How Can Autism Be Treated?

How Can Autism Be Treated?

Wilczynski: What is the current state of treatment for autism?  Anyone?

Bookheimer:  There are many treatments for autism, but I think that we would agree that the most effective treatments are still behavioral treatments.  There are some drug treatments, which perhaps Chris can tell us about. But behaviorally I think that most of us agree that early intense treatment is still the very best interventions for autism and usually involving increasing joint attention, getting children to learn how to attend together with their caregivers, involving parents in the care giving in the treatment process, and doing it intensely and as early as possible.  Most people think that still gives us the best outcome in autism.

Wilczynski:  Very good, and Chris, did you want to add to that?

Walsh:  Yeah.  I agree.  The tried and true and the best documented methods of treatment involve this early behavioral intervention and it’s interesting that in animal models if you take a mouse and you do an enriched environment it changes patterns of gene expression in the brain. And so it will be interesting to see whether this kind of early behavioral intervention in humans may have actually some genetic or gene-expression profile in the human brain as well. 

Fischbach:  I bet it’s going to end up being a combination of behavioral therapy and some medicine.  We just don’t know what the medicine is yet.  It’s strange that we’re all saying genes point to synapses, to connections. But none of the traditional therapies used in other neuropsychiatric disorders that either increase or decrease the action of a certain transmitter at a synapse seem to be effective in autism, in the core symptoms of autism.  They may help in reducing the anxiety component or the aggressive component, but the social cognition seems to be resistant to traditional synoptically active drugs.  Something new is going to be needed here. 

Bookheimer:  I think in part that reflects a general problem in that we tend to want to find interventions, particularly pharmacal interventions that are going to treat autism as a whole when in fact I think that we’re going to end up being more successful in treating specific features of autism—the repetitive behaviors aspect of it, the anxiety aspect of it and so forth—rather than finding a single bullet, a magic pill that is going to do everything for us.

New drugs for patients may be on the horizon, but "early, intense" behavioral treatment remains "the very best intervention for autism."

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Accretion disk surrounding a neutron star. Credit: NASA
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The competition between forces from protons and neutrons inside a neutron star create super-dense shapes that look like long cylinders or flat planes, referred to as "spaghetti" and "lasagna," respectively. That's also where we get the overall name of nuclear pasta.

Caplan & Horowitz/arXiv

Diagrams illustrating the different types of so-called nuclear pasta.

The researchers' computer simulations needed 2 million hours of processor time before completion, which would be, according to a press release from McGill University, "the equivalent of 250 years on a laptop with a single good GPU." Fortunately, the researchers had access to a supercomputer, although it still took a couple of years. The scientists' simulations consisted of stretching and deforming the nuclear pasta to see how it behaved and what it would take to break it.

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One of the study's co-authors, Matthew Caplan, a postdoctoral research fellow at McGill University, said the neutron stars would be "a hundred trillion times denser than anything on earth." Understanding what's inside them would be valuable for astronomers because now only the outer layer of such starts can be observed.

"A lot of interesting physics is going on here under extreme conditions and so understanding the physical properties of a neutron star is a way for scientists to test their theories and models," Caplan added. "With this result, many problems need to be revisited. How large a mountain can you build on a neutron star before the crust breaks and it collapses? What will it look like? And most importantly, how can astronomers observe it?"

Another possibility worth studying is that, due to its instability, nuclear pasta might generate gravitational waves. It may be possible to observe them at some point here on Earth by utilizing very sensitive equipment.

The team of scientists also included A. S. Schneider from California Institute of Technology and C. J. Horowitz from Indiana University.

Check out the study "The elasticity of nuclear pasta," published in Physical Review Letters.


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Image: NASA
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"If [glacial geoengineering] works there then we would expect it to work on less challenging glaciers as well," the authors wrote in the study.

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The most effective design, according to the team's computer simulations, would be a miles-long and very tall wall, or "artificial sill," that serves as a "continuous barrier" across the length of the glacier, providing it both physical support and protection from warm waters. Although the study authors suggested this option is currently beyond any engineering feat humans have attempted, it was shown to be the most effective solution in preventing the glacier from collapsing.

Source: Wolovick et al.

An example of the proposed geoengineering project. By blocking off the warm water that would otherwise eat away at the glacier's base, further sea level rise might be preventable.

But other, more feasible options could also be effective. For example, building a smaller wall that blocks about 50% of warm water from reaching the glacier would have about a 70% chance of preventing a runaway collapse, while constructing a series of isolated, 1,000-foot-tall columns on the seafloor as supports had about a 30% chance of success.

Still, the authors note that the frigid waters of the Antarctica present unprecedently challenging conditions for such an ambitious geoengineering project. They were also sure to caution that their encouraging results shouldn't be seen as reasons to neglect other measures that would cut global emissions or otherwise combat climate change.

"There are dishonest elements of society that will try to use our research to argue against the necessity of emissions' reductions. Our research does not in any way support that interpretation," they wrote.

"The more carbon we emit, the less likely it becomes that the ice sheets will survive in the long term at anything close to their present volume."

A 2015 report from the National Academies of Sciences, Engineering, and Medicine illustrates the potentially devastating effects of ice-shelf melting in western Antarctica.

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