (2016, November 28). Flu Vaccine During Pregnancy Not Linked To Autism. Retrieved November 29, 2016, from http://www.npr.org/sections/health-shots/2016/11/28/503592933/

Categories
Autism Spectrum Disorder

The Land of Opportunity: How Companies Are Embracing Autism

Securing your first full-time job as a young adult can be a stressful, often difficult process. Not only do you want to a job in the field of your choice, but you also have to think about how successfully the salary, benefits, and potential experience gained will accommodate your needs. For people diagnosed with autism, the stresses associated with searching for employment are heightened, mainly due to the communicative struggles related to their disorder.

Although autism can present challenges when searching for a job, it is increasingly becoming more of a desired trait in the eyes of hiring companies. Recently started within several large-scale companies, there have been initiatives started within several large-scale companies geared toward creating employment opportunities for autistic people who struggle to find work.

In 2013, German software maker SAP announced its intention to make people with autism 1% of its workforce (approximately 700 people) by 2020. The professional service firm EY launched a program aimed at hiring autistic individuals in their Philadelphia office, with the goal of expanding the program to other cities by 2018 (Zillman, 2016). In April 2015, Microsoft announced a pilot program that sought to hire autistic individuals at its Washington headquarters; their initiative has recently expanded to the United Kingdom.

These companies represent the growing interests within the corporate world to unlock the potential autistic young adults have to offer. SAP, EY, and Microsoft all turned to Specialisterne, a Danish company that trains people with autism for the workplace. These companies work alongside Specialisterne “to develop training and support programs for their interview candidates and new hires, in the hopes that these processes will eventually become organic” (Che, 2016).  These training programs help management engage their potential hires, which is particularly important because people with autism can often misunderstand social cues. The desired outcome for Specialisterne is simple–make the workplace a more inclusive environment.

Aside from the necessary desire for a workplace that promotes inclusion and diversity, there is a genuine business interest in hiring autistic individuals. Lori Golden, who oversees EY’s accessibility programs, in recognizing the business motivations behind these hires, stated that people with autism “often have very strong mathematical and technical abilities” (Zillman, 2016). Golden also highlighted how autistic people can be incredibly detail-oriented, and comfortable with pattern recognition: two qualities that make them attractive candidates for work in a corporate environment.

The need for increased inclusion and opportunity for people with autism in the workforce is crucial, especially when the statistics regarding current unemployment rates for those with the disorder are taken into account. According to a report by A.J. Drexel Autism Institute released in 2015, young adults with autism had lower employment rates than people with other disabilities. Only 58% of autistic young adults in the study were employed, compared to 74% of young people with intellectual disabilities, and 95% with learning disabilities, an alarming gap of 16% and 37%, respectively (Singh, 2015). In addition, over two-thirds of young people with autism had neither a job nor educational plans during the first two years after high school, and this continued into the early 20s for a third of young adults with autism into their early 20s.

Despite these sobering statistics, the inclusive programs that companies like Microsoft and SAP have started in order to recruit autistic individuals are an encouraging step in the right direction. It is of utmost importance that our workforce is as accepting and fair as possible. Regardless of race, gender, age, and yes, disability, everyone should have equal opportunity to find employment. People with autism work hard to overcome obstacles that make it more challenging for them to find work, but once they overcome those obstacles, there needs to be opportunities waiting for them.

References:

Che, J. (2016, March 29). Why More Companies Are Eager To Hire People With Autism. Retrieved November 5, 2016, from http://www.huffingtonpost.com/entry/companies-hiring-people-with-autism_us_56e99cdfe4b065e2e3d82ab4

Singh, M. (2015, April 21). Young Adults With Autism More Likely To Be Unemployed, Isolated. Retrieved November 05, 2016, from http://www.npr.org/sections/health-shots/2015/04/21/401243060/young-adults-with-autism-more-likely-to-be-unemployed-isolated

Zillman, C. (2016, October 26). Autistic? More Companies Say Add It to Your Resume. Retrieved November 05, 2016, from http://fortune.com/2016/10/26/autism-jobs-employment-ey/

Categories
Autism Spectrum Disorder

A Sister’s Perspective

I first met Amanda Ezechi in the fifth grade, when our assigned seats found us next to each other. A friendship quickly developed, and we have remained close ever since. When I first chose to write about autism, I instantly thought of Austin, Amanda’s 18-year-old brother. Austin is autistic, and I have had the pleasure of watching him develop over the years. To shed light on how autism affects more than just the diagnosed individual, Amanda opened up about her brother’s disorder, and the impact it has had on her life.

The Humanology Project: How old were you when you found out Austin had autism? What was that like?

Amanda Ezechi: I was about five years old when Austin was diagnosed with severe autism. He was two-years-old. I don’t really remember how I felt when I first found out. I don’t think his diagnosis had as much of an immediate impact on me as it did my parents. I do remember, quite clearly, the moment I was told that Austin would have to switch schools. My favorite part of the day in preschool was always going downstairs to visit my brother and his nursery class. My teachers let me do it because I would cry until they took me to see him. I think my first experience of heartbreak was learning that I wouldn’t be able to visit him during the school day anymore.

THP: Could you describe some of the therapy Austin has received throughout his life?

AE: My brother was immediately enrolled in the Developmental Disabilities Institute (DDI). DDI is a special school for children on the autism spectrum up until the age of twenty-one. During his first few years at DDI, he was learning a lot of the same things you’d imagine any child his age would be learning in school like reading, forming sentences, and writing. At the same time, was also learning some of the basic skills that typical children would pickup outside of the classroom, like folding clothes, putting food away, and using the bathroom. We were also teaching him a lot of these things at home, but children with autism require a lot more repetition in order to master certain skills.

Austin also started One-to-One Applied Behavioral Analysis, which is an early intervention program specifically for children with autism. A teacher would come to our house and work with my brother for about two hours. The point of this home therapy was to apply what he was learning in school to a home setting.

THP: As you’ve watched Austin grow up, what would you say his biggest challenge has been?

AE: I think my brother’s greatest challenge, and also the most devastating one, is communicating what is bothering him. My brother is generally a very happy kid. He’s extremely expressive; we always know when he is excited, having fun, or even simply pleased with his food. We can also tell when he’s upset, scared, or annoyed. The problem was that it was always difficult for him to tell us the source of his frustration or sadness. He is nonverbal, so abstract or complex feelings were nearly impossible for him to communicate.  [Communicating his frustration] has improved as he’s grown older, and as we’ve gotten used to his way of expressing his emotions.

Sometimes it’s difficult for him to express sadness about a particular situation. After I moved away for college, Austin would walk into my bedroom at home and just sit on my bed sulking, sometimes even crying. At first, no one made the connection as to why he was doing this, but eventually my parents realized it was because he missed me. Now whenever he does this, they call me so I can talk to him on the phone. He’s always happy to hear my voice, but I know it frustrates him that he can’t properly communicate why he is upset in the first place.

THP: Were you ever concerned about how other people would treat your brother because of his disorder?

AE: When he was first diagnosed, I didn’t understand that there was the possibility that he could be treated differently until I watched it happen. I was so young when he was diagnosed, I remember my biggest concern was whether or not we’d be able to play together the way I saw my school friends play with their siblings. My brother was not socializing the same way other children his age were when we were younger. I think what made me want to visit him in school so much was the fact that he was always alone and playing by himself. Apparently when I was a kid I attributed this to his “being too cool for the other kids.” I always knew that if people spent at least five minutes with Austin, they’d fall in love with him immediately. I knew that once they got to know him, they would treat him with respect and compassion because that’s how he treats everyone. The real concern for me was that people would use his autism as an excuse to not get to know him.

THP: How was your family impacted by Austin’s diagnosis?

AE: It’s impossible for any family to not be radically transformed after a child is diagnosed with a developmental disability, and I think anyone who says otherwise is lying. We all had our different reactions to my brother’s diagnosis. It’s definitely a test of resilience. There’s always the temptation to wallow in pity or to get lost in denial. I think all of us—my father, mother and I—did our fair share of both. It takes a toll on the family. Every time you reach a milestone, you have to be prepared for the next set of roadblocks.  

Looking back, I really see the detriment of us all not always being on the same page [in regards to] the best way to get past those roadblocks. It’s tough because there is no medication to take for autism and there is no step-by-step guide on how to deal with an autistic child. A lot of it is following your gut instinct, but every decision you make, as rational and pragmatic as it may be, is fueled by emotion—love and fear. Navigating this has been really hard, and we’re still not always on the same page.

THP: Would you say it’s made your family stronger or…

AE: Absolutely. The test of resilience has made us stronger. That sounds so cliché, but it’s honestly so true. There is still the temptation to let the pain that comes with [autism] take over. At the same time, I think my family quickly saw that focusing on all the joy my brother brought into our lives was much more fruitful. I’m not saying that we decided to just look on the bright side and ignore the negatives, because you can’t. You really need to look at the reality of the situation in its totality in order to move forward. We just realized that when we looked at the reality of the situation, we were beyond lucky to have Austin in our lives.

THP: What is your favorite memory with Austin?

AE: My parents love music, so there was always music playing in our house. They used music to teach us everything. We listened to and sang along to every genre. I think Motown is Austin’s favorite genre. My proudest childhood accomplishment was getting him to dance and sing along to every Jonas Brother song with me, much to my parents’ dismay. My brother and I were singing songs before we were talking and this was so important for our relationship.

My brother has a phenomenal memory when it comes to music. He can reproduce any song after hearing it once. This would actually sometimes frustrate me because I would take lessons to be able to do what he could do, and he was just born with this ability. We used to play this game where I would start to hum any song, and I would honestly pick the most obscure songs, and after one line he would finish the verse. We would run around the house playing this game; he absolutely loved it. We still play it to this day.

THP: Autism is increasingly more common, and yet, people may not know much about the disorder. What is the one thing you want people to know about autism?

AE: I think I’ve learned more about life and humanity from my brother than anyone else. My brother has this overwhelming desire to welcome and love everyone he meets. I think I can speak for my whole family, and anyone who has had the pleasure of knowing Austin, when I say that his joy and compassion forces you to reciprocate and pass it on. I’ve been lucky enough to work with other children at DDI over the years, and each of them have taught me to pay more attention to the simple beauties of life. My brother looks at everything with wonder. In his eyes, everything has the potential to be magical. Children with autism still have a certain innocence about them. Growing up around that outlook transforms your perspective of the world, so long as you let it. Perhaps this sounds idealistic, maybe even borderline utopian, but I sincerely believe that people would be monumentally happier, and the world significantly better, if everyone could learn to look at life the way children with autism do.

 

This interview has been edited and condensed.