Posts Tagged ‘
Wednesday, December 18th, 2013
Two themes stand out when I reflect on autism research in 2013.
First, there was substantial debate about how we diagnose autism, primarily spurred by changes introduced in DSM-5 (which was published in May). The reformulation of the diagnostic criteria – which led to a discontinuation of the category of Asperger Syndrome in favor of a broad-based category of Autism Spectrum Disorder (ASD) – spurred concerns that many youth would no longer qualify for a diagnosis and hence have their intervention options limited. Others suggested that more precise diagnostic criteria are needed to ensure that ASD does not get overdiagnosed. While we await empirical resolution via publication of well-designed studies, it’s clear that the DSM-5 debate will stand out as an important time in which we wrestled (again) with the best way to be inclusive in diagnosis without expanding diagnostic criteria too broadly.
Second, we are seeing more research on the early diagnosis of ASD, or at least detection of early warning signs, using methods like tracking eye movements of babies when looking at a human face. While this line of work will need to continue to refine the validity and feasibility of the approach – particularly when studying infants – it is an intriguing approach that may eventually have important implications for delivering interventions in the first year of life. Given the proven utility of early intervention, the hope is that the earliest interventions may hold the most promise for promoting development.
Wherever these research directions take us, we know for sure that early detection and intervention is essential. That’s one message that has not changed in 2013.
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Thursday, November 7th, 2013
Early diagnosis of autism spectrum disorders (ASD) offers the promise of early intervention – with the premise being the earlier, the better. New research suggests that we may be on the horizon of finding signs of ASD in the first 6 months of life. Here’s the breakdown of why this study – which examined attention to eyes in infants as a predictor of a diagnosis of ASD in toddlerhood – is so important.
Why Is This Study Design Powerful? This study – which builds on substantial prior research on eye contact in ASD – uses a powerful longitudinal design to search for the early signs of ASD in infants, including some at high risk (babies of older siblings with ASD). These design features give confidence in the results – the sampling frame goes from early infancy through the typical age of first diagnosis of ASD, and the high-risk component ensures enough cases to draw meaningful conclusions. And the construct of interest – attention to eyes – has been well-studied, is theoretically grounded, and can be measured with precision.
Why Are The Findings Provocative? Two reasons. First, while ASD (or the risk, or liability, to develop ASD) is assumed to be present at birth, early signs of ASD have been elusive. This study offers hope that by detecting a lack of attention to eyes in the first 6 months of life may offer one potentially powerful screen for risk for ASD. But there’s more. An especially novel finding is that infants later diagnosed with ASD started out in life attending to eyes – but that that ability declined over time. This may eventually be a clue in terms of underlying brain mechanisms – and it also suggests that if these fundamental mechanisms are “in tact” at birth and then decline, perhaps there is even more room for change with very early intervention. Either way, a strong signal of risk in the first 6 months of life may be translated – perhaps rapidly – into very early intervention strategies.
What’s The Take-Home Message? Parents have been encouraged to be mindful of some of the signals of risk for ASD in the early years – including 7 early signs of ASD. Although this study has not yet led to formal recommendations for parents, it does suggest how important face-to-face interaction is during infancy – and also highlights that parents should be vigilant about seeing how their baby reacts when eye contact is expected. The way a baby looks at the human face changes a lot over the first year in life – but the constant is that they spend a lot of time looking at it. The suggesting from this new research is that babies at risk for ASD show a decrease in their interest in the face during infancy. If this is happening, it is certainly worth bringing to the attention of a pediatrician, who will be positioned to look for other developmental milestones and indicators.
What’s The Future? Research studies are especially influential if they give a glimpse into the future. Here the hope is that a screening protocol can be developed to route infants into very early intervention – a developmental time that may hold promise for a lot of plasticity and response to intervention. Bear in mind that some of the most exciting findings to date about intervention – based on application of the Early Start Denver Model (ESDM) – demonstrated that one of the results of intensive intervention is changing the brain response to the human face, with normative patterns of brain activity achieved in some cases. Starting that process in infancy might lead to even more effective intervention programs for ASD.
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Wednesday, October 23rd, 2013
You may hear about lots of educational products that will make your babies “smart.” You may download lots of apps to try to give them an early cognitive “edge.” But what’s a simple thing you can do that will, over time, have huge effects on their development that far exceed whatever “benefits” the latest marketing fad can achieve? Talking to your baby.
Yes, just talking. Studies continue to show that there are huge differences in the number of words that babies (and toddlers for that matter) get exposed to – in the home. A new research study has revealed part of the effect of exposure to lots of words – it helps babies and toddlers process words quicker. The key here – as pointed out by lead researcher Anne Fernald at Stanford University – is that the faster an infant can process one word, the more ready they are to process a word that follows. While this should sound intuitive, the meaning is very deep in terms of brain processing – differences in processing speed can mean one infant is understanding a simple sentence, whereas another is not.
What’s the net effect of all of this? A language gap that starts in infancy and reverberates and grows larger through childhood. Kids who were exposed to lots of words frequently will have much better language skills.
So what can you do? Talk to your babies – a lot! Use child friendly language. Make it playful and fun. If you are out taking them for a walk and they see a dog and smile, look at them and smile and say “Doggie! Cute Doggie!” – and keep talking.
Sounds simple, right? Sounds obvious too. But we continue to see studies that suggest many babies do not get nearly enough of this. It’s so easy to do, costs nothing, makes your baby happy, makes you happy – and predicts good language development and eventual reading ability and success in school. So put down the silly toys and give the phone a rest – and talk to your baby.
Track your baby’s development with our Baby Milestone Tracker, or shop for the perfect baby book to read to your little one.
Mom With Baby via Shutterstock.com
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Friday, June 29th, 2012
I’ve come across a number of new studies that have examined how consistent exposure to negative emotions can have a very strong impact on kids, particularly in terms of their risk for depression. I’m not talking about the occasional frustration that all parents have – rather I’m referring to negative interaction styles that can seem innocuous but in fact become insidious. Every parent expresses some anger, hostility, a sharp tone, or annoyance now and then – but what happens if it starts to become habit?
The short answer is that there are two things to consider.
First, it is very clear that emotions are contagious. Recent studies show that parental negativity can bring an infant down – even if the baby is not especially prone (via temperament) to negativity. Parents can start “behavior chains” early in life – if you are often cranky with your baby, chances are your baby will respond the same way. Studies with older kids have confirmed (for a long time now) that negativity in the home leads to early emerging symptoms of depression in the school years (not full blown depressive episodes, but the first signs of depressed mood). Of course, the opposite is true – for example, when parents are treated successfully for depression, their kids shown rapid improvements with respect to their own depressive symptoms.
Second – and this is the big piece for me – new research is suggesting that this cumulative exposure to parental negativity can lead kids to develop the cognitive risks for later, full blown, depressive episodes. Researchers typically assess what they call “attributional style” – sort of how kids see themselves and the world. It’s very clear that certain attributional styles (think kids with low self-image and a lot of defeatist attitude) are a strong risk factor for later depression. What’s emerging is the idea that the chain goes like this: parental negativity -> child negativity -> negative attributional style -> later depression. In particular, the middle childhood years – and the entry into adolescence – are key developmental periods when attributional style comes together. So the thinking is that kids’ developmental history of emotional experiences in the home help shape their emerging attributional style.
I bring all this up because, to my mind, it’s become somewhat fashionable to talk about the downside of parenting. Much of this is healthy venting – sure, parenting is stressful, it changes your life, there are lots of not great moments that occur, and sometimes it can be overwhelming. But the thing is, if negativity starts to become the overriding experience of being a parent – and if kids get exposed to habitual (rather than occasional) negativity – their chances of becoming depressed later in life go way up.
So I have two take-home messages:
If you think you may be depressed, seeking out treatment (behavioral, pharmaceutical, a combination) could have a very positive impact on your life. Treatment works – and when it works, it helps kids too.
If you find yourself slipping into negative interaction styles with your kids, take the lead and change the emotional climate. Keep in mind that positivity – like negativity – can be contagious!
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