What is Autism?

What is Autism?

Wilczynski:  Beginning with Dr. Fischbach, tell us as simply as possible what is autism?

Fischbach:  Autism is a developmental disorder characterized by two main components: an inability to interact socially with other people with joint attention to understand other people’s thoughts. And the second component, the major component, is a real tendency to restricted interests, very narrowly focused interests and repetitive behaviors.  That is just the core definition; autism reaches out in many different directions.  It can be associated with language delays.  It can be associated with epilepsy.  It can be associated with some degree of intellectual disability, but the two core features of autism, I see, is impairments and social cognition, understanding and in restricted interests and repetitive behaviors.

Wilczynski:  And how is it diagnosed?

Fischbach:  Right now I think the gold standard is a clinical diagnosis, that an astute clinician interacting with a child, interviewing the parents, talking with teachers makes the diagnosis based on some standard tests and also on clinical impression and skill.  There are no good tests yet, we’ll talk more about that later, that I know of for biochemical tests or imaging tests, although people are getting close and that is one of the real pushes that we’ll talk about and other objective tests. But right now the gold standard objective test is clinical judgment.

Wilczynski:  Very good and I think that brings up the point that the clinicians really need to have broad experience at diagnosing individuals on the autism spectrum.  Seeing one or two cases of autism or even a couple of cases of Asperger’s is often insufficient to prepare a psychologist, a developmental pediatrician or other health professional to really provide a comprehensive diagnosis. Tell me what in the brain seems to go awry to create autism spectrum disorders?

Fischbach:  We just don’t know.  Everyone on this panel I'm sure will have certain interests and biases and thoughts.  I think my own bias is that there may be something wrong with the timing and the connectivity between regions rather than pointing to one particular spot in the brain.  That it’s how these regions talk to each other and how they interact that is just not quite right.

Bookheimer:  In particular I think that we’re getting closer to a model of autism that has to do with connectivity abnormalities in the brain and particularly early in development how connections are formed in the brain and, as Fischbach has pointed out, when they are formed in the brain. And in autism I think that one of the problems is that areas of the brain that are far from each other are not as well connected, whereas areas of the brain that are very close to each other seem to be over-connected. And so I think that it has to do with the developmental trajectory of when and where connections are formed that it appears to be awry.

Susan Bookheimer: The symptoms of autism are far better understood than its causes; psychiatrists classify the disorder as having two major components: impaired social cognition and a tendency toward narrow interests and repetitive behaviors.

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It looks like a busy hurricane season ahead. Probably.

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  • Before the hurricane season even started in 2020, Arthur and Bertha had already blown through, and Cristobal may be brewing right now.
  • Weather forecasters see signs of a rough season ahead, with just a couple of reasons why maybe not.
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Welcome to Hurricane Season 2020. 2020, of course, scoffs at this calendric event much as it has everything else that's normal — meteorologists have already used up the year's A and B storm names before we even got here. And while early storms don't necessarily mean a bruising season ahead, forecasters expect an active season this year. Maybe storms will blow away the murder hornets and 13-year locusts we had planned.

NOAA expects a busy season

According to NOAA's Climate Prediction Center, an agency of the National Weather Service, there's a 60 percent chance that we're embarking upon a season with more storms than normal. There does, however, remain a 30 percent it'll be normal. Better than usual? Unlikely: Just a 10 percent chance.

Where a normal hurricane season has an average of 12 named storms, 6 of which become hurricanes and 3 of which are major hurricanes, the Climate Prediction Center reckons we're on track for 13 to 29 storms, 6 to 10 of which will become hurricanes, and 3 to 6 of these will be category 3, 4, or 5, packing winds of 111 mph or higher.

What has forecasters concerned are two factors in particular.

This year's El Niño ("Little Boy") looks to be more of a La Niña ("Little Girl"). The two conditions are part of what's called the El Niño-Southern Oscillation (ENSO) cycle, which describes temperature fluctuations between the ocean and atmosphere in the east-central Equatorial Pacific. With an El Niño, waters in the Pacific are unusually warm, whereas a La Niña means unusually cool waters. NOAA says that an El Niño can suppress hurricane formation in the Atlantic, and this year that mitigating effect is unlikely to be present.

Second, current conditions in the Atlantic and Caribbean suggest a fertile hurricane environment:

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  • There's reduced vertical wind shear.
  • Atlantic tropical trade winds are weak.
  • There have been strong West African monsoons this year.

Here's NOAA's video laying out their forecast:

But wait.

ArsTechnica spoke to hurricane scientist Phil Klotzbach, who agrees generally with NOAA, saying, "All in all, signs are certainly pointing towards an active season." Still, he notes a couple of signals that contradict that worrying outlook.

First off, Klotzbach notes that the surest sign of a rough hurricane season is when its earliest storms form in the deep tropics south of 25°N and east of the Lesser Antilles. "When you get storm formations here prior to June 1, it's typically a harbinger of an extremely active season." Fortunately, this year's hurricanes Arthur and Bertha, as well as the maybe-imminent Cristobal, formed outside this region. So there's that.

Second, Klotzbach notes that the correlation between early storm activity and a season's number of storms and intensities, is actually slightly negative. So while statistical connections aren't strongly predictive, there's at least some reason to think these early storms may augur an easy season ahead.

Image source: NOAA

Batten down the hatches early

If 2020's taught us anything, it's how to juggle multiple crises at once, and layering an active hurricane season on top of SARS-CoV-2 — not to mention everything else — poses a special challenge. Warns Treasury Secretary Wilbur Ross, "As Americans focus their attention on a safe and healthy reopening of our country, it remains critically important that we also remember to make the necessary preparations for the upcoming hurricane season." If, as many medical experts expect, we're forced back into quarantine by additional coronavirus waves, the oceanic waves slamming against our shores will best be met by storm preparations put in place in a less last-minute fashion than usual.

Ross adds, "Just as in years past, NOAA experts will stay ahead of developing hurricanes and tropical storms and provide the forecasts and warnings we depend on to stay safe."

Let's hope this, at least, can be counted on in this crazy year.

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