Autism: 2012 In A Snapshot
There were three big themes this year in autism research from my vantage point:
DSM-5: The ongoing debate and speculation about the diagnostic changes that have now taken hold in the upcoming DSM-5 was clearly the biggest story of the year. Proponents suggest that the change to a singular diagnostic category (which eliminates Asperger’s Disorder as a separable diagnosis) will provide clearer criteria and hence more precision. Those who disagree worry that some youth will no longer receive diagnoses – and hence access to services. Another concern is that even if children meet diagnostic criteria, the new severity ratings may prove troublesome when it comes time to receiving coverage for services. The only thing for certain is that it will take some time until we see enough data – and feedback from clinicians and parents – to know how this will all play out.
Causes of Autism: There were a number of studies which demonstrated the complexity of searching for the causes of autism. Genetic research continued to focus on rare mutations that may help explain a very small number of cases. Included here were studies suggesting potential links between paternal age and risk for spontaneous mutations. While these findings continue to appear in the journals, it is not clear if there are many other genes involved – and if a vast majority of cases of autism are due to many genes acting in combination with environmental effects. To that end, environmental studies pointed to prenatal influences, including use of antidepressants and exposure to the flu virus. The studies to date are preliminary, require replication and expansion in terms of isolating mechanisms, and again account for small increases in absolute risk (typically a magnitude of 1%). Overall, the pieces of the puzzle continue to be researched, but the puzzle remains elusive.
Early Intervention: While it is known that early intervention yields positive changes in development, new studies suggest that intensive intervention that is especially tailored to promoting reactivity to the social environment may hold considerable promise. One study showing changes in brain activity in response to faces after such intervention (the Early Start Denver Model) was particularly intriguing. While autism remains a mystery, the one thing we know is that early intervention is beneficial – and we can hope that it will become even more powerful in the future.