Study: Some autistic kids recover

Some children diagnosed with autism recover completely, according to a study in the Journal of Child Psychology and Psychiatry. A team led by Deborah Fein of the University of Connecticut at Storrs evaluated the social and communications skills of 34 people who had been diagnosed as autistic before the age of 5 and no longer had any symptoms. They ranged in age from 8 to 21 years old.

The “optimal outcome” group did just as well in socialization, communication, face recognition and most language measures as the “typical development” control group. Early in their development, the optimals displayed milder social deficits than others in the high-functioning autistic range, but had “equally severe difficulties with communication and repetitive behaviors.”

“They no longer qualified for the diagnosis,” Dr. Fein told the New York Times. “I want to stress to parents that it’s a minority of kids who are able to do this, and no one should think they somehow missed the boat if they don’t get this outcome.”

Researchers have long known that between 1 and 20 percent of children given an autism diagnosis no longer qualify for one a few years or more later. They have suspected that in most cases the diagnosis was mistaken; the rate of autism diagnosis has ballooned over the past two decades, and some research suggests that it has been loosely applied.

The new study should put some of that skepticism to rest.

In 1987, “the pioneering autism researcher O. Ivar Lovaas reported that 47 percent of children with the diagnosis showed full recovery after undergoing a therapy he had devised,” reports the Times. “This therapy, a behavioral approach in which increments of learned skills garner small rewards, is the basis for the most effective approach used today; still, many were skeptical and questioned his definition of recovery.”

My niece is a behavioral therapist working with autistic children. Her clients are not high functioning.

 

Autism and violence

Adam Lanza had Asperger’s Syndrome and a personality disorder, his brother reportedly said. Can autism explain the Sandy Hook tragedy? asks Amy S. F. Lutz in Slate Magazine. Overall, people with autism are less likely to commit crimes than “neurotypicals.” Very few plan and execute an attack, as Lanza did.

However, some erupt in short episodes of violence: “Studies have found that up to a staggering 30 percent suffer from aggressive and/or self-injurious behaviors of varying degrees.”

As president of EASI Foundation: Ending Aggression and Self-Injury in the Developmentally Disabled, Lutz helps “many families struggling to manage their autistic children’s dangerous behaviors.”

Autism alone doesn’t lead to violence, writes Lutz. The problem is autism plus a psychiatric disorder.

One 2008 study by scientists at King’s College London found that 70 percent of their young autistic subjects had at least one co-morbid disorder, such as childhood anxiety disorder, depressive disorder, oppositional defiant and conduct disorder, or ADHD. Forty-one percent had two or more co-morbid disorders. . . . A 2008 review by Stewart S. Newman and Mohammad Ghaziuddin reported that “an overwhelming number of violent cases had co-existing psychiatric disorders at the time of committing the offence”—84 percent, to be precise. And Newman and Ghaziuddin couldn’t rule out personality disorders, such as anti-social personality disorder, in the remaining subjects.

School shooters “are almost always mentally or emotionally ill,” said Katherine S. Newman, author of the 2004 book Rampage: The Social Roots of School Shootings in a CNN editorial.

. . . those of us who care for a person on the autism spectrum . . .  need to watch for those secondary psychiatric disorders our loved ones are vulnerable to. Often, parents and clinicians assume that patients are anxious or depressed or manic or aggressive because of their autism, when in fact those symptoms may have a different etiology. . . .  it was only once my son was diagnosed with bipolar disorder and treated accordingly that the frequent, unpredictable, and intense rages that characterized his childhood finally subsided.

 People with Asperger’s Syndrome and their parents are very worried about being seen as cold-blooded killers. On I Speak of Dreams, Liz Ditz rounds up reactions from people with autism, parents and others.

It’s a bit off topic, but everything you thought you knew about autism is wrong, writes Bookworm in a review of Ido in Autismland, a collection of essays by a 16-year-old boy who doesn’t speak but learned to communicate with a letter board. Ido Kedar also blogs.

Do charters serve fewer disabled students?

Charter schools are doing a better job serving special-needs students than reported, according to a New York State Special Education Enrollment Analysis by the Center on Reinventing Public Education.

Nationwide, charters serve fewer special-ed students, according to a General Accounting Office (GAO) report. However, the New York study finds “important variations in the enrollment patterns of students with special needs,” said Robin Lake, CRPE director.

In New York, charter middle and high schools enroll more special-needs students than district-run schools, according to CRPE. Charter elementary schools enroll fewer.

Some district-run elementary schools offer programs for special-needs students, the report noted.

Charter schools at the elementary level might also be less inclined to label students as needing special education services. This raises a troubling question: are charter schools under-enrolling or under-identifying students with special needs, or are district-run schools over-identifying them?

Instead of setting statewide special education enrollment targets, policy makers should set “school or regional targets that pay careful attention to those very specific factors that influence such enrollment choices as locations, grade-spans, and neighborhoods,” the report advises.

Setting targets assumes that every school should include the same percentage of disabled students. I’d like to see more schools (charter or district-run) designed for students with specific special needs, such as attention deficit disorder or autism, and more designed for academically gifted students.

New autism definition excludes many

new definition of autism – renamed autism spectrum disorder — proposed by the American Psychiatric Association could exclude 45 percent of those now diagnosed as high-functioning, reports the New York Times. People with Asperger’s Syndrome, Pervasive Developmental Disorder and mild autism could find it harder to qualify for health, educational and social services.

Autism spectrum diagnoses have skyrocketed in recent years. The new definition could end the surge, said Dr. Fred R. Volkmar, director of the Child Study Center at the Yale School of Medicine.

 

Math prodigy: Autism is key to success

A young math prodigy tells 60 Minutes he’s proud of his autism and considers it a key to his success. At 13, Jake Barnett is a college sophomore.

Autism linked to educated parents

Autism “is more a surge in diagnosis than disease,” concludes the Los Angeles Times. Statewide, 1.1% of California elementary students have been identified as autistic, but rate is much higher in affluent communities than in rural districts.

. . .  the number of students receiving autism services, including speech, behaviorial and other therapies, has grown fivefold since 2000, driving up special education costs even as school budgets are being slashed.

“Warrior parents” who fight for services get much more help, adds the Times.

For autistic children 3 to 6 — a critical period for treating the disorder — the state Department of Developmental Services last year spent an average of $11,723 per child on whites, compared with $11,063 on Asians, $7,634 on Latinos and $6,593 on blacks.

. . . The divide is even starker when it comes to the most coveted service — a behavioral aide from a private company to accompany a child throughout each school day, at a cost that often reaches $60,000 a year.

In the state’s largest school district, Los Angeles Unified, white elementary school students on the city’s affluent Westside have such aides at more than 10 times the rate of Latinos on the Eastside.

My niece provides after-school therapy for children on the autism spectrum. She plans to earn a doctorate in psychology and specialize in the field.

The Education Commission of the States reviews state efforts (pdf) to help students with autism, notes On Special Education.

A ‘tsunami’ of disabled students

Community colleges are seeing a “tsunami” of students with intellectual and physical disabilities. Some colleges offer special programs for students with developmental disabilities or autism.

Also on Community College Spotlight: Why do so many “proficient” high school students end up in remedial math?

A ‘tsunami’ of disabled students

Community colleges are seeing a “tsunami” of students with intellectual and physical disabilities.  Some colleges offer special programs for students with developmental disabilities or autism.

Also on Community College Spotlight: Why do so many “proficient” high school students end up in remedial math?

Korea: 1 in 38 kids have autistic traits

Autism diagnoses — including children somewhere on the “autism spectrium” — are soaring. Is it a real rise or a change in diagnosis?  Korean researchers say 1 in 38 children have autistic traits; two-thirds attend mainstream classes and receive no special help.  This looks like seek and you shall find.

Retracted autism study an ‘elaborate fraud’

A now-retracted study linking autism to vaccine was an “elaborate fraud,” concludes an investigation published by BMJ, a British medical journal.

The study’s author, Dr. Andrew Wakefield, “misrepresented or altered the medical histories of all 12 of the patients whose cases formed the basis of the 1998 study,” charges investigator Brian Deer. Of the 12 cases in Wakefield’s paper, five showed developmental problems before receiving the MMR vaccine and three never had autism, said Fiona Godlee, the journal’s editor.

Wakefield received $674,000 from lawyers hoping to sue vaccine manufacturers, BMJ reports.  He also hoped to make money from  diagnostic and other tests for autism and MMR-related issues, said Godlee.

Wakefield was stripped of his medical license earlier this year.

“Meanwhile, the damage to public health continues, fueled by unbalanced media reporting and an ineffective response from government, researchers, journals and the medical profession,” BMJ states.

The now-discredited paper panicked many parents and led to a sharp drop in the number of children getting the vaccine that prevents measles, mumps and rubella. Vaccination rates dropped sharply in Britain after its publication, falling as low as 80 percent by 2004. Measles cases have gone up sharply in the ensuing years.

Measles cases are up in the U.S. as well, according to the Centers for Disease Control and Prevention. More than 90 percent of those infected had not been vaccinated or their vaccination status was unknown.

“But perhaps as important as the scare’s effect on infectious disease is the energy, emotion and money that have been diverted away from efforts to understand the real causes of autism and how to help children and families who live with it,” the BMJ editorial states.

Evidence of fraud isn’t likely to change the minds of true believers. The damage continues.