Risk of diabetes, heart disease and dyslipidemia all elevated in autism
A review of all the current research looking at the risk of cardiometabolic disease allied to a diagnosis of autism spectrum disorder (ASD) has concluded that more urgently needs to be done to monitor for various conditions. Thirty-four studies, including over a quarter of a million people with ASD, were analyzed. Diabetes (both type 1 and type 2), dyslipidemia and heart disease were all more frequently seen in those with ASD compared to non-autistic control participants. Such work adds to a raft of studies suggesting that various somatic diagnoses are significantly over-represented alongside a diagnosis of ASD with important, often life-saving, preferential screening implied.
One in 54 kids with autism in 2016
A new study from researchers based in New York has further added to the large body of evidence pointing to sustained increases in autism prevalence rates in the US over the last couple of decades. Including researcher Walter Zahorodny, who has an impressive publication record in this area, the team looked at “active ASD surveillance” data in the New York-New Jersey Metropolitan Area for 2016, further dividing the data up into those 8-years diagnosed with ASD and intellectual (learning) disability and those just diagnosed with ASD. Unsurprisingly, the rate of ASD had increased in 2016 compared with previous years in line with other independent data. Of equal importance were findings that 1 in 3 children with ASD also had an intellectual disability. Alongside lingering issues regarding uneven assessment and diagnostic practices for non-white children, the collected data has important consequences for education, healthcare and future planning services.
Where we’re currently at with autism research
A recent perspectives article out of Columbia University in New York provides an important overview of the state of autism research with particular focus on prevalence, advocacy and the use of prospective birth cohorts to assess potentially important variables leading to a diagnosis of ASD. Illustrating some important milestones in autism research, particularly the various movements driven by parent-professional partnerships, the review concludes that far from knowing nothing about ASD, some important trends have emerged over the years. One important trend is recognition that environment as well as genes can influence onset of ASD; such environmental factors can include the involvement of the folate cycle, the presence of various toxic elements including infection, and the risks attached to various medicines (sodium valproate being the example mentioned, in line with various Governments’ guidance on reducing exposure during pregnancy).
“Aggressive behaviors are common in autism, but reduce with age”
Aggression, including behaviors directed at oneself and others, is unfortunately a facet of many experiences of ASD. New research from the UK confirms how widespread aggressive behaviors are in relation to ASD (present in about two-thirds) and how maturation and the presence of specific target behaviors may affect their presentation over the longer-term. Relying on caregiver garnered information, researchers plotted questionnaire responses covering aggressive behaviors over a 10 year period. Maturation seemed to bring about a reduction of such behaviors; although the co-occurrence of features of ADHD (attention deficit hyperactivity disorder) seemed to correlate with their persistence. Such data is vitally important to developing models of such life-affecting behaviors and stimulating research on ways to reduce such behaviors and the sometimes all-encompassing effects they have on the person and the people around them.
Profound Concerns about “Profound Autism”
Further welcomed debate on the rise of the term ‘profound autism’ is starting to filter into the peer-reviewed autism research domain. Profound autism, denoting those with high support needs on the basis of what might be described as severe autism, was initially suggested as part of a wide-ranging review document on ASD published in 2022. Several people and groups have subsequently taken to social media to voice their disquiet with the term and particularly the idea of ‘separating off’ those with higher support needs. The review article highlights the current gaps in knowledge and terminology used, particularly the need for assessing those potentially categorized as profoundly autistic with non-verbal measures of skills. Assuming there remains an appetite for classifications such as profound autism, the next step would be to present ideas for operationalized criteria perhaps building on already existing ‘levels of support’ seen in some diagnostic classification tools.
Full-text: https://www.mdpi.com/2227-7102/13/2/106
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