By Audrey Wolfe, AIR-P clinical coordinator
This week at the International Meeting for Autism Research (IMFAR), researchers from the Autism Speaks Autism Treatment Network (ATN) and its Autism Intervention Research Network for Physical Health (AIR-P) presented early findings from 15 studies selected as being among the most important of the year. The research covered a range of topics including gastrointestinal symptoms, sleep problems, behavioral issues, nutrition, gender differences in autism-related medical issues, access to services and more.
Below are brief summaries of the 15 presentations. To read the full text of the scientific abstracts, click here.
Gastrointestinal symptoms in ASD. This AIR-P funded research study examined whether GI symptoms are associated with increases in stress-associated endocrine and cytokine biomarkers in children who have autism. The sample included 120 children ages 6 to 18 recruited through two ATN sites. Findings suggest that children with autism and GI symptoms may have an increased response to stress, but that this effect is not associated with concomitant changes in stress-associated cytokines.
Restricted and repetitive behaviors and sleep disturbance. This study analyzed information in the Autism Speaks ATN Registry to investigate the association of sleep problems in children with autism and restricted and repetitive behaviors: repetitive sensory motor behaviors and resistance to change (insistence on samenesss). The analysis included registry information on 339 children ages 2 to 17. The findings support previous research indicating that restricted and repetitive behaviors are two separate factors.
Describing family navigation as a service model. The objective of this ATN-funded study was to 1) develop an operational definition of family navigation for the ATN; 2) describe the common service models of family navigation within the ATN; and 3) identify potential best practices and appropriate outcome measures to evaluate the effectiveness of a family navigation models for children with autism. The researchers found that all family navigators provide referrals for community services (100 percent), educate parents on available options and the service system (92 percent) and help empower families (62 percent). This study will be expanded upon to develop an effective family navigation model for ASD that can be shared more broadly.
Implementing behavioral interventions in hospital settings. Several abstracts related to this AIR-P funded study will be presented at IMFAR. The main study investigated the feasibility of implementing brief Analogue Functional Analysis (AFA) in an inpatient setting for children with autism to improve and guide care during hospitalization. The pilot study included 36 children ages 6 to 18. Investigators also examined the ability to draw relevant financial data from existing electronic medical records to quantify potential costs of hospitalization. They were able to quantify length and total cost of hospitalization, use of physical/medical restraint and staffing ratios for all patients.
Latency based functional analysis in hospital settings. Building on the above study, investigators examined descriptive evidence of the capability of latency based functional analysis (LBFA) to identify functional reinforcers for problem behavior when conducted within typical inpatient hospital settings. A subset of 18 children in the larger study participated in this study. Results indicate that it is possible to identify behavior function through LBFA conducted by new therapists in inpatient hospital units after evoking and reinforcing a minimal number of target responses.
Bone microarchitecture in ASD. This AIR-P funded study aimed to assess distal radius and tibial microarchitecture in adolescent boys with autism compared to typically developing boys. The sample included 34 boys (16 with autism, 18 typically developing) from a single ATN center. Results show reductions in bone strength estimates at the distal radius and tibia, which may result from lower physical activity causing increased bone resorption in boys with autism compared to typically developing boys.
Impact of (special education services) and race on service utilization. This study analyzed information in the Autism Speaks ATN Registry to identify how disparities in race/ethnicity, parent education, SES and insurance type affect medical and therapy services for children with autism. By analyzing information on more than 4,000 kids previously enrolled in the ATN Registry, the investigators found patterns of service use vary by race and special education services.
Sleep and behavioral problems in children with ASD. The purpose of this study was to examine the relationships between distinct types of sleep and behavioral problems (aggression, irritability/hostility, inattention and hyperactivity) in children with autism. Participants included 81 children and adolescents ages 3 to 19 with autism, all recruited through one ATN center. Results show that sleep disturbance is associated with behavioral dysregulation among children with autism.
Bringing best autism care to primary care. This study used the ECHO (Extension for Community Healthcare Outcomes) model of telehealth to disseminate evidence-based screening and management guidance to community providers. In all, 14 primary care providers participated in ECHO® Autism clinics facilitated by an interdisciplinary team of autism and behavioral experts at the University of Missouri. This study showed that the ECHO Autism model is an effective model to improve primary care provider effectiveness in identification and management of autism.
Gender differences in co-morbidities in children with ASD. This observational study of the Autism Speaks ATN Registry explored differences in medical and behavioral issues by gender in a sample of 3,981 children (662 females and3,319 males) ages 2 to 5 years with autism. Results show a higher prevalence of medical and behavioral co-morbidities in females, but no difference between genders regarding the types of medications prescribed, severity of autism symptoms, age of first concern and age of diagnosis.
Therapy and medication use in children with ASD. This secondary data analysis of the ATN Registry described interventions received by young children, ages 36 to 72 months, with autism six months or more after diagnosis. Findings indicate that relatively few young children with autism are receiving evidence-based behavioral therapies and few are receiving psychosocial interventions at the recommended intensity.
Omega 3 Fatty Acids and ASD. This AIR-P funded study assessed reported use of DHA and EPA, two commonly used nutritional supplements for children with autism. It looked at both diet and nutritional supplementation as well as to examine the demographic and behavioral characteristics of children who are or are not given DHA and EPA supplementation. The study sample included 286 participants ages 2 to 11 from five ATN sites. Only 1 of the 286 participants (a nonsupplement user) met the daily requirement for DHA and EPA from diet alone. This study suggested that children (in this case, with autism) tend to be deficient in their intake of Omega 3 Fatty acids when the nutrients come from diet alone.
Somatosensory difficulties with behavior problems. This retrospective study used information on 6,902 children and adolescents from the Autism Speaks ATN Registry. The aim of this study was to determine the relationship between somatosensory difficulties and problem behaviors in children with autism, including investigation of the relation of individual somatosensory domains with specific problem behaviors. Findings demonstrate a strong relationship between somatosensory difficulties and problem behaviors in a cross-sectional sample of children with autism.