As many of you may be aware, the US Preventive Services Task Force (USPSTF) released a draft report last month indicating that there is not sufficient research evidence to support early universal screening for ASD in children three years of age and younger. Through the process of universal screening, all children are screened at their well-child visit, including those who appear to be “asymptomatic” because no red flags are observed and/or mentioned by parents and/or providers.  The report acknowledged that the current screening tools available are effective in detecting ASD in toddlers and young children, and that early treatment of ASD leads to improved outcomes. However, they note that the treatment studies have not been conducted specifically with children who were identified through the process of screening; therefore, there is no direct line of evidence indicating that early detection through screening itself leads to better outcomes for those children with ASD.

The final recommendation statement from the USPSTF will be released following a review of the public comments to this draft report (comments are invited as part of the process). Many organizations, including the American Academy of Pediatrics, Autism Speaks, Autism Science Foundation, and Baby Siblings Research Consortium, submitted compelling arguments for the importance of early screening and intervention, and the challenges (financial, logistical, and ethical) of conducting the randomized clinical trial research that would provide the “missing link” between screening and improved outcomes. The AAP, for example, continues to stand behind its Bright Futures Guidelines, which recommend universal ASD screening using a validated tool at children’s 18- and 24-month well-child visits. We hope that USPSTF will give these comments their careful consideration prior to issuing their final report.

This NY Times article provides some additional insight into the USPSTF draft report and its potential implications.

The Lewis County Autism Coalition is hosting its 5th Annual Autism Conference on Friday, October 16th, 2015 from 9:00 am – 4:00 pm in Chehalis. This year the conference theme is Transitions: Pathways from Infancy to Adulthood, and Dr. Gary Stobbe of Seattle Children’s Autism Center will be presenting the keynote address. Similar to previous years, conference-goers will have the opportunity to attend informative workshops and a vendor fair, and the program is geared toward parents and professionals alike. Click here to register.

The READi Lab is proud to support this conference, and excited about our partnership with Lewis County for the Screen-Refer-Treat project. Come visit us at the vendor fair!  

We are happy to welcome Allycen Kurup as the newest member of the READi Lab team.  A Seattle native, she recently graduated from UW with a degree in Psychology, where she spent time working in an experimental lab examining children’s social cognition. Allycen will now be applying her previous research experiences to our community-based Screen-Refer-Treat (SRT) study as a research study assistant. She will act as liaison to some of the counties in the SRT study and facilitate the research activities for providers and caregivers, so some of you may be seeing her soon!

For more information about Allycen or the rest of the READi Lab Team, visit the About Us section!

The READi Lab is continuing to make clinical and research tools available for download from our website.  Our latest addition is the Motor Imitation Scale (MIS), which was developed by Dr. Stone to measure elicited imitation skills in young children with ASD.  These materials are located in the Tools & Materials section under the Tips and Resources tab.  We’ll keep you posted as new tools are uploaded.

If the baby pumpkins are growing, it must mean that school will be starting soon. Here are some tips for making the transition from summer fun to school fun easier for children with ASD and their families!

 

READi Lab researchers Lisa Ibanez and Devyani Gupta visited Yakima this week to meet with early intervention providers at Children’s Village and primary care physicians who are participating in the SRT study.  While there, they managed to visit some wineries and take in some scenic views of the region. Our lab members are now jockeying for position as the lucky person who will accompany Lisa on her next visit!

Drs. Wendy Stone and Lisa Ibañez are co-authors on a study published recently in Developmental Psychology, which examined positive emotional engagement at 6 months of age in high-risk infants later diagnosed with ASD (HR/ASD infants; n= 11), high-risk infants without later ASD (HR/noASD infants ; n= 32), and low-risk infants (LR infants, n= 25). At the 6-month visit, infants and their parents completed the Face-to-Face Still-Face Protocol (FFSF), during which parents played with their infants for 3 minutes (i.e., face-to-face [FF] episode), then stopped interacting and maintained a neutral expression for 2 minutes (i.e., still-face [SF] episode), and finally resumed interacting with their infants for 3 minutes (i.e., reunion [RE] episode). Positive emotional engagement was examined during the two interactive episodes (i.e., FF and RE) as infants’ smiling rate (i.e., number of smile onsets per minute) as well as contingent responsiveness (i.e., the proportion of parent smiles to which infants responded with a smile); parents’ smiling rates and contingent responsiveness to their infants’ smiles were also examined during the two episodes and there were no differences between the three groups of parents. Diagnostic outcome was assessed for all infants at 36 months of age through a gold-standard ASD evaluation conducted by a licensed child psychologist.

For infants’ smiling rate, there was a significant decline between the FF and RE episode for LR infants only; HR/noASD infants exhibited a similar, but attenuated decline and HR/ASD infants exhibited no reduction across the episodes. It appears that LR infants may have been more sensitive than the HR groups to their parents’ non-responsiveness during the SF episode, which subsequently depressed their positive affect sharing during the RE episode. While infants’ levels of contingent responsiveness did not differ across the two episodes, HR/noASD infants  exhibited significantly lower overall levels of contingent responsiveness than LR infants, but comparable levels to HR/ASD infants. These findings suggest that lower levels of positive emotional engagement among HR infants may be related to increased familial risk for ASD and not specifically to later ASD, which parallels findings from some of our previous studies examining shared positive affect within the first two years of life in HR infants (Gangi, Ibañez, & Messinger, 2014; Nichols, Ibañez, Foss-Feig, & Stone, 2014).

We’d like to extend special thanks to our collaborators at the University of Miami, who are the lead authors on this article, and to all of the families who participated and remained dedicated to this study over the course of almost 3 years!

Article Reference:
Lambert-Brown, B. L., McDonald, N. M., Mattson, W. I., Martin, K. B., Ibañez, L. V., Stone, W. L., & Messinger, D. S. (2015). Positive emotional engagement and autism risk. Developmental psychology, 51(6), 848-855.

 

 

The READi Lab welcomes Devyani Gupta as the newest research study assistant on our team. Devyani is a recent graduate from Whitman College, who will be putting her Spanish-speaking skills to use as she works on the many different aspects of our community-based Screen-Refer-Treat study. She will also have the opportunity for some “play-time” when she becomes one of the assessors for our ImPACT study in the near future.

For more information about Devyani or the rest of the READi Lab team, visit the About Us section!

 

With the aim of reaching Spanish-speaking families throughout the world, Autism Speaks recently partnered with the Carlos Slim Foundation (CSF) for the translation of many of its free, online tools and resources into Spanish. The CSF is a philanthropic organization based in Mexico with a mission of improving global health for some of the worldʼs most vulnerable populations. CSF will be working with families and experts in Mexico during the translation process to ensure that the materials are accurate and culturally appropriate. Among the materials that will be translated are over 40 Autism Speaks tool kits, which cover a broad range of topics relevant to families and providers, including the 100 Day Kit, a guide for parents of recently diagnosed children, as well as materials on ASD treatments, advocacy, and managing behavioral challenges. These Spanish-language tool kits will start becoming available to the public later this year!

To learn more about this exciting partnership, check out the Autism Speaks press release.

 

 

Results of a recent study suggest that children with ASD may have an altered olfactory (sniffing) response. The sniff response is thought to be controlled by “internal action models,” a brain mechanism whereby motor actions are initiated and refined automatically, based on sensory expectations. In the case of olfaction, work with adults has demonstrated that the strength of a sniff is automatically modulated in response to the valence of the odor, with pleasant odors eliciting stronger sniffs and unpleasant odors eliciting weaker sniffs.

The current study measured the sniff response in 18 children with ASD and 18 typically developing (TD) children ranging in age from 4 to 11 years. The authors designed a cannula that delivered a series of pleasant and unpleasant odors directly into the child’s nose and measured the sniff response to each. The procedure took 10 minutes and was conducted while the child watched a cartoon. Results indicated that the TD children, as a group, showed an “adult like” sniff response, whereas the group of children with ASD failed to modulate their sniffs in response to the unpleasant odors. In addition, in the ASD group, longer sniff durations for unpleasant vs. pleasant odors were associated with ASD severity. 

The authors propose that this measure of olfactory response may have value in identifying early risk for ASD, in that it is brief and language-free. However, additional research is needed to determine whether this altered olfactory response is specific to ASD and whether the same patterns are found for younger children.

Long ago, in a faraway place, some practical tools and materials were born of clinical necessity.  We are pleased to offer access to two such tools in the ‘Tips & Resources’ section of the READI Lab website: the TRIAD Social Skills Assessment (TSSA) and the Visual Supports Booklet. Both were developed by Wendy Stone, in collaboration with colleagues and graduate students at the Vanderbilt University Treatment and Research Institute for Autism Spectrum Disorders (TRIAD).  Dr. Stone founded TRIAD in 1998 and served as its director until joining the University of Washington Department of Psychology in 2010 and creating the READi Lab.

Find out how families can get involved.

It is exciting to start up new research projects, but it also takes preparation and training. Our team needs your help as we learn new play-based assessments. 

Researchers at UCSF conducted a study to better understand the relation of sensory dysfunction to ASD. This group examined both auditory (i.e., sound) and tactile (i.e., touch) processing in three groups of 8-12 year old boys: 20 with ASD, 15 with a diagnosis of sensory processing dysfunction (SPD) from an occupational therapist, and 19 with typical development. The auditory processing test measured dichotic listening (i.e., hearing and repeating different numbers simultaneously), temporal patterning (i.e.,  pitch perception of high and low tones), and auditory discrimination (i.e., auditory filtering of non-sense syllables presented amid background noise). The tactile tasks measured tactile detection (i.e., least force required to detect touch), sensitivity (i.e., shortest distance where two prongs placed on the finger are still detected as two separate points instead of just one), form discrimination (i.e., detection of the directional orientation of a grating pressed against the finger), and proprioception (i.e., detection and recreation of designs drawn on both hands). On the tactile processing tasks, both the ASD and SPD groups exhibited impairments on right-handed proprioception relative to the TD group, and the SPD group also had weaker tactile detection relative to the other two groups. On the auditory processing tasks, the ASD group showed weaker performance than both the TD and SPD groups. Furthermore, for the ASD group, auditory processing was significantly associated with parental reports of the child’s verbal communication. Overall, the findings suggest that difficulties in tactile processing are shared between the ASD and SPD groups, but auditory processing impairments may be unique to ASD and contribute to the development of ASD symptomatology.

To learn more about the study, read the Simons Foundation Autism Research Initiative’s article. 

 

NIH Funds New Study to Refine Measurement of Social Behavior and Treatment Response in Children with ASD

On Monday, NIH announced a four-year, $28 million grant that will fund 5 academic centers to develop new tools to more precisely measure changes in core ASD symptomatology. These novel measures, which include eye tracking responses and measures of brain activity (EEG) will be combined with genetic analyses to better evaluate the clinical effects of different interventions or treatments for children with ASD. The study is supported by the Biomarkers Consortium—a public-private research partnership— which employs a “precision medicine” approach to develop targeted technologies and treatments for ASD by combining information about an individual’s genes, environment, and lifestyle.

For the current study, researchers will first develop new lab-based measures to assess changes in social functioning and impairment over time and compare them to the gold-standard clinician and caregiver assessments of social function. Once these lab-based measures have been validated, the projects will examine the extent to which eye tracking and EEG relate to these lab-based measures of social function.

UW is one of the 5 sites funded to conduct the project, with Dr. Raphael Bernier serving as the lead researcher. This project will be recruiting preschoolers (3-5 years) as well as school-aged children (6-11 years) with and without ASD.

For more information about this project and the Biomarkers Consortium, click here. Families interested in participating can go online at www.asdbiomarkers.org or http://depts.washington.edu/rablab or call 206-616-2889.

Hailing from Michigan State University, Dr. Brooke Ingersoll paid a special visit to the READi Lab this week to discuss the ImPACT research project that we are conducting in collaboration with Vanderbilt University. Dr. Ingersoll developed the ImPACT program (Improving Parents as Communication Teachers), which blends developmental and naturalistic behavioral intervention strategies to help parents improve their child’s social engagement, language, imitation, and play. In this photo, Dr. Ingersoll (4^th from left) spends some time with our ImPACT team to share insights, provide feedback, and brainstorm ideas for future collaborations.

Dr. Ingersoll currently conducts research in the Autism Research Lab at Michigan State University. She is also the developer of Reciprocal Imitation Training (RIT), which READi Lab staff have taught to over 400 providers in Washington State, and which is also a component of our NIMH Screen-Refer-Treat study.  For more information about the ImPACT research project, or other READi Lab research, click here.

The READi Lab enjoys America’s favorite pastime, but loves spreading autism awareness even more! On Sunday, July 12th, the Seattle Mariners teamed up with Autism Speaks Puget Sound/Oregon for Autism Awareness Day at the Ballpark.

Over 40,000 baseball fans came out in support of Sunday’s game, and ticket proceeds will be used to support autism awareness and research. Baseball fans had an opportunity to stop by the resource fair, located just above the bullpen, to get a Seattle Mariners autism awareness bracelet and talk with local and national organizations about autism resources and research in the Pacific Northwest.

Daniel Tiger, from the PBS children’s show ‘Daniel Tiger’s Neighborhood’, is any preschooler’s instant best friend — an engaging peer who is easy to relate to. What’s special about Daniel is that he provides child-friendly lessons on important social skills, such as perspective-taking, social understanding, and self-regulation. The show is filled with catchy phrases and songs that can help children – with or without autism – navigate the complex arena of social interactions. In the New York Times blog, Motherlode, a parent of a child with autism shares the personal and transformative journey that her son and family have taken, after adopting Daniel Tiger as their social-codes guru. Click here to read more!”

Grab your popcorn, snacks, and put on your goggles in search of the world’s biggest, baddest villain! AMC Theaters across the country are offering sensory-friendly film showings on a monthly basis for children with ASD and other special needs. The sound will be turned down, the lights will be up, and the audience is welcome to walk around, shout, or sing!

The next monthly showing is MINIONS, on Saturday 7/18 at 10 AM. This film will be shown in four AMC locations in Seattle (Cascade Mall 16, Kent Station 14, Lakewood Mall 12, and Woodinville 12) and one in Spokane (River Park Square 20). For more information and future showings, visit the AMC site. Show times and dates are subject to change, so don’t forget to call the theater beforehand to verify dates and times for films.

A recent population-based cohort study – the largest one to date — analyzed Swedish birth records from 1982-2010 to examine the link between Cesarean section (C-section) births and autism. The results from this cohort of 2.7 million live births confirmed previous findings of higher rates of autism in children born by C-section; children born by C-section were 21% more likely to have autism than those with unassisted vaginal births, even after controlling for confounding risk factors such as prematurity.

But these researchers went one step further. They also studied 13,411 pairs of siblings in which only one had autism. Within this group, there were 2,555 sibling pairs in which one had a C-section delivery and the other had an unassisted delivery. In this sibling control sample, they did not find an association between C-sections and autism; that is, children born by C-section were no more likely to have autism than their counterparts with unassisted births. These results suggest that C-sections alone do not cause autism; rather, it is more likely that the presence of unknown genetic and/or environmental factors contribute to the increased risk of both autism and C-sections.

To learn more, you can read Autism Speaks’ coverage of the study.