Innovative Behavior Solutions

Ultrasound use and risk of autism

admin — Sun, 08 Oct 2023 03:22:40 +0000

Prenatal ultrasound use and risk of autism spectrum disorder:

Findings from the case-control Study to Explore Early Development.

Article Source : https://pubmed.ncbi.nlm.nih.gov/

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development.

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development.
7-2

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development

.1, 95% CI

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development.

Findings from the case-control Study to Explore Early Development.

Findings from the case-control Study to Explore Early Development.

Abstract
Background: Studies evaluating the association between prenatal ultrasounds and autism spectrum disorder (ASD) have largely produced negative results. Concern remains due to the rising identification of children with ASD and ultrasound use.

Objective: To evaluate the association between prenatal ultrasound use and ASD.

Methods: We used data from the Study to Explore Early Development, a multisite case-control study of preschool-aged children with ASD implemented during

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development.

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development.
7-2

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development.
12. We recruited cases from children receiving developmental

disability services and randomly selected population controls

from birth records. ASD case status was based on in-person

standardised assessments. We stratified analyses by pre-existing

maternal medical conditions and pregnancy complications associated

with increased ultrasound use (ultrasound indications) and used

logistic regression to model case status by increasing ultrasound

counts.

For pregnancies with medical record data on ultrasound timing,

we conducted supplementary tests to model associations by trimester

 of exposure.

Results: Among

Findings from the case-control Study to Explore Early Development.

Prenatal ultrasound use and risk of autism spectrum disorder:

Findings from the case-control Study to Explore Early Development.
7-2

singleton pregnancies, ultrasound indications were more common for ASD cases than controls; respectively, for each group, no indications were reported for

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development.
7-2

Findings from the case-control Study to Explore Early Development.

% and Prenatal ultrasound use and risk of autism spectrum disorder:

Findings from the case-control Study to Explore Early Development.
7-2 % of pregnancies, while ≥indications were reported for Prenatal ultrasound use

and risk of autism spectrum disorder:

Findings from the case-control Study to Explore Early Development.
12. We recruited cases from children receiving developmental

disability services and randomly selected population controls

from birth records. ASD case status was based on in-person

standardised assessments. We stratified analyses by pre-existing

maternal medical conditions and pregnancy complications

associated with increased ultrasound use (ultrasound indications)

 and used logistic regression to model case status by increasing

ultrasound counts. For pregnancies with medical record data on

ultrasound timing, we conducted supplementary tests to model

associations by trimester of exposure.

Findings from the case-control Study to Explore Early Development.

% and Findings from the case-control Study to Explore Early Development.

Prenatal ultrasound use and risk of autism spectrum disorder:

Findings from the case-control Study to Explore Early

Development.1, 95% CI

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development.
7-2

% of pregnancies. The percentage of pregnancies with multiple ultrasounds varied by case status and the presence of ultrasound indications. However, stratified regression models showed no association between increasing ultrasound counts and case status, either for pregnancies without (aOR

Findings from the case-control Study to Explore Early Development.

Prenatal ultrasound use and risk of autism spectrum disorder: 
Findings from the case-control Study to Explore Early Development

.1, 95% CI Findings from the case-control Study to Explore Early Development.

Prenatal ultrasound use and risk of autism spectrum disorder:

Findings from the case-control Study to Explore Early Development.

Prenatal ultrasound use and risk of autism spectrum disorder:

Findings from the case-control Study to Explore Early Development.

1, 95% CI. Trimester-specific analyses using medical record data showed no

association in any individual trimester.

Conclusions: We found no evidence that prenatal ultrasound use increases ASD risk. Study strengths included gold-standard assessments for ASD case classification, comparison of cases with controls, and a stratified sample to account for conditions associated both with increased prenatal ultrasound use and ASD.
Keywords: autism; developmental disorder; epidemiology; pregnancy complications; prenatal ultrasound.

Why Is the Gender Gap in Autism Shifting So Rapidly?

admin — Tue, 16 Aug 2022 13:06:00 +0000

Why Are There So Many More Autistic Males Than Females?

One part of the answer is straightforward: Some instances of autism are inherently more common among males because males have only one X chromosome (Bartholomay et al., 2019). For example, males are more susceptible to severe symptoms of fragile X syndrome, which is caused by changes in a gene on the x chromosome. Fragile X often co-occurs with autism. Females have two X chromosomes, which means one chromosome can sometimes compensate for the other, making them less susceptible to fragile X and, in turn, autism. There are other similar examples, such as Klinefelter syndrome. Because of this, there might always be a gender gap in autism.

For 2008, the U.S. Centers for Disease Control and Prevention reported a ratio of 1 to 4.7 (Baio, 2012). But the most recent data from the agency show a female-to-male ratio of 1 to 3.8 for autism diagnoses among 8-year-old children (Maenner et al., 2023). That is a huge change in a short amount of time.

Innovative Behavior Solutions

Why Are There So Many More Autistic Males Than Females?

One 2020 study used genetic analysis to address this question (Zhang et al., 2020). The researchers looked at 174 different genes and compared how they are expressed in males with ASD, females with ASD, and unaffected control participants.

Among the autistic subjects, females were likelier than males to express the genes the researchers studied. The authors cited this as evidence for a “female protective effect” such that “a higher threshold of genetic liability is required for [autistic] females as compared with [autistic] males.”

I am not here to argue with their conclusions or to criticize their methods, as I am not a geneticist. Instead, I would like to explore a question the authors raised further.

They wrote that “a higher genetic load was required in females to reach the threshold for a diagnosis” of ASD.

The italics above are mine. Zhang et al. chose their words with appropriate care. To clarify, I read them as an acknowledgment that having autism and being diagnosed with it are not always the same thing and that their research can be linked only to diagnosis. Elsewhere in the article, they addressed issues similar to the ones I’ve raised above, pointing to research that suggests bias in the way we diagnose autism and specifically in the way that we diagnose females. These issues “might influence the sample and some conclusions,” the authors wrote. That brings me to my last question.

Source :

https://autismspectrumnews.org/genetics-diagnosis-and-the-male-female-gender-gap-in-autism/

Advocating for Sensory-Inclusive Education: IEPs, Classrooms, and Schools

admin — Mon, 15 Aug 2022 17:00:11 +0000

IEPs, Classrooms, and Schools

There are many lists and suggestions for sensory-inclusive education for autistic students. Gaining a sense of your student’s unique sensory profile – what causes distress or helps them stay regulated – is important. They may be impacted differently at school than at home. How can a caregiver ensure their child’s or teen’s sensory needs are met at school?

In the Individualized Education Program (IEP) or 504 Plan
Request that the occupational therapist observe the classroom and school environment as part of an OT assessment. They can identify situations and environmental changes that may help avoid sensory overload. For example, if a teacher shares that a student is struggling with the transition into the classroom, the occupational therapist may be able to pinpoint the pertinent issues. Is the busy environment causing the student to get distracted? The student may need to come in a bit before or after everyone else to ease successfully into the day.
Ask the team to review your child’s IEP or 504 plan to see if accommodations pass the stranger test. Accommodations should be specific enough that a person reading the document for the first time can support your student. “Preferred seating,” “access to flexible seating,” and “movement breaks as needed” are all too vague. For instance, preferred seating refers to the student’s preference, not the teacher’s. This may be front and center or where the student can move around and easily access the door. Staff will not know which types of equipment (standing desk, hokki stool, etc.) to have in the room unless these types are listed specifically in the IEP or 504 plan.

When providing a sensory-inclusive education, consider if there is a related skill that can be taught. Self-awareness (the student knowing their accommodations and recognizing when they need one) and self-advocacy (asking for the accommodation) are critical skills that can be written into IEP goals and objectives.

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In the Classroom

The instance when an autistic student is most likely to need an accommodation for sensory-inclusive education may be when they are least able to request it due to overwhelm. Natural opportunities for regulation can be built into the school day. For instance, having a student be a designated equipment carrier after gym is an opportunity for heavy work. A student who dreads the commotion of breaking into small groups may be given the chance to walk a note to the office instead. Encourage the team to get creative.

Sensory breaks are not rewards and should never need to be earned. A student’s accommodations are necessary for them to stay regulated and ready to learn. Consequently, taking away accommodations as punishment may set off a behavioral spiral and increase a student’s anxiety.

Normalize that we all have sensory needs – things we seek out or avoid to stay comfortable. Non-autistic students also benefit from permission to move as they need, stand, stretch, or draw at their desks while attending a lesson.

President Obama Signs ABLE Act

admin — Mon, 15 Aug 2022 16:55:55 +0000

President Obama Signs ABLE Act

On December 19, 2014, President Barack Obama signed into law the Achieving Better Life Expectancy (ABLE) Act. First introduced in 2006, and subsequent sessions of Congress, the ABLE Act will allow people with disabilities (with an age of onset up to 26 years old) and their families the opportunity to create a tax-exempt savings account that can be used for maintaining health, independence and quality of life.

“Today marks a new day in our country’s understanding and support of people with disabilities and their families,” Michael Morris, National Disability Institute (NDI) Executive Director, said. “A major victory for the disability community, ABLE, for the very first time in our country’s policy on disability, recognizes that there are added costs to living with a disability.” He continued. “For far too long, federally imposed asset limits to remain eligible for critical public benefits have served as a roadblock toward greater financial independence for the millions of individuals living with a disability.”

NDI has long championed the ABLE Act as a critical strategy to providing a pathway to a better economic future for all people with disabilities. As the nation’s first nonprofit dedicated to improving the financial health and future of all people with disabilities, the organization has extensively documented and called attention to the daily reality and extra expenses associated with living with a disability, and the challenges of navigating the complex web of government rules to maintain public benefits eligibility.

In recognition of this unprecedented legislation, NDI has created a list of 10 items about ABLE accounts that individuals with disabilities and their families should know:

ABLE Accounts: 10 Things You Must Know

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10 Things You Must Know

1-What is an ABLE account?

ABLE Accounts, which are tax-advantaged savings accounts for individuals with disabilities and their families, will be created as a result of the passage of the ABLE Act of 2014. Income earned by the accounts would not be taxed. Contributions to the account made by any person (the account beneficiary, family and friends) would not be tax deductible.

2-Why the need for ABLE accounts?

Millions of individuals with disabilities and their families depend on a wide variety of public benefits for income, health care and food and housing assistance. Eligibility for these public benefits (SSI, SNAP, Medicaid) require meeting a means or resource test that limits eligibility to individuals to report more than $2,000 in cash savings, retirement funds and other items of significant value. To remain eligible for these public benefits, an individual must remain poor. For the first time in public policy, the ABLE Act recognizes the extra and significant costs of living with a disability. These include costs, related to raising a child with significant disabilities or a working age adult with disabilities, for accessible housing and transportation, personal assistance services, assistive technology and health care not covered by insurance, Medicaid or Medicare.

For the first time, eligible individuals and families will be allowed to establish ABLE savings accounts that will not affect their eligibility for SSI, Medicaid and other public benefits. The legislation explains further that an ABLE account will, with private savings, “secure funding for disability-related expenses on behalf of designated beneficiaries with disabilities that will supplement, but not supplant, benefits provided through private insurance, Medicaid, SSI, the beneficiary’s employment and other sources.”

3-Am I eligible for an ABLE account?

Passage of legislation is a result of a series of compromises. The final version of the ABLE Act limits eligibility to individuals with significant disabilities with an age of onset of disability before turning 26 years of age. If you meet this criteria and are also receiving benefits already under SSI and/or SSDI, you are automatically eligible to establish an ABLE account. If you are not a recipient of SSI and/or SSDI, but still meet the age of onset disability requirement, you would still be eligible to open an ABLE account if you meet SSI criteria regarding significant functional limitations. The regulations to be written in 2015 by the Treasury Department will have to explain further the standard of proof and required medical documentation. You need not be under the age of 26 to be eligible for an ABLE account. You could be over the age of 26, but must have the documentation of disability that indicates age of onset before the age of 26.

4-Are there limits to how much money can be put in an ABLE account?

The total annual contributions by all participating individuals, including family and friends, is $14,000. The amount will be adjusted annually for inflation. Under current tax law, $14,000 is the maximum amount that individuals can make as a gift to someone else and not pay taxes (gift tax exclusion). The total limit over time that could be made to an ABLE account will be subject to the individual state and their limit for education-related 529 savings accounts. Many states have set this limit at more than $300,000 per plan. However, for individuals with disabilities who are recipients of SSI and Medicaid, the ABLE Act sets some further limitations. The first $100,000 in ABLE accounts would be exempted from the SSI $2,000 individual resource limit. If and when an ABLE account exceeds $100,000, the beneficiary would be suspended from eligibility for SSI benefits and no longer receive that monthly income. However, the beneficiary would continue to be eligible for Medicaid. States would be able to recoup some expenses through Medicaid upon the death of the beneficiary.

5-Which expenses are allowed by ABLE accounts?

A “qualified disability expense” means any expense related to the designated beneficiary as a result of living a life with disabilities. These include education, housing, transportation, employment training and support, assistive technology, personal support services, health care expenses, financial management and administrative services and other expenses which will be further described in regulations to be developed in 2015 by the Treasury Department.

6-Where do I go to open an ABLE account?

Each state is responsible for establishing and operating an ABLE program. If a state should choose not to establish its own program, the state may choose to contract with another state to still offer its eligible individuals with significant disabilities the opportunity to open an ABLE account.

Now that President Obama has signed the ABLE Act, the Secretary of the Department of Treasury will begin to develop regulations that will guide the states in terms of a) the information required to be presented to open an ABLE account; b) the documentation needed to meet the requirements of ABLE account eligibility for a person with a disability; and c) the definition details of “qualified disability expenses” and the documentation that will be needed for tax reporting.

No accounts can be established until the regulations are finalized following a public comment period on proposed rules for program implementation. States will begin to accept applications to establish ABLE accounts before the end of 2015.

7-Can I have more than one ABLE account?

No. The ABLE Act limits the opportunity to one ABLE account per eligible individual.

8-Will states offer options to invest the savings contributed to an ABLE account?

Like state 529 college savings plans, states are likely to offer qualified individuals and families multiple options to establish ABLE accounts with varied investment strategies. Each individual and family will need to project possible future needs and costs over time, and to assess their risk tolerance for possible future investment strategies to grow their savings. Account contributors or designated beneficiaries are limited, by the ABLE Act, to change the way their money is invested in the account up to two times per year.

9-How many eligible individuals and families might benefit from establishing an ABLE account?

There are 58 million individuals with disabilities in the United States. To meet the definition of significant disability required by the legislation to be eligible to establish an ABLE account, the conservative number would be approximately 10 percent of the larger group, or 5.8 million individuals and families. Further analysis is needed to understand more fully the size of this market and more about their needs for new savings and investment products.

10-How is an ABLE account different than a special needs or pooled trust?

An ABLE Account will provide more choice and control for the beneficiary and family. Cost of establishing an account will be considerably less than either a Special Needs Trust (SNT) or Pooled Income Trust. With an ABLE account, account owners will have the ability to control their funds and, if circumstances change, still have other options available to them. Determining which option is the most appropriate will depend upon individual circumstances. For many families, the ABLE account will be a significant and viable option in addition to, rather than instead of, a Trust program.