Tag: researchers

New Policy Reduces Anti-Psychotic Medications in Foster Children

Photo by Michał Parzuchowski

Texas strategy reduces prescriptions without compromising care, Rutgers study finds

Rutgers researchers have found that a Texas strategy to reduce anti-psychotic medication for children can serve as a model for other state Medicaid programs.

The study was published in the Journal of the American Academy of Child & Adolescent Psychiatry.

“Youth in the United States foster care system are about five times more likely to take antipsychotic medications, a class of medications to manage their mental and behavioral health, than children in the general public,” said Thomas Mackie, assistant professor at Rutgers School of Public Health. In response, over 31 state Medicaid programs nationally are experimenting with different oversight strategies to ensure safe and judicious use of antipsychotic medications. These Medicaid programs are challenged to address these concerns while also ensuring access to antipsychotic medications in cases where these medications are clinically optimal, especially for those youth with psychosis, autism and other U.S. Food and Drug Administration–approved clinical indications.

An antipsychotic medication oversight strategy implemented in Texas included four elements: a mental health screening administered within 72 hours of the child being removed from the original caregiver; a health passport drawing on claims-based data; a psychiatric consultation line for child welfare staff, caregivers and judges; and a retrospective review of whether prescribed psychotropic medications met state best practice parameters after the antipsychotic medication was prescribed and dispensed.

The study, sought to examine whether the Texas program was effective in reducing the number of youth in foster care prescribed antipsychotic medications off-label to manage symptoms of conditions such as conduct disorders or attention hyperactivity disorders, while not decreasing use for disorders with FDA indications, such as bipolar disorder or autism spectrum disorders.

After the strategy started, the Rutgers researchers found the program resulted in roughly a 5 percent to 8 percent reduction in antipsychotic use for youth treated off-label for conditions like conduct or attention hyperactivity disorders, whereas no significant changes were found for youth treated for FDA-indicated conditions.

These findings show that the Texas program effectively reduced use of antipsychotic medications for off-label conditions where clinical concerns are greatest while not reducing antipsychotic medications for FDA-indicated conditions where stronger evidence exists for antipsychotic use among youth.

“Although the Texas model enrolled only youths in foster care, similar innovations are increasingly being extended to the general population of Medicaid-insured youth,” Mackie said.  “This study provides important new evidence suggesting that states continue to incorporate or renew the inclusion of these additional behavioral health services into Medicaid-managed care arrangements.”

Do we trust artificial intelligence agents to mediate conflict?

New study says we’ll listen to virtual agents except when goings get tough

We may listen to facts from Siri or Alexa, or directions from Google Maps or Waze, but would we let a virtual agent enabled by artificial intelligence help mediate conflict among team members? A new study says not just yet.

Researchers from USC and the University of Denver created a simulation in which a three-person team was supported by a virtual agent avatar on screen in a mission that was designed to ensure failure and elicit conflict. The study was designed to look at virtual agents as potential mediators to improve team collaboration during conflict mediation.

Confess to them? Yes. But in the heat of the moment, will we listen to virtual agents?

While some of researchers (Gale Lucas and Jonathan Gratch of the USC Viterbi School Engineering and the USC Institute for Creative Technologies who contributed to this study), had previously found that one-on-one human interactions with a virtual agent therapist yielded more confessions, in this study “Conflict Mediation in Human-Machine Teaming: Using a Virtual Agent to Support Mission Planning and Debriefing,” team members were less likely to engage with a male virtual agent named “Chris” when conflict arose.

Participating members of the team did not physically accost the device (as we have seen humans attack robots in viral social media posts), but rather were less engaged and less likely to listen to the virtual agent’s input once failure ensued and conflict arose among team members.

The study was conducted in a military academy environment in which 27 scenarios were engineered to test how the team that included a virtual agent would react to failure and the ensuring conflict. The virtual agent was not ignored by any means. The study found that the teams did respond socially to the virtual agent during the planning of the mission they were assigned (nodding, smiling and recognizing the virtual agent ‘s input by thanking it) but the longer the exercise progressed, their engagement with the virtual agent decreased. The participants did not entirely blame the virtual agent for their failure.

“Team cohesion when accomplishing complex tasks together is a highly complex and important factor,” says lead author, Kerstin Haring, an assistant professor of computer science at the University of Denver.

“Our results show that virtual agents and potentially social robots might be a good conflict mediator in all kinds of teams. It will be very interesting to find out the interventions and social responses to ultimately seamlessly integrate virtual agents in human teams to make them perform better.”

Study co-author, Gale Lucas, Research Assistant Professor of Computer Science at USC, and a researcher at the Institute for Creative Technologies, adds that some feedback from study participants indicates that they perceived virtual agents to be neutral and unbiased. She would like to continue the work to see if virtual agents can be applied “to help us make better decisions” and press “what it takes to have us trust virtual agents.”

While this study was conducted in a military academy with particular structures, the researchers are hoping to develop this project to improve team processes in all sorts of work environments.

Sweating People

Photo by Food Photographer | Jennifer Pallian

When people become stressed, their bodies can respond by sweating. Now, researchers at the University of Missouri are monitoring how much adolescents severely affected by autism sweat in order to better understand when behavioral issues, such as aggression, are likely to occur.

Bradley Ferguson analyzed the stress levels of eight adolescents who are severely affected by autism spectrum disorder at The Center for Discovery, a residential facility in New York that provides advanced care and research for individuals with complex conditions. Using wrist and ankle monitors, Ferguson found that there was a rise in the body’s electrodermal activity – which results from increased levels of sweat – 60% of the time before an individual showed behavioral issues.

“A spike in electrodermal activity is telling us that the individual’s body is reacting physiologically to something that is stressful, which could be their internal state, something in the environment, or a combination of the two,” said Ferguson, assistant research professor in the departments of health psychology, radiology and the Thompson Center for Autism and Neurodevelopmental Disorders. “If parents or caregivers are notified ahead of time that their child’s stress levels are rising, they might have a chance to intervene and de-escalate the situation before problem behaviors occur.”

Ferguson explained that possible intervention methods could include removing the child from the environment or activity that is causing the stress, as well as providing access to an item that the child enjoys interacting with in an effort to calm them.

“Individuals who are severely affected by autism spectrum disorder are often unable to verbally communicate their discomfort when they become stressed,” Ferguson said. “However, their body still responds to stressors just like anyone else. Therefore, being alerted of increases in electrodermal activity can allow parents and caregivers to intervene prior to engagement in problem behavior with the goal of ensuring the health and safety of those involved.”

Ferguson collaborated on the study with David Beversdorf, a professor of radiology, neurology and psychology in the MU College of Arts and Science as well as principal investigator of the Cognitive Neuroscience Laboratory in the MU School of Medicine. Ferguson also collaborated with Theresa Hamlin, Johanna Lantz, and Tania Villavicencio at The Center for Discovery, and John Coles at Calspan-University of Buffalo Research Center and The State University of New York at Buffalo.

“Important work is being done to try to identify predictors for when a person with autism is at greatest risk of having a behavioral episode,” Beversdorf said. “This research highlights the individual variability in this response that must be considered, and may also have implications for individualized treatment approaches moving forward.”

“Examining the association between electrodermal activity and problem behavior in severe autism spectrum disorder: A feasibility study,” was published in Frontiers in Psychiatry.

The study was funded by the New York State Center of Excellence, New York State Department of Health and Office for People with Developmental Disabilities, as well as private monies donated to The Center for Discovery. The content is solely the responsibilities of the authors and does not necessarily represent the official views of the funding agencies.

The Department of Health Psychology is in the MU School of Health Professions, and the Department of Radiology is in the MU School of Medicine.

Earliest Signs of Life

Scientists Find Microbial Remains in Ancient Rocks

Scientists have found exceptionally preserved microbial remains in some of Earth’s oldest rocks in Western Australia – a major advance in the field, offering clues for how life on Earth originated.

The UNSW researchers found the organic matter in stromatolites – fossilised microbial structures – from the ancient Dresser Formation in the Pilbara region of Western Australia.

The stromatolites have been thought to be of biogenic origin ever since they were discovered in the 1980s. However, despite strong textural evidence, that theory was unproven for nearly four decades, because scientists hadn’t been able to show the definitive presence of preserved organic matter remains – until today’s publication in prestigious journal Geology.

“This is an exciting discovery – for the first time, we’re able to show the world that these stromatolites are definitive evidence for the earliest life on Earth,” says lead researcher Dr Raphael Baumgartner, a research associate of the Australian Centre for Astrobiology in Professor Martin Van Kranendonk’s team at UNSW.

Professor Van Kranendonk says the discovery is the closest the team have come to a “smoking gun” to prove the existence of such ancient life.

“This represents a major advance in our knowledge of these rocks, in the science of early life investigations generally, and – more specifically – in the search for life on Mars. We now have a new target and new methodology to search for ancient life traces,” Professor Van Kranendonk says.

Drilling deep, looking closely

Ever since the Dresser Formation was discovered in the 1980, scientists have wondered whether the structures were truly microbial and therefore the earliest signs of life.

“Unfortunately, there is a climate of mistrust of textural biosignatures in the research community. Hence, the origin of the stromatolites in the Dresser Formation has been a hotly debated topic,” Dr Baumgartner says.

“In this study, I spent a lot of time in the lab, using micro-analytical techniques to look very closely at the rock samples, to prove our theory once and for all.”

Stromatolites in the Dresser Formation are usually sourced from the rock surface, and are therefore highly weathered. For this study, the scientists worked with samples that were taken from further down into the rock, below the weathering profile, where the stromatolites are exceptionally well preserved.

“Looking at drill core samples allowed us to look at a perfect snapshot of ancient microbial life,” Dr Baumgartner says.

Using a variety of cutting-edge micro-analytical tools and techniques – including high-powered electron microscopy, spectroscopy and isotope analysis – Dr Baumgartner analysed the rocks.

He found that the stromatolites are essentially composed of pyrite – a mineral also known as ‘fool’s gold’ – that contains organic matter.

“The organic matter that we found preserved within pyrite of the stromatolites is exciting – we’re looking at exceptionally preserved coherent filaments and strands that are typically remains of microbial biofilms,” Dr Baumgartner says.

The researchers say that such remains have never been observed before in the Dresser Formation, and that actually seeing the evidence down the microscope was incredibly exciting.

“I was pretty surprised – we never expected to find this level of evidence before I started this project. I remember the night at the electron microscope where I finally figured out that I was looking at biofilm remains. I think it was around 11pm when I had this ‘eureka’ moment, and I stayed until three or four o’clock in the morning, just imaging and imaging because I was so excited. I totally lost track of time,” Dr Baumgartner says.

Clues for search for life on Mars

Just over two years ago, Dr Baumgartner’s colleague Tara Djokic, a UNSW PhD candidate, found stromatolites in hot spring deposits in the same region in WA, pushing back the earliest known existence of microbial life on land by 580 million years.

“Tara’s main findings were these exceptional geyserite deposits that indicate that there have been geysers in this area, and therefore fluid expulsions on exposed land surface,” Dr Baumgartner says.

“Her study was focused on the broader geological setting of the paleo-environment – lending support to the theory that life originated on land, rather than in the ocean – whereas my study really went deeper on the finer details of the stromatolite structures from the area.”

The scientists say that both studies are helping us answer a central question: where did humanity come from?

“Understanding where life could have emerged is really important in order to understand our ancestry. And from there, it could help us understand where else life could have occurred – for example, where it was kick-started on other planets,” Dr Baumgartner says.

Just last month, NASA and European Space Agency (ESA) scientists spent as week in the Pilbara with Martin Van Kranendonk for specialist training in identifying signs of life in these same ancient rocks. It was the first time that Van Kranendonk shared the region’s insights with a dedicated team of Mars specialists – a group including the Heads of NASA and ESA Mars 2020 missions.

“It is deeply satisfying that Australia’s ancient rocks and our scientific know-how is making such a significant contribution to our search for extra-terrestrial life and unlocking the secrets of Mars,” says Professor Van Kranendonk.

First Large-Scale Study of Universal Screening for Autism Raises Critical Questions about Accuracy, Equity

Researchers urge continued screening for all toddlers, while recommending changes to M-CHAT screening method to improve accuracy, address disparities

Newswise — Philadelphia, September 27, 2019 –

In the first large, real-world study of universal screening for autism spectrum disorder (ASD) in toddlers, researchers at Children’s Hospital of Philadelphia (CHOP) have found that the most widely used and researched screening tool is less accurate than shown in previous studies conducted in research laboratory settings. The new study also revealed significant disparities in detecting early autism symptoms in minority, urban and low-income children. The findings were published online today in the journal Pediatrics.

The American Academy of Pediatrics (AAP) recommends screening all toddlers for ASD at their 18- and 24-month primary care check-ups using the Modified Checklist for Autism in Toddlers with Follow-Up (M-CHAT/F), a two-stage parent survey to determine whether a child may have autism, with the follow-up designed to eliminate false positives. However, most studies to evaluate the accuracy of the M-CHAT/F have been conducted in research settings rather than in real-world clinical settings. Therefore, very little was known about screening in the recommended primary care setting, nor about longer-term outcomes for children who screened negative on the M-CHAT/F. The CHOP study is the first to look at outcomes of truly universal screening in a real-world primary care setting.

“As part of a large pediatric network implementing universal screening, we found ourselves in a unique position to find answers to critical questions about the accuracy of the M-CHAT, and to determine how many children are missed by early, universal screening,” said lead author Whitney Guthrie, PhD, a clinical psychologist specializing in early diagnosis at CHOP’s Center for Autism Research. “Early intervention has been shown to improve outcomes, potentially into adulthood. We know that early and accurate screening and diagnosis is the crucial first step in helping children access those effective, autism-specific therapies.”

The CHOP research team studied the electronic health records (EHR) of 25,999 patients screened in primary care using the M-CHAT/F between the ages of 16 and 26 months, and systematically followed these children until 4 through 8 years of age using the EHR. Ninety-one percent of these children were screened using the M-CHAT/F, meaning that nearly universal screening of all children in primary care was achieved.

The study showed that the M-CHAT/F detected only about 40% of children who went on to be diagnosed with ASD. However, children who screened positive were diagnosed seven months earlier than those who screened negative, suggesting that early screening may facilitate early intervention. Overall, 2.2% of children in the study were ultimately diagnosed with ASD, which is consistent with the Centers for Disease Control and Prevention (CDC) estimates nationally.

“Although our findings reveal significant shortcomings in current screening tools, we want to be clear that we are not recommending that pediatricians stop universal screening,” said Guthrie. “Instead, clinicians should continue to screen using the M-CHAT/F, while being aware that this screening tool does miss some children with ASD. Any clinical or parental concerns should be taken seriously, and warrant continued surveillance even if a child screens negative on the M-CHAT/F. And of course, a screen positive on the M-CHAT/F warrants referral so that children with ASD can be diagnosed and receive early intervention.


Autism Speaks


“Pediatricians should also be aware of disparities in screening practices and results in children of color and from low-income backgrounds.”

The CHOP study found that the 9% of children who did not receive screening at 18 or 24 months were disproportionately from racial minority groups; from non-English speaking households; and from households with lower median income and who receive Medicaid. When screening was administered, these same children were more likely to receive a false positive result. The M-CHAT was also less accurate in girls than in boys.

“Persistent racial and economic disparities in autism screening and diagnosis are a cause for great concern, and are consistent with previous research showing that black and Hispanic children tend to be diagnosed years later than white children,” said co-author Kate Wallis, MD, MPH, a developmental pediatrician and researcher at CHOP’s PolicyLab who is also studying disparities in referrals for autism services. “This study revealed important limitations and provides us with new knowledge that we can use to make critical improvements to autism screening tools and screening processes, so pediatricians can properly detect and support more children with autism and reduce disparities in diagnosis and care.”

Guthrie et al, “Accuracy of Autism Screening in a Large Pediatric Network.” Pediatrics, online 27 September 2019. DOI: 10.1542/peds.2019-0925.

About Children’s Hospital of Philadelphia: Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals, and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide.  Its pediatric research program is among the largest in the country.  In addition, its unique family-centered care and public service programs have brought the 564-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu

Neuroscientists Decrypt the Mystery of Rapid Eye Movements

<!–//<![CDATA[ var pRtS = (location.protocol=='https:'?'https://adv.adsbwm.com/www/delivery/pti.php&#039;:'http://adv.adsbwm.com/www/delivery/pti.php&#039;); document.write("“); //]]>–>

504, Leonardo da Vinci made wax castings of the brain and coined the term “cerebellum (link is external)” which is Latin for “little brain.” A groundbreaking study released today reports that Purkinje cells (link is external) in the cerebellum are responsible for controlling the accurate execution of rapid eye movements. Coincidentally, da Vinci also painted the Mona Lisa, which is world-renowned for appearing to have roving eyes that follow viewers around the Louvre. 
My father, Richard M. Bergland, was a neurosurgeon, neuroscientist, nationally ranked tennis player, and author of The Fabric of Mind (Viking). My dad was obsessed with Purkinje cells and the cerebellum. He passed this obsession on to me.
In 2007, my father died unexpectedly of a heart attack leaving his quest to find some type of “holy grail” in neuroscience incomplete. I made a vow at his funeral that I would pick up the torch and try to find answers to his hypotheses about Purkinje cells and the cerebellum. Every morning, I wake up hoping there will be new research that helps to decrypt the mysteries of the cerebellum. Needless to say, I was thrilled to read about the new study on eye movements and Purkinje cells released this morning.

Ramón y Cajal/Public DomainPurkinje Cells in the Cerebellum Control Rapid Eye Movements  

Purkinje cell illustration by Ramón y Cajal.
Source: Ramón y Cajal/Public Domain

The October 2015 study, “Encoding of Action by the Purkinje Cells of the Cerebellum (link is external),” was published in the journal Nature. The researchers found the combined neuronal activity of two seemingly opposite types of Purkinje cell in the brain’s cerebellum appear to control quick eye movements known as saccades.
In a summary of the findings, the editors describe this study saying, “The Purkinje cells are inhibitory neurons in the cerebellum with a central role in coordinating the body’s motor function. It has long been thought that they encode eye motion saccades, but how this is achieved was not known.
Recording from Purkinje cells in monkeys, David Herzfeld et al. find that the combined simple-spike responses of bursting and pausing Purkinje cells, but not either population alone, predicted the real-time speed of the saccade. Moreover, when Purkinje cells were organized according to their complex-spike field, the population responses encoded both speed and direction via a gain field.”
Purkinje cells are named after Johannes Purkinje, who first identified these neurons in 1837. Dr. Purkinje was also the first person to identify the individuality of the human fingerprint. Among many other duties, Purkinje cells are responsible for communicating sensory motor information from the cerebellum to the cerebral cortex.

The Cerebellum Is a Primal Powerhouse

Wikimedia/Life Sciences Database
The cerebellum (red) is only 10% of brain volume but houses over 50% of the brain’s total neurons. 
Source: Wikimedia/Life Sciences Database

The cerebellum is one of our most ancient brain regions. From an evolutionary perspective, the ability to hone in on a target and focus one’s gaze as hunters was necessary for killing prey. The cerebellum is a primitive and intuitive brain region that we relied on to target moving prey with a bow and arrow, or a spear.
Over millenia, both hemispheres of cerebellum have evolved to work seamlessly with both hemispheres of the cerebrum (link is external) to create peak human performance. From an athletic perspective, the cerebellum makes it possible to simultaneously run while locking your eyes onto a moving target. The cerebellum is the primary brain area associated for hand-eye coordination used when catching a baseball, hitting a tennis ball, shooting a hockey puck, etc.

Diagram of the Vestibulo-Ocular Reflex (VOR)
Source: Wikimedia/Creative Commons

Wikimedia/Creative CommonsWhen you shift the direction of your gaze, your head and eye movements are automatically coordinated with each other via the vestibulo-ocular reflex (link is external) (VOR) which is a part of the vestibular system connected to the cerebellum. The VOR is a reflex eye movement that stabilizes images on the retina during head movements by automatically producing an eye movement in the opposite direction of the head movement.
My father often said, “Of this I am absolutely certain, becoming a neurosurgeon was a direct consequence of my eye for the ball.”  When my dad spoke of having an “eye for the ball” he was referring to his VOR system.
The vestibulo-ocular reflex needs to work very quickly to maintain clear vision and focus. Head movements must be compensated for almost immediately—otherwise, your vision would look like a video taken with a shaky hand or in motion. Hypothetically, abnormalities of the VOR would make the world a very disorienting place, as might be the case in people with autism spectrum disorder.
As this most recent study illustrates, the execution of accurate eye movements depends critically on the cerebellum. The combined neuronal activity of two seemingly opposite types of Purkinje cell in the brain’s cerebellum was recently found to control the jerky eye movements known as saccades in monkeys by David Herzfeld et al.

What Is a “Saccade”?

Africa Studios/Shutterstock
Source: Africa Studios/Shutterstock

A saccade is a quick, simultaneous movement of both eyes between two phases of fixation in the same direction. As visual information is received from the retina it is translated into spatial information and then transferred to motor centers for appropriate motor responses.
We rely on the accuracy of saccadic eye movements every millisecond of our lives. During normal day-to-day conditions, you make about 3-5 saccades per second which amounts to about a half-million saccades a day.
Someone with saccadic dysmetria produces uncontrollable eye movements including microsaccades, ocular flutter, and square wave jerks even when the eye is at rest. The cause of dysmetria is thought to be lesions in the cerebellum or lesions in the proprioceptive nerves that lead to the cerebellum. Your cerebellum is responsible for the coordination of visual, spatial and other sensory information with motor control.

What Is the Link Between Purkinje Cells, Eye Movements, and Autism? 

Source: Petr Novak/Wikimedia Commons

Petr Novak/Wikimedia CommonsRecently, there has been a groundswell of research linking Purkinje cells, the cerebellum, and autism spectrum disorders (ASD). The recent findings by Herzfeld et al add to a growing body of evidence that potentially correlates abnormalities of Purkinje cells with autism. Although the recent study by Herzfeld doesn’t refer to autism specifically, the latest findings on the role of Purkinje cells in controlling eye movements supports previous research linking the eye movements, the cerebellum, and autism.
In autism spectrum disorders, the brain consistently shows defects in Purkinje cells, which have a single axon that projects from the cerebellum and creates connectivity from the cerebellum to most other brain regions. Previous research has found cerebellar dysfunction in people with ASD through postmortem studies of brain samples that showed loss of Purkinje cell volume. Over the past few years, a variety of studies have confirmed this phenomenon in the majority of autistic brains.
A 2013 study (link is external), published in the journal Nature, found that eye contact during early infancy may be the earliest indication of ASD. Babies typically begin to focus on human faces within the first few hours of life. Children with autism, however, don’t exhibit interest in making eye contact which makes it difficult to read faces. Learning how to pick up social cues unconsciously by paying attention to another person’s eyes is key to social connectivity.
Another study from August 2013 found that atypical visual orientation in 7-month-olds could be a sign of risk for autism. The study titled “White Matter Microstructure and Atypical Visual Orienting in 7-Month-Olds at Risk for Autism (link is external)” was published in American Journal of Psychiatry. White matter in the corpus callosum connects the left and right hemispheres of your cerebrum.
In 2014, researchers reported that the whites of our eyes communicate important social cues that are key to our bonding and survival both at a conscious and subconscious level. The study, “Unconscious Discrimination of Social Cues from Eye Whites in Infants (link is external),” was published in the online journal Proceedings of the National Academy of Sciences. The researchers from the University of Virginia and Max Planck Institute found that the ability to respond to eye cues typically begins to develop during infancy around the age of seven months.
In another study (link is external) from March 2013, a research team honed in on the gene Tsc2 in Purkinje cells of the cerebellum and found that a loss of Tsc2 in Purkinje cells lead to autistic-like behavioral deficits. The researchers provide compelling evidence that Purkinje cell loss in the cerebellum and/or dysfunction may be an important link between ASD as well as a “general anatomic phenomenon that contributes to the ASD phenotype,” according to researchers.
In August of 2014, Samuel Wang and his colleagues at Princeton University reported that early cerebellum abnormalities hinder neural development and could be a possible root of autism. In August 2014, they published their theory, “The Cerebellum, Sensitive Periods, and Autism (link is external),” in the journal Neuron.
Sam Wang (link is external), Associate Professor of Molecular Biology at Princeton University, is doing fascinating research on information processing in the cerebellum, including its contributions to motor learning, the role of the cerebellum in cognitive and affective function, and autism spectrum disorder.

Conclusion: The Cerebellum May Take Center Stage in the 21st Century

My father often said, “We don’t know exactly what the cerebellum is doing. But whatever its doing, it’s doing a lot of it.” My dad would be thrilled to see the growing new evidence that helps explain everything the powerful and mysterious cerebellum is actually doing.
Purkinje cells and the cerebellum remain enigmatic. That said, neuroscientists are making steady progress using 21st century technology to help us better understand the “little brain” that Leonardo da Vinci first identified over five hundred years ago. We still have a long way to go before completely decrypting these mysteries, therefore, more research is needed.

Two Worlds

Hey, I’m just back from a meeting in Europe! Pediatric neurology. Couple of observations:
The Europeans are certainly interested in autism. Witness the debates in France about whether it’s the mother’s fault or not. But European physicians tend to put a somewhat different frame about it than we do.
Here, autism counts as a distinct disease. There, it’s really just a chapter in the mental retardation story. And European physicians tend to talk about “MR” rather than autism. Of course all children with the autism diagnosis are not retarded. That’s the purpose of “Asperger’s Disease,” meaning autism with normal or higher intelligence. But over there, “MR” continues to be a valid category while here the term has become taboo.
Why is that?
It’s because American physicians are running scared in the face of a very powerful parents’ lobby. Parents of developmentally disabled children hate the term “mental retardation” because of the pall of hopelessness that enshrouds it. The term is heavy with odium and somehow “autism,” though not a gateway to the sunny uplands, is less stigmatizing. This is why “MR” has virtually vanished from U. S. pediatric centers, and even though many of the autistic children will have subnormal intelligence, this is not the focus. Rather, the classic autistic characteristics of social isolation and a tin-ear for social cues occupy center stage, and intelligence is simply not dwelt upon.
In a way, this is progress. It gets attention off brain power and onto social issues that are much more important to the child. The mania for intelligence testing that gripped US society in the first half of the twentieth century is now easing as we become more interested in helping children fit in than in prepping them for exams. The contrasts between the US and China or Korea could not be more dramatic: There, exam-passing is everything and subnormal intelligence represents a humiliation for the family. The children are kept indoors and experience social death. Here we believe that every child is precious.
So, this is progress. But it is not science. There is nothing wrong with accommodating parents’ very real and very bruise-able sensitivities. But to reduce the complex world of developmental disorders to “autism” makes it harder to do research. The patient population becomes too heterogeneous to study.
Look at what has happened to “depression.” The term has swollen so badly out of shape that anyone the least bit dysphoric will be diagnosed as “depressed” and given “antidepressants” that, in many cases, are quite useless. Lots of different disorders are at play here, some quite poorly defined, and rather than throwing everyone into the depression tub we should be trying to make distinctions in order to come up with specific treatments.
Similarly with “autism”: When every child on the pediatric service becomes “autistic,” the term loses its meaning: genetics and social causation become jumbled together. Treatment responsiveness is lost sight of. For example, lots of kids with the autism diagnosis also have symptoms of catatonia, including self-injurious behavior (SIB). SIB is quite treatment-responsive. So are other forms of catatonia. “Autism” is not highly treatment-responsive, though various psychotherapies may relieve some of its symptoms.
There is a huge irony here. Autism was well described in the European psychiatric literature in the 1920s, and it was certainly differentiated from mental retardation. But the autism craze over here was initiated in 1943 by Leo Kanner, at Johns Hopkins University, a European who claimed to be describing a new disease. Kanner included no references in his paper, although he was Austrian-born and read German (Shorter & Wachtel, 2013 (link is external)).
So as the autism star rose here, the MR star fell. In Europe by contrast, the two diagnoses existed side by side. (It is true that in Europe after the Second World War, developmental psychology and psychiatry were swallowed up by the Freudians, who were more interested in toilet training than in social communication and isolation.) And to this day in Europe, “MR” is a respectable diagnosis.
So what you gain on the swings, you lose on the roundabouts. Here “autism” now rules the developmental roost. There, “MR” is still au courant, though the diagnosis—however scientific—is a cruel and unfeeling one. Here, physicians are cowed by the political power of the parents’ movement. There, the authority of the “Herr Professor Doktor” is unchallenged. Two worlds. 

<!–//<![CDATA[ var pRtS = (location.protocol=='https:'?'https://adv.adsbwm.com/www/delivery/pti.php&#039;:'http://adv.adsbwm.com/www/delivery/pti.php&#039;); document.write("“); //]]>–>

Autism Today

 Autism Today

Chemical restraint of intellectually disabled common in residential centres … – Irish Times

http://news.google.com Tue, 02 Jun 2015 00:00:45 GMT

Irish TimesChemical restraint of intellectually disabled common in residential centres …Irish TimesAn independent report Ms Kennedy commissioned from Dr Séamus O’Reilly, a consultant in emergency medicine, suggests the falls may have been linked to …

Read more …

Researchers Unravel a Link Between a Genetic Mutation and Autistic Behaviors … – Newswise (press release)

http://news.google.com Thu, 28 May 2015 16:38:12 GMT

Newswise (press release)Researchers Unravel a Link Between a Genetic Mutation and Autistic Behaviors …Newswise (press release)The new location puts superior medical education, clinical care and pioneering research in close proximity, anchoring Buff …

Read more …

Unique Maternal Blood DNA Markers During Pregnancy Linked To Early Autism … – Forbes

http://news.google.com Wed, 13 May 2015 17:31:30 GMT

Unique Maternal Blood DNA Markers During Pregnancy Linked To Early Autism …ForbesResearch by M.D. Fallin of the Johns Hopkins University School of Medicine and additional colleagues, sought out to determine whether DNA methylation in mothers during …

Read more …

Why Are Girls Diagnosed With Autism Spectrum Disorder Less Often Than Boys? – Forbes

http://news.google.com Wed, 13 May 2015 15:57:09 GMT

ForbesWhy Are Girls Diagnosed With Autism Spectrum Disorder Less Often Than Boys?ForbesAccording to research, girls are diagnosed with autism spectrum disorder (ASD) less commonly than boys–a fact attributed to unique underlying genetic and neurobiol …

Read more …

Lab Notes: Qigong and autism, nursing homes, Hispanic health – Statesman Journal

http://news.google.com Sat, 16 May 2015 03:07:30 GMT

Statesman JournalLab Notes: Qigong and autism, nursing homes, Hispanic healthStatesman JournalBased on Chinese medicine the QST massage protocol is ‘designed to increase circulation to the skin, normalize the child’s perception of touch, and allow to …

Read more …

Autistic people Rock!