Posted on Autism

Unusual visual examination of objects may indicate later autism diagnosis in infants

Infant inspecting object

Unusual visual examination of objects in infants may indicate later autism diagnosis CREDIT UC Regents

infants 9 months of age and older is predictive of a later diagnosis of autism spectrum disorder (ASD), a new UC Davis Health study has found.

Unusual visual inspection is defined as:

  • looking out of the corners of the eyes,
  • holding an object up very close to the face,
  • looking at something with one eye closed, or
  • staring at an object uninterrupted for more than 10 seconds.

“Unusual visual inspection behavior has long been associated with autism but never yet as early as 9 months of age,” said Meghan Miller, associate professor in the Department of Psychiatry and Behavioral Sciences and UC Davis MIND Institute and the first author on the study.

The study, published in the Journal of Abnormal Psychology, also found that this behavior at 9 months predicted 12-month social behavior, but not vice versa.

“The findings support major theories of autism which hypothesize that infants’ over-focus on objects might be at the expense of their interest in people. Ultimately, this study suggests that unusual visual inspection of objects may precede development of the social symptoms characteristic of ASD,” Miller said.

Visual inspection, repetitive behavior and social engagement in children with autism

About 1 in 54 children in the U.S. has been identified with ASD. Younger siblings of children with autism are at an elevated risk of being diagnosed with autism, at a rate of approximately one in five.

The researchers evaluated 89 infants whose older siblings have ASD (High-Risk group) and 58 infants with siblings with typical development (Low-Risk group). The infants completed a task designed to measure a variety of different ways of playing with and using objects at 9, 12, 15, 18, 24 and 36 months of age.

The examiners rated each infant’s social engagement behavior after every assessment session. They measured the infant’s frequency of eye contact, frequency of smiling at other people, and overall social responsiveness.

They also tallied the number of times the infant engaged in unusual visual inspection, spinning, and rotating behaviors with the objects. Spinning was defined as dropping, tossing or manipulating an object in order to make it spin or wobble. Rotating behavior indicated turning, flipping, or rotating the object at least twice.

At 36 months, the infants were classified into one of three groups: Low-Risk Non-ASD (58 children), High-Risk Non-ASD (72 children) and Diagnosed with ASD (17 children).

The study found that differences in unusual visual inspection were most prominent, consistent and present earliest in infants who developed ASD. At 9 months, the ASD group engaged in this behavior more frequently than both other groups and the behavior continued at higher rates at all ages.

Differences in frequencies of spinning and rotating were later-appearing, more time-limited, and related to familial ASD risk rather than the infant’s autism diagnosis.

“An increased focus on objects early in life may have detrimental cascading effects on social behavior,” said Sally Ozonoff, professor in the Department of Psychiatry and Behavioral Sciences and the MIND Institute at UC Davis and principal investigator of the study. “Findings from our study suggest that unusual visual exploration of objects may be a valuable addition to early screening and diagnostic tools for ASD.”

Posted on Sleep disorders

Nine Tips for Battling Insomnia and Getting a Great Night’s Sleep

Nine Tips for Battling Insomnia
Nine Tips for Battling Insomnia

“I called my mattress a bed of nails. It was a place of anger, torment, frustration, and anxiety that I felt compelled to return to night after night, sometimes spending up to 14 hours there,” says Joseph Pannell.

“Eventually my insomnia became all consuming, it stole my happiness and completely eroded who I was as a person.  But in just 8 weeks through behaviour changes, consistency and habit building CBT-I put an end to over 20 years of misery,” he adds.

 It is literally impossible to make yourself sleep in the short term, explains Joseph in his self-help guide ‘You Can Sleep Too!’ What you can do, the author advises, is to build a strong regulated sleep drive so that you sleep well over the long term. CBT-I uses behavioural techniques such as sleep scheduling and stimulus control to achieve this. In a nutshell, if I had 15 seconds to either help someone sleep or prevent them from ever getting insomnia in the future, I’d tell them this:

“Don’t try to get 7-8 hours of sleep because, like shoe size, there is no one size fits all, and don’t set your bedtime by your watch. Just go to bed when you’re ‘can’t keep your eyes open’ sleepy, get up at the same time everyday, get light ASAP and no matter how well or poorly you’ve slept the previous night, change nothing, do nothing and make no effort to force or try to protect sleep whatsoever. That’s it!”

There are 9 Gold Standard techniques to overcome insomnia the author recommends:

Only go to bed when you are can’t-keep-your-eyes-open sleepy.

Sleep is a drive state. Just as you have a drive to eat when you feel hungry, you also have a drive to sleep when you feel sleepy. It is a common belief that you should set a fixed bedtime. Setting your bedtime by your watch rather than based on how you feel causes you to spend more time in bed trying to force sleep and becoming anxious if it doesn’t come. Go to bed when you physically can’t keep your eyes open, and sleep feels irresistible!

If you are in bed and feeling worried about not sleeping, leave the bedroom.

If you are in bed not asleep, think about how you feel. If you are sleepy, relaxed and just as happy to be in bed awake as you are asleep. Wonderful! If you stay there, do nothing and allow sleep to come, it will. If you start to feel anxious about not sleeping and are trying to make yourself sleep, give yourself permission to leave the bedroom and do something you find relaxing and enjoyable. When you feel sleepy again, return to bed.

Get up at the same time every day.

Getting up at the same time every day is one of the most essential pieces of advice to improve your sleep because a regular wake time anchors your circadian rhythm and homoeostatic sleep drive. Even when you sleep poorly, if you can resist the urge to sleep late so that you can catch up on sleep in the short term, you will see a dramatic improvement in your sleep over the long term.

Get light!

Get plenty of light (natural or artificial) as soon as possible and throughout the first third of your day.

Don’t believe the 8-hour sleep myth.

Objectively measured in a sleep lab, most adults who do not have a sleep problem sleep between 5.5 and 7 hours and overestimate the amount of sleep they actually get by about an hour. Some people may need 8 hours of sleep, but this is not typical. Everybody is different. The amount of sleep you personally need is enough for you to feel happy and refreshed. That’s it!

Spend less time in bed.

People with insomnia typically try to force sleep by spending more time in bed. Doing so serves to increase the amount of time spent in bed awake in an anxious, hyper aroused state; this conditions the brain to see the bed as a place of worry and wakefulness rather than sleep.

The fastest way to regulate your sleep drive and tackle the hyperarousal that can mask your drive to sleep is to spend less time in bed.

Understand what causes and perpetuates insomnia.

Stressful events, ailments and medication can all cause a short-term sleep problem. Normal sleepers have short-term sleep problems too. What causes and allows insomnia to continue are behaviours to try to make yourself sleep and catch up on sleep (napping, sleeping late, going to bed early when you are not sleepy) and your anxiety around sleep (your hyper aroused state).

Insomnia boils down to two problems: unregulated sleep drive and hyperarousal. Your insomnia is not unique. Knowing this with absolute certainty gives you the confidence it can be resolved.

Be mindful of active sleep efforts.

Hot baths, kiwi fruit, meditation, supplements, sleeping on the left side of the bed, sleeping at the north end … These are all active sleep efforts to try to force sleep. Just as it is impossible to turn your hair blue using breathing exercises, it is impossible to make yourself sleep if you are not already sleepy.

Hot baths and breathing exercises feel great, but if you have a laundry list of things you must do in order to sleep, this only increases your anxiety.

Be mindful of avoidance sleep efforts.

If I want to sleep, I can’t go out with friends and drink any alcohol. I can’t go out to a restaurant and eat late. I can’t exercise after a certain time. I can’t, I can’t, I can’t. All of these things mentioned may have an impact on sleep in the short term, but normal sleepers still do them, and they still sleep.

Avoidance sleep efforts limit your life, lead to loss of control and agency over it, and increase the power that insomnia has over you. This will damage your sleep over the long term. If it’s 9 pm and you want to go roller skating, get stuck in!

Posted on Diabetes

Continuous glucose monitoring for remote diabetes management during the COVID-19 pandemic

JULIET BRAVO SERIES 2 - INSPECTOR DARBLEY AND SERGEANT BECK DISCOVER A CORPSE - YouTube

New case studies show the benefits of remote management based on continuous glucose monitoring (CGM) and telemedicine visits for patients with type 1 and type 2 diabetes during the COVID-19 pandemic. Use of remote monitoring technology can significantly improve glycemic control, as described in a supplement to the peer-reviewed journal Diabetes Technology & Therapeutics (DTT). The Supplement is titled “Emerging Landscape of Continuous Glucose Monitoring.” Click here to read the supplement now.

Anders Carlson, MD, from the University of Minnesota Medical School, and coauthors, present case studies of patients with type 1 and type 2 diabetes managed during the COVID-19 pandemic using CGM and telemedicine visits, including a 3-year-old patient with newly diagnosed type 1 diabetes. Current CGM systems can automatically transmit patients’ glucose data to healthcare providers for analysis.

Juliet Bravo | Drama Channel

“We found that use of telemedicine patient consults and remote monitoring of CGM and insulin data enabled us to assess glycemic control and make therapy adjustments without the potential hazards and patient burden of in-person clinic visits,” said the authors. “Moreover, our ability to review and discuss the data with our patients helped them better understand how their therapy impacted daily glucose management, which, in turn, enhanced their engagement in their daily self-management.”

Also in the supplement is an article titled “Real-World Studies Support Use of Continuous Glucose Monitoring in Type 1 and Type 2 Diabetes Independently of Treatment Regimen.” James Gavin, III, MD, PhD, from Emory University School of Medicine, and Clifford Baily, PhD, from Aston University review findings from recent real-world studies of CGM systems. These provide greater insights into the clinical effectiveness and economic impact of this technology within various diabetes populations.

“Results from these studies suggest that wider use of CGM within the broader diabetes population could increase overall glycemic control and improve the effectiveness while reducing the enduring cost of diabetes healthcare,” state the authors.

Juliet Bravo Catching Up - YouTube

“Results from these studies suggest that wider use of CGM within the broader diabetes population could increase overall glycemic control and improve the effectiveness while reducing the enduring cost of diabetes healthcare,” state the authors.

This supplement was supported by an educational grant from Abbott.

About the Journal
Diabetes Technology & Therapeutics (DTT) is a monthly peer-reviewed journal that covers new technology and new products for the treatment, monitoring, diagnosis, and prevention of diabetes and its complications. Led by Editor-in-Chief Satish Garg, MD, University of Colorado Denver (Aurora), the Journal covers topics that include noninvasive glucose monitoring, implantable continuous glucose sensors, novel routes of insulin administration, genetic engineering, the artificial pancreas, measures of long-term control, computer applications for case management, telemedicine, the Internet, and new medications. Tables of contents and a free sample issue may be viewed on the Diabetes Technology & Therapeutics (DTT) website. DTT is the official journal of the International Conference on Advanced Technologies & Treatments for Diabetes (ATTD)

Posted on Autism

WVU researchers aim to make identifying autism easier via A.I.

Characterizing an autism patient’s behavior can be challenging, but these West Virginia University researchers aim to make identification easier by conducting the first systematic study toward autism spectrum disorder phenotyping using behavior-tracking technology.

Phenotyping is the characterization of a behavior or trait, and in this study, researchers will be looking at autism patients’ behaviors and traits.

Supported by a $500,000 award from the National Science Foundation, Xin Li, professor in the Lane Department of Computer Science and Electrical Engineering, and Shuo Wang, an adjunct assistant professor, plan to conduct this research using the latest advances in imaging and data sciences.

“This project is important because it aims at filling an important gap in our existing knowledge about autism,” Li said. “Improved understanding of autism phenotyping is expected to help with not only more accurate diagnosis, but also more personalized intervention .”

One of the biggest challenges facing autism research is that there is not one form of autism, but many subtypes. Each person with autism can have unique strengths and challenges, which has contributed to the difficulty in identifying the specific traits associated with this disorder (phenotyping), genetically or behaviorally, according to Li.

Li said that there is currently no consensus about the standard of behavior characterization for humans yet, but animal models have used the following three phenotypes: abnormal social interactions, communication deficits and repetitive behavior.

“We expect to identify similar phenotypes for autism patients as the first step,” Li said.

This project will assess autism using behavior-imaging data (eye-tracking, audio/video) with neuroimaging data.

According to Li, neuroimaging data are a direct measurement of brain activities and behavior imaging data are the consequence of brain activities.

“Integrating these two multimodal data represents a natural strategy for understanding the relationship between brain activities and behavioral patterns,” Li said.

Artificial Intelligence will identify the traits associated with autism using both neuroimaging and behavioral imaging, Li said.

According to Li, autism is a neurodevelopmental disorder affecting one out of 54 children in the U.S., and this study could also help with early detection in young children.

The earlier children with autism get intensive intervention, the better their developmental outcomes, he said.

“Currently, the average age of a child when she or he receives an ASD diagnosis in the U.S. is 4 years old,” Li said. “However, about half the parents of children with autism report that they suspected a problem before their child was one year of age. This has been known as the ‘detection gap.’ Many research teams including us are working on reducing this gap.”