Dr. Henry Paul, MD

Psychiatrist, Author and Educator

LOOK THROUGH MY LENS

February 1st, 2016

I made a great video discovery on YouTube this week. I found this 14-minute video that explained autism. Most impressive was that this video was done, start to finish, by a 16-year-old high school student who wanted to let her peers know what it was like to have autism. No she doesn’t have autism, nor does anyone in her family. But, after she met her friend Jaime with cerebral palsy, she realized that we all need a better understanding of what it is like to live with a physical disability or learning difficulties. With her single YouTube video, she has helped thousands of teens understand a complex disorder.

Alex Jackman told Choices Magazine that it all began when out of curiosity she joined a girl for lunch at summer camp. Jaime was in a wheelchair and often ate by herself. Alex and Jaime became good friends. Alex tells Choices how that might not have happened had she not approached Jaime and sat down with her for lunch.

Jackman says that through her volunteer work at a local autism organization she was inspired to create the video, specifically targeted at teens, to help them better understand the developmental disorder. She told Choices, “I wanted to make something simple that put you in someone with autism’s shoes.”

After a year of interviewing kids she had met through her volunteering, interviewing experts on Autism, and writing, filming and editing – Jackman posted “A Teens Guide to Autism.” And, guess what? It took off. The video has been seen around the world and has won several awards! Kudos to Jackman for making a difference!

LINKS
The Autism Activist

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

AUTISM – WHAT IS REALLY BEHIND THE RISING NUMBERS?

November 7th, 2014

“The dramatic increase in the number of children diagnosed with an autism spectrum disorder is largely the result of changes in how the condition is reported,” Danish researchers contend in a study out this week, and I agree!

The Danish study says that the increase in numbers is due largely to the changes in diagnosing and reporting.

“As our study shows, much of the increase can be attributed to the redefinition of what autism is and which diagnoses are reported,” said lead researcher Stefan Hansen, from the section for biostatistics in the department of public health at Aarhus University in an interview with CBS News. “The increase in the observed autism prevalence is not due alone to environmental factors that we have not yet discovered.”

In the United States, the U.S. Centers for Disease Control and Prevention estimates that one in 68 children have an autism spectrum disorder. The reported prevalence of the condition has increased over the past 30 years, according to the new study.

In the same CBS News interview, Amy Daniels, the assistant director for public health research at Autism Speaks, a New York City-based advocacy group, agreed that a significant part of the increase in autism has resulted from changes in diagnosis and reporting.

“The findings from this study are consistent with past research documenting the role of non-causal factors, such as increase in autism awareness, changes to diagnostic criteria and the increase in autism prevalence over time,” she said.

Scientists aren’t certain about what causes autism, but it’s likely that a combination of genetics and environmental factors play a role, according to the U.S. National Institute of Neurological Disorders and Stroke.

I believe that autism is a neurological disorder and not an environmental one. There are plenty of new studies and research about Autism. I just posted a blog in September about a research study that indicates that children’s brains with autism fail to trim the synapses as they develop, and that if safe therapies can be developed to clear these synapses, there might be new hope for treating autism.

Now, the most important thing about autism is that people are talking about it. The medical community is stepping up its research, and medical professionals and schools are looking at treatment and accommodations to help those diagnosed with the disorder. We have a lot of work to do to understand and to treat autism, and that work has begun! Stay tuned.

For more on the Danish study visit CBS News “What’s Behind the Dramatic Rise in Autism Cases?” For more on autism visit my recent blogs:

Children with Autism Have Oversupply of Synapses, Says New Study
Shock Em’ Out of Autism
CDC Says 11 in 68 Children is on the Autism Spectrum – So What Does That Really Mean?

DISCLAIMER

Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

CHILDREN WITH AUTISM HAVE OVERSUPPLY OF SYNAPSES, SAYS NEW STUDY

September 3rd, 2014

Study Finds That Brains with Autism Fail to Trim Synapses as They Develop — Now a new study suggests that in children with autism, something in the process goes awry, leaving an oversupply of synapses in at least some parts of the brain.

The finding provides clues to how autism develops from childhood on, and may help explain some symptoms like oversensitivity to noise or social experiences, as well as why many people with autism also have epileptic seizures.

It could also help scientists in the search for treatments, if they can develop safe therapies to fix the system the brain uses to clear extra synapses. The New York Times

This is a very interesting article showing some of the latest research on Autism. The study, recently published in the journal Neuron, involved tissue from the brains of children and adolescents who had died from ages 2 to 20. About half had autism; the others did not.

The study suggests that children with autism have an oversupply of synapses in some parts of their brain. These synapses are normally “pruned” during childhood and adolescent development so different areas of the brain can develop specific functions without an overload of stimuli. When that pruning does not happen, and there is a continued overload of the synapses, the research suggests that this might be the cause of autism. If safe therapies can be developed to clear these synapses, there might be new hope for treating autism.

What I find interesting about this study is that there has been an ongoing debate in the medical community for years as to whether autism is a problem of too little, too much or a combination of connectivity in the brain.

In the NY Times article, Ralph-Axel Müller, a neuroscientist at San Diego State University, said, “Impairments that we see in autism seem to be partly due to different parts of the brain talking too much to each other. You need to lose connections in order to develop a fine-tuned system of brain networks, because if all parts of the brain talk to all parts of the brain, all you get is noise.”

The research is very interesting. What needs much further study is rapamycin, a drug that has serious side effects, and which is being discussed as a form of therapy for this neurological finding. Finding the cause is the beginning of finding a cure. Best not to jump too quickly looking for a silver-bullet cure, however. Let’s all follow the research. I am sure this will open up a much wider debate on the cause of autism and how to treat it. Stay tuned!

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

SHOCK EM’ OUT OF AUTISM?

August 21st, 2014

Jennifer Msumba is on the autism spectrum. For seven years, she was treated at the Judge Rotenberg Center in Canton, Massachusetts, where she received painful electric shocks aimed at modifying her behavior. She describes being strapped, spread-eagle to a restraint board and shocked multiple times before she left the center in 2009. CBS Evening News.

Autism Spectrum Disorder (ASD), also known as Pervasive Development Disorder, is a diagnosis that is more prevalent than ever before and one that is concerning not only for the medical community, but for the parents and families of those diagnosed with it, too.

Back in March of this year, a CDC study reported that one in 68 children has Autism (ASD). This was a 30 percent increase since the agency estimated just two years before that one child in 88 suffered from the disorder. There is some controversy as to the validity of the reported increase in diagnosis but ASD remains a major issue in this country. It is one of a parent’s most feared diagnoses.

The CBS News story is the first to really “out” electric shock as a treatment for those with ASD. After watching the segment, you certainly can see there is controversy attached to its usage, as well.

ASD is a condition that has a number of variables, and those are specific to each person diagnosed with it. Some people cannot communicate at all while others are social. Some can be compulsive and inflexible, preoccupied with similar ritualized behaviors that can go on for hours. Others can be aggressive and prone to angry outbursts or temper tantrums. Some have mood swings, can be hyperactive, and the list goes on. The important thing to recognize is that all these symptoms do not show up in every person diagnosed with ASD.

Without knowing the full story and seeing the diagnoses of the patients included in the news story, I cannot render an appropriate opinion on specific treatment recommendations, but I can say that the use of shock therapy for these types of children seems far-fetched to me. Using shock conditioning seems primitive, if not downright out of the realm of accepted standards of care. When I treat young people with ASD I almost always recommend medication and behavioral therapy, as well as proper educational placement. I have never recommended electric shock and find it difficult to imagine ever prescribing.

CDC SAYS 1 IN 68 CHILDREN IS ON THE AUTISM SPECTRUM – SO WHAT DOES THAT REALLY MEAN?

March 28th, 2014

This morning, almost every news outlet ran a story about the latest CDC study stating one in 68 children has Autism. Lenny Bernstein reported today in The Washington Post “To Your Health” section that “ The number of U.S. children with autism has surged to one in 68, the Centers for Disease Control and Prevention reported Thursday, a 30 percent increase since the agency estimated just two years ago that one child in 88 suffered from the disorder.

The new estimate, based on a review of records in 2010 for eight year olds in 11 states, also showed a marked increase in the number of children with higher IQs who fall somewhere on the autism spectrum, and a broad range of results depending on where a child lives. Only one child in 175 was diagnosed with autism in Alabama, while one in 45 was found to have the disorder in New Jersey.”

What does all this mean to parents? First, if you suspect that your child may be on the spectrum [read my earlier blog this week on the signs of Autism] then you need to have your child seen by a professional who will make a diagnosis. You will also need to speak with the CSE (Committee on Special Education) at your child’s school to discuss testing. The testing will identify what support services the school will be able to offer your child through an Independent Education Plan, known as the IEP.

As frightening as this diagnosis may be for parents there are children on the autism spectrum that are able to lead productive lives. Many celebrated people have been diagnosed or are suspected of being on the autism spectrum. The best thing you can do is to learn about autism and be sure your child receives all the services available in your area.

The Signs of Autism — I Think My Child Might Be on The Spectrum

DISCLAIMER

I THINK MY CHILD MIGHT BE ON THE SPECTRUM

March 24th, 2014

“I’m terrified, Doctor, Philip is almost two and he still hasn’t said a word. Could he be Autistic?”

Autism, today, is one of the most talked about, and feared, diagnoses for parents. Autism and Autism spectrum disorder (ASD) are both general terms for a group of complex disorders of brain development that affect each person in different ways, and can range from very mild to severe. Generally symptoms start before the age of three years old and last a lifetime. There are three types ASD’s; Autistic Disorder, Asperger Syndrome, and Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS; also called “atypical autism”). All three are characterized by varying degrees of difficulty with social interaction, verbal and nonverbal communication and repetitive behaviors. These symptoms include:

Impaired social relatedness
Lack of social reciprocity
Decreased peer relationships
Sharing deficits
Delayed or lack of language
Odd/repetitive speech
Poor conversational skills
Rigidity
An obsessive need for sameness
Rituals
Motor mannerisms
Preoccupations with parts of objects or narrow interests

As with so many other psychiatric syndromes, we don’t know exactly what causes autism, but we do know that it is not caused — as had once widely been thought — by cold, inattentive, negligent or unloving parents. Autism seems to be a disorder connected with dysfunction in the central nervous system. While no clear lesion or specific neurotransmitter has been isolated as the cause, we know that genetics plays a role.

As for treating with medication, antipsychotic drugs have only proven helpful in a narrow range of symptoms including irritability, tantrums, some of the motor issues, the occasional high anxiety of these children (sometimes to the point of psychosis), and repetitive behaviors. Unfortunately, there is little pharmacological help for the core of Autism, which is impaired communication and decreased relatedness.

THERE IS SOMETHING WRONG WITH MY CHILD

November 7th, 2013

These are three phone calls that I received in one week:

(Steven)
“The school principal just called and said our son Steven, a fourth grader, was overheard talking with some friends about bringing a knife to school. He has a history of misbehavior, but recently he has gotten worse. He has been fighting a lot, not following rules, talking back, leaving the classroom without permission, and now this. I’m freaking out. When can we see you?”

(Jessica)
“Our fourteen-year-old daughter, Jessica, has been sad since her grandma died six months ago. She’s been withdrawn, sleeping a lot, and hardly eats. At first we sympathized with her and gave her space. But this morning I looked in her diary and read a note in which she talked about yearning to be dead and join her grandma in heaven. I think this is much worse than just grieving. What should we do?”

(Marty)
“Marty, our eleven-year-old son, has always been shy. Ever since we can remember, he was scared to do anything new. We would have to accompany him everywhere — school, camp, after school activities, and the like. He could never go on a play date without great fear. He never made close friends. But now he is beginning to act really strange. He talks to himself, he is over-involved on strange websites, he smiles about things we can’t understand, and yesterday said something about being connected to other people through mind reading. I read something about psychosis on the Internet and he seems to fit the bill. I’m terrified something really serious is wrong with him.”

I get calls like these almost every day. Realizing that your child may have a problem is really scary. It can be devastating to learn that your child is physically sick, but discovering that your child suffers from a mental disorder adds another layer of confusion and anxiety. Mental disorders are not as well understood as physical disorders, and it is only recently that they have begun to be talked about openly. Add the fact that new diagnoses come up seemingly weekly, along with all the misinformation in the media about the medications used to treat mental disorders, and you have some very confused and worried parents. Through my blog I want to address your questions, fears, and worries about treating your child. I want you to ask me questions and I want to hear your concerns.