Study: ASD evaluations up for preschoolers, but room to improve

An increasing proportion of children with autism spectrum disorders are undergoing recommended evaluation in the preschool years — but population rates of ASD remain higher in 8-year-olds compared with 4-year-olds, a new study reports. Findings were published Dec. 9 on the website of the Journal of Developmental & Behavioral Pediatrics, the official journal of the Society for Developmental & Behavioral Pediatrics. Based on nationwide monitoring data, the study “offers valuable insight into the early identification of ASD and suggests some progression towards lowering the age of first evaluation in participating communities,” Daisy Christensen, PhD, of the National Center on Birth Defects and Developmental Disabilities and colleagues wrote in the study, according to a news release. New insights on rates, characteristics of preschoolers with ASD The study used 2010 data from five of 11 U.S. sites participating in the CDC’s Autism and Developmental Disabilities Monitoring Network. The prevalence of ASD was assessed by screening and review of the children’s health and/or education records. Researchers compared population rates of ASD among 4-year-olds (born in 2006) with those in 8-year-olds (born in 2002) in the same areas. In the overall population of nearly 58,500 4-year-olds, the estimated prevalence of ASD was 13.4 per 1,000 children. That figure varied substantially across sites: from 8.5 per 1,000 in Missouri to 19.7 per 1,000 in New Jersey. Estimates of ASD prevalence were about 30% lower in 4-year-olds compared with 8-year-olds, researchers found, suggesting that many cases aren’t being recognized until after school age — especially ASD without cognitive impairment. Eight-year-old children had a 40% higher prevalence of ASD without cognitive impairment compared with 4-year-old children. The reverse was true for ASD plus cognitive impairment: 4-year-olds had a 20% higher prevalence compared [...]

By |December 18th, 2015|Categories: News|0 Comments

Slow walking speed in elderly associated with Alzheimer’s hallmarks

How fast elderly people walk might be related to the amount of amyloid they have built up in their brains, even if they don’t yet have symptoms of Alzheimer’s disease, according to a new study. Findings were published Dec. 7 on the website of Neurology, the medical journal of the American Academy of Neurology. The study involved 128 people with an average age of 76 who did not have dementia but were considered at high risk for developing it because they had some concerns about their memory. The participants had positron emission tomography scans of their brains to measure amyloid plaques in the brain. These plaques consist of dense deposits of a protein called beta amyloid, and their progressive buildup in the brain has been associated with the development of Alzheimer’s disease. Of the participants, 48% had a level of amyloid often associated with dementia. Participants also were tested on thinking and memory skills and how well they could complete everyday activities. A total of 46% of the participants had mild cognitive impairment, which can be a precursor to the dementia that occurs in Alzheimer’s disease. Walking speed was measured by timing people on how fast they could walk 4 meters (about 13 feet) at their usual pace. The average walking speed was 3.48 feet per second, results showed. All but two of the participants tested in the normal range of walking speed. The researchers found an association between slow walking speed and amyloid in several areas of the brain, including the putamen, a key region involved in motor function. The researchers compared how fast people walked both with and without taking into account the amount of amyloid and found the amyloid level accounted for [...]

By |December 15th, 2015|Categories: News|0 Comments

Study links congenital heart disease mutations to neurodevelopmental issues

Scientists have confirmed the role of a set of gene mutations in the development of congenital heart disease and simultaneously discovered a link between them and some neurodevelopmental abnormalities in children. These abnormalities include cognitive, motor, social and language impairments. “The risk of developing neurodevelopmental disabilities is so high when these particular gene mutations are present that we might consider testing for them in all patients with congenital heart disease,” investigator Jonathan R. Kaltman, MD, said in a news release. Kaltman is the program administrator of the National Heart, Lung and Blood Institute’s Bench to Bassinet Program, which funded the study. He noted the findings from the study would have to be replicated and refined before a clinical test could be available. NHLBI is part of the National Institutes of Health. Congenital heart disease — in which there are structural defects in the heart — is the most common type of birth defect in the U.S., and one of the leading causes of infant death. Nearly 40,000 children are born with congenital heart disease each year, and experts estimate about 1 to 2 million adults and 800,000 children in the U.S. are living with the disease. “Surgery is often performed early in life to repair heart defects,” Kaltman said in the release. “However, we have found that once children reach school age, many exhibit various attention deficits, including attention deficit hyperactivity disorder, and other neurobehavioral problems.” In their study, published Dec. 4 in the journal Science, investigators from the Bench to Bassinet Program’s Pediatric Cardiac Genomics Consortium used a technique called exome sequencing to genetically evaluate 1,220 family trios — composed of a child with congenital heart disease and the mother and father. Through this [...]

By |December 14th, 2015|Categories: News|0 Comments

Research: Breast cancer gene linked to Alzheimer’s disease

Scientists have linked the mutation of a protein associated with a specific gene to breast and ovarian cancer. Now a recent study by California researchers has found that low levels of the same protein, BRCA1, might contribute to Alzheimer’s disease. BRCA1 is a protein, which in mutant form, “has been studied primarily as a genetic risk factor for ovarian and breast cancer,” the authors wrote in the study published Nov. 30 in Nature Communications. The study was funded by the National Institutes of Health. The researchers suspected defects in DNA repair mechanisms could contribute to cognitive decline in Alzheimer’s disease and focused their studies on BRCA1, which plays a key role in repairing DNA. The authors examined brains of patients who died with Alzheimer’s and discovered low levels of BRCA1, according to the release. In addition, the researchers found reductions of BRCA1 in the brains of mouse models of Alzheimer’s. Experimental reduction of BRCA1 levels in brains of healthy mice made their brain cells shrink and become dysfunctional, according to the release. Mouse models of Alzheimer’s disease showed even greater declines in learning and memory following reductions of BRCA1. “The functions of BRCA1 in the brain remain to be fully elucidated, but our findings suggest that it may play an important role in supporting critical brain functions in both health and disease,” senior author Lennart Mucke, MD, said in the release. Mucke is director of the Gladstone Institute of Neurological Disease, San Francisco, and the Joseph B. Martin Distinguished Professor of Neuroscience and professor of neurology at the University of California, San Francisco. Further research is necessary to determine whether BRCA1 may be a potential therapeutic target for treating dementia, and whether BRCA1 mutations that [...]

By |December 11th, 2015|Categories: News|0 Comments

New York is 50th state to enact licensure law for OTAs

With the signature of Gov. Andrew Cuomo on Nov. 20, New York has become the 50th state to enact legislation requiring licensure for OTAs, according to a news release. The legislation passed both chambers of the New York General Assembly with bipartisan support. “This is a landmark event for New York state occupational therapists,” Gloria Lucker, MS, OTR/L, FAOTA, BCP, president of the New York State Occupational Therapy Association, said in the release. “Finally, after 30 years, we have full recognition for occupational therapy assistants in our state. I am so proud of our occupational therapists and occupational therapy assistants who worked so hard to make this happen. Having licensure for occupational therapy assistants will assure their full participation in the profession and will enhance practice standards as well as providing greater recognition by the community.” According to the newly signed S. 1567-A sponsored by state Sen. Kenneth P. LaValle, R-1st District, the OTA licensure provisions will go into effect in May 2016. Existing law requires OTAs to meet certain requirements to become authorized to practice by the Department of Education. The bill repeals that provision and establishes licensure requirements for OTAs in statute that are consistent with existing requirements. The new law also changes the composition of the State Board of Occupational Therapy by requiring one member be a licensed OTA. New York is the last state in the U.S. to require licensing for OTAs. Hawaii passed licensure legislation for OTs and OTAs in July 2014, becoming the 50th state to enact a licensure law for OTs and the 49th state to require licensure for OTAs, according to the release. The American Occupational Therapy Association has been working alongside state occupational therapy associations and [...]

By |December 8th, 2015|Categories: News|2 Comments

Toward truly interprofessional teamwork

Last month I had the honor of co-presenting at the annual convention the American Speech-Language-Hearing Association, along with Kathy Fahey, PhD, CCC-SLP, OnCourse Learning clinical editor. I was so impressed by the participants’ enthusiasm and dedication to their professions. I often have sensed the same energy at occupational therapy gatherings, so I felt oddly at home although I was the only OT in the room. Interprofessional education and practice was a major theme of the conference. The World Health Organization has emphasized interprofessional teamwork as a priority in improving health because it improves clinical outcomes, decreases medical errors and adds to worker retention and satisfaction. The concept may seem obvious, but practicing it is anything but automatic, simple or typical. Genuine interprofessional teamwork involves: • Knowledge of and respect for other professionals’ roles, knowledge and skills • Clarity regarding each team member’s role and ways to proactively negotiate role release, overlap or merging as situations indicate and/or occur • Consistent communication and collaboration among professionals • A core set of agreed-upon ethics and values, and a common sense of mission I cannot imagine any practitioner disagreeing with these values, yet we often work alongside one another in a “parallel play” model of teamwork. This occurs for a number of reasons. Here are some ideas for solutions to common obstacles. Problem No. 1 We have been acculturated to focus our attention and loyalty onto our chosen professions. I am absolutely guilty of this, as I just love OT so much that I frequently act like an evangelist. We need to balance our professional pride with humility and curiosity about others’ ways of knowing and doing. Solutions • View patients’ progress as a result of the whole [...]

Trial: Safe form of estrogen helps MS patients avoid relapses

Taking the pregnancy hormone estriol along with their conventional medications helped patients with relapsing-remitting multiple sclerosis avoid relapses, according to results of a clinical trial. The phase 2 randomized, placebo-controlled study was led by researchers at UCLA. Findings were published online Nov. 24 in the journal Lancet Neurology. It is estimated that more than 2.1 million people are affected by MS worldwide. Approximately 85% of patients are diagnosed at onset with RRMS, the most common form of MS. It long has been observed that during the second half of pregnancy, women with RRMS have reduced relapses. It is also during this period that the fetal placenta produces estriol, increasing the hormone levels in the blood. This protection during pregnancy also occurs in other autoimmune diseases such as psoriasis and rheumatoid arthritis. The study’s lead author, Rhonda Voskuhl, MD, a professor and Jack H. Skirball Chair for Multiple Sclerosis in UCLA’s neurology department and director of UCLA’s Multiple Sclerosis Program, hypothesized the increased estriol in the blood might play a role in suppressing a woman’s immune system so the fetus is not rejected as being foreign. This temporary suppression of the immune system would be good for pregnant mothers with autoimmune diseases. Her team found treatment with estriol was protective in the MS model. “The beauty of estriol is that it is not a shot and can be taken in pill form, and also that it’s not a new drug,” Voskuhl said in a news release. “It has decades of safety behind it. Also, current MS treatments are very complex to manufacture. These findings hopefully will pave the way for oral, safe treatments that are more widely accessible, since estriol is simple and naturally occurring.” In [...]

By |December 4th, 2015|Categories: News|0 Comments

Study: Air evacuation may do more harm in patients with TBI

Air evacuation might pose a significant added risk to patients who have suffered a traumatic brain injury, possibly causing more damage to already injured brains, according to a new study. During the past 15 years, more than 330,000 U.S. soldiers have suffered a TBI, according to the Defense and Veterans Brain Injury Center. TBI is one of the leading causes of death and disability connected to the country’s recent conflicts in Afghanistan and Iraq. Many of these patients were evacuated by air from these countries to Europe and the U.S. for further treatment. In general, these patients were flown quickly to hospitals outside the battle zone, where more extensive treatment was available. However, the new study by researchers at the University of Maryland’s School of Medicine is the first to suggest air evacuation may be hazardous for TBI patients, according to a news release. The study was published Nov. 30 in the Journal of Neurotrauma. “This research shows that exposure to reduced barometric pressure, as occurs on military planes used for evacuation, substantially worsens neurological function and increases brain cell loss after experimental TBI — even when oxygen levels are kept in the normal range,” lead researcher Alan Faden, MD, the David S. Brown Professor in Trauma at UM, said in the release. “It suggests that we need to carefully re-evaluate the cost-benefit of air transport in the first days after injury.” Faden also serves as the director of the Shock, Trauma and Anesthesiology Research Center and the National Study Center for Trauma and Emergency Medical Services at UM. About 25% of all injured soldiers evacuated from Afghanistan and Iraq have suffered head injuries, according to past research. Faden and his colleagues tested rats that [...]

By |December 1st, 2015|Categories: News|0 Comments

Study explores risk to people in wheelchairs from car-pedestrian crashes

People who use wheelchairs are a third more likely to die in car-pedestrian crashes than those who do not, and more than half of those deaths occur at intersections, according to a new investigation. The study, led by researchers at Georgetown University in Washington, D.C., also found men who use wheelchairs are five times more likely than women who use wheelchairs to die in pedestrian crashes. Findings were published Nov. 20 in BMJ Open. “Understanding and describing risks are the first steps to reversing them,” John Kraemer, JD, MPH, assistant professor at Georgetown’s Department of Health Systems Administration and a scholar at the university’s O’Neill Institute for National and Global Health Law, said in a news release. “While there was a little data on nonfatal pedestrian injuries among people who use wheelchairs, there were almost none on fatal injuries.” According to the U.S. Department of Transportation, nearly 5,000 pedestrians are killed in traffic crashes each year and an estimated 76,000 are injured. For the study, researchers used data from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System, which is based on police reports of road traffic collisions on U.S. roads, and data from news stories about car crash fatalities published on the LexisNexis U.S. newspaper database to estimate how many people using wheelchairs were pedestrian fatalities. The researchers calculated about 528 pedestrians using wheelchairs were killed in road traffic collisions in the U.S. between 2006 and 2012. This equates to a 36% higher risk of death for a person using a wheelchair in a car-pedestrian crash than a person who is not using a wheelchair. They also found the risk of car-related death was more than five times higher for men in wheelchairs [...]

By |November 30th, 2015|Categories: News|1 Comment

Report names transportation challenges for adults with ASD, families

An integrated approach to providing access to reliable and safe transportation is needed for adults with autism spectrum disorders and their families, according to research that offers recommendations for removing barriers to better mobility. The report, written by researchers with Rutgers University in New Brunswick, N.J., identifies transportation obstacles people with ASD and other developmental disabilities, and their families, must overcome to carry out daily activities. Many challenges are associated with transportation, such as the inability to live independently, reach employers and healthcare providers and engage in community and social activities. Findings showed New Jersey adults with ASD travel primarily as passengers of cars driven by their parents and other family members, which often results in stress, inconvenience and negative employment consequences for both the adults with ASD and their drivers. While the availability of accessible public transportation is crucial for everyone with all types of disabilities, including adults who have ASD, many do not have access to public transportation or possess the familiarity or skills to use these services, according to the report. “Very little has been written about the transportation issues encountered by adults with autism spectrum disorders,” co-principal investigator Cecilia Feeley, PhD, transportation autism project manager at the Center for Advanced Infrastructure and Transportation, said in a news release. The center conducted the two-year study with the Alan M. Voorhees Transportation Center at Rutgers’ Edward J. Bloustein School of Planning and Public Policy. The report, “Detour to the Right Place: A Study with Recommendations for Addressing the Transportation Needs and Barriers of Adults on the Autism Spectrum in New Jersey,” gathered information on the challenges New Jersey adults with ASD face as they pursue employment, continuing education and other opportunities, Feeley said [...]

By |November 27th, 2015|Categories: News|0 Comments