Monday, February 23, 2015

Presentations of Anxiety in ASD



Anxiety occurs in about 40%-60% of children diagnosed with Autism Spectrum Disorder (ASD), yet clinicians aren’t exactly sure how the symptoms present and how to treat them.

A recently completed study study by a team at the Center for Autism Research (CAR), suggested that individuals with ASD experience anxiety in two ways.

They hypothesized that some children with ASD experience traditional anxiety. These behaviors are the ones mental health specialists see on a regular basis, such as everyday worries, generalized anxiety, and separation anxiety.

They also hypothesized that some children experience atypical anxiety. These behaviors are ones not commonly seen in anxiety disorders, but cause high levels of distress for children with ASD. Atypical anxiety includes symptoms such as excessive worry about changes in routine, anxiety about knowing what to expect, or worry about very specific topics (the time, following rules, etc.). For a subset of individuals with ASD, these worries can be debilitating. 

The scientists found that of the participants, 63% presented with impairing anxiety. Of the 63%, 17% had traditional anxiety symptoms, 15% had atypical symptoms, and 31% had both.

The children who had traditional anxiety were more likely to be anxious thinkers, have sensory hypersensitivity, and have strong language ability. The severity of their ASD diagnosis did not play a role.

The results suggest that youth with ASD express anxiety in ways similar and dissimilar to children without ASD. This has implications for how we identify, treat, and study anxiety disorders in ASD. If we rely only on traditional definitions of anxiety, we may miss the opportunity to understand and treat some of the atypical anxieties facing children with ASD.  


Source: Kerns, C.M., Kendall, P.C., Berry, L., Souders, M.C., Franklin, M.E., Schultz, R.T., Miller, J., and Herrington, J. (2014). “Traditional and Atypical Presentations of Anxiety in Youth with Autism Spectrum Disorder.” Journal of Autism and Developmental Disorders, 44(11), 2851-2861. doi: 10.1007/s10803-014-2141-7

Friday, February 20, 2015

Spring 2015 Autism Events in Greater Philadelphia



There may be snow on the ground, but spring is just around the corner! Spring is a busy time for autism events in the Greater Philadelphia region. Here is a sampling of what’s coming up!

Thursday, February 26th
Hosted by the Center for Autism Research at CHOP

Thursday, March 5th
Hosted by the Montgomery County Intermediate Unit

Monday, March 9th
Hosted by the Center for Autism Research at CHOP

Thursday, March 12th
Hosted by the Asperger & Autism Alliance for Greater Philadelphia (ASCEND)

Wednesday, March 25th
Hosted by the Center for Autism Research at CHOP

Hosted by the A.J. Drexel Autism Institute

Saturday, March 28th
Hosted by the Bucks County Autism Support Coalition

Sunday, March 29th
Hosted by the Asperger Autism Spectrum Education Network

Wednesday, April 2nd
Resolution 62/139 of the United Nations General Assembly

Date TBD
8th Annual Autism Expo
Hosted by the Philadelphia School District

Saturday, April 11th
Hosted by the Autism Institute of Gwynedd Mercy University

Sunday, April 12th
Hosted by the Autism Society of Greater Philadelphia

Saturday, April 18th
Hosted by Autism Speaks

Hosted by Autism Speaks

Friday, April 24th
Hosted by Penn Behavioral Health and Philly AIMS

Saturday, April 25th
Hosted by the Philadelphia Phillies

Sunday, April 26th
Hosted by the Philadelphia Eagles and the Center for Autism Research at CHOP

Wednesday, April 29th
Hosted by the Center for Autism Research at CHOP

Thursday, May 14th
Hosted by ASCEND

Saturday, May 16th
Hosted by Autism Speaks

Tuesday, June 9th through Thursday, June 11th
Hosted by the Pennsylvania Department of Public Welfare’s Bureau of Autism Services




Monday, February 9, 2015

Twenty-Year Outcome for Individuals with ASD



Past research on adults diagnosed with Autism Spectrum Disorder (ASD) with average or near-average IQ scores have found a great variability in their outcomes (job, living independently, and friendships). To learn more about these outcomes, researchers at the University of Utah interviewed the parents of adults with ASD – average age was 33 years old - who had participated in a study twenty years earlier.

After conducting interviews with the parents of the participants, the researchers rated their job status, living situation, and number and quality of friendships as “Very Good,” “Good,” “Fair,” “Poor,” or “Very Poor.”

They found that this sample had comparable or better outcomes in adulthood than other samples with similar IQ scores. Half of the adults received ratings of “Very Good” or “Good” on a global outcome measure that combined across all the domains.

Stable or improved IQ scores and good daily living skills seemed to be most closely related to better outcomes. Daily living skills include bathing, dressing, feeding oneself, managing a household, and taking care of one’s health and finances. If daily living skills are a key component of desirable adult outcomes, this may have implications for future training/intervention programs to foster independence in adulthood.

Another factor that may account for part of the outcome success of this sample is that they lived in a local community that emphasized the inclusion of individuals with disabilities. Other scientists across the country are now examining how family and community factors can positively influence the outcomes of individuals with ASD and other developmental disabilities. Early returns on this research are showing that praise and positive parent-child relationships also contribute to better outcomes.


Sources: Farley, M.A., McMahon, W.M., Fombonne, E., Jenson, W.R., Miller, J., Gardner, M., Block, H., Pingree, C.B., Ritvo, E.R., Ritvo, R.A., and Coon, H. (2009). Twenty-Year Outcome for Individuals with Autism and Average or Near-Average Cognitive Abilities. Autism Research, 2(2):109-118. doi: 10.1002/aur.69.

Woodman, A. C., Smith, L. E., Greenberg, J. S., Mailick, M. R. (2015). Change in Autism Symptoms and Maladaptive Behaviors in Adolescence and Adulthood: The Role of Positive Family Processes. Journal of Autism and Developmental Disorders, 45(1), 111–126. doi:10.1007/s10803-014-2199-2

Employment and Educational Activities for Young Adults with ASD



A study by researchers at Vanderbilt University and the University of Wisconsin at Madison examined the post-high school occupational and employment activities of young adults with Autism Spectrum Disorder (ASD) who had exited high school within the past five years.

The researchers identified five categories of post-high school activities: (1) post-secondary degree-seeking program, (2) competitive employment, (3) supported employment, (4) adult day services, and (5) day activities fewer than 10 hours a week.

They found that there was a significant relation between employment/day activities and whether the individual with ASD had an additional diagnosis of intellectual disability (ID). Those with ASD and ID had more autism symptoms and were likely to have a supported job or to be receiving adult day services. Those who only had ASD and significantly less autism symptoms were likely to be enrolled in a degree-seeking program or have a competitive job.

Interestingly, the findings suggested that there might be a group of young adults with ASD in the mid-level of functioning whose autism symptoms aren’t severe enough to receive adult day services but whose symptoms are too severe to function independently (manage a household, manage one’s health and finances, or enroll full-time in a college program). These individuals are “falling through the cracks” during the transition to adulthood because there isn’t appropriate programming for them.

The researchers suggest that there should be more autism-focused adult services specifically for young adults with ASD who do not have ID. Services focused on these individuals will help them achieve their maximum level of independence and develop sustainable careers.

The 2014 Pennsylvania Autism Census estimated that there will be over 36,000 adults with ASD living in the state by 2020. As examined in the study findings above, there is no mandate for an adult system. This means that programming and services are fragmented, leaving many adults with ASD and their families unsure of what steps they should take in the years following high school. If you have a child with ASD or are an individual with ASD who is about to graduate from the secondary education system, check out these suggestions and resources from the CAR Autism Roadmap™.


Source: Taylor, J.L., and Seltzer, M.M. (2011). Employment and Post-Secondary Educational Activities for Young Adults with Autism Spectrum Disorders During the Transition to Adulthood. Journal of Autism and Developmental Disorders, 41(5), 566-574. doi: 10.1007/s10803-010-1070-3.

Monday, January 26, 2015

Brain Connections and Infant Behavior



The Infant Sibling (IBIS) Network studies infants and toddlers born into families where there is already an older sibling with Autism Spectrum Disorder (ASD). This network aims to understand the earliest manifestations of ASD in both brain and behavior. To do so, the study uses MRI and detailed clinical assessments to compare infants and toddlers from families with ASD to those without a family history of ASD. CAR is one of the primary centers in the IBIS network, an NIH Autism Center of Excellence.

A new IBIS study used eye tracking to measure how and when infants shifted their eye gaze to different objects in front of them. We found that 7-month-olds who went on to develop ASD were slower to shift their attention from one object to another when compared to 7‐month‐olds who did not develop ASD. Slow eye gaze shifts are believed to make it more difficult for the infant to learn about their environment, placing them at risk for developmental delays.

In this study, slower eye gaze shifts also correlated with the maturity of one part of the brain – the  “corpus callosum.” The corpus callosum is the largest group of fibers connecting the right and left halves of the brain. Sharing of information between both halves of the brain helps with shifting of eye gaze and attention. Using MRI, we were able to show that the corpus callosum was immature in 7-month-old infants who later were diagnosed with ASD. This finding is consistent with other MRI studies in older youth with ASD that show abnormalities in the brain’s “wiring.” However, prior to our IBIS studies it was not known to occur at such a young age. 

This research is important because it pinpoints a specific brain circuit that is developing atypically very early in life, prior to the child showing outward signs and symptoms of ASD. This early marker for ASD within the biology of the child (a “biomarker”) could be very helpful for earlier detection of ASD when combined with other biomarkers. All early detection markers are important for guiding the development of early treatments. Thus, our team is hopeful that these findings may lead to earlier diagnoses, intervention, and subsequent improved outcomes for individuals with ASD.

In addition to the Center for Autism Research at CHOP, other institutions that took part in the study include The University of North Carolina, University of Utah, Washington University in St. Louis, University of Washington, McGill University, and the University of Alberta. The National Institutes of Health, Autism Speaks, and the Simons Foundation Autism Research Initiative fund this research.


Source: Elison, J.T., Paterson, S.J., Wolff, J.J., Reznick, J.S., Sasson, N.J., Gu, H., Dager, S.R., Estes, A.M., Evans, A.C., Gerig, G., Hazlett, H.C., Schultz, R.T., Styner, M., Zwaigenbaum, L., Piven, J., & IBIS Network. (2013). White matter microstructure and atypical visual orienting in 7-month-olds at risk for autism. The American Journal of Psychiatry170(8), 899–908. PMID: 23511344