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7 things everyone should know about autism
Autism is a widely misunderstood condition surrounded by falsehoods, half-truths, and cultural assumptions.
- Autism-spectrum disorder covers a wide range of neurodevelopmental conditions that are highly individualized.
- The prevalence of autism continues to increase in the United States, not due to vaccines but increased awareness and improved diagnosis.
- Autism awareness is crucial as treatment strategies are more effective if accessed early.
Autism has captured headlines, and therefore an undue amount of cultural panic, for many years. Yet, many people remain befuddled regarding basic information of this developmental disorder.
They don't believe people with autism experience emotions. (They do.) They fear that their child may catch autism from a classmate. (No, it's not contagious.) They wonder if the parents are to blame. (They aren't.) And they always want to know what an autistic person's savant talent is. (Autistic people certainly have talents, but movies have left us with the false assumption that autism equals Rain Man.)
To help spread awareness — and cut through the falsehoods, half-truths, and misinformation — here are seven things everyone should know about autism.
1) What is autism?
Autism is a neurodevelopment disability. People with autism have difficulty communicating or interacting socially and may engage in repetitive behaviors. They interact, behave, and learn in unique ways. Their behaviors may include avoiding eye contact, having trouble processing everyday sensory intake, showing no interest in make-believe games, and not enjoying physical contact such as hugging.
It's considered a spectrum condition because it affects people differently (hence the phrase "on the spectrum"). No two people will display identical conditions nor require the same support. Some autistic people can live healthy, independent lives, while others require more extensive care and support.
Originally, the Diagnostic and Statistical Manual of Mental Disorders categorized autism under the umbrella term "pervasive developmental disorder." But when the manual was updated to its fifth edition in 2013, it revised its criteria for autism. The category is now "autism-spectrum disorder," and it combines conditions that used to be diagnosed separately. These include autistic disorder, Asperger syndrome, and pervasive development disorders not otherwise specified (or PDD-NOS).
There is no lab test, like a blood test or genetic screening, available to determine if someone has an autistic-spectrum disorder. Medical professionals must make the determination based on behavior and development observations.
2) What causes autism?
Scientists don't know what exactly causes autism. Current investigations suggest a genetic origin, though environmental factors have not been ruled out entirely.
While it's difficult to untangle the interplay between genes and the environment, a longitudinal cohort study published in JAMA Psychiatry has provided the largest attempt so far. Researchers examined health data of more than 22,000 children diagnosed with autism spectrum disorder (ASD) from five countries. They estimated the heritability of ASD to be approximately 80 percent. They also found maternal effects — that is, the idea that the condition of the mother's body makes a child more likely to develop autism — to be insignificant.
"Although families are often most concerned about environmental risk factors for autism, the reality is that genetic factors play a much larger role overall," Andrew Adesman, director of developmental and behavioral pediatrics at Cohen Children's Medical Center in New Hyde Park, told HealthDay News. (Dr. Adesman was not involved in the study.)
It remains unclear how genes linked to autism are being activated, and researchers are quick to note that we can't altogether ignore potential environmental factors. After all, they are the ones we can potentially adjust or learn to avoid, and even if genes play the dominant role, the environment could still activate them.
The National Institute of Environmental Health Sciences lists the following as associated with autism:
- advanced parental age at time of conception;
- prenatal exposure to air pollution or certain pesticides;
- maternal obesity, diabetes, or immune system disorders;
- extreme prematurity or very low birth weight; and
- any birth difficulty leading to periods of oxygen deprivation to the baby's brain.
Please note: No one claims these environmental factors cause autism, but they do appear to increase a child's risk of developing it when combined with unfavorable genetic factors.
3) Are rates of autism increasing?
A graph showing the number of people with autistic-spectrum disorder in the world. (Source: IHME/Our World in Data)
Yes, they are.
The CDC's Autism and Developmental Disabilities Monitoring Network estimates the prevalence of autism among 8-year-old children in the U.S. Its estimates are based on more than 300,000 children across the U.S., with updates released every two years.
In 2016, the CDC estimated the prevalence of autism to be 1 in 68 children. By 2018, about 1 in 59 children were identified as autistic. That's a rate twice as high as 2004 (1 in 125).
Worldwide, the trend is similar. According to the Institute for Health Metrics and Evaluation, in 2014 17.92 million people were estimated to have autism. By 2016, the number had grown to 18.30. As in the United States, boys are four times more likely than girls to be diagnosed as autistic.
4) What is causing this rising prevalence?
Scientists aren't sure why the numbers keep climbing, but they know it's not something we added to the water. The likely answer is increased awareness and improved diagnosis.
For example, white children are identified as autistic more often than black or Hispanic children, but the reason for this is not genetic. Rather, income, a lack of healthcare access, and non-English primary language are all cited reasons for the discrepancy. As these barriers are reduced, the gap has shrunk.
"Autism prevalence among black and Hispanic children is approaching that of white children," Stuart Shapira, associate director for science at CDC's National Center on Birth Defects and Development Disabilities, said in a release. "The higher number of black and Hispanic children now being identified with autism could be due to more effective outreach in minority communities and increased efforts to have all children screened for autism so they can get the services they need."
States with more extensive outreach services report higher a prevalence of autism among children, too. New Jersey has the highest reported prevalence, but it furnishes extensive resources for professionals and support services. Conversely, the rural state of Alabama reports the lowest prevalence in the nation.
And let's remember that Asperger's syndrome and other disorders on the spectrum have been folded into a single diagnosis. As such, the number of children being diagnosed under a more cohesive criteria may bolster numbers previously spread out over distinct conditions.
5) Do vaccines cause autism?
Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn't feel good and changes - AUTISM. Many such cases!— Donald J. Trump (@Donald J. Trump)1396010150.0
No, they do not.
This isn't news, but there remains a lot of doubt and confusion. To pick one notable anti-vaxxer, President Donald Trump recently walked back this 2014 tweet linking autism to vaccines but still claims that too many vaccines in too short a time frame could have caused the rise in autism rates. He has also considered establishing a special autism commission to investigate this thoroughly-vetted practice.
A 2019 Danish cohort study look at the medical histories of more than half a million children born between 1999 and 2010. The researchers found no link between autism and the MMR vaccine (a vaccine against measles, mumps, and rubella). They also found no increased risk of the vaccine triggering autism in susceptible subgroups.
This is just one of many such studies that have failed to link the two. So again: Vaccines do not cause autism.
6) Is there a cure for autism?
No, there is no cure for autism, but the question — often phrased in this manner — is misleading.
Autism is a neurodevelopmental disorder, not a disease. It seems unlikely that we'll ever cure it with a pill; however, therapies and interventions have been developed to assist individuals and families addressing the challenges of living with autism.
"Intervention can help to lessen disruptive behaviors, and education can teach self-help skills for greater independence," writes the Autism Society. "But just as there is no one symptom or behavior that identifies people with autism, there is no single treatment that will be effective for everyone on the spectrum." [Emphasis original.]
Treatment strategies can include social skills training, speech therapy, cognitive behavioral therapies, occupational therapy, family service plans, and individualized education plans. Which psychosocial interventions are selected will depend on the individual's strengths and weaknesses.
Biomedical interventions have been proposed and utilized, but the National Institute for Health and Clinical Excellence has ruled out many of them. In children, for example, they recommend never using chelation, secretin, or hyperbaric-oxygen therapies.
While treatment strategies will vary based on the individual's needs, they are all most effective if they are accessed as soon as possible.
"The earlier a child with autism is diagnosed and connected to services, the better," Coleen Boyle, director of the CDC's National Center on Birth Defects and Developmental Disabilities, told Scientific American. "Our message to parents is, if you have a concern about how your child learns, plays, speaks, acts or moves, take action. Don't wait."
7) What does the future hold for autism?
The future looks bright. A drive toward autism awareness means more children are more likely to be diagnosed younger so they can begin therapies sooner. More communities are developing the resources necessary to support individuals and families living with autism. And a cultural shift toward neurodiversity has begun to lessen the stigma surrounding autism-spectrum disorders and other mental health conditions.
Even the increased prevalence of autism, which seems scary as a raw number, is ultimately a positive trend. The more young children diagnosed, the sooner their families can connect with the support and resources they need.
Researchers continue to look into the genetic causes of autism, too. They have begun to identify the genes linked to autism and to understand the relationship between autism, hereditable genes and de novo mutations. Revelations that may lead to new treatments and advancements in personalized medicine.
"In essence, that is personalized medicine, that is taking the genetic finding and determining what is the logical treatment and matching that patient up with an appropriate drug," said Jonathan Sebat, chief of the Beyster Center for Molecular Genomics of Neuropsychiatric Diseases. "If we can find a few compounds that modulate neurodevelopment in the way that we want it to, and we can understand real disease mutations and how they respond to these drugs, then that's the beginning of precision medicine."
With improved awareness, dispelled half-truths, and scientists working toward new treatment options, the future may be very bright indeed.
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Emotional intelligence is a skill sought by many employers. Here's how to raise yours.
- Daniel Goleman's 1995 book Emotional Intelligence catapulted the term into widespread use in the business world.
- One study found that EQ (emotional intelligence) is the top predictor of performance and accounts for 58% of success across all job types.
- EQ has been found to increase annual pay by around $29,000 and be present in 90% of top performers.
Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.
- Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
- They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
- The research raises many ethical questions and puts to the test our current understanding of death.
What's dead may never die, it seems<p>The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called Brain<em>Ex</em>. Brain<em>Ex </em>is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.</p><p>Brain<em>Ex</em> pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.</p><p>The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if Brain<em>Ex</em> can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.</p><p>As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.</p><p>The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.</p><p>"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told <em><a href="https://www.nationalgeographic.com/science/2019/04/pig-brains-partially-revived-what-it-means-for-medicine-death-ethics/" target="_blank">National Geographic</a>.</em></p>
An ethical gray matter<p>Before anyone gets an <em>Island of Dr. Moreau</em> vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.</p><p>The Brain<em>Ex</em> solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness. </p><p>Even so, the research signals a massive debate to come regarding medical ethics and our definition of death. </p><p>Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?</p><p>"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told <a href="https://www.nytimes.com/2019/04/17/science/brain-dead-pigs.html" target="_blank">the <em>New York Times</em></a>. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."</p><p>One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.</p><p>The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, <a href="https://www.nature.com/articles/d41586-019-01216-4#ref-CR2" target="_blank">told <em>Nature</em></a> that if Brain<em>Ex</em> were to become widely available, it could shrink the pool of eligible donors.</p><p>"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.</p><p>It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.</p><p>Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? <a href="https://bigthink.com/philip-perry/after-death-youre-aware-that-youve-died-scientists-claim" target="_blank">The distress of a partially alive brain</a>? </p><p>The dilemma is unprecedented.</p>
Setting new boundaries<p>Another science fiction story that comes to mind when discussing this story is, of course, <em>Frankenstein</em>. As Farahany told <em>National Geographic</em>: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have <em>Frankenstein</em>, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."</p><p>She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.</p>
Starting and running a business takes more than a good idea and the desire to not have a boss.
- Anyone can start a business and be an entrepreneur, but the reality is that most businesses will fail. Building something successful from the ground up takes hard work, passion, intelligence, and a network of people who are equally as smart and passionate as you are. It also requires the ability to accept and learn from your failures.
- In this video, entrepreneurs in various industries including 3D printing, fashion, hygiene, capital investments, aerospace, and biotechnology share what they've learned over the years about relationships, setting and attaining goals, growth, and what happens when things don't go according to plan.
- "People who start businesses for the exit, most of them will fail because there's just no true passion behind it," says Miki Agrawal, co-founder of THINX and TUSHY. A key point of Agrawal's advice is that if you can't see yourself in something for 10 years, you shouldn't do it.
After a decade of failed attempts, scientists successfully bounced photons off of a reflector aboard the Lunar Reconnaissance Orbiter, some 240,000 miles from Earth.
- Laser experiments can reveal precisely how far away an object is from Earth.
- For years scientists have been bouncing light off of reflectors on the lunar surface that were installed during the Apollo era, but these reflectors have become less efficient over time.
- The recent success could reveal the cause of the degradation, and also lead to new discoveries about the Moon's evolution.
A close-up photograph of the laser reflecting panel deployed by Apollo 14 astronauts on the Moon in 1971.
NASA<p>The technology isn't quite new. During the Apollo era, astronauts installed on the lunar surface five reflecting panels, each containing at least 100 mirrors that reflect back to whichever direction it's coming from. By bouncing light off these panels, scientists have been able to learn, for example, that the Moon is drifting away from Earth at a rate of about 1.5 inches per year.<br></p><p style="margin-left: 20px;">"Now that we've been collecting data for 50 years, we can see trends that we wouldn't have been able to see otherwise," Erwan Mazarico, a planetary scientist from NASA's Goddard Space Flight Center in Greenbelt, Maryland, <a href="https://www.nasa.gov/feature/goddard/2020/laser-beams-reflected-between-earth-and-moon-boost-science" target="_blank" rel="dofollow">said</a>. "Laser-ranging science is a long game."</p>
NASA's Lunar Reconnaissance Orbiter (LRO)
NASA<p>But the long game poses a problem: Over time, the panels on the Moon have become less efficient at bouncing light back to Earth. Some scientists suspect it's because dust, kicked up by micrometeorites, has settled on the surface of the panels, causing them to overheat. And if that's the case, scientists need to know for sure.</p><p>That's where the recent LRO laser experiment comes in. If scientists find discrepancies between the data sent back by the LRO reflector and those on the lunar surface, it could reveal what's causing the lunar reflectors to become less efficient. They could then account for these discrepancies in their models.</p>